Man dies of Marburg fever in Uganda
2014-10-05

Kampala - A man has died in Uganda's capital after an outbreak of Marburg, a highly infectious haemorrhagic fever similar to Ebola, authorities said on Sunday, adding that a total of 80 people who came into contact with him had been put under quarantine.

Marburg starts with a severe headache followed by haemorrhaging and leads to death in 80% or more of cases in about nine days. It is from the same family of viruses as Ebola, which has killed thousands in West Africa in recent months.
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Full article at:
http://www.news24.com/Africa/News/Man-dies-of-Marburg-fever-in-Uganda-20141005

Interesting read - Interview with a scientist who discovered & named the virus 4 decades ago

http://www.spiegel.de/international/wor ... 93111.html

Almost four decades ago, Peter Piot was part of the team that discovered the Ebola virus. In a SPIEGEL interview, he describes how the disease was isolated and explains why the current outbreak is different than any that have come before.

B.B.C. - Spain investigates new case

Mike_L wrote:

Man dies of Marburg fever in Uganda
2014-10-05

Kampala - A man has died in Uganda's capital after an outbreak of Marburg, a highly infectious haemorrhagic fever similar to Ebola, authorities said on Sunday, adding that a total of 80 people who came into contact with him had been put under quarantine.

Marburg starts with a severe headache followed by haemorrhaging and leads to death in 80% or more of cases in about nine days. It is from the same family of viruses as Ebola, which has killed thousands in West Africa in recent months.
...

CONTINUED
Full article at:
http://www.news24.com/Africa/News/Man-dies-of-Marburg-fever-in-Uganda-20141005

Marburg (MVD) in the same family as EVB and probably has a similar reservoir in the fruit bat population. The person first infected was brought in from an outlying area and died in Kampala on Sunday, I hear unofficially that 8 others may have died, although this not confirmed. MVD works a bit faster than EVD and has a similar mortality rate.

kiore, how happy are you, too have left Africa?

DougC wrote:kiore, how happy are you, too have left Africa?

Still here.. have been delayed and due to go to Kampala on Sunday to visit embassy...
Anyway even when I go will be popping over to Sierra Leone every now and then to give a hand.

Apparently its all the Wests fault now.

I can't say how stay in your homes, don't steal infected patients and linin, don't spread it to others, required giant finances, but the West didn't pour in the cash and now is getting blamed by the great unwashed Russell Brand because they stop flights leaving.

Mike_L wrote:Seems as though it's going to get a whole lot worse before it gets better...

oh way worse.. one dire possibility being that this is happening in mainly Muslim countries I heard was a few infected might mosey on down to Mecca on pilgrimage and have it go world wide from there.

Peter Brown wrote:

Mike_L wrote:Seems as though it's going to get a whole lot worse before it gets better...

oh way worse.. one dire possibility being that this is happening in mainly Muslim countries I heard was a few infected might mosey on down to Mecca on pilgrimage and have it go world wide from there.

Of the three countries most hit by Ebola, only Guinea is predominantly muslim. And anyway the Saudis didn't accept any pilgrims from those countries for the Hajj this year.

What's with the Spanish nurse, anyway? You'd think a nurse in Spain would understand basic isolation techniques. Is this just a stupid nurse, a breakdown in infection control procedures, or a transmission vector they're not being forthcoming about?

laklak wrote:What's with the Spanish nurse, anyway? You'd think a nurse in Spain would understand basic isolation techniques. Is this just a stupid nurse, a breakdown in infection control procedures, or a transmission vector they're not being forthcoming about?

The person described as a Nurse is an auxiliary, involved in cleaning up, which is one of the more dangerous activities. Hard to say what happened and why they are investigating, perhaps a break in barrier protection at fault, I am currently teaching people to work in pairs, one doing and one watching for risks or breaks in protection. I do not think the early reports of the use of only level 2 protection sufficient for reasonable contact, however if they were cleaning up it is possible a fluid spill penetrated the level 2 suit which is splash resistant only.

