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Speedy diagnosis key in fighting Marburg

With the toll from the largest, deadliest and most intense outbreak of Marburg fever on record steadily climbing in Angola, the United Nations health agency is focusing on the need for exceptionally precise diagnostic steps to prevent the spread of the rare but highly lethal haemorrhagic disease further afield, or even to another country.

An international network of expert laboratories set up by the World Health Organization (WHO) in Canada, Germany, South Africa and the United States to diagnose such viral haemorrhagic fevers is helping Angola fight the outbreak of Marburg, for which there is no vaccine or treatment.

Thus early diagnosis and isolation are vital in detecting suspected cases in people who may have placed numerous others at unusually high risk for the disease with epidemic potential, which has already killed 173 of the 200 victims in the current outbreak and has now affected six provinces, all in the northwestern part of the country.

Yesterday the UN launched a three-month $3.5 million flash appeal to combat Marburg, of the same family as the deadly Ebola, which begins with severe diarrhoea, abdominal pain, nausea, vomiting and chest and lung pains, with a high proportion developing severe haemorrhage in the gastrointestinal tract and lungs.

Close contact with bodily fluids of infected people, as in medical care or burial, appears to increase the risk of infection and the UN Office for the Coordination of Humanitarian Affairs (OCHA) says the most urgent needs are protective clothing for health workers, disinfectants, body bags, emergency kits and essential drugs.

In its latest update, WHO says sophisticated laboratory studies may help shed some light on certain unusual features of the current outbreak, including the high fatality rate and the overwhelming concentration of initial cases in children under five years.

A longer-term objective is to determine where the virus hides in nature between outbreaks. It appears to be geographically confined to a few countries in southern Africa and was first identified in 1967 during outbreaks among laboratory workers in Marburg and Frankfurt, Germany, and Belgrade, Yugoslavia. These were linked to infected monkeys imported from Uganda.

The previous highest toll occurred from 1998 to 2000 in the Democratic Republic of the Congo (DRC), when 123 people died out of 149 cases. The current outbreak has spread and killed in just a few weeks.

From United Nations



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