Lab Confirmation of Marburg Victims in Angola is a Challenge
Recombinomics Commentary
April 18, 2005
>> When we arrived in Songo we found out that a woman had died in the hospital during the night. Her baby had been in the hospital about two weeks ago and had died last week.
Sophie wanted to take a saliva swab before the burial team arrived so that we could determine whether she had died of Marburg but I was worried about how we would decontaminate ourselves and where we would put all the contaminated material afterwards.
I certainly didn't want to put it in the car and travel back to Uige with it.
It was frustrating not to know if this was definitely another case. We have now agreed that the burial team will go tomorrow morning so Sophie can go with them and take the swab. <<
The above description of the suspect Marburg case in Songo demonstrates why lab confirmation of cases is difficult. The case described above seems to be a likely Marburg case. The baby had symptoms two weeks ago and died last week. The mother died this week. There had already been 9 confirmed cases in Songo (the official ministry of health report shows 9 "reported" cases, 8 deaths, and 1 confirmed)..
However, collection of samples for lab confirmation is not routine. A safe packaging and transport system was not in place. The victim was already dead when first observed. A sample would not be collected for at least a day after death. Refrigeration or packing in ice was not mentioned. There was considerable reluctance to touch dead bodies, even while wearing an "ebola" suit.
Thus, it would seem that laboratory confirming victims observed after they had died would be a challenge. The challenge would be even greater for victims discovered in neighborhoods. The potential for false negatives would also be high in most instances.
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