Mystery fever death toll rises

[pandemic_1918]

Mystery fever death toll rises
22/03/2005 13:17 - (SA)

http://www.news24.com/News24/Africa/News/0,,2-11-1447_1679783,00.html

Luanda - An outbreak of an unidentified haemorrhagic fever has claimed the lives of 93 people in northern Angola, Deputy Health Minister Jose Van Dunem said late on Monday.

Of the 101 cases reported in the Uige provincial hospital in northern Angola, 93 people have died and two have left the hospital without being properly discharged, said Van Dunem at a news conference.

"We are engaged in an effort with the community to find the two patients who fled the hospital and to detect new cases," he said.

The results of blood samples sent to Senegal showed that the mysterious outbreak was not due to yellow fever, dengue fever, the West Nile virus, the Crimean-Congo haemorrhagic fever or rift valley fever, said Moises Francisco, a member of the Angolan technical team monitoring the outbreak in Uige.

EDITED BY ADMIN: COPYRIGHT

[Dogmudgeon]

1. Beat me to it!

I just read about the Angola Mystery Bug half an hour ago -- and it seems that I'm still three days behind the news.

Most of these diseases turn out to be less contageous than originally thought, but the rules of the viral game seem to have changed in the past few years.

--p!

[pandemic_1918]

2. H5N1 NOT Ruled Out

Although many viruses have been ruled out, H5N1 has not (and it causes dengue hemorrhagic fever symptoms

http://news.google.com/news?hl=en&lr=&tab=nn&ie=UTF-8&q=dengue+angola&btnG=Search+News

[NorthernSpy]

4. your posts are very informative!

:toast:

[pandemic_1918]

12. Five Nurses Killed by Marburg

Five nurses have died from Marburg

http://news.google.com/news?hl=en&ned=au&ie=UTF-8&q=marburg+nurses

Situation can get out of control very quickly.

[pandemic_1918]

16. 3 Doctors 5 Nurses Infected

The toll on health care workers continues to rise. Five nurses have been infected and all have died. one Italian pediatrician has died in Luanda. There are 1-2 deaths and 3 infections in Luanda now as the virus spreads. In addition an Angolan and Vietnamese physician are also infected

http://news.google.com/news?hl=en&lr=&tab=nn&ie=UTF-8&q=marburg+health+care

[pandemic_1918]

18. Seventh Health Care Worker Dies

A seventh health care worker (another doctor in Luanda) has died

http://news.google.com/news?q=marburg+health+care&hl=en&lr=&sa=N&tab=nn&oi=newsr

[pandemic_1918]

19. Spread to Cabinda

Marburg virus has spread to Cabinda

http://news.google.com/news?hl=en&lr=&tab=wn&ie=UTF-8&q=marburg+cabinda

Eighth health care worker have died as death toll nears record of 124 for an Ebola-like outbreak.

[pandemic_1918]

71. Fatalities Found in Angola Neighborhoods

The main hospital in Uige is closed and now dead bodies are being found in residential neighborhoods

http://news.google.com/news?hl=en&lr=&tab=wn&ie=UTF-8&q=marburg+fatalities+hemorrhagic

[Media_Lies_Daily]

72. Sounds like they've lost total control....not good.

[pandemic_1918]

73. Marburg More Deadly Than Ebola

Marburg fatality at at 100%. It's more deadly than Ebola

http://news.google.com/news?hl=en&ned=ca&ie=UTF-8&q=ebola

[pandemic_1918]

84. Marburg Spreading in Luanda Slum

Marburg appears to be spreading in a Luanda slum - worst fears realized (maybe its the second worst, since Luanda has an international airport)

http://news.google.com/news?hl=en&lr=&tab=nn&ie=UTF-8&q=marburg+luanda+cacuaco+slum&btnG=Search+News

[pandemic_1918]

49. 14 Under Hospital Quarantine in Cabinda

14 relatives and contacts of Cabinda fatality have been placed under hospital quarantine


http://news.google.com/news?hl=en&lr=&tab=nn&ie=UTF-8&q=marburg+cabinda

[Frederik]

3. Did enyone hear Kofi Annan

yesterday, giving a speech concerning the proposed reforming of the UN? He said something strange. He listed the challenges facing the UN, and among them were "infectious diseases, natural and man-made". What a funny thing to say. Of course, there as been fear of bioterror since 9/11, but "terrorism" was one of the other challenges, and that would normaly be the category under which you'd put bioterrorism. Mentioning "man-made" infectious diseases separately like that struck me as unusual. There are no special indications that this is anything other than a natural disease, so I'm not implying that this is one of Annan's man-made diseases, I'm just mentioning it for what it's worth.

