Evelyn Depoortere,1 Pedro Pablo Palma2
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An outbreak of Marburg haemorrhagic fever in Uige, Angola
Evelyn Depoortere,1 Pedro Pablo Palma21Epicentre, Brussels2Médecins Sans Frontières, Spain BackgroundOn 21 March, 2005, Marburg virus was detected in nine samples from 12 patients from the Provincial Hospital in Uige, for the first time in Angola. International teams arrived 1 week later: an isolation ward was set up at the hospital, safe burial activities were organised and teams were trained for contact tracing and the investigation of incoming alerts. MethodsA standardized admission form was used for all patients admitted in the isolation ward, in order to record clinical history and exposure to possible risk factors. Daily surveillance of the main (municipal) cemetery was ensured from 1 April onwards, and interviews with families of probable and confirmed cases were done to investigate possible epidemiological links. FindingsBetween 1 April and 8 May, 59 patients were admitted in the isolation ward, 42 of whom were classified as probable (based on the combination of clinical and epidemiologic criteria) or lab confirmed Marburg cases. Among these, case-fatality was 78.5%, while 14.3% were cured. Daily counting of the new graves at the municipal cemetery showed a decrease for the month of May compared to April. InterpretationWhile the latest information indicates a decrease in the number of new cases, the management of the largest outbreak of Marburg haemorrhagic fever ever reported, was hampered by the lack of confidence of the community. Good communication is essential to ensure community collaboration with the medical intervention teams, for patient isolation and infection control activities to be effective. |