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Lessons for Ebola Crisis in 2005 Marburg Outbreak

Friday, 10 October 2014 07:57 AM

When I see the footage of health workers in protection suits taking up the fight against Ebola in west Africa, memories come flooding back.
Nine years ago, I took a Reuters team into the heart of another hemorrhagic fever catastrophe, the 2005 Marburg virus outbreak in northern Angola. I saw what it took to bring it under control.

The outbreak was much smaller. In the final analysis, some 227 people were believed to have died - at its peak it was thought higher but laboratory testing showed some cases were misdiagnosed.

Still, in many ways it was a microcosm of the current crisis.

As with Ebola now, Marburg - a fever that kills through massive internal bleeding - leapt out of the jungle into a region struggling to recover after decades of war.

Similarly, it overwhelmed fragile medical facilities, killing doctors and nurses and fuelling panic and horror.

The world, perhaps belatedly, responded. By the time I arrived in April 2005 with a four person Reuters team, the United Nations World Health Organization and other aid groups were starting to have an effect.
Ultimately, however, it was local people who broke the cycle of infection.
That meant overcoming some of the most natural human instincts, making people so scared they were no longer willing to treat their own sick loved ones.

It was all about fear and in the end, the right kind of fear won.

Mercifully, the sheer isolation of Uige and Angola's destroyed transport infrastructure helped limit the virus' spread. In the local area, however, it wreaked havoc.

By the time we flew in, almost all essential supplies were running out. Trucking firms were simply avoiding the region. 

The first international health teams were met with hostility and fear. Getting the population onside required huge compromises and greater risk for the medics.

In the early days, teams from WHO and elsewhere wore full body protective gear as soon as they left their vehicles before entering crowded slums to check the sick and the dead.

The teams were attacked, at one stage entirely pulled from their work. Terrified residents, health workers said, were convinced it was the specialists spreading the virus.

Almost no one was willing to bring sick relatives to hospital. As with Ebola, the virus was spread through bodily fluids - blood, sweat and urine in particular. Through looking after their loved ones, wider families became infected and died.

Gradually, things started to change. The health workers changed their tactics, making their way to the doorsteps of affected homes in regular clothing, only then pulling on their isolation suits.

The day before we flew out, a UN anthropologist told me a story that made them think they were finally winning.

In a village outside Uige, a pregnant woman had begun to vomit blood. Her husband had heard the warnings. Instead of nursing her, he locked her in the house, took his children out and called the authorities.

By the time they arrived two days later, she was dead.    

He was utterly heartbroken, no longer sure he wanted to live. But the family survived.

"It is impossible for us to tell how he was feeling," the anthropologist told me. "We're working so hard to save people that we do not have time to cry for the dead."    

The scale of the current crisis dwarfs that of the Angola outbreak, close on 4,000 infected, more than half of them dead.

That is a much lower mortality rate than Marburg in Angola but that only serves to make the virus more virulent. Marburg killed so quickly it limited its own spread.

In Sierra Leone and Liberia, in contrast, the higher survival rate means more victims seek out hospitals. Families take sweating sickening relatives from health center to health center in search of the handful of spare beds. The taxis that take them, health experts say, become vectors for transmission and further infection.

The broadening international aid effort, now including several thousand U.S., British and other foreign military medics as well as engineers and logistics experts, will doubtless build medical capacity and probably save lives.

Once again, however, I fear that what it will really take is persuading ordinary people to overcome their strongest instincts and abandon their sick. 

Peter Apps is Reuters global defence correspondent. His E-book "Before Ebola: Dispatches from a Deadly Outbreak" was published this week by Amazon Kindle Singles.

© 2019 Thomson/Reuters. All rights reserved.

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When I see the footage of health workers in protection suits taking up the fight against Ebola in west Africa, memories come flooding back. Nine years ago, I took a Reuters team into the heart of another hemorrhagic fever catastrophe,the 2005 Marburg virus outbreak in...
marburg, virus, ebola, angola
Friday, 10 October 2014 07:57 AM
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