22 April 2005: Marburg haemorrhagic fever in Angola - update

As of 19 April 2005, the number of cases of Marburg haemorrhagic fever reported from Angola [1] has risen to 266 including 239 deaths [2]. This represents a case fatality of 90%. The majority of cases (over 90%) have been recorded in Uige Province , predominantly in Uige city itself, and all cases reported from other provinces have so far originated from Uige province. Children continue to be the worst hit group [3].

The outbreak has not yet shown signs of peaking as cases and deaths are continuing to be detected in the community. A lack of trained healthcare workers in Angola as well as socio-cultural factors are affecting surveillance, early diagnosis and control. The mobile surveillance teams have employed anthropologists and social mobilisation experts, as well as local traditional leaders to assist with the public awareness campaign, which will be vital to the control of this outbreak.

The World Health Organization (WHO) maintains that casual contact does not play a role in the spread of Marburg virus and that transmission involves extremely close contact with blood or bodily fluids of an infected person; this may also include contact with items such as bedding and clothing which have been contaminated by an infected patient. As of 13 April 2005, the WHO were not aware of any cases of Marburg infection in foreign nationals apart from those involved in the direct care of patients in Uige and do not recommend any travel restrictions to Angola [4]. They do however recommend that travellers to Angola should be aware of the outbreak and to avoid close contact with ill persons. Any travellers leaving Angola who may have had contact with ill persons should seek medical advice immediately if they develop any illness with fever within ten days of their departure.

The UK Foreign and Commonwealth Office are currently advising against all but essential travel to Uige province (due to the Marburg outbreak) and to N orth and South Lunda Provinces and the interior of Cabinda province (due to civil unrest) [ 5].

References

1. NaTHNaC. Clinical update. 7 April 2005: Marburg haemorrhagic fever in Angola.
2. World Health Organization. Marburg virus disease in Angola - update 14. Disease Outbreak News [online] [cited 22 April 2005] Geneva : WHO, 2005. Available at http://www.who.int/csr/don/2005_04_21/en/index.html
3. Personal communication from the British Embassy in Luanda via the Foreign and Commonwealth Office, 19 April 2005.
4. World Health Organization. Marburg virus disease in Angola - update 11. Disease Outbreak News [online] [cited 20 April 2005] Geneva : WHO, 2005. Available at http://www.who.int/csr/don/2005_04_13/en/print.html
5. Foreign and Commonwealth Office. Travel Advice by Country: Angola . [Online] [cited 5 April 2005]. Available at Foreign and Commonwealth Office .