A deadly haemorrhagic fever that has claimed the lives of 96 people, mainly children, in Angola’s northern Uige province has been identified as the rare Marburg virus, officials from the ministry of health and the World Health Organisation (WHO) said late on Tuesday.
The illness, characterised by high fever, severe headaches, vomiting and diarrhoea, was first spotted in Uige and is from the same family as the deadly Ebola virus.
Vice-Minister for Health Jose van Dunem and the WHO’s representative in Angola, Dr Diallo Fatoumata Binta, declared the situation an epidemic after nine out of 12 samples sent to the Centers for Disease Control (CDC) in Atlanta had tested positive for Marburg.
“We are dealing with the Marburg virus, a haemorrhagic disease,” Van Dunem, who described the outbreak as “a disaster”, told a news conference.
Binta said the extreme rarity of the phenomenon — the last occurrence was recorded in the Democratic Republic of Congo in 1998, according to the CDC website — means that the disease is deemed an epidemic by international standards.
A total of 107 cases of the virus have been detected at the provincial hospital in Uige since October, and while the mortality rate in more advanced countries is about 30%, Angola’s health system, left in tatters after 27 years of civil war, is failing to cope with the outbreak.
“In the top hospitals, the mortality rate from the Marburg virus is around 30%, but in our case it is much higher. We have 107 cases and 96 dead, but Uige is one of the weakest provinces from the point of view of health facilities,” Van Dunem said.
“There is a lack of medical doctors, a lack of trained nurses, a lack of resources, so it is very difficult to manage an epidemic like this one which is new,” he added.
Angola is enlisting the support of the WHO, as well as international medical NGO Médécins sans Frontières (MSF), to combat the disease.
WHO representative Binta said the United Nations health agency will send in extra surveillance and outbreak control staff. It will also provide logistics to identify the extent of the disease and put measures in place to limit its spread.
Officials denied that it had taken them too long to tackle the virus. The symptoms of the Marburg virus can be easily confused with other infectious diseases, such as malaria and typhoid, and diagnosis can be difficult.
Risk of virus spreading
Van Dunem said there are concerns that carriers of the “virulent and highly dangerous” bug could already be spreading it to other areas of the country.
“The fear is that infected members of the population could move to other provinces. As the incubation period is 21 days, it is possible that some people can,” he said.
“They will go probably to neighbouring provinces and Luanda, so we must set up a surveillance system to follow these people and to have opportunities to catch these people,” he added.
Part of the strategy to fight the outbreak is to boost surveillance efforts and train health-care workers in the high-risk provinces of Bengo, Zaire, Malange and Kwanza Norte, which border Uige, as well as the capital, Luanda.
“I am sure we will tackle and solve the problem, but we have some difficulties. We need more people in the field; we are supporting the teams in the field with colleagues from the WHO and the CDC in Atlanta. Our colleagues from MSF are ready to come and give support,” Van Dunem said.
Binta noted that the immediate priorities are to focus on case management, including establishing and communicating simple guidelines, creating isolation facilities, training health-care workers and identifying and providing the necessary materials.
On its website, the CDC describes the Marburg virus as a rare, severe type of haemorrhagic fever that affects both humans and non-human primates.
First recognised in 1967 and indigenous to Africa, little is known about its cause or any specific treatment. However, supportive hospital therapy, including balancing fluids, maintaining oxygen levels and blood pressure, and the treatment of complicating infections helps overcome the disease. — Irin