Dr. Andy

Reflections on medicine and biology among other things

Tuesday, April 26, 2005

Marburg

An excellent article in today's New York Times about the recent outbreak of Marburg virus in Angola.

Among the interesting tidbits:
Traditional healers here say their grandmothers knew of a bleeding disease similar to the current epidemic of hemorrhagic fever that has killed 244 of the 266 people who have contracted it. The grandmothers even had a treatment for the sickness, the healers told Dr. Boris I. Pavlin of the Centers for Disease Control and Prevention. But the remedy has been lost. The old disease was called kifumbe, the word in the Kikongo language for murder.

But kifumbe did not seem to be contagious. And so, Dr. Pavlin said, though he did not doubt it was real, it was probably not the same as the disease in Uíge today.
It is interesting to speculate that various hemorrhagic fevers exist in non-human primates and occassionally jump to the human population. What exactly kifumbe was we can only guess, but a non-contagious disease that kills a few people in an underdeveloped country probably won't get much attention.

The paradox of the high mortality rate is also explained, colorfully
"It is easier to count the dead people," said Dr. Pierre Rollin, a physician in the special pathogens branch of the C.D.C. "The numbers in the beginning don't mean anything."
The article also gives us some useful information about the animal reservoir:
It must have a natural host in some animal, but one that is not known for Marburg or Ebola. The host would have to be a species that is not wiped out by the virus. That requirement would rule out monkeys and apes, because when they catch Marburg or Ebola, they have even higher death rates than people do. Health authorities in Africa warn people to stay far away from the corpses of dead primates, because they may have died of Ebola.
There is some indication bats may be the primary carrier, then spread them either directly to humans or to non-human primates.

Finally, this article and another one from the day before suggest that what they call traditional healers may have helped spread the virus:
The experts suggest that the healers, who lack medical training and supplies but are a substitute for doctors in many rural African communities, are administering injections in homes or in makeshift clinics with reused needles or syringes.
Someow it doesn't seem like injections with reued needle or syringes qualify as traditional healing, but clearly these kind of practices are a disaster waiting to happy.

Full props to the New York Times for their coverage of this story. They have one reporter actually in Angola where the outbreak is going on and seem to have by far the best reporting on this from both a news and a science perspective.

Be sure to check out the cool multimedia features with the original article

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