Tourist Dies in Netherlands of Ebola-like Marburg Fever

[Anne]

Tourist Dies of Ebola-Like Fever Probably Caught From Bats
By ANRICA DEB, AP
AMSTERDAM, Netherlands (AP) - A Dutch woman has died from Marburg fever, a rare Ebola-like virus she is thought to have caught from bats while touring caves in Uganda, hospital officials said Friday.

To avoid an outbreak of the highly contagious disease, health authorities said they have been in touch with everyone known to have had contact with the 40-year-old woman since she returned to the Netherlands at the end of June.

So far, no one else has reported symptoms, said the National Institute for Public Health and Environment.

It is the first known case of a tourist catching Marburg virus. Previous outbreaks of the disease have largely struck African miners and hunters.

The World Health Organization said no effort was made to notify passengers on the plane who flew with her from Uganda. The virus has an incubation period of five to 10 days.

The woman, whose name has not been released, died Thursday night, said Marlene van Toever, a spokeswoman at the Leiden University Medical Center.

She began having symptoms a few days after returning to the Netherlands and was admitted to a regional hospital July 5. Two days later she was transferred to Leiden with liver failure and severe hemorrhaging.

WHO said the woman had traveled in the African country for three weeks last month. She is likely to have contracted the disease from contact with at least one fruit bat when she visited the "python cave" in the Maramagambo Forest on June 19.

WHO said in a statement the bats living in the cave may be the same species known to carry Ebola and Marburg in other regions of sub-Saharan Africa.


Last year, there was a small outbreak of Marburg virus in the same region of Uganda.

Van Toever said the woman was kept isolated after her arrival in the hospital, and medical personnel had worn protective suits.

Roel Coutinho, director of the Netherlands Center for Disease Control, said people who had contact with the woman before July 2 when she first showed symptoms were not in danger.

"Patients with Marburg are not infectious as long as they are not ill," he told The Associated Press.

The woman had contact with about 50 people before she was transferred to Leiden, and they all have been asked to take their temperature twice daily and isolate themselves if they have symptoms, Coutinho said.

Marburg virus can cause massive bleeding in multiple parts of the body and is thought to be spread by body fluids. There is no treatment or vaccine.

The fever was first identified during an outbreak in Europe in 1967, with a virus that arrived in monkeys imported from Uganda.

[knight66]

I visited Uganda a few years ago at the height of an Ebola outbreak. It caused a lot of worry in the country. Although it usually stays in localised outbreaks, we were warned in the UK and in Uganda to avoid visiting the affected areas. One of the villages which was a centre for the disease was Masindi, it is on the only road from Kampala to the north. So we had to go through it, but it was decided that we would not stop.

We travelled for a few hours and the driver said we would stop for petrol. Once he had stopped and the other passangers had got out of the van and were chatting with the locals, we then discovered we were in Masindi. I was not exactly best pleased, as we had my 12 year old with us. Staying on a field hospital had been exposing us to all sorts without going to any extra effort to visit Masindi and that particular strain of Ebola killed 60% of those infected.

On the way back south, it was agreed we definitely would not stop at Masindi. We took a slightly different route and stopped at a hut in a mud clearing which bizarrely had an upright Coke fridge. We were immediately surrounded by village kids who were very friendly and wanted to rub the white off our arms to see the black underneath.

After a while we got back in the van, went 200 yards round a bend and we passed the town sign for Masindi...we had again stopped exactly where we should not.

We were absolutely fine, but there was real anxiety nationally, the newspapers were full of scare stories. One in particular that I remember was that of an old man who had died in Kampala. He had bled from his eyes and ears. As this was a possible sign of Ebola, the emergency medics refused to go near the body. The locals therefore left him on his mat and pulled the mat and body into the middle of a busy main road. There the body was driven over repeatedly by large trucks...then photographed for the newspaper.

There turned out not to be any cases of Ebola in the city, or anywhere outside of the two affected villages. It died out after about two months, for some reason it does not normally travel.

By the way, a mortality rate of 60% seemingly indicated a weak strain of the virus.

Mike

[Anne]

I visited Uganda a few years ago at the height of an Ebola outbreak. It caused a lot of worry in the country. Although it usually stays in localised outbreaks, we were warned in the UK and in Uganda to avoid visiting the affected areas. One of the villages which was a centre for the disease was Masindi, it is on the only road from Kampala to the north. So we had to go through it, but it was decided that we would not stop.

We travelled for a few hours and the driver said we would stop for petrol. Once he had stopped and the other passangers had got out of the van and were chatting with the locals, we then discovered we were in Masindi. I was not exactly best pleased, as we had my 12 year old with us. Staying on a field hospital had been exposing us to all sorts without going to any extra effort to visit Masindi and that particular strain of Ebola killed 60% of those infected.