[mordarlar]

5. Pandemic you seem pretty knowledgeable on the subject.

When do you anticipate this thing to break big? Next few months?

I am just asking for your opinion and realize it is just an opinion. Thank you.
Mo

[pandemic_1918]

74. Marburg in Angola is a Recombinant

Marburg in Angola is a recombinant. It will be harder to contain than WHO realizes

http://news.google.com/news?q=marburg%20recombinant&hl=en&lr=&sa=N&tab=wn

[pandemic_1918]

75. Marburg in Angola is a Recombinant

Marburg in Angola is a recombinant. It will be harder to contain than WHO realizes

http://news.google.com/news?q=marburg%20recombinant&hl=en&lr=&sa=N&tab=wn

[Sufi Marmot]

76. Is there any hard evidence, or is this just conjecture on your part?

These observations raise the possibility that the Marburg virus in Angola is a recombinant and has genetically picked up some of the traits associated with Ebola.

Is there genetic seqeunce data that suggests that this has actually happened? I'm not sure it's responsible to imply inter-viral recombinaton just based on casualty and geographical data.

I also note that as of today the most recent WHO update (dated 4/1) has 140 confirmed cases with 132 fatalities.

-SM

[sharonking21]

77. I would also like to know . .

the answer.

I did note that it was acting more like Ebola and at first I wondered if:

1. Someone had made a mistake as to what it actually was?

2. It could be acting that way due to unusually high immunosuppression from high rates of HIV?--but I checked and Angola is not known for its high HIV rates in comparison to other nearby countries.

3. Someone needs to give me a refresher lecture on genetics--other than recombination, what are the other ways it might change just enough to be worse?

4. Also, as an epidemiologist, I'd be a little cautious with these case-fatality rates. Have to wait till the dust settles to get, if ever in a situation like this that is chaotic and focused on care of the sick, reliable information on case-fatalities.

Edited to take out repeated words due to typing and editing.

[Sufi Marmot]

78. Has filovirus recombination ever been documented?

Unlike influenza, filovirus genomes are a single piece of RNA so they can't reassort genetic material like the flu virus can. Informative filovirus link

I would assume that they could (and have) distinguished between Ebola and Marburg, based on sequence analysis or PCR or some other procedure which should give an unambiguous result. Viruses can certainly mutate during replication, and if they can isolate this strain of Marburg from a patient they could certainly sequence the whole thing to see if there are any polymorphisms when compared to other Marburg isolates. I'm not sure how homologous Ebola and Marburg are at the nucleotide level - I've been trying to force an alignment but after a cursory look I don't see any significant stretches of nucleotide homology that might be amenable to recombination between molecules.

-SM

On edit: I agree with your point #4 - Given the limited number of Marburg outbreaks in the world I would hesitate to draw any conclusions based on mortality data. There could be any number of reasons why this outbreak has mortality rates similar to Ebola.

[GOPFighter]

6. Scary Stuff!

A couple of months ago I read "The Great Influenza: The Epic Story of the Deadliest Plague In History" by John M. Barry. It was about the 1918 pandemic and it scared the crap out of me!

It's probably just a matter of time before another pandemic strikes.

[truthpusher]

7. Ebola-like virus blamed for 96 deaths (identified as the "Marburg Virus")

A previous LBN story talked about the situation in Angola. However, this story explains the source of all of the deaths.

Ebola-like virus blamed for 96 deaths
----------------------
By Zoe Eisenstein in Luanda
23mar05
----------------------
AN illness that has killed nearly 100 people in northern Angola was identified today as the rare Marburg virus, which is from the same family as the deadly Ebola disease, state and UN officials said.

Described as "very virulent" and "very contagious" and transmitted through bodily fluids, the haemorrhagic fever threatens to spread from the northern Uige province to other parts of the country.

"This is a possibility. The incubation period is 21 days so we must reinforce the surveillance in neighbouring provinces and especially in Luanda," Vice Minister for Health Jose Van Dunem said.

About 107 people in Uige have fallen victim to Marburg, for which there is no cure, with the number of deaths attributed to the epidemic now standing at 96.

story: http://www.themercury.news.com.au/common/story_page/0,5936,12634312%255E401,00.html

[NYdemocrat089]

8. Not good

Marburg and Ebola are dangerous stuff with very, very high fatality rates.

If anyone wants to know more baout ebola I suggest you read THE HOT ZONE by Richard Preston. It's about an inncident with ebola near Washinton D.C. Very scary...

[XemaSab]

9. It's a race

Bird Flu or Marburg... which will it be?

[Dogmudgeon]

10. Ebola, Marburg and similar viruses

They are very gruesome and have high fatality rates, but for some reason, outbreaks are self-limiting. You seldom hear of thousand-death clusters of Ebola victims. Usually, it's 50-100 people before the outbreak stops.

