Fear, ignorance fuel Marburg outbreak in Angola

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Fear and ignorance are fueling the world’s deadliest outbreak of Marburg fever in Angola, where locals are too suspicious of medics in “astronaut” suits to let them take away infected loved ones, aid workers said on Monday.

Terrified residents stoned World Health Organization (WHO) workers’ vehicles late last week, putting a brief halt to their operations to contain the disease in Uige province, northeast of Angola’s capital Luanda.

"We no longer have people coming to the isolation ward—people are hiding their patients at home because they’re scared. That means the virus keeps on spreading in the community,” Monica Castellarnau, emergency coordinator for Medecins Sans Frontieres (MSF) in Uige, told Reuters by phone from Uige.

The outbreak has killed 192 of the 213 known cases. There is no cure for the disease, which is related to Ebola.

“We’ve become scapegoats. That’s how people express their fear, grief and anger at the situation. They see we’ve got an isolation ward with very restricted access—they think we’re doing funny things,” Castellarnau said.

“People have not been given sufficient information to understand the measures that are necessary to stop the virus ... It’s crucial people understand the public health risk of keeping sick people at home. Only then can we start to control the spread of the virus,” she said.

Marburg, a rare hemorrhagic fever, is spread through contact with bodily fluids including blood and saliva. Symptoms include headaches, internal bleeding, nausea, vomiting and bloody diarrhea.

MSF has opened the city’s only isolation ward in a cordoned-off section of the general hospital.

But Castellarnau said the hospital should be closed to all non-Marburg cases to avoid it becoming a source of infection.

“We have strongly recommended that the hospital be closed temporarily and this is because the risk of infection at the hospital is unacceptably high,” she said.

Health workers have said basic hygiene rules are still not fully observed in Angolan hospitals.

Emergency measures to deal with the outbreak have stretched to the limit Angola’s healthcare facilities, which have been left in tatters after decades of civil war.

But many locals have not welcomed the strange-looking healthcare workers who have descended on Uige city dressed in full protective clothing.

Experts say that is to be expected.

“Wherever there is (an) epidemic we are used to seeing ... hostility, sometimes from the community, because we are interfering in how they are living,” said WHO country representative Fatomata Diallo.

“Especially in this kind of epidemic where you have to have special clothes, like an astronaut, and come into the family to take a sick person or suspected case. When you come to take away a body, a dead body, with all this kind of clothing, sometimes it is not easy for the community to accept it,” she said.

Marburg gets its name from the German town where it was first reported in the 1960s after researchers there contracted it from monkeys imported from Africa. The previous worst recorded outbreak was during a 1998-2000 epidemic in the neighboring Democratic Republic of Congo when 123 people died.

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