Tuesday, April 05, 2005

Outbreak Continues...


National Geographic Online reports today that Angola's Marburg outbreak has now claimed 150 people as of Monday and confirms CIDRAP's assessment of this strain's extraordinarily high mortality rate...

Scientists are puzzled by the epidemic's remarkably high fatality rate. So far, the Angolan Ministry of Health has reported 163 cases of the hemorrhagic fever, putting the fatality rate around 90 percent. In previous outbreaks, the disease has had a fatality rate as low as 25 percent.

This time, at least 75 percent of the victims have been children under the age of five.
"This is something we haven't seen in previous Marburg outbreaks," said David Daigle, a spokesperson for the infectious disease program at the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

Discussing the strain, it's history, and the particular conditions of this deadly event that began last Fall, the NG report represents one of the most comprehensive assessments of this outbreak yet, noting the severity of its potential against the race for containment,

Efforts at containing the Angolan epidemic have been complicated by the country's poor health care system. Officials worry that the epidemic will spread from its epicenter in the remote, northern Uige province to more densely populated areas.

So far, two deaths have been confirmed in Luanda, the Angolan capital, according to Dick Thompson, the spokesperson for the World Health Organization (WHO) in Geneva, Switzerland...

As this outbreak became the deadliest ever last week, claiming its 126th victim, the WHO mobilized an outbreak response team to the area to work with local officials and help subdue the crisis. (See previous post) But, they race against the clock to aid the infected and contain the spread both within Angola and from a broader, infinitely more dangerous breach.

The prospect of the virus gaining a foothold in Luanda, almost four million people live in the Angolan capital, is ominous.

"The first thing that comes to mind is the international airport," said Daigle, the CDC spokesman. "We saw with SARS how fast it was able to spread to Canada and other countries once people started getting on planes."

Containing an outbreak is more difficult in a densely populated area where people are crowded together. The virus has the potential to rapidly spread to other people, especially health-care staff and family members who care for patients.

As with past Small Pox episodes, epidemic outbreaks have the potential of growing fast, overwhelming regional containment. Once that happens, response efforts can be diluted quickly and the disease can spread beyond the capacity for effective control. Add the speed and ease of global transconnection and the real potential for malicious intent into consideration, and the nightmare could be but a concourse away. Its a danger worth watching; and a crisis dared not entrusted to UN supervision alone.

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