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Marburg disease outbreak in Angola now worst-ever recorded: UN health agency

4 April 2005 – As the Marburg virus outbreak in Angola became the worst-ever recorded with 163 cases so far, 150 of them fatal, the United Nations health agency said today significant international aid will be needed to control the rare but highly lethal haemorrhagic disease with epidemic potential.

The World Health Organization (WHO) is working with Angola's Ministry of Health to finalize a national plan of action to control the outbreak in the southern African country with sustained technical and operational support from WHO and international partners in the Global Outbreak Alert and Response Network (GOARN), a technical collaboration of existing institutions and networks.

"WHO anticipates that implementation of this plan will require significant assistance from the international community," the agency said in its latest update on the disease, which begins with severe diarrhoea, abdominal pain, nausea, vomiting and chest and lung pains, with a high proportion developing severe haemorrhage in the gastrointestinal tract and lungs. There is no vaccine or curative treatment.

The previous worst outbreak of the disease, which is of the same family as the deadly Ebola, occurred from 1998 to 2000 in the Democratic Republic of the Congo (DRC), with 149 cases, 123 of them fatal.

This time the virus seems to have spread more rapidly since all the cases have occurred since October, with monthly numbers increasing progressively, although this could be due to intensified surveillance.

WHO has already dispatched 500 kilos of personal protective equipment and other supplies to assist in the immediate improvement of infection control in hospitals and the protection of front-line staff in the region around the northern Uige Province, epicentre of the outbreak. Close contact with bodily fluids of infected people, as in medical care or burial, appears to increase the risk of infection, and at least a dozen current cases involve health workers.

Five mobile surveillance teams in Uige continue to investigate rumours and search for additional cases. More than 100 contacts are being followed up. Cases have also been identified in Luanda, Cabinda, Malange and Kuanza Norte provinces but all these are thought to have originated in Uige.

Marburg occurs very rarely and appears to be geographically confined to a few countries in southern Africa. It was first identified in 1967 during simultaneous outbreaks affecting laboratory workers in Marburg and Frankfurt, Germany, and in Belgrade, Yugoslavia. The outbreaks, which involved 31 cases and seven deaths, were subsequently linked to contact with infected monkeys imported from Uganda.