Bioscope ‘05

by Dr. Barbara Price

Marburg Fever

          The recent and continuing outbreak of Marburg fever is disturbing because it has come closer to western civilization and has a higher mortality than previously thought. Two cases have now been found in the capitol of Angola and the two men with this disease had been in the Uige Province, the epicenter of the current outbreak.
          The current outbreak, believed to have started in October 2004, is 210/231 (91%), ProMedMail, April 12, 2005. The mortality of Marburg had previously been at about 25% (according to CDC at http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg/qa.htm), although with so few total cases, the accuracy of this might have been questioned. The last large outbreak was in the Democratic Republic of the Congo in 1998--2000 and it had a mortality of 123/149 (82%). Does the higher mortality in 2000 and 2005 mean the reported cases have decreased or is the mortality really higher and why? Additionally the reports show that the majority of deaths are at an age of 5 and below - children.
          As noted below, China does have a special interest in Angola and the scientific and medical teams deployed in Angola include three of their experts in epidemiology. In Angola the government reported, "the Chinese ambassador said that his country will analyze the situation caused by the Marburg virus to find out the concrete support to be taken to the areas affected by this disease." March 30, 2005. But, as many other countries, last week China issued an order to all of their quarantine offices to better check visitors from Angola. As China looks for more secure oil sources, Angola has become China's second largest trading partner in Africa. Recent bilateral agreements have emphasized oil, gas and mineral (exports to China) and include about US $500 million from China's telecom industry investments in Angola.
          Avian Flu. WHO gives the current cumulative numbers for human avian flu (A/H5N1) since Jan 28, 2004 as total deaths 50 out of 80 cases, ( Cambodia 3/3, Thailand 12/17, and Viet Nam 35/60). The countries which have had infected birds (over 100 million in 2003 -- 2004) are Cambodia, China, Indonesia, Japan, Lao, South Korea, Thailand and Vietnam.
          North Korea has reported an H7 strain of avian flu, but so far has not reported H5N1. North Korea is believed to be fully cooperating with WHO, a big step for North Korea and one done with the understanding of the threat avian flu poses to the world, especially if H7 resorts with the H5. Human to human transmission can occur with the H7 viruses, which makes a possible H7 virus with genetic material from the more lethal H5N1, more likely to stretch to become a pandemic.