Health officials identify Marburg virus, 96 dead

A deadly hemorrhagic fever which 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 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 WHO's representative in Angola, Doctor 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 hemorrhagic 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 (DRC) in 1998 according to the CDC website - meant that the disease was deemed an epidemic by international standards. Some 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 around 30 percent, Angola's health system, left in tatters after 27 years of civil war, was failing to cope with the outbreak. "In the top hospitals, the mortality rate from the Marburg virus is around 30 percent, 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 was enlisting the support of the WHO as well as international medical NGO Médecins Sans Frontières (MSF) to combat the disease. WHO's representative Binta said the UN health agency would send in extra surveillance and outbreak control staff and provide logistics to identify the extent of the disease and put measures in place to limit its spread. Officials denied that they had taken them too long to tackle the virus - the symptoms of Marburg can be easily confused with other infectious diseases such as malaria and typhoid and diagnosis can be difficult. RISK OF SPREAD Van Dunem said there were 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 was 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 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 were 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 hemorrhagic fever which 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, said the CDC.