MSF-USA: MSF Combats the Marburg Epidemic in Angola

April 16, 2005
MSF Combats the Marburg Epidemic in Angola

Ten days after an outbreak of Marburg Hemorrhagic Fever was officially confirmed in Angola, Doctors Without Borders/Médecins Sans Frontières (MSF) teams are working on the front line of operations. The Marburg outbreak, a virus in the same family as Ebola, is centered in the province of Uige in northern Angola, where an MSF team is leading the response in the provincial hospital. The situation was found to be quite dramatic: patients left on their own, a demoralized and scared staff, and no adequate follow-up of the existing cases in the community. The MSF team, which includes several staff members with experience in controlling hemorrhagic fever outbreaks, has taken the responsibility of managing suspected cases.

In the capital, Luanda, where cases have also been reported, another MSF team is helping to establish an isolation unit in case the virus spreads through this city of four million people. It is also providing training to local medical staff and technical advise to the National Crisis Committee.

According to the official numbers provided by the Angolan Ministry of Health and the World Health Organization (WHO), as of April 2, 163 cases were recorded and 150 people have died. Until now, all these cases were infected in Uige, although several of them were treated in other provinces. More accounts were reported in different regions. Some of them were unconfirmed cases, however, many seemed to match the symptoms of Marburg Fever.

Only a few outbreaks of Marburg were reported since the virus was first recognized in 1967, and the current one seems extremely lethal compared to previous epidemics. The transmission of the disease occurs either through direct contact with an infected person or their body fluids, or through contact with infected animals. After an incubation period of 5 to 10 days, the disease might suddenly appear through high fever, headache, vomiting, or diarrhea. Since the early symptoms are similar to those of other common infections in Angola, such as malaria, diagnosis can be difficult. Hemorrhagic signs begin to appear in an already advanced stage.

The MSF team in Uige has created an isolation ward where highly suspected cases are being admitted in order to perform safe, clinical case management. The local medical staff has been trained on strict bio-safety rules in order to ensure their own personal safety. The MSF team is also cooperating closely with the Ministry of Health in Uige and a WHO team, which is in charge of the epidemiological surveillance and case finding in the region.

The need to increase the response to this epidemic is urgent. The search for new cases and the identification of people who may have come in contact with infected persons needs to be intensified. The task of measuring the scale of this epidemic, in addition to preventing further transmissions, will require an enormous effort by the Ministry of Health, the WHO, along with MSF and partnering aid organizations.