Alarm in Luanda over Marburg outbreak eases

Angola's vice minister for health, Jose Van Dunem, warned on Tuesday that it was premature to claim the outbreak of the deadly Marburg virus in the northern province of Uige was under control, as the latest death toll from the haemorrhagic fever rose to 117 out of 124 cases. He told IRIN the situation in Uige was slowly improving, with experts from the World Health Organisation (WHO) and the international medical NGO, Medecins Sans Frontieres, supporting teams from the ministry in both Uige and the capital, Luanda. The government was prohibiting anyone who had visited Uige from leaving the country for 21 days - the incubation period of the disease - to prevent the bug from spreading beyond Angola's borders. "The situation is better, but it is not realistic to say it is under control," Van Dunem commented. "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 - army personnel and people in the communities. "I can assure you that we are very committed, very well assisted, and that the government is very well engaged. We will stop the spread of this outbreak as soon as possible," he added. Most of the deaths so far have been among children under five, confined mainly to the city of Uige, the capital of Uige province. More recently, however, the disease has spread to adults: two people, including an Italian paediatrician, died in Luanda, and one in the northern enclave province of Cabinda. Weekend media reports that the virus had appeared elsewhere spread panic in the capital, but turned out to be misleading because all three deaths had originated in Uige and were therefore not classed as primary cases. But Van Dunem warned that the risk of the disease spreading, particularly to the capital and neighbouring provinces of Bengo, Zaire, Kwanza Norte and Malanje, was still very real. "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," Van Dunem said. "We are quarantining people from Uige, or people who spent time in Uige - they will not be able to leave Angola for 21 days." 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. "The European Union is concerned and is sharing information on what is happening. At this moment there is no emergency, but we're keeping the EU partners informed," said Bas Brusche, a counsellor at the Dutch embassy in Angola. STRUGGLING HEALTH SYSTEM Van Dunem said Angola had received financial support from the European Union and several other governments, as well as some NGOs and companies doing business in Angola, but more was needed. The Marburg mortality rate in more developed countries is around 30 percent, but with much of Angola's health system left in tatters after 27 years of civil war that ended in April 2002, the country was struggling to cope. "We are facing an epidemic. We need more support; more disposable equipment, such as gowns, gloves and boots; more protective clothing. We are requesting this through the WHO," Van Dunem told IRIN. 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 remarked. "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 moderated. "We freaked out a little bit on Friday and Saturday when we heard of these Luanda cases, but once we discovered that they had originated in Uige, everyone calmed down," said one oil industry executive who requested anonymity. "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," the executive added. Marburg haemorrhagic fever, a member of the extremely virulent Ebola virus family, is transmitted through bodily fluids, including perspiration. The symptoms include high fever, severe headaches, vomiting and diarrhoea, sometimes with blood. The largest outbreak of the disease, which was first recognized in 1967 and is indigenous to Africa, occurred in the Democratic Republic of Congo between 1998 and 2000, when 123 people died. There is no specific cure, but supportive hospital therapy, including balancing fluids, maintaining oxygen levels and blood pressure, with treatment of complicating infections, can help overcome the illness.