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Marburg Spread to Democratic Republic of the Congo?

Recombinomics Commentary

April 30, 2005

>>  The recent surge in cases of Marburg haemorrhagic fever in Angola has alerted many neighbouring countries to the risk it poses. Many have responded by means of task forces or focus committees. Cross-border travel and high mobility of people can easily lead to a spread of Marburg fever to countries like the Democratic Republic of the Congo (DRC) and the Republic of Congo (Congo). This potential risk has panicked many in these two countries, particularly in the border provinces of Bas Congo, Bandundu, Kasai Occidental and Katanga in DRC, and the provinces of Kouilou and Niari in Congo-Brazzaville.

Some cases that are suspected to be Marburg have been reported in Matadi (2), Kisantu (1) and Kinshasa (1), DRC; however, these are unconfirmed. There are currently no reported cases in Congo. <<

The continued reports of Marburg in Democratic Republic of the Congo are cause for concern.  Although these reports remain unconfirmed, a confirmation of the agent causing the Marburg symptoms would be useful.  The discarding of most of the cases outside of Uige in Marburg raises the same concerns.  Since the number of confirmed cases outside of Uige is limited to 3 cases, all in Luanda, the capability of these other regions inside and outside Angola to collect a positive sample and deliver it to Uige or Luanda for testing remains unproven.

Negative data from sources that have never collected a positive sample is not very conclusive.  Statements on non-confirmation would be more convincing if a positive diagnosis was available for these patients.  The situation in Luanda is a good example.  Last month there were 5 Marburg deaths reported as well as two patients in Cacuaco who were hemorrhaging and sounding like Marburg victims.  The reported cases in Luanda grew to 12 and 6 of the patients had died.  However, the cases in Luanda were removed over a period of several days as were cases in other provinces in Angola.  In Luanda the number of cases was reduced to 4.  The number of other cases outside of Uige was reduced to 7 (5 in Zaire, and 1 each in Kwanza del Norte and Cabinda).  All 11 of the cases have died.  However, there have been no reports on what caused the deaths of the other discarded cases, which raises questions about the accuracy of the official list as well as comments on unconfirmed cases outside of Angola.

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