/ 1 April 2005

DRC alert over virus outbreak

The Democratic Republic of Congo (DRC) has set up a quarantine zone along the frontier with Angola in response to fears that a recent outbreak of the deadly Marburg virus could spread across the 1 750km border. Congolese Health Minister Emile Bongeli said: “Though there are no signs of any cases in the DRC, we live with the threat of another outbreak, so we are taking precautions.”

A team of 15 experts has been sent to train local health workers to improve detection of the disease.

Health officials acknowledge the difficulty of stopping the disease from crossing the frontier, the site of much trade between Angola and the DRC.

Angola’s vice-minister for health, Jose Van Dunem, warned this week that it was premature to claim the Marburg outbreak in the northern province of Uige was under control, as the latest death toll rose to 117 out of 124 cases.

He said the situation in Uige was slowly improving, with experts from the World Health Organisation and Médécins Sans Frontières supporting teams from the ministry in both Uige and the capital, Luanda.

“The situation is better, but it is not realistic to say it is under control,” said Van Dunem.

“We have a very strong team in the field and in Luanda. We have much more knowledge now, thanks to these experts working with us and actively searching for cases, helping us with case management, improving our isolation and training our personnel.

“Most of the deaths so far have been among children under five, confined mainly to the city of Uige. More recently, however, the disease has spread to adults: an Italian paediatrician [Maria Bonino] died in Luanda and another in the northern enclave province of Cabinda.”

Van Dunem warned: “There is a risk that the disease will spread, but it is a controlled risk; there is always a possibility — all we can do is try to reduce it.”

The government is prohibiting anyone who had visited Uige from leaving Angola for 21 days — the incubation period of the disease. Diplomatic sources in Luanda said governments were monitoring the situation very closely and had issued travel advisories warning potential visitors to Angola of the Marburg outbreak.

“We are facing an epidemic. We need more support; more disposable equipment, such as gowns, gloves and boots; more protective clothing,” said Van Dunem.

Getting reliable information on the extent of the disease, its transmission methods and ways of preventing it was vital to avoid panic, he noted.

Luanda-based domestic worker Lucia da Costa said Marburg was the main topic of conversation in the city. “Everyone is very worried,” she said.

“We’re worried that people from Uige may come here and bring the virus with them — there is already so much sickness here that we’re not sure if we will cope.”

But reports that expatriates, particularly those with children, were clamouring for flights out of the country, appeared to have subsided.

“We’ve sent internal memos to staff, informing them about the fever and advising them on how to prevent it — the dos and the don’ts — but, basically, it’s business as usual, although I’m sure most companies will be dusting off their evacuation policies, just in case,” said an oil executive who requested anonymity.

The Marburg disease causes massive haemorrhaging as well as fever, headaches, vomiting and diarrhoea. Related to the deadly Ebola virus, it is transmitted through bodily fluids, including perspiration.

Identified by scientists in 1967, the first large-scale outbreak of the rare disease in the DRC occurred between 1998 and 2000, when 123 people died.

In 2000, an even larger outbreak killed 140 people in just three weeks.

The disease has no specific cure, but hospital therapy — including the balancing of fluids and the maintenance of oxygen levels and blood pressure — combined with the treatment of any complicating infections, can help overcome the symptoms.