--p!

[DrRang]

13. No time to spread . . .

Yeah, I've read about diseases that are so virulent, like pneumonic plague, that they kill their victims before the poor people have really had time to infect many others. Almost build their own back-fire. But the 21-day incubation period--you could infect a lot of people in 21 days.

[frustrated_lefty]

15. They're self-limiting

because they kill too quickly to spread far. They basically have no latency period.

[Tyler Durden]

53. EBOLA incubates and kills quickly. MARBURG has a longer incubation.

That makes Marburg more dangerous: those two cases that fled could infect THOUSANDS.

Or maybe just one schmuck headed for the airport and New York City.......

[Willy Lee]

54. Exactly why AIDS is so dangerous.

How many do you infect before you know you have it?

[sharonking21]

61. HIV to AIDS

Yes, the principle is the same but with HIV the natural history of the disease (the disease without any intervention)shows a timeline of about 10 years between the time a person is infected and the time they first have symptoms severe enough to send them to a clinician seeking an answer to "What's wrong?" That's why HIV spread so far and wide before we even had a clue it was occurring.

Now, clinicians know to order a test for people (in Western countries at least) who have a risk pattern that might lead to infection--if they ever bother to ask about risks. Not all of them do, by any means.

Also, there are often subtle clinical signs and symptoms shortly after the time of infection (but most people just think they have a touch of the flu).

[dArKeR]

11. Fever outbreak in Angola leaves as many as 96 dead

http://www.taipeitimes.com/News/world/archives/2005/03/24/2003247567

[Pepperbelly]

14. NPR said it was Marburg yesterday. nt

[Media_Lies_Daily]

52. NPR doesn't have much credibility with me since....

...they began serving as just another outlet for NeoCon propaganda.

[Moderator]

17. pandemic_1918

Per DU copyright rules
please post only four
paragraphs from the
copyrighted news source.


Thank you.

DU Moderator

[Moderator]

20. kick to combine

[norml]

21. ANGOLA VIRUS SPREADING

ANGOLA VIRUS SPREADING
27.3.2005. 10:21:37



Angolan health officials have appealed for outside help to prevent the spread of a lethal virus as the death toll from the Ebola-like Marburg disease rose to 120.

The country's deputy health minister, Jose Van-Dumen, said the situation was critical after returning from a two-day field visit to the province of Uige in northern Angola.

A health ministry official said a pregnant woman died yesterday of the Marburg virus in a hospital in Cabinda in the north.

It was the first fatality outside the capital, Luanda and the province of Uige.

The nationwide death toll stands at 120 in less than six months.


snip

http://www9.sbs.com.au/theworldnews/region.php?id=108080®ion=5

[etherealtruth]

22. Truly frightening...

Hey folks if we don't get involved for humanitarian reasons, how about selfish ones. We are a (reasonably) short plane ride away...

[CC]

23. Getting involved for humanitarian reasons

should be enough reason. But maybe * will think about doing something if it could fall under homeland security. Any virus can travel world wide with in 24 hours.

[sharonking21]

26. Travel of virus

True, it can get here that fast, but in this case, because it is a blood-borne pathogen (more exactly perhaps a bodily-fluids borne one), were it to arrive in the US, the people who could potentially become ill would be limited to those in close contact with the patient. Thus it's impact would be limited, unlike, say that of flu, which can be transmitted in an airborne manner. The people most likely to become ill would be those treating the patient plus family members who had exposure to the person's bodily fluids.

There is a team of 30 on the way to Angola and some of them are from our CDC--probably from the Special Pathogens unit.

I used to worry a lot about this one, given the lab outbreak in Europe and the association with vervet monkeys in that outbreak. I worried because for three years, long before I became an epidemiologist, I worked as a primate observer at Southwest Foundation for Biomedical Research in San Antonio.

Monkey watchers even back then in the 70s knew that there were certain diseases we had to fear--this and Monkey B were the two biggies back then. We did more than just watch monkeys--for some experiments we came into close bodily contact with them--hauling them already anesthetized out of cages to do anthropometric measurements or in "help" missions outside SWF, to round up monkeys living here in Texas and give them their shots etc.

[MnFats]

28. I thought Marburg & Ebola viruses were easily passed..

....via airborne droplets, for example.
....which would make this, if it's a cousin to Marburg and Ebola, much more serious than a pathogen that was solely blood-borne.
....please correct me if I'm wrong. please.

[sharonking21]

31. No, not in comparison with flu or colds, etc

Ebola and Marburg are scary because of their clinical severity and case fatality rates, but just like with HIV, efficient transmission depends upon coming into contact with the body fluids of an infected person to become ill--usually blood or semen. However, unlike HIV, filoviruses cause messy, messy symptoms that make it likely that those close to them and caring for them will become exposed through contact.

