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17 Health Care Worker Deaths May Close 3 Hospitals in Uige

Recombinomics Commentary

April 9, 2005

>>   An international medical charity battling a hemorrhagic fever that so far has killed 181 Angolans has urged the government to close the regional hospital here, at the center of the outbreak, saying the medical center itself is a source of the deadly infection.

Doctors Without Borders, the global relief organization that runs an isolation ward at the hospital for victims of the deadly fever, Marburg virus, told Angolan officials on Friday that the hospital should be closed if the rapidly spreading epidemic was to be contained.

Two other hospitals within 60 miles of Uige may also have to be shut down, said Monica de Castellarnau, the organization's emergency coordinator in Uige, the provincial capital, where the outbreak was first reported.

That possibility raises the prospect of a second health care crisis, one in which hundreds of thousands of people already facing a disease that is almost always fatal may suddenly have no access to hospital care. But in an interview in the streets of Uige, where an intensive effort is under way to find and isolate new cases of the virus, Ms. Castellarnau said there might be no alternative.

"The hospital has been the main source of infection," she said. "We have to break that chain somehow. It is a massive public health decision, and it must be taken by the government."<<

The closing of three hospitals in Uige would truly be remarkable, and may force more to flee the area, spreading the Marburg virus even further.  Although said to be transmitted by bodily fluids, there are now 15 dead nurses and 2 dead physicians, suggesting viral spread is quite efficient.  The deaths of the 17 health care workers have all been within the last month.

The situation in Angola is clearly deteriorating.  Closing the hospital in Uige may create similar new outbreaks elsewhere.  The closing of three hospitals in Uige that are 60 miles apart demonstrates the rapid spread of the virus, and will almost certainly ring alarm bells in Luanda, where transmission has been reported.

This will almost certainly result in some leaving Luanda, increasing the likelihood of Marburg being seeded internationally.

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