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Official Marburg Toll at 218 - True Number Much Higher

Recombinomics Commentary

April 10, 2005

>>  "As of noon, the total number of cases nationwide is 218 and 193 people have died," a joint statement said, adding that 360 others were under surveillance in the southern African country where the outbreak was first detected in October.

The last toll based on figures compiled up to Friday was 184.

The communique said there were 173 fatalities and 189 cases in the northern province of Uige, the epicentre of the outbreak, followed by six deaths each in the Kwanza Sul and Zaire regions, four in Luanda province, two in Mananje and one each in Cabinda and Kwanza Norte. <<

The data above gives detail on where Marburg patients have died, as well as where there are patients who are still alive.  The total number of cases is up to 218, which is 62 shy of the record 280 fatalities for Ebola.  However, the distribution of the cases suggests the data is lagging the actual cases by 1-2 weeks.  Thus, it is likely that the number infected is already well in excess of 280, and since virtually all infected patients have died, a new fatality record has already been set.

The numbers for Luanda are a good example of how the official numbers lag daily reports.  Initial media reports provided considerable detail on new cases and deaths, which are now absent from reports.  Old reports however indicated that by March 28 there were already 4 deaths in Luanda.  The first death was the 15 year old male who died at Josina Michel hospital on March 24.  The same day the Italian pediatrician died at Sagrada Esperanca clinic.  The next day the Vietnamese physician died, and on March 28 a child under the age of 1 died.  The fifth Luanda fatality was on March 31, so it would seem that Luanda reported cases are almost 2 weeks behind the actual date of death.  Other patients admitted to Luanda hospitals last month were a Portuguese national who entered a military hospital as well as the 12 year-old from Cacuaco who was transferred to Luanda last month.  This month a 22 year-old patient from Cacuaco was also transferred to Americo Boa Vida in Luanda.

Since Luanda has been monitored closely, yet some deaths from last month have not been added to the official tally, it seems that the number of dead and infected patients is currently markedly higher than the reported numbers.  Moreover, since the reported numbers have increased so dramatically in recent days, it seems likely that the number of dead patients that are known, but not confirmed or added to the official tally exceeds the record number of 280 deaths from the Ebola outbreak in 1976.

In addition to the number of known deaths that are not reflected in the official Marburg numbers would be deaths in neighborhoods that have not been investigated.  Cases that have not begun to hemorrhage and cases being hidden by relatives would also not be included.

Thus, although the official numbers indicate there are only 16 diagnosed patients alive in Uige province, and another 9 patients alive in the rest of the country, the true number of dead and dying is significantly higher.

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