Attempts to contain Marburg disease epidemic have limited effect
http://www.100md.com
《英国医生杂志》
An outbreak of Marburg haemorrhagic fever in Angola that has so far affected 205 people, killing 180 of them, does not yet seem to be under control despite high level international efforts. The disease is rare, has a high mortality, and has no vaccine or treatment. It had not been seen in Angola before this epidemic began in late 2004.
The latest number of deaths was announced in a statement released last Friday by the World Health Organization. WHO has also launched an appeal, through the United Nations, for funding to support the emergency response to the outbreak. WHO needs $2.4m (?.3m; �1.9m) to support the Ministry of Health in Angola to intensify ongoing operations in the field.
Although adults have been affected, children were the worst hit initially. Seven provinces, all in the north of Angola, are affected, the latest being Zaire province, which borders the country of the same name. The centre of the outbreak is Uige, a city with about half a million residents.
The medical charity M閐ecins Sans Fronti鑢es is in charge of operations at Uige抯 Provincial Hospital and is working at an isolation unit in the capital, Luanda, where a few cases have been reported. The charity抯 team includes several staff members experienced in the management of haemorrhagic fever.
A WHO spokesperson said: "The dramatic symptoms of Marburg haemorrhagic fever and its frequent fatality are resulting in a high level of fear, which is further aggravated by a lack of public understanding of the disease. Moreover, because the disease has no cure, hospitalisation is not associated with a favourable outcome, and confidence in the medical care system has been eroded." One health worker for M閐ecins Sans Fronti鑢es said: "People now see the hospital as a place where one goes to die."
In response to the situation, WHO is strengthening its capacity and has deployed medical anthropologists and social experts to the area to intensify its health education campaign. It has also set up a network of international laboratories in Canada, Germany, South Africa, and the United States to link up with field laboratories in Angola to try to understand more about the outbreak.
Angola抯 response capacity is limited as a result of damage to the country抯 health infrastructure from more than three decades of civil war and unrest.
Marburg haemorrhagic fever is caused by Marburg virus, an RNA virus of the Filovirus genus, another member of which is Ebola virus. The Marburg virus was first recognised in Marburg, Germany, in 1967. The disease had arrived there with African green monkeys imported from Uganda and spread to Frankfurt and to Belgrade.
Since then four separate outbreaks have been recorded, the largest before this (128 deaths) being in the Democratic Republic of the Congo in 1998, where cases were linked to workers in a gold mine. The disease affects humans and other primates, although its natural reservoir host and how this host transmits the virus to humans are unknown. Humans can become infected by handling infected monkeys or by coming into contact with the body fluids of other infected people.
Healthcare workers are particularly at risk and must use barrier nursing techniques. Cases in this epidemic have been recorded among healthcare staff. Early diagnosis is often difficult because the disease shares early signs and symptoms with other common tropical infectious diseases, such as malaria and salmonella enteric fever. No specific treatment yet exists for the disease, and patients can only be offered supportive treatment.(Calabar, Nigeria Chibuzo Odigwe)
The latest number of deaths was announced in a statement released last Friday by the World Health Organization. WHO has also launched an appeal, through the United Nations, for funding to support the emergency response to the outbreak. WHO needs $2.4m (?.3m; �1.9m) to support the Ministry of Health in Angola to intensify ongoing operations in the field.
Although adults have been affected, children were the worst hit initially. Seven provinces, all in the north of Angola, are affected, the latest being Zaire province, which borders the country of the same name. The centre of the outbreak is Uige, a city with about half a million residents.
The medical charity M閐ecins Sans Fronti鑢es is in charge of operations at Uige抯 Provincial Hospital and is working at an isolation unit in the capital, Luanda, where a few cases have been reported. The charity抯 team includes several staff members experienced in the management of haemorrhagic fever.
A WHO spokesperson said: "The dramatic symptoms of Marburg haemorrhagic fever and its frequent fatality are resulting in a high level of fear, which is further aggravated by a lack of public understanding of the disease. Moreover, because the disease has no cure, hospitalisation is not associated with a favourable outcome, and confidence in the medical care system has been eroded." One health worker for M閐ecins Sans Fronti鑢es said: "People now see the hospital as a place where one goes to die."
In response to the situation, WHO is strengthening its capacity and has deployed medical anthropologists and social experts to the area to intensify its health education campaign. It has also set up a network of international laboratories in Canada, Germany, South Africa, and the United States to link up with field laboratories in Angola to try to understand more about the outbreak.
Angola抯 response capacity is limited as a result of damage to the country抯 health infrastructure from more than three decades of civil war and unrest.
Marburg haemorrhagic fever is caused by Marburg virus, an RNA virus of the Filovirus genus, another member of which is Ebola virus. The Marburg virus was first recognised in Marburg, Germany, in 1967. The disease had arrived there with African green monkeys imported from Uganda and spread to Frankfurt and to Belgrade.
Since then four separate outbreaks have been recorded, the largest before this (128 deaths) being in the Democratic Republic of the Congo in 1998, where cases were linked to workers in a gold mine. The disease affects humans and other primates, although its natural reservoir host and how this host transmits the virus to humans are unknown. Humans can become infected by handling infected monkeys or by coming into contact with the body fluids of other infected people.
Healthcare workers are particularly at risk and must use barrier nursing techniques. Cases in this epidemic have been recorded among healthcare staff. Early diagnosis is often difficult because the disease shares early signs and symptoms with other common tropical infectious diseases, such as malaria and salmonella enteric fever. No specific treatment yet exists for the disease, and patients can only be offered supportive treatment.(Calabar, Nigeria Chibuzo Odigwe)