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Commentary

Marburg Toll In Angola to 205 - Bodies in Uige Uncollected


Recombinomics Commentary

April 8, 2005

>>  As of 7 April, 205 cases of Marburg haemorrhagic fever have been reported in Angola. Of these, 180 have died. Zaire Province has reported its first 6 cases, bringing the number of affected provinces to seven, all concentrated in the north-western part of the country......

WHO staff in Uige were notified today of several fatalities but teams were unable to investigate the cause of death or collect the bodies for safe burial. Discussions have been held with provincial authorities to find urgent solutions.

The dramatic symptoms of Marburg haemorrhagic fever and its frequent fatality are resulting in a high level of fear, which is further aggravated by a lack of public understanding of the disease. Moreover, because the disease has no cure, hospitalization is not associated with a favourable outcome, and confidence in the medical care system has been eroded.  <<

Contact tracing has become more difficult because many victims have moved away from Uige because of the deaths of patients and health care workers.  The case fatality rate of approximately 100% offers little incentive to visit medical facilities where there have been Marburg deaths.

These added difficulties will create challenges for just finding the victims.  Tracing contacts will create additional problems.  However, Marburg transmission will continue to accelerate, because the number of cases has grown substantially in the past few weeks.  Now there are cases in 7 provinces.  At least two countries, Democratic Republic of Congo and South Africa, have samples being tested by the CDC in Atlanta.

The testing capabilities were further eroded by damage to surveillance vehicles.

The above difficulties indicate a significant increase in WHO presence of the ground in Angola, and possible adjacent countries, is urgently needed.

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