On the way back south, it was agreed we definitely would not stop at Masindi. We took a slightly different route and stopped at a hut in a mud clearing which bizarrely had an upright Coke fridge. We were immediately surrounded by village kids who were very friendly and wanted to rub the white off our arms to see the black underneath.

After a while we got back in the van, went 200 yards round a bend and we passed the town sign for Masindi...we had again stopped exactly where we should not.

We were absolutely fine, but there was real anxiety nationally, the newspapers were full of scare stories. One in particular that I remember was that of an old man who had died in Kampala. He had bled from his eyes and ears. As this was a possible sign of Ebola, the emergency medics refused to go near the body. The locals therefore left him on his mat and pulled the mat and body into the middle of a busy main road. There the body was driven over repeatedly by large trucks...then photographed for the newspaper.

There turned out not to be any cases of Ebola in the city, or anywhere outside of the two affected villages. It died out after about two months, for some reason it does not normally travel.

By the way, a mortality rate of 60% seemingly indicated a weak strain of the virus.

Mike

I agree.  What I read was that just plain ebola has a 90% death rate.  What the medical people finally determined was that a hunter would go out into the forest, come home, and develop the signs of ebola, fever, bleeding from every orifice of the body.  Then the grieving family would prepare his body for burial.  Next thing happened was the family members had ebola.

One of the things the CDC worried about was that with modern travel, just as in this marburg case, ebola was 24 hours away from anyone.  I remember there was another breakout but this time the travelers were
Canadian and they returned to Toronto or Ottawa.  I live in Michigan.  That was close enough for me.

The first book I read on this subject was Hot Zone by Richard Preston.

http://www.amazon.com/Hot-Zone-Terrifying-True-Story/dp/0385495226/ref=sr_1_15?ie=UTF8&s=books&qid=1215911275&sr=8-15

The second book was The Coming Plague by Laurie Garrett.

http://www.amazon.com/Coming-Plague-Emerging-Diseases-Balance/dp/0140250913/ref=pd_sim_b_2

[Anne]

Good News!

Science News Vaccine For Ebola Virus Successful In Primates
ScienceDaily (Mar. 31, 2008) — One of the world's deadliest diseases, caused by the Ebola virus, may finally be preventable thanks to US and Canadian researchers, who have successfully tested several Ebola vaccines in primates and are now looking to adapt them for human use.


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Dr Anthony Sanchez, from the Centers for Disease Control & Prevention in Atlanta, Georgia is presenting an overview of Ebola vaccine development March 31, 2008 at the Society for General Microbiology's 162nd meeting.

"The biothreat posed by Ebola virus cannot be overlooked. We are seeing more and more naturally occurring human outbreaks of this deadly disease. With worldwide air travel and tourism the virus can now be transported to and from remote regions of the world. And it has huge potential as a possible weapon of bioterrorism", says Dr Sanchez. "We desperately need a protective vaccine."

So far, there have been over 1500 cases of Ebola haemorrhagic fever in humans. Illness starts abruptly and symptoms include fever, headache, sore throat, weakness, joint and muscle aches, diarrhoea, vomiting and stomach pain. A rash, red eyes and bleeding may also occur. Ebola haemorrhagic fever can have a mortality rate of around 90% in humans.

Because Ebola virus is so dangerous, producing and testing a vaccine is extremely challenging for the scientists. One significant factor slowing down progress has been that there are only a very limited number of high containment facilities with staff capable and authorised to conduct the research.

"Ebola virus is a Biosafety Level 4 threat, along with many other haemorrhagic fever viruses", says Dr Sanchez. "As well as the difficulty in getting the right staff and facilities, vaccines for viruses like Ebola, Marburg and Lassa fever have been difficult to produce because simple 'killed' viruses that just trigger an antibody response from the blood are not effective. For these viruses we need to get a cell-mediated response, which involves our bodies producing killer T-cells before immunity is strong enough to prevent or clear an infection."

The researchers have now used several different recombinant DNA techniques, which have allowed them to trigger a cell-mediated response and produce a vaccine that is effective in non-human primates. One of the candidate vaccines is about to be tested on people for the first time, after entering Phase 1 clinical trials in autumn 2006.

"Ebola virus infection of humans can be highly lethal but monkeys rarely survive the infection and have been very useful as animal models. Ebola vaccine trials using nonhuman primates have provided unambiguous results and have allowed the development of protective vaccines to progress rapidly", says Dr Sanchez. "Successful human trials will mean that we can vaccinate healthcare workers and other key personnel during outbreaks of Ebola haemorrhagic fever, helping us to protect their lives and control the spread of the disease."

The US team hopes that the findings from their studies will provide important insights that will improve or accelerate the future development of vaccines for other haemorrhagic fever viruses like Marburg virus, and agents such as HIV and avian influenza.

[DavidRoss]

One of the candidate vaccines is about to be tested on people for the first time, after entering Phase 1 clinical trials in autumn 2006.

Enrollment may be difficult.