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Fatalities Outside of Uige Fuel Fears of Marburg Spread in Angola

Recombinomics Commentary
March 30, 2005

>> While all the known cases have originated from Angola's northern Uige province, medical workers in Luanda said they could not be sure Marburg had not already spread to the capital, only 150 km (100 miles) southwest of Uige province.

"Luanda's the province where it's most likely to spread to. Maybe it already has, but hasn't been registered yet," the male nurse said. "Many sick people are refusing to go to hospital because they think if they do, they'll catch the disease."  <<

The monitoring of Marburg in Angola is compromised by the closing of the main hospital in Uige, coupled with the case fatality rate of nearly 100% and the recent deaths of eight health care workers and two first responders.

Although initial cases were detected last fall, the Marburg infections began to significantly increase only recently.  Most of the health providers have died in the past week, creating a climate of fear in Uige, as well as the Angola capital of Luanda.  These issues have limited the ability to monitor patients, which hampers control efforts.

There have been eight deaths in the past two days including two fatalities at Negage, a town about 30 km from Uige, the epicenter of the outbreak.  The eight deaths in the past two days may be signaling a new wave a cases that are more dispersed than the initial fatalities in Uige. 

Within the past week deaths were reported for the first time in Cabinda and Luanda, fueling fears of further spread.  Although these cases originated in Uige, and contacts in Cabinda and Luanda are under 21 day quarantine. Other residents may have moved to new locations, especially since the main hospital has closed.

The cases or deaths in the next week should give a much better indication of the significance of these cases outside of Uige.

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