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Apr 2005 |
The deadly and contagious Marburg Hemorrhagic Fever continues to
ravage the Angolan province of Uige. As of Sunday 17 April, 235, of the 257 cases
reported, have proved fatal. Without a stronger response, the epidemic will continue
to spread. Biological tests carried out by the WHO confirmed on March 22 the presence
of the virus. Since then, 114 new cases have been identified, 107 of which have
proved fatal.
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READ THE DIARIES OF THOSE FIGHTING MARBURG:
Zoe Young
Water and Sanitation Specialist
Luis Encinas
Medical Coordinator
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Despite these alarming statistics, measures announced to contain the epidemic
have been slow to act and have so far failed to stop the epidemic spreading. While
the epicentre of the outbreak is in Uige, last week saw the emergence of new areas
of infection. In Songo, an hour west of Uige, 4 cases have been reported. While
in Negage, thirty minutes south-west of Uige, the figure stands at 3. The health
infrastructure in these two localities has been affected.
Fighting a Deadly and Contagious Disease and a Complex Epidemic
Marburg Fever – from the same family as the Ebola virus – is a deadly
and contagious disease. Stamping it out requires a rigorous, multi-level strategy.
Because Marburg Fever can be transmitted through direct contact with bodily fluids,
it is imperative that isolation units be put in place to treat those affected.
No specific treatment exists but measures must be taken to treat those affected
(rehydration, administering of antalgics and drugs to prevent vomiting, etc.)
Since the beginning of the crisis our teams have set up two isolation and treatment
units: one in Uige Hospital, and one in Amerigo Boavida Hospital in the capital,
Luanda. 23 patients have already been admitted to the centre in Uige. Isolation
units are also being set up in Negage and in Songo, while the unit in Camabatela
is already in place.
Human and Logistic Action, Informing the Population To limit
the risk of infection, efforts must be made to identify and assess suspected cases,
and to locate and check on any people who may have come into contact with those
affected by the virus. Nearly 500 'contacts' have so far been counted in Angola
– 360 of these in Uige alone. In addition, strict sanitary procedures must
be adhered to when burying victims of the Marburg virus – whether they have
died at hospital or at home.
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Such priorities require important logistic and human efforts.
Protective clothing (gloves, gowns, masks, glasses, boots, etc.) is essential,
while proper vehicles must be provided to locate suspected cases in different
areas of the country, and to transport patients and bodies. All medical and non-medical
personnel must be notified immediately. Our volunteers are in charge of training
Angolan medical and military personnel, alerting them to the strictest sanitary
precautions to be taken in order to guarantee their own safety in the event of
contact with victims and bodies. This effort must however be intensified. |
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If these measures are to succeed, they must be supported by specific policy
aimed at informing the local population. So far little has been done to raise
awareness, and in a climate of fear, MSF teams and WHO personnel have been met
by hostile reactions during their visits to the areas of Cadongo and KimaKongo
in Uige. Because fighting the outbreak means isolating patients and burying the
victims in body bags, the local population often see the medical personnel as
'confiscating' the sick and the dead. What's more, the high mortality rate of
patients admitted to the isolation units (only 2 have survived more than 24 hours)
has led to a culture of suspicion among the local population. Consequently, locals
sometimes refuse to hand over the sick and the dead to medical teams, preferring
instead to keep them at home, which creates a potential for future contamination.
By informing the population and alleviating the panic, those showing early signs
of the virus may be hospitalised sooner – a move that will lead to a drop
in mortality rates.
| The story as it unfolded...
04/04/05
MSF working on front line of operations against Marburg epidemic outbreak in Angola
01/04/05
Marburg fever overwhelms Angolan hospital
25/03/05
Emergency intervention in Uige province, Angola, following a Marburg fever outbreak
23/03/05
Marburg fever outbreak in Uige province, Angola |
Reorganising the hospitals affected
Elsewhere, hospitals affected by the virus must completely reorganised to avoid
any risk of the virus 'nosocomiale' infection (this occurs when the virus is spread
in the confines of the hospital itself). All services must be disinfected and
an isolation ward must be put in place. Triage of patients must be stepped up
in order to isolate suspected cases, and to prevent those infected by the virus
coming into contact with patients of other illnesses. These precautionary measures
must be applied throughout the hospital. This involves not only the wearing of
safety equipment but also the suspension of all invasive procedures (surgical
operations, lab inspections, intravenous and intramuscular injections, etc.) with
the exception live-saving operations (emergency surgery, caesarian sections, etc.)
which should be carried out in accordance with strict sanitary procedures.
An inadequate reaction so far
For the time being, our efforts and those at both the national and international
level remain largely inadequate given the gravity of the situation. It is imperative
that Angolan authorities take into account the extent of the epidemic. Without
proper treatment of patients and protection of the population, Marburg Fever will
continue to spread throughout Angola.
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Watch an audio slideshow featuring nurse Janet Hearn, a UK
volunteer, who has been working on the Marburg outbreak in Luanda, Angola.
Watch the audio slideshow with »
Windows Media May 2005 |
» Read other feature articles
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