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Marburg Virus Transmission in Angola Capital of Luanda?

Recombinomics Commentary
March 27, 2005

>>  Luanda provincial health director Vita Mvemba said in the capital: "One Portuguese citizen who has visited Uige was admitted on Sunday at the military hospital and one girl, about 12 years old, has been transferred from the Cacuaco Health Centre to the Americo Boa Vida hospital."

Cacuaco is a suburb about six kilometres (four miles) north of Luanda on the road to Uige.

"The girl is from Luanda. She has been admitted with a fever for the last two days at the Cacuaco centre. Today, she started bleeding. That's why we urgently had to transfer her to the Americo Boa Vida hospital," Mvemba said.  <<

The description above suggests the 12 year-old girl represents the first reported transmission of Marburg virus in Luanda.  There had been six prior cases reported in Luanda, including the death of a 15 year-old boy, an Italian pediatrician, and a Vietnamese physician.  However, all of the prior reported cases, like the Portuguese citizen, had come to Luanda for treatment after visiting or working in Uige.  Similarly, the death in Cabinda was of a pregnant woman who had returned from a funeral in Uige of a Marburg victim.

However, the 12 year-old girl is a Luanda resident who was initially hospitalized in a Luanda suburban treatment center in Cacuaco.  She was transferred to the Luanda medical facility because her condition had worsened and she started to bleed. 

Her admission two days prior to transfer with a fever raises concerns about transmission to others in the suburban facility.  Moreover, the report does not describe a source for the 12 year-old's infection, raising the possibility of additional transmissions in Luanda.

The latest report of 121 deaths in 132 cases produces a case fatality rate of at least 92%.  However, there are no reports of discharges of  Angolan patients diagnosed with Marburg hemorrhagic infections, so the case fatality rate may be closer to 100%.

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