The situation is still alarming.

Six weeks after the confirmation of the Marburg fever outbreak in Angola through biological tests on March 22nd, the epidemic is still not under control. The official toll as of April 30th is of 271 deaths and 301 cases. The disease has taken a heavy toll among the medical staff, at least 19 of them have died.

The situation is still alarming. Collection of bodies takes place every day in the city of Uige, main focus of the epidemic. Since the alert was given, a new focus has sprouted in the hospital of Songo, about 50 kilometres northwest from Uige.

Many problems remain unsolved and new difficulties arise every day. Last week, three Marburg cases died in different wards of Uige hospital. The infection control system put in place has been inefficient. The World Health Organization (WHO), that was supporting the Angolan Ministry of Health in the implementation of this system, recognized last Friday that "under such conditions, amplification of transmission is highly likely to occur". In order to protect both the patients and the medical staff, and in response to a request from the authorities, Mèdecins Sans Frontiéres (MSF) will step up responsibility for infection control. All wards will be disinfected and a stringent triage of patients needs to be put in place in order to temporarily restrict admissions to life-saving emergencies. For these measures to succeed it is imperative that they be strictly respected.

As a consequence of this new situation, the peripheral health centres need to be reinforced in order to deal with the additional flow of patients and treat diseases other than Marburg fever. The local health authorities and the WHO need equally to improve the system of identification of suspect cases and the follow up of people that have been in contact with infected patients. MSF believes that to control the epidemic it is vital to inform the population about the disease and its prevention. Families and patients must receive the support from the authorities, the community and all present actors in this crisis. Violence and threats to families affected will only worsen the situation and lead to stigmatisation.

MSF has treatment wards for Marburg patients in Uige, Songo, Negage and Luanda. These centres allow MSF to isolate the cases and take care of the patients. MSF is also collecting patients and bodies in the community and carries out burials respecting the strictest bio-protection measures. Sensibilisation activities have also been intensified so that these public health measures can be understood by the population.

MSF has 55 expatriates working in this emergency.


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