ZKEA

Biological Warfare : Biological Terrorism : Emerging Diseases

Archived News
Week ending April 18th, 2005

Flu used to be the "Rodney Dangerfield of diseases," as Tim Uyeki puts it. Uyeki is a flu epidemiologist at the Centers for Disease Control and Prevention (CDC) in Atlanta, and he's been concerned that for years people didn't give influenza the respect it deserved.

But now flu has all the attention any germ can get. First, there was a flu vaccine shortage over the winter, prompting long lines and provoking rage from people who couldn't get their shots. Later, bird flu mesmerized the world, with the CDC and the World Health Organization (WHO) keeping up a steady drumbeat: A flu pandemic -- overdue for decades -- would be upon us at any moment. Finally, it was announced that a pandemic flu strain had been accidentally sent to influenza labs around the world as part of a testing kit by Meridian Bioscience, a contractor for the College of American Pathologists.

The jittery WHO, poised for catastrophe, insisted on the immediate destruction of the strain, for fear of accidental release. And while the threat posed by Meridian's error is far less than initial reports suggested, the reality is that lab accidents do happen. What's more, the feverish anxiety of public health officials to head off a new influenza pandemic may be generating the greatest influenza threat we face.

The threat is man-made. Scientists in the United States and Great Britain are studying the deadliest flu epidemic of the last century, the 1918 pandemic. In order to learn what made it kill so many, they are working on producing artificial viruses that replace common human flu genes with 1918 genes. An accidental release of one of their constructs could make the Meridian error look as menacing as a cauliflower.

The flu strain sent out by Meridian is known as H2N2/Japan. H2N2 strains first appeared in 1957..

The death toll in Angola from an epidemic caused by an Ebola-like virus rose to 174 Friday as aid workers in one northern provincial town reported that terrified people had attacked them and that a number of health workers had fled out of fear of catching the disease. International health officials said the epidemic, already the largest outbreak of Marburg virus ever recorded, showed no signs of abating. Seven of Angola's 18 provinces have now reported suspected cases and several neighboring countries have announced health alerts.

"It's becoming a huge problem," said Dick Thompson, a spokesman for the World Health Organization, which has dispatched surveillance teams to the country's northern provinces. "We clearly don't know the dimensions of the outbreak."

Health officials said some Angolans are hiding sick relatives out of fear that they will die if taken to the hospitals, thereby increasing the chance the disease will spread. There is no cure or vaccine for the highly contagious virus. Victims suffer a high fever, diarrhea, vomiting and severe bleeding from bodily orifices and usually die within a week. The initial outbreak appears to have spread through a pediatric ward in Uige, a town in a farming district about 180 miles north of the capital of Luanda. More than 60 percent of the victims so far have been children.

One health official in Uige said that more than a dozen health care workers have perished from the disease, including two doctors, and that many workers are deserting the town's hospital in fear. Some townspeople are refusing to allow their sick relatives to be taken to an isolation unit set up at the hospital there by Doctors Without Borders, fearing it leads only to a graveyard.

As field workers tried to trace suspected cases in two Uige neighborhoods Thursday, townspeople threw stones at them, accusing them of killing people who had been taken away sick and who were returned to them dead. The violence forced the health workers to suspend their checks, according to officials from the World Health Organization and Doctors Without Borders. The government has dispatched soldiers to the province but so far made only a limited effort to educate an increasingly terrified public.

"We want people to understand that in a public health emergency you sometimes have to take unpopular measures," said Monica Castellarnau, the emergency coordinator for Doctors Without Borders in Uige. "At the moment all they understand is that we take someone to a locked-up place in a hospital, and then they die."..

edical experts are having some success countering an outbreak of a deadly Ebola-like virus in Angola, but it has yet to be brought fully under control, the U.N. health agency said Friday.

The rare Marburg virus has killed 174 people out of a total 200 cases, said Dr. Mike Ryan, director of alert and response operations for the World Health Organization.

"The situation right now in Angola is not under control yet," Ryan told reporters in Geneva. "This is still a crisis, and a health crisis on a national level."

The disease first appeared in the northern province of Uige in October, and Ryan said officials had since seen some success against the virus there. Several deaths attributed to Marburg have been reported in four other provinces, but all the victims had been in Uige. Two cases have been confirmed in Angola's capital, Luanda, but there has been no transmission of the virus there.