I heard it might have been sub standard equipment. why am I not surprised, the ward I was on had a manager forever cutting out protocol as per manufacturer instructions to save a few pennies.

Peter Brown wrote:I heard it might have been sub standard equipment. why am I not surprised, the ward I was on had a manager forever cutting out protocol as per manufacturer instructions to save a few pennies.

Really the substandard equipment should not be the issue here, the level 2 equipment is good enough for most stuff (all we have) they were supposedly double gloving and taping and doing reasonable things.
More likely a breech in procedure where items not removed in the correct order and or followup washing done incorrectly, or alternately a fluid splash penetrating the barrier, these items are splash proof but will not resist soaking, and not being acted on.

It is easy to break procedure.. Your goggles mist up and you touch your face to clear or adjust them, you discard items in the wrong order contaminating a clean layer.. Why as I said I am training staff to work in pairs to lessen these risks.

DougC wrote:B.B.C. - Ebola death rates 70% - WHO study

Here's the paper for that study: http://www.nejm.org/doi/full/10.1056/NEJMoa1411100

The majority of patients are 15 to 44 years of age (49.9% male), and we estimate that the case fatality rate is 70.8% (95% confidence interval [CI], 69 to 73) among persons with known clinical outcome of infection.

Assuming no change in the control measures for this epidemic, by November 2, 2014, the cumulative reported numbers of confirmed and probable cases are predicted to be 5740 in Guinea, 9890 in Liberia, and 5000 in Sierra Leone, exceeding 20,000 in total.

kiore, maybe you can spread some light on this:
Why are the laboratory confirmed cases for Liberia significantly lower (as a proportion of the estimated cases) than either Guinea or Sierra Leone?

There are even more confirmed deaths than confirmed cases, which does not make sense at all to me.

We have it here at the local university. But we have also had the anthrax attack and the sniper, so life just goes on as normal.

Acetone wrote:kiore, maybe you can spread some light on this:
Why are the laboratory confirmed cases for Liberia significantly lower (as a proportion of the estimated cases) than either Guinea or Sierra Leone?

There are even more confirmed deaths than confirmed cases, which does not make sense at all to me.

I do not know for sure, but probably due to the testing being done disproportionately on well cases, those already dead or showing clear clinical signs will be assumed to be cases without lab tests. Really lab work a low priority in this setting, someone reporting a history and showing relevant symptoms during an epidemic will be a presumed case without the risk of taking samples.

kiore wrote:It is easy to break procedure.. Your goggles mist up and you touch your face to clear or adjust them, you discard items in the wrong order contaminating a clean layer.. Why as I said I am training staff to work in pairs to lessen these risks.

BBC reporting she admits she may have touched her face and broken protocol on the order of removing protection.
http://www.bbc.com/news/world-europe-29539444

A doctor in Madrid says the Spanish nurse infected with Ebola remembers touching her face with her gloves after treating a dying priest

and

Ms Romero told the El Pais newspaper that she might have become infected when removing her protective suit after cleaning Mr Garcia Viejo's room.

"I think the error was the removal of the suit," she told El Pais by phone. "I can see the moment it may have happened, but I'm not sure about it."

As I noted failures such as these will occur even when using level 4 protection if the protection not used correctly. This is very hard stuff to do, I find myself hot and itchy and goggles fogging even after 5 minutes wearing level 2 gear.
Cleaning up after a fatality possibly the most dangerous activity to do in this situation.
When I was an undergrad we did a microbiology lecture where our fingers were dyed, then had to just not touch anything while listening to an hour long lecture, at the end of the lecture we were asked: "did you touch your face" almost everyone said no, while no one had clean faces, many had multiple finger prints around their eyes, nose and mouth. An excellent lesson I would recommend.

The tragic case of Karen Wetterhahn comes to mind... not a virus, but dimethylmercury... a few drops on her gloved hand, the toxin penetrated the latex and her skin... and she died horribly.