Military

19 April 2005

Angolan Optimistic About Containing Marburg Virus Outbreak

Dr. J. Van-Dunem cites "social mobilization" as key factor in successful control

By Jim Fisher-Thompson
Washington File Staff Writer

Washington -- An outbreak of the killer Marburg virus beyond northern Angola is being successfully controlled thanks to a combination of frontline assistance by international health agencies and "social mobilization," says Angola's top health official.

Speaking April 19 via a video satellite hookup from Luanda, Angolan Vice Minister of Health Dr. Jose Van-Dunem told a workshop in Washington, sponsored by the Center for International and Strategic Studies (CSIS), he was "hopeful about stopping an outbreak" of the disease because of foreign help and efforts to galvanize public action in a process called “social mobilization.”

The Angolan health official thanked international partners for "giving us the skills, support and confidence" to fight the virus as well as to help set up a "strong [disease] surveillance system" to monitor and control future outbreaks.  He singled out the United Nations World Health Organization (WHO), the World Bank, the U.S. Centers for Disease Control and Prevention (CDC), the Portuguese government, and local U.S., French, British and Spanish embassies.

The Marburg virus causes hemorrhagic fever and is related to Ebola Hemorrhagic fever. It was first identified in 1967 when an outbreak occurred in Marburg, Germany, among laboratory technicians handling blood from African monkeys.  The virus, which interferes with the body's normal blood-clotting ability, is spread through transfer of bodily fluids and has a fatality rate ranging from 25 to 100 percent.

Since it arose in Angola in September 2004, the disease has been mainly confined to the northern province of Uige, where 277 people have died, Dr. Van-Dunem told the workshop led by CSIS Africa Director Steve Morrison.  The Angolan acknowledged Marburg victims were traced outside rural areas in Uige but he claimed they have not spread the disease to the cities.

Van-Dunem said some victims living in the countryside traveled to nearby towns to be near family after they became seriously ill and realized they were dying.  Now, special “social mobilization” teams are fanning out into local "municipalities to search for those cases and take care of the bodies" because the virus is so infectious.

Dr. Tom Ksiazek, chief of the Special Pathogens Branch of the CDC, also spoke from Luanda supporting Van-Dunem's claim that the virus had been contained.  The U.S. health official noted that blood specimens examined by a special CDC laboratory in Angola confirm that "active transmission of the [Marburg] virus was limited to the area around Uige [province]."

Van-Dunem emphasized “social mobilization” teams were critical to educating the public of the need to report Marburg cases because "getting communities to be part of the outbreak control strategy" was a key factor in public health policy.

Traditional healers also play an important role in that strategy, said Dr. Fatima Diallo, a WHO expert helping to fight the virus in Angola.  Calling traditional healers "a very powerful" resource in “social mobilization,” she said, "We need to reach them because they are part of the health system.  We need to inform them [about Marburg] and get them skills to help transport victims to isolation wards."

She added, "We also have a very good involvement with the Angolan military," which provided “social mobilization” personnel who traveled throughout the country "to train people to prevent and handle such outbreaks."

U.S. Ambassador Cynthia Efird, who moderated the Luandan end of the workshop discussion, cited the Angolan government's National Technical Commission for its efforts in coordinating the national and international responses to the outbreak.  She also called attention to Portugal as "the first country to provide assistance" in the fight against the virus.  American efforts were led by the CDC, the U.S. Agency for International Development (USAID) and the Defense Department's European Command (USEUCOM), according to the ambassador.

The U.S. diplomat also singled out several nongovernmental organizations as "active participants," including Doctors Without Borders and the United Nation’s Children’s Fund (UNICEF).

Efird also said the private sector played an important role in the effort to combat the Marburg virus.  "International corporations, especially Chevron/Texaco, Exxon/Esso, BP and Total all provided important assistance during this crisis," she added.

(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)