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May 2, 2005
Marburg Fever: Epidemic Still Not Under Control

It has been six weeks since the World Health Organization (WHO) confirmed an outbreak of Marburg fever in Angola. Today, the epidemic is still not under control, and as of April 30 there have been 271 deaths out of 301 confirmed cases. The disease has also taken a heavy toll on medical staff, claiming the lives of at least 19 Angolan health professionals.

The situation is still quite alarming. More dead are collected every day for burial in the city of Uige, the epicenter of the epidemic. Since the alert was given, a new focal point has emerged in the hospital of Songo, about 30 miles (50 kilometers) northwest of Uige.

Many problems remain unsolved and new difficulties arise every day. Last week, three patients with Marburg fever died in separate wards of the Uige Hospital, indicating how the infection control system established there has not been sufficiently effective. Following a request from health authorities, Doctors Without Borders/Mèdecins Sans Frontiéres (MSF) will take on more responsibility for infection control in order to better protect patients and medical staff. All wards will be disinfected and a stringent triage will be introduced in order to temporarily restrict new hospital admissions to life-saving emergencies only.

As a consequence of these new measures, neighboring health centers will need to accommodate the overflow of patients and treat those with illnesses other than Marburg fever. Local health authorities and the WHO also need to improve their system of identifying suspected cases, and follow up with those who have been in contact with infected patients. Educating people in these communities about the disease and its prevention is vital in controlling the epidemic. Families and patients must therefore receive a great deal of support from local authorities, medical teams, and all other relevant organizations working in their communities. Aggressive actions and threats to families will only lead to more fear and stigmatization, and only intensify the situation.

MSF has 55 international volunteers working in Angola to address the outbreak, including treatment wards for people infected with Marburg in Uige, Songo, Negage, and Luanda. These centers allow MSF teams to isolate patients and properly tend to them. MSF teams have been instrumental in transporting patients to hospitals and carrying out burials following the strictest bio-protection measures. Sensitivity training is also being stepped up so these public health measures may be better communicated to people in the affected areas.

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