Africa: Angola's virus numbers rising

Angola's virus numbers rising
Tuesday, April 12, 2005 Posted: 9:27 PM EDT (0127 GMT)


(CNN) -- The number of cases of Marburg hemorrhagic fever has continued to rise in northwestern Angola, but efforts to educate residents about the disease are appearing to be having an effect, the World Health Organization said.

As of Friday, 214 cases of the fever -- which is closely related to the Ebola virus -- had been reported, the WHO said Monday. Of those, 194 people have died.

About 90 percent of the cases are located in Uige province, but officials said six other provinces have also been affected.

Two cases have occurred in the capital city of Luanda, which has an international airport, raising the specter that the disease could spread.

But the head of the Centers for Disease Control and Prevention said Tuesday it is unlikely the disease would spread widely in the United States if it were to reach the country.

"This is a tragic virus, but it is mainly there in that province, and is a very low threat to people here in this country," Dr. Julie Gerberding told CNN from Washington.

In addition, there is little direct contact between the two countries: the only direct flights from Angola to the United States are private routes taken by petroleum companies.

And authorities are posted at U.S. ports of entry to identify anyone entering the country with symptoms of the disease.

Still, if the Marburg virus were to reach the United States, U.S. health officials, unlike their counterparts in Angola, have the ability to isolate people effectively, Gerberding said.

Since the virus spreads through contact with blood, sweat and other body fluids, caregivers and burial workers are at highest risk, according to health authorities.

The disease first makes its presence felt by producing high fever and head and muscle aches, experts say. Within five to seven days, patients usually deteriorate quickly: liver and kidneys fail, spontaneous bleeding occurs, followed by death.

In other outbreaks, the disease's mortality rate has been lower, a hint that patients in this instance may not be seeking care quickly enough, Gerberding said.

The health-care infrastructure in Angola is not well developed; there is evidence that the disease is spread in the very hospitals where infected people are cared for, one WHO doctor said.

To keep that from happening, the Atlanta-based disease agency has dispatched to Angola eight scientists who are teaching local health-care workers how to treat the illness without infecting themselves or others, Gerberding said.

"Ultimately, we are going to be on the search for the animal host to see if we can't figure out what the source of this is," she said.

One theory holds primates responsible for spreading the virus, she said, and health workers are cautioning people not to eat the animals.

"Sometimes, people don't cook it well; so they can even eat it raw," she said.
A lack of education and understanding about the disease among local residents has contributed to hostility toward health workers, authorities said.

Last week, mobile surveillance teams in Uige suspended operations after residents attacked and damaged their vehicles.

Those teams resumed operations Saturday, following campaigns to improve public understanding of the disease, WHO said Monday.

The campaigns seemed to be bringing about improvements, WHO authorities said in a written statement. "More alerts to suspected cases and deaths are being reported directly by residents. Some 360 contacts are being followed up by the teams in Uige, but more improvements are needed to detect cases earlier, ensure their isolation and supportive care and find and manage contacts."

The group Doctors Without Borders (Medecins sans Frontieres) has established an isolation ward at the hospital.

Marburg has no vaccine or specific treatment.
In addition to Angola, outbreaks and sporadic cases have been reported in the Democratic Republic of Congo, Kenya and South Africa.

Marburg virus is named after the town in Germany where one of the first outbreaks occurred, in 1967.

http://www.cnn.com/2005/WORLD/africa/04/12/virus.marburg/index.html