There was some worry and speculation that the monkeys in the book, The Hot Zone, had become infected through airborne transmission and even some reports that humans had done so--luckily, if true, that particular strain of Ebola did not seem to make humans ill.

[Sufi Marmot]

48. Didn't the Reston workers test positive for simian Ebola antibodies?

If memory serves the evidence suggested that they had indeed been directly exposed to the virus and had generated antibodies against it, but hadn't become sick (hence the theory that the Reston strain doesn't make humans sick...)

On a related note, is it really known that filoviruses (Ebola and Marburg) aren't transmissible through the air, or has that mechanism of transmission just never been documented, especially given the limited number of documented outbreaks? For instance, have they ever detected virus in saliva or sputum?

-SM

[sharonking21]

58. Yes re: Reston

I loaned my copy of The Hot Zone to someone and never got it back. So I checked some MMWR articles.

Filovirus Infections Among Persons with Occupational Exposure to Nonhuman Primates

http://www.cdc.gov/mmwr/preview/mmwrhtml/00001608.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/00001646.htm

[Sufi Marmot]

66. Thanks for the info...I wonder about their assays...

To provide a perspective for interpreting antibody seropositivity rates for persons having contact with monkeys (or monkey body fluids or tissues), serum specimens from 449 persons from throughout the United States randomly selected from a cross-sectional adult primary-care outpatient population were tested by the same IFA and Western blot assays. Of these, 12 (2.7%) were positive. Reported by: Special Pathogens Br and Epidemiology Activity, Div of Viral and Rickettsial Diseases, Center for Infectious Diseases, CDC....The background seropositivity rate for persons from throughout the United States chosen randomly from an adult primary-care outpatient population remains unexplained. One possibility is antigenic crossreactivity between the known filoviruses and another, as yet undetermined, antigen. Further investigations are in progress to clarify this. Investigations are also in progress to define risk factors for occupationally acquired infection and to assess the risk for infection of household contacts of infected persons.

I wonder just how specific the antibodies they used here were, if they're lighting up people who have supposedly never been exposed to filoviruses. I also wonder if the Reston workers were somehow exposed only to filovirus proteins or "dead" virus particles, and not live ones.

-SM

[sharonking21]

67. I noticed that

I'd like to know what the sensitivity and specificity of the antibody tests are--not sure with so few cases over the years they really know about those two things though.

[xpunkisneatx]

44. Possible...

but not likely to be spread by another way except blood/body fluids. The reason these hemmhoragic fevers cause such devastation in third world countries is because a) they are certainly not as germophobic as Americans are and b) a main part of many cultures is for the family to clean the body of the deceased, thus exposing them to the blood/body fluids. Ebola and Marburg are certainly scary diseases...I certainly wouldn't want to be around either of them...but the fact is they are just not good bioweapons because they don't create a large enough outbreak and usually exhaust themselves before they can cause mass damage...that is if, of course, the virus doesn't mutate (which i might add is EXTREMELY easy) and become an airborne/droplet spreading organism. This, my friends, would be a very, very, very bad thing. In fact, with Marbug at 98% mortality and Ebola at 90% mortality, we could see the end of the human race.

[sharonking21]

59. Mutation rate?

Does anyone have any idea what the mutation rate for Marburg is?

[pandemic_1918]

41. Death Rate Near 100%

The death rate for Marburg is close to 100%, but media is reporting 121 dead and 132 hospitalized when its really 121 dead and 11 hospitalized. Only a handful die each day, because most who have been hospitalized have already died. There have been no recently reported recoveries in Angola

http://news.google.com/news?q=marburg+luanda+death&hl=en&lr=&sa=N&tab=nn&oi=newsr

[pandemic_1918]

39. Marburg Transmission in Luanda Suburb

Looks like Marburg has transmitted in suburb of Angolan capital city of Luanda (which has international airport)

http://news.google.com/news?q=marburg%20transmission&hl=en&lr=&sa=N&tab=wn

[norml]

40. Marburg Virus Transmission in Angola Capital of Luanda?

Marburg Virus Transmission in Angola Capital of Luanda?

Recombinomics Commentary
March 27, 2005

>> Luanda provincial health director Vita Mvemba said in the capital: "One Portuguese citizen who has visited Uige was admitted on Sunday at the military hospital and one girl, about 12 years old, has been transferred from the Cacuaco Health Centre to the Americo Boa Vida hospital."

Cacuaco is a suburb about six kilometres (four miles) north of Luanda on the road to Uige.

