As the death toll from the Marburg epidemic in Angola passed 200 last week, it emerged that cases of the deadly haemorrhagic fever had been present in the country since October last year. The disease was identified only last month.
“The total disrepair of the health system played a role in not providing the conditions to check the outbreak at the start,” Christophe Illemassene, spokesperson for the United Nations Transitional Coordination Unit in Luanda, told the Mail & Guardian.
Illemassene said the high levels of child mortality common in every rainy season had masked the presence of a new disease in Angola’s northern Uige province. A campaign is now under way to identify everyone who might have come in contact with the highly infectious virus. A team of 6 000 volunteers has been mobilised to locate people who may be infected and to educate people on good hygiene practice. Someone infected with Marburg can carry and transmit the virus for up to three weeks before developing symptoms. Infection is transmitted when blood, saliva or sweat from an infected person comes into contact with another person’s skin.
The need for public awareness is made more acute by the absence of a cure for Marburg fever. Health workers admit privately that the isolation unit set up by Médécins sans Frontières (MSF) at the Uige provincial hospital can be no more than “a place where you go to die”. This reality has discouraged Marburg sufferers from entering the facility.
“We shouldn’t neglect the possibility that there are many more cases hidden at home,” said Joachim Delville of MSF Belgium.
The World Health Organisation (WHO) has confirmed 210 Marburg deaths since the start of the outbreak. While the highest concentration of cases is still in Uige, WHO believes there are now cases in seven Angolan provinces.
Delville said the number of Marburg cases and deaths was increasing daily, and spoke of “clear tensions” between health staff and local communities in Uige province.
“There is a feeling that the ‘astronauts’ coming to check for suspected cases are themselves carrying the disease,” Delville said, in reference to the white isolation suits and masks worn by health staff.
The epidemic has been marked by good cooperation between government and aid agencies, in a country where donors used to complain of red tape hindering the arrival of foreign aid workers and medical supplies.