Public health officials in Angola say the deadly Marburg virus is not out of control in northern Angola. According to the country's health ministry, there were 261 cases and 237 deaths as of Monday. The officials say they hope to know soon whether the disease has peaked.
Angola's health ministry says it is finding cases of Marburg virus in places other than the northern province of Uige, where it broke out. Cases have appeared in Luanda Province, in Cuanza Norte Province next to it, and in neighboring Zaire's Kabinda Province. But vice health minister Jose Van Dunem says all known cases are among those who have visited Uige and so far no transmission has occurred among people outside that area.
"All cases are in Uige Province,” he said. “The cases that have taken place in Luanda, in Kabinda, in Cuanza Norte have been exported from Uige."
The vice-minister was among several public health officials who spoke from Luanda by video link to the Center for Strategic and International Studies in Washington.
The lack of Marburg transmission outside Uige is one sign giving officials hope that the outbreak can be contained. One of the U.S. government experts participating in international control efforts in Angola, physician Tom Ksiazek of the Centers for Disease Control in Atlanta, says there are other hopeful conditions.
"In terms of things that make us assured that it's not out of control, it takes very close contact with known patients, usually very seriously ill, to become infected with this virus,” he explained. “Those circumstances unfortunately continue to some extent and thus transmission continues. But this is not a disease that is going through the general community in Uige. Should those circumstances change, then there would be a need for much greater concern."
However, the World Health Organization (WHO) coordinator of Marburg control activities in Angola, physician Fatima Diallo, says public health officials cannot say for certain that the number of cases has reached its peak. She does say that the spread is slowing and expresses confidence that the outbreak will peak soon if the trend continues.
"We have a very good trend, actually. We are tracking properly all the contacts. We have a clear picture of what is going on in the community. From that, we feel in the coming days we can start talking about prediction, and if we have already reached the peak or not, if we are in the face of the decreasing of this outbreak. But we are confident that we will contain this outbreak very soon," she said.
The Angolan government has mounted a public information campaign using the mass media, trucks with loudspeakers, teachers in schools, and traditional healers to tell people to avoid physical contact with Marburg patients. The campaign is also asking people not to touch corpses of those who have died from the disease, which is a common practice as relatives kiss the body and cleanse it before burial.
At the U.S. Centers for Disease Control (CDC) in Atlanta, infectious diseases expert John Jernigan says there is little chance that Marburg virus will spread globally from Angola.
"The likelihood of such imported cases seems low given the nature of the mode of transmission of this particular virus and the nature of the travel patterns associated with the primarily affected areas," he added.
If cases are imported from Angola, Dr. Jernigan says routine hospital infection control precautions such as patient isolation should prevent their spread.