Marburg outbreak not under control

As the death toll from the Marburg virus in Angola creeps up to the 300 mark, the World Health Organisation (WHO) has expressed concern at the current situation and is warning that the outbreak is not yet over. Uige-based WHO spokesperson Aphaluck Bhatiasevi told IRIN on Monday that some recently-identified cases of the killer disease had not been linked to earlier cases, raising fears that the epidemic was not yet under control since it first appeared in October 2004. "The outbreak is not over. We've seen new cases in new municipalities that don't have obvious links to earlier cases of Marburg. We are very concerned about the situation," she said, speaking by phone from the northern Angolan province where all cases have so far originated. "We are trying to do as much tracing as possible. But some of the cases we have seen in the last 10 days don't have a clear link to previous cases," she added. The rare haemorrhagic fever, which is from the same family as Ebola, is spread by body fluids including saliva, tears and blood. There is no specific cure and some 292 people have so far died from the 336 people who are known to have been infected. Deputy Health Minister Jose Van Dunem said that no new cases had been reported in over 21 days in provinces other than Uige, indicating that the epidemic was "over" in most of Angola. "We're having cases only in Uige city in the slums," he said. "We could say that [the epidemic] is over everywhere except Uige. But we need to maintain our surveillance system." But convincing some communities to change their traditions in order to protect themselves from the communicable disease remained a serious challenge. "We're working hard on social mobilisation in communities in Uige, trying to motivate a change in behaviour," Van Dunem said. "We have some cultural problems. People think if they don't bathe the dead body then they are not properly putting them to rest," he added. Bodily secretions increase after death, making the corpses of Marburg victims highly contagious. Specialists say communities must adapt their burial traditions in order to stop the chain of transmission of the disease. Bhatiasevi said some breast milk had tested positive for Marburg, prompting calls for mothers suspected of being infected to avoid breastfeeding or wet feeding other children. "If we get an alert from any suspected case of Marburg who may be breastfeeding, we try and convey the message to them," she said. "But we have to be very careful with this message as breast milk is one of the major food sources for children here," she added. According to a joint WHO and health ministry statement, 44 percent of reported Marburg cases have been among children.