- As more than 150 Angolans in five provinces have died from the current outbreak of the Ebola-like Marburg epidemic, Angola's Ministry of Health claims the situation is under control. The UN, on the other hand, today holds that the outbreak is not under control and that "significant international aid will be needed to control" the epidemic.
According to the latest numbers released by the World Health Organisation (WHO) and Angola's Ministry of Health, there are now 163 confirmed cases of Marburg fever in the country, with 150 of them fatal. New cases are reported every day.
The Angolan government publicly insists that the Marburg outbreak is confined to the northern province of Uige, at the border with Congo Kinshasa (DRC). The outbreak's "focus remains limited to" Uige, an Angolan Health Ministry official said yesterday.
According to the WHO, which again refers to the same Angolan Ministry, the outbreak is however spreading. "Cases have been identified in Uige, Luanda, Cabinda, Malange, and Cuanza Norte provinces," the UN agency said in an update yesterday, however adding that "Uige remains the epicentre of the outbreak."
According to this new information by the WHO, "to date, all cases detected in other provinces are thought to have originated in Uige." The UN agency thus claims that no one has been infected with the Marburg virus outside Uige, in contradiction to earlier statements. There had earlier been reports of several deaths in the Cabinda exclave indicating a new epicentre, in addition to reports on health personnel infected in Luanda, the capital.
Efforts to control the outbreak however remain confined to Uige. According to the WHO, there are now five mobile surveillance teams in Uige, which "continue to investigate rumours and search for additional cases." Angola would not have the capacity to increase the surveillance area as the vast country only counts on an estimated 1,200 doctors.
The Angolan government, while publicly downplaying the Marburg outbreak, already last week asked for emergency aid from international organisations and from the armed forces, saying it did not have enough health personnel to fight the epidemic. Also the WHO emphasised today that "significant international aid will be needed" to control the spread of the deadly Marburg virus.
The strain of the virus that is causing the current outbreak seems to be especially vicious. The outbreak in Uige is already the largest ever recorded, with a 1998-2000 outbreak in Congo Kinshasa (149 cases, 123 of them fatal) setting the previous record. It further seems more deadly and contagious than earlier strains. The fatality rate is estimated at 100 percent.
Despite the Angolan government's limited possibilities of meeting the crisis, great efforts are made to prevent the outbreak from spreading. The WHO is currently working with Angola's Ministry of Health to finalise a national plan of action to control the outbreak. However, "WHO anticipates that implementation of this plan will require significant assistance from the international community," the UN agency says.
So far, the international efforts made to control the outbreak at least seem to have prevented the Marburg virus to cross borders into neighbouring countries. Health Minister Daniel Movando of Congo Kinshasa, which borders Angola's Uige province, yesterday said that there were no cases in is country. "Our research in two suspected cases of Marburg virus in the border town of Matadi show that no cases have been confirmed," said Dr Movando.
Marburg occurs very rarely and appears to be geographically confined to the southern half of Africa. It was first identified in 1967 during simultaneous outbreaks affecting laboratory workers in Marburg and Frankfurt, Germany, and in Belgrade, Yugoslavia. The outbreaks, which involved 31 cases and seven deaths, were subsequently linked to contact with infected monkeys imported from Uganda.
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