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Africa: Subsaharan
Marburg Toll in Angola Explodes to 313
2005-05-03
There have been 313 cases detected of the Marburg virus since monitoring of the outbreak, the worst recorded to date, began on October 13, it added

. Deputy Health Minister Jose van Dunem told journalists that a health team travelled to the village of Ngombe, 150km north of the city of Uige, on Sunday and was told that a woman who had attended the funeral of a relative in Uige had spread the virus to the village. "When she returned to Ngombe, she contaminated 12 other members of her family and they all died," said Van Dunem. A traditional healer who treated many patients sick with Marburg in a town outside of Uige has also died from the haemorrhagic fever, he added.

No new cases of the Marburg virus have been detected outside the province. Results from a blood test on a suspected case of Marburg in nearby Malange province were negative, he said. The dramatic jump of Marburg cases to 313 is cause for concern. The official death toll of 280 matches the total death toll in the worst recorded Ebola outbreak. The prior record Marburg death toll of 126 was eclipsed last month. However, the sudden jump in cases raises serious questions about the accuracy of the official tally put out daily by the Angola Ministry of Health. That list has discarded most of the previously reported cases outside of Uige. The basis for the discarded cases remains unclear.
I guess this answers the question I was asking - why isn't marburg spreading in the bush? It is and and we are only just getting reports.
Posted by:phil_b

#12  Chuck the WHO is incorrect and arguably deceptive to claim a 90% death rate. To date only one person has recovered and 280 died, with 33 persons whose outcome is unknown. That gives a death rate of 99.5%. The decrease in the death rate you quote is wholly attributable to the increase in cases.

Otherwise, I understand as well as the next person what exponential means. A disease that is increasing in numbers is spreading exponentially irrespective of the rate at which it is increasing. You may well be right and what we are seeing does not mean the disease is increasing, however, I conclude it is. I also understand that any exponential trend will eventually encounter one or more limiting factors. I don't know what Marburg's limiting factors are but based on this data they do not appear to be intervention by WHO, etc.
Posted by: phil_b   2005-05-03 21:41  

#11  Phil, the data just doesn't support this being a big deal for the world. Or for Africa. Given the poor data, the graph still shows a leveling off of new cases in late April. The cluster will create a spike, but not that big of a one, since 25 cases could have been anticipated during the same time to begin with. It's 20:00 EST and WHO still has not updated their web site.

The death rate for the numbers in the story is 89.5%. That's a drop from the last figure of 92.7%. I suspect that the generally poor health and poor health care will contribute to a death rate of 90% or more, but it will be due to those conditions as much as Marburg.

We're not seeing exponential growth in cases. In fact, the latter half of April was nearly flat growth. Typically these epidemics have a second wave, and we may see that, however the cluster should not be used to extrapolate anything significant about the overall epidemic.
Posted by: Chuck Simmins   2005-05-03 20:58  

#10  Chuck may well be right that the jump in cases is a reporting artifact. As evidence to the contrary the difference between cases and deaths has also jumped from 20 (where it had been for a week) to 33 in the latest report. This disease is 100% fatal (+/- 1%). Also bear in mind that most cases seem only to be detected when the patient is dead or close to.

The important point is that WHO, MSF and the Angolan government's work to date has not slowed the diseases spread. This means two things. One is that this is going to be a lot harder to stop than WHO and others claim. The other is, a disease spreads where conditions are most conducive to its spread. The more people who are infected and the wider its geographic spread the more likely it is the disease will find its optimum ecological niche. We are dealing with a disease we know almost nothing about and it appears we don't know how to stop its spread.
Posted by: phil_b   2005-05-03 19:28  

#9  Being the low tech sort that I am, I refer you not to a website but to your local public library for the NOVA video on Ebola. Reports from Angola sound exaclty like those from Kikwit. Same reaction, same vectors, probably even similar environment (maybe Angola's a little drier).
Posted by: mom   2005-05-03 18:36  

#8  should I have had to post /sarcasm?
Posted by: Frank G   2005-05-03 18:36  

#7  Here is another report of the family of an infected person fleeing. This is 'normal' human behaviour with killer diseases and a major factor in their spread. For years my hobby was reading first person accounts of historical events and people have always done this.
Posted by: phil_b   2005-05-03 18:31  

#6  It is bad news. It's also symptomatic of the society their parents choose to live in.

They're the ones who make their countries that way.
Posted by: Fred   2005-05-03 13:37  

#5  I hope you'll forgive me for thinking that little kids getting polio is bad news, no matter what nonsense their parents buy into.
Posted by: James   2005-05-03 13:09  

#4  phil and Chuck, check out the good news that Islamic tourists (read Mecca) are communicating Polio all th way from Nigeria to Indonesia....I posted it late last night.....ignorance will kill how many?
Posted by: Frank G   2005-05-03 11:37  

#3  Problem is that the last WHO report is from April 27. At that point, in April 2005, the epidemic had averaged 5 new cases per day. You'd expect, at that rate, at least 25 new cases with this new report. You have 38, and the difference can be explained by the cluster described in the news report.

WHO is not doing daily updates on the number. They skipped seven days between the 12th and the 19th, and again between the 20th and the 27th. That's how you produce statistical jumps, inconsistant reporting.

WHO has yet to update its web site with these numbers. Another correction to the news story is that WHO is the group that did the reclass.

WHO Data
Posted by: Chuck Simmins   2005-05-03 11:13  

#2  When people leave the country to go to the city they travel back whenever they can to see their family and a killer disease will cause significant numbers to leave the city and accelerate the spread.
Posted by: phil_b   2005-05-03 10:14  

#1  influx of people into cities is greater than the numbers leaving cities to go back to a rural enviroment , as there is less money to be made to support families . Could this be another reason phil_b ?
Posted by: MacNails   2005-05-03 10:04  

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