"The girl is from Luanda. She has been admitted with a fever for the last two days at the Cacuaco centre. Today, she started bleeding. That's why we urgently had to transfer her to the Americo Boa Vida hospital," Mvemba said. <<

The description above suggests the 12 year-old girl represents the first reported transmission of Marburg virus in Luanda. There had been six prior cases reported in Luanda, including the death of a 15 year-old boy, an Italian pediatrician, and a Vietnamese physician. However, all of the prior reported cases, like the Portuguese citizen had come to Luanda for treatment after visiting or working in Uige. Similarly, the death in Cabinda was of a pregnant women who had returned from a funeral in Uige of a Marburg victim.

However, the 12 year girl is a Luanda resident who was initially hospitalized in a Luandan, suburban treatment center in Cacuaco, and was transferred to the Luanda medical facility because he condition had worsened and she started to bleed.



snip

http://www.recombinomics.com/News/03270504/Marburg_Luanda_Transmission.html

[Festivito]

24. One must touch the blood to be infected. Un-nice. Not scar;y.

Culture there is to cradle the dying family member, blood ouze and all.

They need help convincing the families not to touch the dying, something the locals will not understand, especially during such emotional losses.

[norml]

25. Marburg Hemorrhagic Fever

Marburg Hemorrhagic Fever

View PDF (132KB)

What is Marburg hemorrhagic fever?

Negative stain image of an isolate of Marburg virus, showing filamentous particles as well as the characteristic "Shepherd's Crook." Magnification approximately 100,000 times. Image courtesy of Russell Regnery, Ph.D., DVRD, NCID, CDC. Go to high-resolution version.
Marburg hemorrhagic fever is a rare, severe type of hemorrhagic fever which affects both humans and non-human primates. Caused by a genetically unique zoonotic (that is, animal-borne) RNA virus of the filovirus family, its recognition led to the creation of this virus family. The four species of Ebola virus are the only other known members of the filovirus family.

Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (now Serbia). A total of 37 people became ill; they included laboratory workers as well as several medical personnel and family members who had cared for them. The first people infected had been exposed to African green monkeys or their tissues. In Marburg, the monkeys had been imported for research and to prepare polio vaccine.





Where do cases of Marburg hemorrhagic fever occur?

Recorded cases of the disease are rare, and have appeared in only a few locations. While the 1967 outbreak occurred in Europe, the disease agent had arrived with imported monkeys from Uganda. No other case was recorded until 1975, when a traveler most likely exposed in Zimbabwe became ill in Johannesburg, South Africa – and passed the virus to his traveling companion and a nurse. 1980 saw two other cases, one in Western Kenya not far from the Ugandan source of the monkeys implicated in the 1967 outbreak. This patient’s attending physician in Nairobi became the second case. Another human Marburg infection was recognized in 1987 when a young man who had traveled extensively in Kenya, including western Kenya, became ill and later died. In 1998, an outbreak occurred in Durba, Democratic Republic of the Congo. Cases were linked to individuals working in a gold mine. After the outbreak subsided, there were still some sporadic cases that occurred in the region.

Where is Marburg virus found?

Marburg virus is indigenous to Africa. While the geographic area to which it is native is unknown, this area appears to include at least parts of Uganda and Western Kenya, and perhaps Zimbabwe. As with Ebola virus, the actual animal host for Marburg virus also remains a mystery. Both of the men infected in 1980 in western Kenya had traveled extensively, including making a visit to a cave, in that region. The cave was investigated by placing sentinels animals inside to see if they would become infected, and by taking samples from numerous animals and arthropods trapped during the investigation. The investigation yielded no virus. The sentinel animals remained healthy and no virus isolations from the samples obtained have been reported.



snip

http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg.htm

[sharonking21]

27. Barrier methods

One recent account said that the spread among hospital personnel most likely was due to the fact that they had little in the way of protective barriers like gloves, special masks, disposable gowns, booties etc. I find that credible given that I have read so many books about outbreaks in Africa. Until you read a lot about it, you have no idea how poor these countries are. We taught them to use Western medicine, but they do not have the money to keep full stocks of all the important preventive goods. And this is an extremely messy disease, much like Ebola, where bodily fluids can be leaking out of the skin and all orifices. You run through protective barrier material quickly. I hope to God we are sending large stores of it with the team of 30 going over there.

[MikeG]

29. If it kills you fast, It won't spread far.

[norml]

30. The case-fatality rate for Marburg hemorrhagic fever is between 23-25%.

What are the symptoms of the disease?

After an incubation period of 5-10 days, the onset of the disease is sudden and is marked by fever, chills, headache, and myalgia. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea then may appear. Symptoms become increasingly severe and may include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.

Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases, such as malaria or typhoid fever, diagnosis of the disease can be difficult, especially if only a single case is involved.

snip

Are there complications after recovery?

