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UN concerned Marburg outbreak in Angola could spread through home care

New York, 11 April 2005
There risk that the deadly Marburg outbreak in Angola could spread is greatly increased if families tend their sick at home without protective gear instead of isolating them in hospital, the United Nations health agency warned today in its latest update on the highly lethal haemorrhagic disease, for which there is no vaccine or treatment.

With 214 cases of Marburg, a relative of the equally deadly but better-known Ebola, already reported, 194 of them fatal, in the largest, deadliest and most intense outbreak of the disease ever recorded, the World Health Organization (WHO) is also focusing on public information to prevent a repeat of attacks by frightened locals that forced mobile surveillance teams to suspends operations last week.

"WHO is concerned that deaths are continuing to occur within the community, as care of patients by family members without adequate protective equipment greatly increases the risk of further transmission," the agency said of the disease with epidemic potential, which has spread faster this time than on any previous occasion.

In northern Uige province, epicentre of the outbreak with almost 90 per cent of the cases and deaths, surveillance teams have resumed following intensive campaigns to improve public understanding after fearful residents attacked and damaged the vehicles last week, seeing hospitalization with no cure as a death sentence.

Yet early diagnosis, isolation and tracing all contacts is the only way to break the transmission chain of the disease, which is spread by blood and other bodily fluids, making health care and burial workers particularly vulnerable without adequate protective equipment.

The provincial governor, officials from the health department and religious leaders have all joined in the educations campaigns, personally visiting affected communities and sensitizing the public to Marburg, which begins with severe diarrhoea, abdominal pain, nausea, vomiting and chest and lung pains, and progresses to severe haemorrhage in the gastrointestinal tract and lungs.

There has already been some improvement with more suspected cases and deaths reported directly by residents and 360 contacts being followed up by the teams in Uige, WHO reported. But more needs to be done to detect cases earlier, ensure their isolation and find contacts.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) says the most urgent needs include protective clothing for health workers, disinfectants and body bags. The non-governmental organization (NGO) Médecins sans Frontières has set up an isolation ward at Uige provincial hospital.

But there is also concern that people infected with the virus might be admitted for another suspected illness and undergo testing or treatment procedures without adequate precautions.

The previous highest Marburg toll occurred from 1998 to 2000 in the Democratic Republic of the Congo (DRC), when 123 people died out of 149 cases over a two-year period. But the current outbreak has spread and killed in just a few weeks.

The disease appears to be geographically confined to a few countries in southern Africa and was given its name when it was first identified in 1967 during outbreaks among laboratory workers in Marburg and Frankfurt, Germany, and Belgrade, Yugoslavia, which were linked to infected monkeys imported from Uganda.
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