Marburg outbreak breeds fear in Angola hospitals

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Amid fears the deadly Marburg virus may reach Angola’s capital, staff at state hospitals in tatters after a ruinous civil war said on Wednesday the government must do more to protect them.

“Of course we’re all panicking. Everyone’s scared, there’s no cure for Marburg,” said a male nurse at one government hospital in Luanda who requested anonymity.

The viral hemorrhagic fever, characterized by headaches, nausea, vomiting and diarrhea accompanied by blood, is spread through bodily fluids including saliva and perspiration.

Medical workers who may have direct contact with potentially infected patients are advised to exercise the most caution, but staff said not enough was being done to ensure staff safety.

“The government should be doing a lot more to protect us. In some hospitals, medical workers aren’t even wearing protective clothing,” said the nurse.

“In private institutions the preventative measures are much more rigorous. In state hospitals I’m not sure they’ve got the means to protect us,” added a female colleague.

The latest figures available show the disease had killed 117 out of 124 people known to be infected as of Tuesday. The Centers for Disease Control and Prevention in Atlanta says the usual death rate is 23 percent to 25 percent, but few infected patients are reported to have recovered in this outbreak. There is no known cure.

While all the known cases have originated from Angola’s northern Uige province, medical workers in Luanda said they could not be sure Marburg had not already spread to the capital, only 150 km (100 miles) southwest of Uige province.

“Luanda’s the province where it’s most likely to spread to. Maybe it already has, but hasn’t been registered yet,” the male nurse said. “Many sick people are refusing to go to hospital because they think if they do, they’ll catch the disease.”

Angola has told people who have visited Uige to stay in Angola for at least 21 days—the virus’s incubation period.

Nearby countries have scrambled to stop Marburg spreading. The Democratic Republic of Congo, Republic of Congo, Zambia and Namibia took steps to prevent infected people crossing borders.

Further afield, Kenyan health authorities are on alert for Marburg, and may consider screening air passengers from Angola.

SHATTERED HEALTH SYSTEM

The outbreak has highlighted the deep cracks in Angola’s health system three years after the end of a 27-year civil war.

“The medical sector is already very bad, and now we have got a real emergency on our hands. This epidemic is going to weaken it even more,” said the female nurse.

Luanda’s oil-driven expatriate community is worried and even though most companies say it is business as usual, sources say some executives have provisionally booked plane seats out.

“There is certainly, among some communities here, a movement of panic that is not justified by the situation. But there exists a certain risk and precautions need to be taken,” said Pierre-Francois Pirlot, resident representative of the United Nations Development Programme (UNDP).

The U.N. told staff this week to defer non-essential travel to Uige and urged those already there to be careful and avoid physical contact especially with people in health facilities.

But an official at one of the U.N. agencies said even personnel working in the capital had been told to step up personal hygiene, avoid kissing or shaking hands. 

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