Dealing With Disease in Uige, Angola

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Dealing With Disease in Uige, Angola

Journal Entry for April 21, 2005

Yesterday, Angola's Ministry of Health announced that there have been 266 documented human infections of the Marburg epidemic since the current outbreak began in October of last year. 244 of these cases have been fatal, providing a horrific mortality rate which can be attributed both to the largely unknown and uncontrollable nature of this disease, and the impoverished state of the nation it is afflicting.

Unfortunately, it took us five months from the first suspected cases of the outbreak to positively identify the cause as the Marburg virus. The region's medical facilities are severely overburdened and under-staffed due to the decades of civil war which have plagued Angola. So, when the epidemic began late last year early cases were mistaken for other more common diseases such as typhoid and malaria--which have similar symptoms to the Marburg virus.

On the first symptomatic day, an infected person suffers from an extremely high fever. The extent of this fever quickly drains the individual of energy, leaving them in a weakened state. By the third day extremely watery diarrhea has begun which will last for a week if the infected is lucky enough to survive so long. The diarrhea also comes with intense abdominal cramps, nausea, and vomiting. The result is a patient left in a state of dehydration and excruciating pain, weakened and unable to clean the contaminated fluids he or she is expelling. Now having faced days of extreme fever and fatigue, the person resembles a corpse with an expressionless face, deep-set eyes and total lack of energy. Between the fifth and seventh days hemorrhages appear on the body, often open to bleeding. Additional blood is excreted in the individual's vomit and feces, as well as from the nose, and gums. This prevalence of contaminated bodily fluids has been part of the reason why reason the epidemic has continued to spread despite our efforts to contain it. Death generally occurs within about two week of symptoms. There is no known cure, so the most our team can do for the infected is to keep their fluid levels high in order to counteract the effects of fever and diarrhea.

The Marburg epidemic is a RNA virus of the filovirus family--whose only other known members are the four Ebola viruses.

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