Recovery from Marburg hemorrhagic fever may be prolonged and accompanied by orchititis, recurrent hepatitis, transverse myelitis or uvetis. Other possible complications include inflammation of the testis, spinal cord, eye, parotid gland, or by prolonged hepatitis.

Is the disease ever fatal?

Yes. The case-fatality rate for Marburg hemorrhagic fever is between 23-25%.

[girl gone mad]

32. Not too dramatic of a mortality rate..

compared to ebola.

I bet that rate could be brought down significantly with good medical care.

[IMayBeWrongBut]

34. Heh, I know this is a serious subject but...

I'm pretty sure more cow bell isn't going to cure this fever. :)

[Theres-a]

50. LMAO!

[Media_Lies_Daily]

47. How far down from 90-100% is "significantly"?

[pandemic_1918]

33. Case Fatality Rate is 93% in Angola

The Marburg Virus case fatality rate is 93% in Angola

http://news.google.com/news?q=marburg&hl=en&lr=&sa=N&tab=nn&oi=newsr

[pandemic_1918]

36. Case Fatality Rate Exceeds 90% in Angola

The case fatality rate is an easy calculation. It is simple the number who die over the number who die or recover. WHO gave numbers for Angola after the determined it was Marburg and came up with 93%. Update numbers are also 93%.

The current outbreak has the highest fatality rate for a large outbreak, including Ebola

http://news.google.com/news?hl=en&lr=&tab=nn&ie=UTF-8&q=marburg+angola+fatality

[xpunkisneatx]

45. I don't know where you got that info...

But anything I have ever read on Marburg (you name it, I have read it...I am a virology geek), they have said it is even worse than Ebola. I have heard mortality rates of up to 98%

[sharonking21]

57. Case Fatality Rates that Differ by Outbreak

Marburg Case Fatality Rates


Europe
Germany and Yugoslavia (YR)1967 (Deaths)7 (Cases)31 (CFR)22.6
The monkeys they handled were from Northern Uganda

South Africa (YR)1975 (Deaths)1 (Cases)3 (CFR)33.3
Index case had traveled to Zimbabwe

Kenya (YR)1980 (Deaths)1 (Cases)2 (CFR)50.0

Zimbabwe (YR)1982 (Deaths)? (Cases)? (CFR)?

Kenya (YR)1987 (Deaths)0 (Cases)1 (CFR)0.0

Sweden (YR)1991 (Deaths)0 (Cases)1 (CFR)0.0
Patient had traveled in Africa

Congo (YR)1998-2001 (Deaths)123 (Cases)149 (CFR)82.6

Angola (YR)2004-2005 (Deaths)126 (Cases)132(?) (CFR)95.5
But data not complete yet

The confusion arises, in part, because the 23-25% figures are cited from a CDC website fact-sheet that has failed to update their CFRs after the Congo outbreak.

However, the case fatility rate can change from outbreak to outbreak, depending (off the top of my head) on level of medical care available, how quickly cases are diagnosed, the strain of virus cirulating in your area, the overall immune status of those infected, and, I suppose, depending on how big a dose of of the infective agent got into their bloodstream.

You can think of the CFR as something like "Okay, given that we are pretty damn sure you HAVE this disease at this time and in this area, this is how likely it is you are going to croak." That likelihood can vary depending on where you are.

This is very different from crude death (aka mortality) rates. You can have an outbreak that has an exceedingly high CFR, but if it fails to spread to a large number of people, it most likely won't cause a high death rate--the death rate is the number who die divided by those living in the area.

[pandemic_1918]

64. Case Fatality Rate Between 99-100% - WHO Data

WHO just released the data, Case fatality rate is somewhere between 99 and 100% (there either has been 1 or 0 survivors)

http://www.recombinomics.com/News/03290505/Marburg_WHO_3.html

[pandemic_1918]

35. 3-9 Day Incubation Period

The incubation period is 3-9 days. The virus has time to get around and if care isn't taken, infection is easily passed by close contact (8 health care workers have already died in Angola)

http://news.google.com/news?q=marburg&hl=en&lr=&sa=N&tab=nn&oi=newsr

[POAS]

37. I read elsewhere that the incubation is 21 days???????????

[POAS]

38. Did some digging and found this

Incubation period for VHF viruses


Arenaviridae
Lassa...........Lassa Fever.......3 - 21 days

Bunyaviridae
Nairovirus......Crimean-Congo HF...1 - 12 days

Filoviridae
Ebola Virus......Ebola HF..........2 - 21 days
Marburg Virus....Marburg HF........3 - 16 days

Period of communicability

Patients who have clinical symptoms are considered infectious. There are reports of late transmission events (92 days for Marburg) and Lassa fever virus can be shed in urine for several weeks or in semen for months after illness has resolved.

