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Marburg Virus in Angola More Deadly Than Ebola Virus

Recombinomics Commentary

April 2, 2005

The case fatality rate of Marburg virus in Angola tops the deadly Ebola virus.  Marburg  (MBGV) and Ebola (EBOV) are closely related Filovirdae.  Both viruses are transmitted via body fluids and produce similar hemorrhagic fevers.  There have been several large outbreaks caused by these two viruses.  They have produced a range of case fatality rates.  Their rates are simply the ratio of patients who die divided by the total number of cases.  The calculation is based on known outcomes, so a true calculation would be of the deaths divided by the deaths plus discharges.  Since none of the current Marburg cases have been discharged, the case fatality rate is 100%.

Recent updates by the WHO have shown a difference of 5-8 patients between the number of deaths and the number diagnosed.  However, the difference represents the small number of patients who have been recently admitted.  Based on outcomes of prior cases in Angola, all or most of these patients will also die.

In 1976 there were two large EBVO outbreaks.  In southern Sudan the fatality rate was 42% (117/284 deaths).  In adjacent Zaire the rate was 88% (280/318 deaths).  The largest MBGV rate, prior to the current outbreak in Angola was in the Democratic Republic of Congo between 1998 and 2000 when it was 83% (123/149 deaths).

Thus, the current outbreak in Angola is not only the largest MBGV outbreak recorded to date, but its 100% case fatality rate tops the 88% for EBOV in Zaire in 1976.

The reason for the high rate in Angola is unclear.  Early cases were young children treated in Uige.
The number of reported cases in Uige alone has now grown to 150.

In the past month the demographics have changed and more adults or teenagers have died, including 12 health care workers.  Some of the patients have been treated in large medical facilities in Luanda and Cabinda, but there have still been no reports of patients who have recovered from Marburg infections in Angola. 

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