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Marburg Spread Outpacing Contact Tracing

Recombinomics Commentary

April 8, 2005

>>  "The situation right now in Angola is not under control yet," Ryan told reporters in Geneva. "This is still a crisis, and a health crisis on a national level."

WHO believes it is having an impact on the virus in the northern province of Uige, where it first appeared in October, Ryan said.

Several deaths attributed to the virus recently have been reported in four other provinces, but all the victims had been in Uige. Two cases have been confirmed in Angola's capital, Luanda, but there has been no transmission of the virus there. <<

The above comments on spread and transmission appear to be describing conditions in Luanda in March.  The first two Luanda deaths were on March 24.  The first death, a 15 year-old male, died at Josina Michel Hospital the same day the Italian pediatrician died in Luanda at the Sagrada Esperanca clinic.  The next day a Vietnamese physician died in Luanda and a few days later a child under the age of 1 died.  Other Luanda cases include a Portuguese citizen treated at a military hospital and a 12  year-old and 22 year old initially treated in Cacuaco before transfer to Americo Boa Verde Hospital in Luanda.  The two cases in Cacuaco appear to be transmissions in the slums just outside of Luanda.

The number of provinces outside of Uige with Marburg patients has now grown to six (Luanda, Cabinda, Zaire, Kwanza Norte, Kwanza-sul, and Malange), and the number of cases has exploded to 200.  Since only 230 contacts are being monitored (200 in Uige and 30 in Luanda), data on transmission outside of Uige would appear to be lacking.

The rapid increase in Marburg cases and provinces would indicate that control is limited, and transmission outside of Uige is unknown for certain, but highly likely.

The Marburg virus is ahead of contact tracers, and well ahead of WHO updates on transmission.

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