http://www.hpa.org.uk/infections/topics_az/deliberate_release/VHF/OrganismDetails.asp?Source=Professional&Agent=VHF&Document=OrganismDetails

[pandemic_1918]

42. Marburg and Ebola

Marburg and Ebola are very similar. In the larger outbreaks, they both kill 90-100% of victims

http://news.google.com/news?hl=en&lr=&tab=nn&ie=UTF-8&q=marburg+luanda+death+angola

[norml]

43. Global Potential Lake Victoria Marburg Virus Code Red Alert

Global Potential Lake Victoria Marburg Virus Code Red Alert



Angola (TAA) __ A one-of-a-kind portable laboratory is heading from Canada to Angola to help contain a deadly disease. This will give a great amount of assistance in seach for how to stop this epidemic.

Governments are failing to stop those refugees from affected areas from leaving to unaffected regions. Refugees potentially are spreading this across the globe as they are allowed to remove their loved ones from affected zones.

WHO has thus far has failed to end this practice that is spreading this outbreak. This is a disease spread by contact both physical and sexual. UN personnel have failed to stop the spread to adjacent Sudan. The disease flared and continues to spread unchecked in Africa.



Quarantine boundaries have not been enforced. Money is buying travel for many who may have or be carrying the virus. Animal population is not being managed nor is the illegal traffic of the animals know to vector this virus.



snip



http://www.teamamberalert.net/New%20York/modules.php?name=News&file=article&sid=106

[Media_Lies_Daily]

46. This situation is getting pretty ugly.

[pandemic_1918]

62. ProMed is Concerned About International Spread

ProMed wants to see the dead body in Portugal

http://www.recombinomics.com/News/03290504/Marburg_International.html

[Theres-a]

63. could it come here? nt

[sharonking21]

68. Sure it could, but also

see my post above about the mode of transmission which operates to limit the number of infections to be expected.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=102&topic_id=1332019&mesg_id=1344958

The only thing to worry about on a wide-spread level is a radical mutation but I don't know how likely that is.

[spinbaby]

51. Death toll rises to 122 as Angola turns to military, civilians

LUANDA (AFP) - The death toll after an outbreak of a deadly Ebola-like disease in Angola has climbed to 122, as the country turned to civilians and the military, saying it did not have enough doctors to fight the Marburg virus.

http://story.news.yahoo.com/news?tmpl=story&cid=1508&e=13&u=/afp/angolahealthvirus

[norml]

55. Death toll rises to 126 as Angola seeks help from military and abroad

Source: Agence France-Presse (AFP)

Date: 28 Mar 2005
Print E-mail Save Death toll rises to 126 as Angola seeks help from military and abroadby Pedro Makuta Nkondo

LUANDA, March 28 (AFP) - The death toll after an outbreak of a fulminating haemorrhagic fever in Angola caused by the Marburg virus climbed to 126 Monday, making it the most serious outbreak ever recorded of the Ebola-like disease, official and hospital sources said.

The government sought emergency help from international organizations and from the military, saying it did not have enough doctors to fight the Marburg virus.

The disease kills around one in four who contract it, and a specific treatment is unknown.

"We have not only asked the military for help, but also from around the world, national and international, in the fight against Marburg," said Luanda's provincial health director Vita Mvemba.

snip

http://www.reliefweb.int/rw/RWB.NSF/db900SID/MHII-6AX422?OpenDocument

[Media_Lies_Daily]

56. Interesting that this article is saying that 1 out of every 4 are dying...

...of the disease, while Marburg is known historically to kill 90% or more.

[sharonking21]

60. See this comment above

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=102&topic_id=1332019&mesg_id=1349544

[tlcandie]

65. There have been some ebola type deaths and illnesses rearing

their ugly heads here recently and still ongoing in Florida. I've linked a couple of the stories, but no one has hit on them. Are these connected? It seems it is children and the elderly...but mostly children who have died.

They are trying to determine what was/is the common denominator for all of the affected people.

Link here to the article:
http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=102&topic_id=1340795

<snip>
The syndrome is most often associated with a virulent form of the E. coli bacterium, commonly found in animals' intestines. Yet none of the children has tested positive for E. coli, according to health officials.

The syndrome can occur with salmonella, which is associated with chicken; shigella, which is associated with sewage; and some viral agents, Sinnott said.

Contaminated food - not petting zoos - is a far more common source of infection, he said.

``It makes me wonder that there's something else going on here,'' Sinnott said. ``This could be an unheard of or unidentified pathogen, and I hope they're looking carefully at viruses.''

Whatever the source of infection, the illness follows a predictable course: diarrhea, especially bloody diarrhea, and possible fever followed by lethargy, anemia and decreased urine output.
<snip>

EDIT: I'm not trying to scare anyone and I am by far not a health and disease person... so, I put this here because they are all so puzzled by it wondering if there could possibly be a connection. Thanks!