Like Ebola, Marburg is a hemorrhagic fever. It spreads through contact with bodily fluids and can kill rapidly. There is no vaccine.

To stop transmission, all possible Marburg contacts need to be followed up, and this is made more difficult by Angola's damaged infrastructure. Containing the virus requires "a profound commitment" from Angolan authorities and the international community, Ryan said. WHO, the U.S. Centers for Disease Control and Prevention and Doctors Without Borders have deployed teams in Uige to combat the virus...

The World Health Organization is investigating an outbreak of hemorrhagic fever in northwestern Angola, it said Friday.

` As of Thursday, 205 cases of Marburg hemorrhagic fever had been reported in the country, and 180 of those affected had died. Seven provinces have been affected, the latest being Zaire province, where six cases have been reported, the WHO said in its most recent update.

"It is a very, very dangerous and lethal virus in human beings," Mike Ryan, director of alert and response operations for WHO, told CNN. The virus -- in the same family as the Ebola virus -- spreads through blood and body fluid contact.

In this case -- only the second natural outbreak of the virus -- there is evidence it has been amplified through ineffective containment in hospitals, Ryan said.

According to WHO, the first large outbreak under natural conditions occurred from 1998-2000 in the Democratic Republic of Congo. Some Angolans have taken their anxiety out on health workers. Mobile surveillance teams in Uige were forced to suspend operations Thursday when vehicles were attacked and damaged by residents, the WHO said Friday. "As the situation has not improved, no surveillance teams were operational today in the province."

In addition, organization staff in Uige were notified Friday of several workers' fatalities, but teams were unable to investigate the causes of death or collect the bodies...

The outbreak of the deadly Marburg virus in Angola is worse than Ebola, a UN disease expert said, as the world body launched an urgent appeal for funds to fight the fever which has claimed 180 lives.

"Marburg is a very bad haemorrhagic fever, even worse than Ebola," said Allarangar Yokouib from the UN World Health Organisation (WHO).

"We have had several Ebola epidemics in the region but none with such a high mortality rate," he told reporters at a press conference in Luanda. In Geneva, the WHO said the world's worst-ever outbreak of the virus was not yet under control.

The world body on Friday launched an emergency appeal for 3.5 million dollars (2.7 million euros) to "intensify the fight" against the outbreak which "was the largest ever recorded and still growing."

"The appeal for 3.5 million dollars will enable UN agencies, including the WHO, UNICEF and the WFP to support the Angolan government intensifying outbreak control efforts," said the UN's resident co-ordinator in Angola, Pierre-Francois Pirlot. "It is clear that this epidemic is unprecedented not only in Angola, but everywhere. It is the biggest epidemic of haemorrhagic fever so far," he said.

Most of the victims ...

The World Health Organization is investigating an outbreak of hemorrhagic fever in northwestern Angola, it said Friday.

As of Thursday, 205 cases of Marburg hemorrhagic fever had been reported in the country, and 180 of those affected had died. Seven provinces have been affected, the latest being Zaire province, where six cases have been reported, the WHO said in its most recent update.

"It is a very, very dangerous and lethal virus in human beings," Mike Ryan, director of alert and response operations for WHO, told CNN. The virus -- in the same family as the Ebola virus -- spreads through blood and body fluid contact. In this case -- only the second natural outbreak of the virus -- there is evidence it has been amplified through ineffective containment in hospitals, Ryan said. According to WHO, the first large outbreak under natural conditions occurred from 1998-2000 in the Democratic Republic of Congo. Some Angolans have taken their anxiety out on health workers.

Mobile surveillance teams in Uige were forced to suspend operations Thursday when vehicles were attacked and damaged by residents, the WHO said Friday. "As the situation has not improved, no surveillance teams were operational today in the province."

In addition, organization staff in Uige were notified Friday of several workers' fatalities, but teams were unable to investigate the causes of death or collect the bodies for burial. Discussions "to find urgent solutions" were under way with provincial authorities, the WHO said. A WHO worker in Angola told CNN that health workers had been killed by residents who erroneously believed the workers were exposing them to the virus...