UN urges faster isolation of sick in Angola to control deadly Marburg outbreak

Faster detection and isolation of Angolans with Marburg haemorrhagic fever are crucial if the worst outbreak ever recorded of the highly lethal disease is to be brought under control, the United Nations health agency warned today.

With 231 cases already reported in just a few weeks, 210 of them fatal, the World Health Organization (WHO) said this would not happen until the public in the southern African country understands the disease, a relative of the equally deadly but better-known Ebola, and the high risks associated with treating patients in homes.

Early diagnosis, isolation and tracing of all contacts are the only way to break the transmission chain of the disease, for which there is no vaccine or treatment, and the agency has repeatedly warned of the danger of families' tending the sick at home since close proximity, including exposure to bodily fluids, is a main source of infection.

Available data indicate that casual contact plays no role in the spread of Marburg, which begins with severe diarrhoea, abdominal pain, nausea, vomiting and chest and lung pains, and progresses to severe haemorrhage in the gastrointestinal tract and lungs.

Transmission requires extremely close contact, involving exposure to the blood and other bodily fluids of a patient most likely showing visible signs of illness. Health care and burial workers are particularly vulnerable without adequate protective gear. The disease can also be transmitted by exposure to items, including bedding and clothing, recently contaminated by a patient.

Although surveillance to detect cases has improved, it remains patchy. In Uige province, epicentre of the outbreak where daily mobile teams are active, surveillance continues to be largely concentrated on the investigation of deaths and collection of bodies. The security of teams remains a concern. More vehicles are needed and WHO is making the necessary arrangements on an urgent basis.

Last week fearful residents attacked and damaged vehicles, seeing hospitalization with no cure as a death sentence. Infection control needs to improve in heath care settings, and WHO is continuing to supply effective personal protective equipment, for national and international staff.

WHO does not recommend restrictions on travel within Angola, but advises some precautions. Travellers to Angola should be aware of the outbreak and the need to avoid close contact with ill persons. Travellers leaving Angola should be advised to seek medical attention should any illness with fever develop within 10 days of departure.