[sharonking21]

69. Update March 30th

This article has things of interest about CDC on the way, other teams there, CDC shipping preventive material for hospitals, training started for local health care workers, and the two Portuguese potential cases tested negative for Marburg.

US Experts Heading for Angola to Help Stop Marburg Spread
Contributed by Lisa Olen | 30 March, 2005 20:11 GMT

http://health.dailynewscentral.net/content/view/000574/31/

[pandemic_1918]

70. More Cases

Marburg continues to spread. The next few days will be important. Infected people may be heading away from Uige

http://news.google.com/news?hl=en&ned=nz&ie=UTF-8&q=marburg+spread+angola+africa

[Moderator]

79. kick to combine

[Lori Price CLG]

80. Angola Marburg death toll climbs

Angola Marburg death toll climbs

The death toll in Angola from an outbreak of the rare Marburg virus has risen sharply to 146 people, the country's health ministry has said.

Twenty of the deaths have been reported since Thursday.

The outbreak, which began last October in Uige province, is the most serious ever recorded of the virus, a fast-spreading haemorrhagic fever.

<snip>

Lori Price

[Media_Lies_Daily]

81. I bet this number is on the low end...

...because the article linked in the post below talks about bodies being found in residential neighborhoods.

They've got a real problem...I hope it doesn't become everyone's problem.

<http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=102&topic_id=1332019&mesg_id=1359437&page=>

[pandemic_1918]

82. Marburg Spread Accelerating

Marburg spread is accelerating. Will soon top Ebola record of 280 dead

http://news.google.com/news?hl=en&lr=&tab=wn&ie=UTF-8&q=marburg+spread+uige

[sharonking21]

83. List of Books on Epidemics and Outbreaks

For those of you so inclined, see my reading list of 'popular' books about outbreaks, epidemics and other medical topics at:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=209x1562

[norml]

85. Marburg virus spreads to 5th Angolan province: so far claimed 156 lives

Marburg virus spreads to 5th Angolan province

April 06 2005 at 10:51AM

By Jan Hennop

Cacuaco, Angola - Angolan health workers in a slum outside Luanda were treating a new suspected case of the Marburg virus on Tuesday.

A senior United Nations official warned that the outbreak of the Ebola-like epidemic was not yet under control.

Nurses at a clinic in the township of Cacuaco, about 18km north of the capital, were scrambling to help the 22-year-old woman who they feared may be the latest casualty of the haemorrhagic fever which has so far claimed 156 lives in the biggest outbreak ever of the disease.

'Alert, Marburg. Don't touch any corpse'
The virus has spread to a fifth province.



snip







http://www.iol.co.za/index.php?set_id=1&click_id=84&art_id=qw1112762702113B252

[sharonking21]

86. Updates, questions of Marburg Outbreak in Angola

Here is an update report, immediately below. 6th province added.

Death toll from Marburg virus hits 173, Reuters
Fri Apr 8, 2005 7:34 AM BST

http://today.reuters.co.uk/news/newsArticle.aspx?type=worldNews&storyID=2005-04-08T073400Z_01_SIN827114_RTRUKOC_0_HEALTH-ANGOLA.xml

Also I got to looking for things about the Congo outbreak and found that it differed in character from this outbreak in Angola, in that in the Congo the cases were mostly young men working in a gold mine and there appeared to be little spread from hospital settings (One thing I mmediately wondered was whether or not there were any hospitals close to the epicenter of the outbreak?? Article doesn't say).

Further, most of the cases in the Congo, although not all, appeared to be primary cases and not cases due to secondary transmission. We know that in Angola it has been centered more around children under the age of 5 and that in Angola there have been several nosocomial (medical care setting infections).

As an epidemiologist I sure would want to follow up on these clues. I'd be asking things about the children like common habits, recent injections, were they mostly primary cases, and trying to map cases geographically, separating out children under age 5, primary and secondary cases, nosocomial vs. non-nosocomial etc.

If anyone comes across information on these things, please post!

I cannot get enough on-line information on either outbreak to even begin to think about it.


Risk Factors for Marburg Hemorrhagic Fever, Democratic Republic of the Congo

Emerging Infectious Diseases Vol. 9, No. 12m December 2003

http://www.cdc.gov/ncidod/EID/vol9no12/03-0355.htm


Who, Weekly Epidemiological Record

http://www.who.int/docstore/wer/pdf/1999/wer7420.pdf

Infection control for viral haemorrhagic fevers in the African health care setting , 1998

http://www.who.int/csr/resources/publications/ebola/WHO_EMC_ESR_98_2_EN/en/