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Marburg Virus Kills Five Nurses in Angola

Recombinomics Commentary
March 24, 2005

>>  "Two nurses died Tuesday of the Marburg illness at the Uige provincial hospital," said Filomena Wilson, the spokesperson of a commission tasked with monitoring the outbreak.

A total of five nurses have died over the past weeks from the virus that is transmitted through contact with bodily fluids of infected people, according to Wilson.  <<

The explosion in the number of Marburg deaths in Angola is clearly cause for concern.  The number of emerging viral diseases is on the rise, and the situation in Angola is a good example of infectious diseases quickly getting out of control.  The dramatic rise in cases points to the need for close monitoring and swift action.

Cases of Ebola-like illness in Angola have been reported since October 24. 2004.  Initial cases were predominantly children, but it is unclear if the clustering was related to exposures or prior immunity.  Although the symptoms and associated high case fatality rate would make cases fairly obvious, a major effort to control the spread was not initiated until health care workers began to show symptoms.  The death of 5 health care workers in the past week indicates that prior exposures in adults is not providing protection, and either the virus has changed, or is now spreading into new areas.

The death toll has now grown to 98 with the vast majority of deaths in the past week or two.  The outbreak may still be controllable because of a relatively long incubation period and clear clinical presentation.

The recent exponential growth however, raises serious monitoring issues for other infectious diseases such as pandemic influenza.  The bird flu cases in southeast Asia are not being carefully monitored.  There are a large number of suspect cases in central Vietnam, and new deaths in the south and adjacent Cambodia.  Although confirmed human-to-human transmissions appear to be inefficient, lack of testing and reporting has clouded the picture.  The locations of H5N1 in people are far from clear.

A quick response to pandemic influenza is important because the incubation time is short and highly efficient transmission is possible.

The rapid increase in Marburg cases in recent days is a clear warning that failure to effectively monitor potential pandemic flu can have catastrophic consequences.

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