/ 6 April 2005

Marburg outbreak ‘not yet under control’

Angolan health workers in a slum outside Luanda were treating a new suspected case of the Marburg virus on Tuesday as a senior United Nations official warned that the outbreak of the Ebola-like epidemic is not yet under control.

Nurses at a clinic in the township of Cacuaco, about 18km north of the capital, were scrambling to help the 22-year-old woman who they feared may be the latest casualty of the haemorrhagic fever that has so far claimed 156 lives in its biggest outbreak to date, which has spread to a fifth province.

”We have a suspected case of Marburg. She arrived here an hour ago complaining of a fever and anal bleeding,” said clinic administrator Analdina Chivukuvuku.

”She is bleeding quite badly,” she said at the clinic — one of three that serve the township with a population of about 613 000 residents on the Atlantic coast’s Baia do Bengo.

”Maybe it’s a case of typhoid or a parasitic illness, but at the moment we don’t know. We have alerted the authorities in Luanda,” she said.

Nurses were putting a drip into the young woman, whose legs and feet were covered in blood. They wore only face masks and rubber gloves and said they fear the virus because of a lack of proper protection.

”Before the Marburg alert, we worked only in a simple blouse. Now we have received paper face masks and rubber gloves, but it is not sufficient to protect the 149 staff working here,” said Chivukuvuku.

The woman could not be transferred to Luanda’s Marburg isolation unit, set up at the Americo Boa Vida hospital — almost an hour’s drive by congested, pot-holed road — because only one ambulance was available.

”We can’t use our only ambulance to take her there for fear of it being contaminated,” Chivukuvuku said.

But later Angola’s Deputy Health Minister, Jose van Dunem, said at a press conference that the 22-year-old woman will be transferred to Boa Vida on Wednesday.

”This is the first case that will be put under quarantine at the new Americo Boa Vida unit,” he said.

Van Dunem also said the virus has now spread to Malenge province, which is on the border with Uige.

The epicentre of the Marburg virus has been the northern Uige province, but four people have died in Luanda of the Ebola-like disease.

In Luanda, the director for Angola of the UN Children’s Fund, Mario Ferrari, said the outbreak ”was not yet under control”, but stressed that all measures to combat the virus have been put into place.

”The epidemic is not yet under control in terms of contamination because some people are maybe still in the incubation stage and we could have some surprises,” Ferrari said.

”We’ll be able to tell it’s under control when the death toll goes down, which is not the case,” Ferrari said, adding that the death rate among children has dropped from 80% to 68%.

”The situation is serious because we have a mortality rate of 88%, instead of between 25% and 30%. This is an indicator of the weaknesses in the health system,” said Ferrari.

The Angolan government has started an awareness campaign featuring radio broadcasts warning: ”Alert, Marburg. Don’t touch any corpse. Inform the health authorities about any suspicious illnesses or death due to bleeding.”

But despite a dramatic rise in the death toll in the past four days — 29 people died between Thursday and Monday — there has been almost no mention of the virus in the state-controlled print media.

A severe haemorrhagic fever akin to Ebola, the Marburg virus spreads on contact with body fluids such as blood, urine, excrement, vomit and saliva.

The disease was first identified in 1967 in Germany after laboratory workers were infected by monkeys from Uganda.

The Marburg outbreak has claimed a record number of lives in Angola, overtaking an earlier peak in the neighbouring Democratic Republic of Congo. — Sapa-AFP