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Marburg Fatality Rate in Angola At 100%?
March 31, 2005
>> The mortality rate is frightening with only six survivors so far out of the outbreak's 132 recorded cases -- and some of them may yet succumb. <<
The case fatality rate for Marburg appears to be 100%. Although media coverage has increased in recent weeks, along with the record number of Marburg deaths in Angola, there has been no mention of any discharged patients. An accurate case fatality rate is based on known outcomes, and would be the ratio of the deaths relative to the number of deaths plus discharges. Tallies, such as the one above, include the recently diagnosed patients, who may be alive, but have not been discharged. Since there are no reported discharges, most or all of those hospitalized will probably die.
WHO's update at the beginning of the week reported 117 deaths out of 124 cases. However, 6 of the 7 who had not died had been described in in media reports as recent hospital admissions. There have been several updates this week with slightly different numbers, but the difference between those who have been diagnosed and those who have died has been less than ten, further supporting the data suggesting that there have been no discharges.
The case fatality rate for Marburg or Ebola cases, caused by this closely related Ebola virus, has varied from 40% to 88% for the larger outbreaks in Africa. At this stage, the current outbreak clearly has the highest case fatality rate. Most of the deaths have been in Uige, but recently there have been deaths in Luanda, Negage, and Cabinda. There have been no reports of discharges at any of the above locations. All of the cases outside of Uige have been linked to the epicenter of the outbreak.
The reason for the high fatality rate is unknown. Initial cases were mostly children, but more recent cases have included adults. Among the adults who have died are 6 nurses, 2 physicians, and 2 policemen. All of these health care workers and first responder cases have died in the past two weeks.