Bio-suits, fear at center of Angola Marburg outbreak

Swathed head-to-toe in protective medical gear, doctors fighting Angola’s deadly Marburg virus swelter in an isolation unit at the epicenter of the worst-ever outbreak of the deadly disease.

“These are difficult working conditions, especially with the heat,” Monica Castellarnau, Medecins Sans Frontieres (MSF) emergency coordinator for the outbreak, said by telephone from Uige, about 140 miles north of the capital Luanda.

“They must have short shifts, usually every three hours they have a break,” she said on Wednesday. “The hardest thing for the medical people is their feeling of helplessness. They know there is no cure for the disease.”

So far at least 156 people have died of the disease in Angola. The previous record was 123 deaths during a 1998-2000 epidemic in the Democratic Republic of Congo.

Doctors and nurses treating Marburg patients can offer little beyond treatment to ease the pain - and even that is limited by the fact that patients are rarely given injections to avoid accidental infection of health staff.

The rare hemorrhagic fever, which is related to Ebola, is characterized by headaches, nausea, vomiting and bloody diarrhea. It is spread through close contact with bodily fluids including blood, saliva and semen.

Known as one of the most virulent diseases affecting mankind, Marburg has a fearsome reputation and is known to bring an exceptionally gruesome death.

Faced with this enemy, medical staff working at the specially set up isolation unit at Uige’s provincial hospital are taking no chances and are using “full bio-protection suits” that take half an hour to put on and a grueling 45 minutes to take off, a procedure that presents the most risk of contamination.

POPULATION TRAUMATISED

Castellarnau, who has been in Uige for 10 days, said while many people in the city had no choice but to go on with their daily lives, it was clear the population was traumatized.

“They’re very scared. Now we have a big problem in town because people don’t want to touch dead bodies,” she said.

“We mustn’t underestimate the trauma this has created among the population. People are scared to the point that even a dead husband or father is someone to stay away from,” she added.

Some local residents contacted by telephone said they had already lost friends to the epidemic and the hospital had become a focus of fear for the city of about 500,000.

“One of my close friends was a nurse working in the pediatrics ward when it all started. She died from the virus,” said Amelia Manuel, who lives near the hospital. “People are scared to go to hospital because that’s where it all started,” she said.

Castellarnau said it would take more resources and commitment to stamp out an epidemic she said was “far from being contained.”

“It’s like a big puzzle where all the pieces need to be in place if we don’t want all the efforts to go to waste,” she said. “We don’t know if we’re at the peak of the epidemic or if it’s still going up. But it’s not going down,” she said.

Provided by ArmMed Media
Revision date: July 6, 2011
Last revised: by Janet A. Staessen, MD, PhD