Locals resist efforts to control the worst ever outbreak of Marburg

Apr 12 2005

The World Health Organisation (WHO) have sent communications experts into Uige, the epicentre of the outbreak of Marburg epidemic to help Health experts in the fight to contain and eradicate the killer virus. It is hoped they will send a clear message to Angolans to take the necessary measures to fight the virus.

Health workers in Uige, 300 kilometres north of the capital Luanda, are facing denial from families who are refusing to send their sick to hospitals or are taking them out of the city, worsening the risk of contamination.

A massive public awareness campaign is being put in place in the city in an effort to contain the haemorrhagic disease, which has already claimed 203 lives and is the worst epidemic to date of the Ebola-like virus.

Quiala Godi, Uige's provincial health director says they must work on social mobilisation reinforcement and contact religious authorities and traditional chiefs for them to pass on the message to the population.

WHO says of 221 cases of the Marburg virus discovered in Angola, 203 have resulted in death, putting the mortality rate countrywide from the outbreak at 92 percent, and the isolation of victims is the only way to slow the spread of the disease, for which there are no drugs or vaccine. The virus can kill a healthy person in a week.

Jose Manuel, the Red Cross' representative in Uige says they are going through the markets and from house-to-house in an effort to get the message across. His organisation has enlisted the help of 45 local employees.

The WHO team of epidemiologists, virologists and anthropologists has faced public resistance to their measures to contain the outbreak, as traditional African culture dictates that relatives spend a long time in the presence of the body of the deceased, which increases the risk of spreading the disease which is transmitted through contact with bodily fluids.

Many local communities also do not want to accept that their relatives died of the killer Ebola-like virus and are in a state of total denial.

William Perea, a Colombian medical epidemiologist says when somebody is sick they prefer to say that it's not Marburg. He has been scouring through the slum outskirts of Uige looking for suspected cases and deaths.

Perea says they leave it too late to contact health experts only doing so when the person is already dead, to dispose of the body. As an example, of nine alerts only one person was alive.

Godi says three weeks ago, when the health teams from the WHO and Medecins sans Frontieres (MSF) arrived they had begun to control the epidemic, but now the situation is changing and people are running away, no one wants to go to hospital. People are dying at home and this is very dangerous. He says others are taking their sick along as they flee to nearby villages, and in one case 90 kilometres away a family left with a child from Uige hospital which died when they arrived at their village. Then the mother and the father also died.

The Marburg virus, is the causative agent of Marburg hemorrhagic fever, the exact origin is unknown but it was first detected in 1967 when German laboratory workers in Marburg were infected by monkeys from Uganda. Both the disease and virus are related to Ebola and originate in the same part of Africa (Uganda and western Kenya). Its source is a zoonosis of unknown origin.

The virus spreads through contact with bodily fluids such as blood, excrement, vomit, saliva, sweat and tears. Victims suffer a high fever, diarrhoea, vomiting, and severe bleeding from bodily orifices and usually die within a week, but the virus can be contained with relatively simple health precautions, according to experts.

This outbreak, which began in October 2004 and continues into 2005, is the world's worst epidemic of any kind of haemorrhagic fever and is killing increasing numbers of people rather than abating. Through 2005, the number of cases has increased by roughly 3% per day. The mortality rate for this outbreak has remained above 99%.