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| Africa: Subsaharan |
| 17 Health Care Worker Deaths May Close 3 Hospitals in Uige |
| 2005-04-10 |
| An international medical charity battling a hemorrhagic fever that so far has killed 181 Angolans has urged the government to close the regional hospital here, at the center of the outbreak, saying the medical center itself is a source of the deadly infection. Doctors Without Borders, the global relief organization that runs an isolation ward at the hospital for victims of the deadly fever, Marburg virus, told Angolan officials on Friday that the hospital should be closed if the rapidly spreading epidemic was to be contained. Two other hospitals within 60 miles of Uige may also have to be shut down, said Monica de Castellarnau, the organization's emergency coordinator in Uige, the provincial capital, where the outbreak was first reported. That possibility raises the prospect of a second health care crisis, one in which hundreds of thousands of people already facing a disease that is almost always fatal may suddenly have no access to hospital care. But in an interview in the streets of Uige, where an intensive effort is under way to find and isolate new cases of the virus, Other reports say efforts to find cases have almost stopped completely several days ago after workers were attacked. Ms. Castellarnau said there might be no alternative. "The hospital has been the main source of infection," she said. "We have to break that chain somehow. It is a massive public health decision, and it must be taken by the government." The breakdown of the healthcare system is a sign the epidemic is out of control. There are likely many thousands of people on the move trying to get away from the outbreak and some of those are likely infected. We may be two or three weeks away from entire countries being isolated. |
| Posted by:phil_b |
| #7 I take it that the worst case scenario is mutation into airborne transmission? |
| Posted by: Matt 2005-04-10 10:32:18 PM |
| #6 This outbreak of Marburg is clearly a lot more lethal than previous outbreaks. Fatality rate is close to 100%. And right now we have no idea why it is spreading much faster than previous outbreaks. It could be spreading due to a particular (local) combination of factors, e.g. I've read that a local practice is for close relatives of the deceased to wash the body and drink the water afterwards. Maybe the MSF person is right and the hospital is the main source of infection. The alternative is that the virus has become more lethal and better at transmission. |
| Posted by: phil_b 2005-04-10 10:20:24 PM |
| #5 If Marburg has mutated to become less virulent and thus less lethal to its host this presents a _MAJOR_ world health problem. Marburg, in its earlier incarnations, killed its hosts so fast it didn't have time to spread. That's one reason why the German outbreak (and the one in Washington, DC as reported in The Coming Plague) was snuffed out and hushed up so quickly. Right now, people are thinking "Ebola" and "It's that not so serious African thingie that breaks out every now and then over there - nothing for us to worry about" when the reality is that this is a _MAJOR_ world health crisis for evryone if it breaks loose in a more heavily populated area. It kills health workers first as they're most directly effected by those infected - just like Ebola, but, as I recall, somewhat faster (at least in the old version). Disrupt medical and health care facilities and you disrupt medical treatment and isolation capabilities. This could explode right in our faces if folks at the CDC aren;t watching carefully. Thanks, LC FOTSGreg |
| Posted by: LC FOTSGreg 2005-04-10 8:50:33 PM |
| #4 I don't trust WHO on this. In part becuase the outbreak may have gotten started through reuse of needles in a WHO childhood vaccination program. In answer to Matt's question. Viruses 'mutate' (in the loose sense of changing their genetic makeup) much faster than other organisms. We are used to thinking of organisms evolving over long periods. Viruses can do the same over days/weeks/months. All they need is sufficient opportunity i.e. enough infections. |
| Posted by: phil_b 2005-04-10 4:22:50 PM |
| #3 There's a cheery book written about ten years ago by a lady named Laurie Garrett titled "The Coming Plague." It's the nonfiction equivalent of the Andromeda Strain. |
| Posted by: Matt 2005-04-10 11:46:54 AM |
| #2 Matt- I don't know myself, but I am shuddering at the possibility that Ebola may have mutated. Can you say 'Andromeda Strain'? Mike |
| Posted by: Mike Kozlowski 2005-04-10 11:24:21 AM |
| #1 I've read that the Ebola-type viruses kill such a high percentage of their victims that outbreaks tend to "burn out" fairly quickly. So what's going on here? |
| Posted by: Matt 2005-04-10 10:51:34 AM |