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WHO Update on Current Reported Marburg Cases in Angola

Recombinomics Commentary
March 29, 2005

>> As of 29 March 2005, the Ministry of Health has reported a total of 124 cases and 117 deaths in Cabinda, Luanda and Uige. All these cases had originated in Uige Province. Ten of these cases have been laboratory confirmed by the Centers for Disease Control and Prevention (CDC), Atlanta, USA......

Two travelers returning to Portugal from Angola were investigated for possible Marburg virus infection and laboratory results were negative in tests performed by the Bernard-Nocht Institute for Tropical Medicine, Hamburg, Germany, a WHO Reference Laboratory. <<

The latest update from WHO on the Marburg hemorrhagic fever outbreak in Angola, address several issues. The case fatality rate for the first 124 diagnosed patients is at least 94%.  However, the true case fatality rate is the number who died over the total number who died or were discharged.  Most, if not all, of the 7 patients who have been diagnosed and are still alive, are patients who have recently been admitted.  These would include one of the first five treated in Luanda, the patients admitted in Uige on March 27, and the two most recent admissions in Luanda, a Portuguese citizen admitted to a military hospital in Luanda, and a 12 year old transferred from a suburban health center to a larger facility in Luanda.  Thus, there seems to be only 1 patient at most who has been discharged, indicating the true case fatality rate is between 99 and 100%.

The update also indicates that all of the initial 124 patients originated in Uige Province indicating there has been no documented transmission in Luanda or Cabinda.  In addition, the two travelers from Angola to Portugal tested negative for Marburg.  The fatal case was positive for Malaria, indicating that there is no known Marburg virus outside of  Uige Province and Luanda.

The small number of known diagnosed cases who are alive would explain the relatively small number of newly reported deaths.  However, the reported cases do not exclude other unreported cases with symptoms, or infected patients who have yet to develop symptoms.  Moreover the animal reservoir for the virus remains uncertain.

Thus, the latest WHO update indicates that the known cases are limited, but uncertainty remains over contacts of the relatively high number of recent cases who have died.

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