Oh crap....

[Sindawe]

Angola Struggles to Contain Viral Outbreak


Tuesday April 12, 2005 8:31 PM

By CASIMIRO SIONA

Associated Press Writer

LUANDA, Angola (AP) - Disease experts struggling to contain the largest recorded outbreak of the Marburg virus said Tuesday it will take weeks to determine whether a long-term crisis can be averted in Angola, where the disease already has killed at least 194 people.

The experts say they are recruiting tribal elders and musicians to help educate villagers who are hiding infected family members and have attacked aid groups sent to check the virus' spread in this southwest African nation.

The World Health Organization, which already has 50 experts in the field helping local authorities, is bolstering its team by flying in more specialists.

The medical aid group Doctors Without Borders also has a heavy presence on the ground, and the U.S. Centers for Disease Control and Prevention has sent experts to Uige province in northern Angola.

Marburg hemorrhagic fever is a rare but deadly disease caused by a virus from the same family as the one that causes Ebola hemorrhagic fever. It spreads through contact with bodily fluids and can kill rapidly, usually about nine days after the first symptoms.

Continues here: http://www.guardian.co.uk/worldlatest/story/0,1280,-4932208,00.html

The mortality rate on this one is not looking good (203 out of 214 according to some reports), and from the news articles I've read, at least one case was in a city with an international airport.  The cited article notes lack of cooperation with WHO folks by fearful residents, which could exacerbate the situation/spread of the disease.  This bears watching closely.

[brimic]

"However, even if the drug looks promising on monkeys, it may take months before it can be tried on people infected with Marburg, Ryan said.

``There are complex ethical issues. This is an unlicensed drug and the ethics will have to be looked at extremely carefully,'' Ryan said. ``There may be a case for compassionate use, but we can't just give it to people just like that.''

"

Holy blissninny bullcrap. If I had a disease that was certain to kill me in the next 3 or 4 days, I would hope this guy wasn't my doctor. I wouldn't have a problem with them trying out leaches, mercury injections, or even exposure to other harmful microbes if there were even a small chance of curing the disease because it worked in monkeys.

[Preacherman]

There are serious problems with testing a potential remedy too early:

1.  It can cause actual harm to the patient (e.g. organ damage, etc.) - the cure might be worse than the disease.

2.  If tried too early, the illness can begin to build up a resistance to the drug (i.e. mutate) before it's widely available.  This means that when it's finally in general distribution, it won't be as effective.

3.  Further down the line, one has to worry about interaction with other drugs.  All too often, a drug that works fine on its own can be highly dangerous if the patient is also taking other drugs.

Doctors have to worry about all these things.  Sure, as a patient, I'd want to grasp at any straw available if it would help an otherwise helpless situation:  but the doctor has to think about more than just me...  which may suck for me, but may save a lot of lives further down the road.

As for this particular outbreak, yes, Angola (and Zaire, and other nations with widespread disruption caused by civil conflict) is a very good place for it to develop.  There are minimal medical and social services, widespread social disruption, a low level of education (and a correspondingly high level of superstition and fear of the unknown), and all the other factors that lend themselves to an epidemic.  The WHO has its hands full on this one, and I understand several medical personnel have already died from the disease.

[wasrjoe]

I do not think nukes, giant outer space rocks, war or even AI will kill off mankind. I believe it will be a germ that does it. Organic germs are scary enough as it is, but the synthetic ones we might (actually, will...) make in the future scare me the most. Hopefully we can colonize space or something before something like that happens. Would be a shame if we went extinct.

Anyway, this stuff scares me. I freaking hate germs.

[brimic]

.1.  It can cause actual harm to the patient (e.g. organ damage, etc.) - the cure might be worse than the disease.

With a 95+% mortality rate, nothing short of a .45 slug to the head is going to do the patient much more harm.

2.  If tried too early, the illness can begin to build up a resistance to the drug (i.e. mutate) before it's widely available.  This means that when it's finally in general distribution, it won't be as effective.

Good point, but with Marburg and Ebola only popping up once every other blue moon before burning out really fast, there is a very small window of opportunity to try the drugs on humans. If WHO has to wait another month or two before they can try out the drugs, they might as well wait another 2 to 3 years.

3.  Further down the line, one has to worry about interaction with other drugs.  All too often, a drug that works fine on its own can be highly dangerous if the patient is also taking other drugs.

Problem is that there will be no "further down the line" for just about every one of these people who are infected, seems more prudent to try extreme lifesaving measures and deal with the side effects further down the road if they survive than just let them die.



Even the FDA has contingiencies for fast tracking drugs that might save lives right now vs waiting.

[Mabs2]

I always seem to get sick at the same time these things start out...causes a bunch of unnecessary worrying.

[Sylvilagus Aquaticus]

The more virulent the virus, the faster it burns itself out and is easier to isolate and contain.  Marburg historically wasn't this virulent. I suspect it probably has a lot to do with local superstition, resistance to seek treatment, and lack of supportive care to get patients through the disease.  

Read Richard Preston's books for an understanding of how these things work for the layperson.

Regards,
Rabbit.

[jefnvk]

Yep.  Never could understand why governments won't let terminally ill people try new, yet-to-be-approved drugs.  If I have a month to live, I'm not too worried about whether or not the drug will kill me.

[Holly76201]

The Marburg, Ebola and Reston viruses are so scary. However, since there have been survivors, why aren't their anti-bodies being used to develop a vaccine? It may not be soon enough for this outbreak, but, how about a stockpil;e for the next one?

[Antibubba]

Forget Marburg-have you seen the news on the virulent flu strain mistakenly sent out to 3000 labs worldwide?  Criminy!

[spacemanspiff]

http://www.blueletterbible.org/kjv/Mat/Mat024.html

now if you will all excuse me, i'm going to just go about my normal daily routine of being apathetic and uninterested in the plight of this world.

spacemansomesaytheendisnearsomesaywe'llseearmageddonsoonicertainlyhopewewillisurecoulduseavacationfromthispiff