UN health agency helps Angola fight outbreak of highly fatal Marburg disease

The United Nations health agency is helping Angola tackle an outbreak of Marburg virus disease, a rare but highly fatal haemorrhagic illness with epidemic potential that has already killed 95 of the 102 victims so far identified in the southern African country.

Since the start of the outbreak in October, monthly numbers of cases have progressively increased, although this could be due to intensified surveillance, the World Health Organization (WHO) said today of the disease, for which there is no vaccine or curative treatment.

Most deaths have occurred between three to seven days following the onset of symptoms, and about 75 per cent of cases have occurred in children under the age of 5. Cases in adults include a small number of health care workers.

Past outbreaks of the disease, which begins with severe diarrhoea, abdominal pain, nausea, vomiting and chest and lung pains, with a high proportion developing severe haemorrhage in the gastrointestinal tract and lungs, indicate that close contact with bodily fluids of infected people, as in health care or burial, increases the risk of infection.

WHO is supporting efforts by Angola’s Ministry of Health to strengthen infection control in hospitals, to intensify case detection and contact tracing, and to improve public understanding of the disease and its modes of transmission.

The disease was first identified in 1967 during simultaneous outbreaks affecting laboratory workers in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia. The outbreaks, which involved 31 cases and seven deaths, were subsequently linked to contact with infected monkeys imported from Uganda.

Marburg occurs very rarely and appears to be geographically confined to a small number of countries in the southern part of Africa. The largest outbreak on record, from 1998 to 2000 in the Democratic Republic of the Congo (DRC), involved 149 cases, of which 123 were fatal.