AUS DEM SPIEGEL
Ausgabe 15/2005

Marburg Virus: A Deadly Illness Sweeps Through Angola

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The Marburg virus is deadly efficient and has killed almost 200 people already in Angola in recent weeks. Medical workers are struggling to contain the outbreak but panic in the Angolan capital is spreading. Nine out of ten of those infected, die.

A woman brings her child to the David Bernardino Hospital in Luanda, Angola for testing following an outbreak of the deadly Marburg virus.
AFP

A woman brings her child to the David Bernardino Hospital in Luanda, Angola for testing following an outbreak of the deadly Marburg virus.

The victims of the Marburg virus suffer horribly. Severe pain. Muscles twitching out of control. Blood bubbling from eyes and ears. Within days, portions of their tissue are transformed into a slimy mass. And then they die.

Christa Kitz, though, has no time to worry about the suffering of her patients; her job forces her to contain her compassion. "Not being able to help is horrible," says the Dusseldorf-born doctor, "but our main goal is to save those who are still healthy." Kitz spends her days visiting the hospitals in the Luanda, Angola's capital, where the virus has now arrived. Any patients identified as suffering from the virus are sent to an improvised isolation unit set up by Doctors Without Borders. It's risky work and she wears two layers of gloves, along with goggles and a mask when making her rounds. Her motto is: "Anyone who is aware of the risk can control it."

Kitz is one of dozens of medical professionals who are desperately trying to prevent the aggressive virus, which has been raging in Angola for the past few weeks, from claiming even more victims. And officials with the World Health Organization (WHO) are also concerned; they fear that the current outbreak is more than just a brief, localized flare-up of the epidemic. Especially concerning is the fact that almost 200 victims have succumbed to the disease already. And nine out of every 10 people infected, die.

An almost unknown virus

Unlike the related Ebola virus, little is known about the Marburg virus. It derives its name from the location of its first outbreak, the German city of Marburg, where employees of the Behring pharmaceutical company contracted the virus in 1967 after being infected by laboratory monkeys from Uganda.

"While Ebola behaves like a bush fire, Marburg smolders under the surface," says virologist and Marburg expert Stephan Becker, who studies the virus at a high-security laboratory.

The Marburg virus up close.
DPA

The Marburg virus up close.

The virus was slow-moving at first in Angola. A few suspected cases were reported five months ago in the country's north Uige province. Then, in March, dozens of children suddenly died in the pediatric ward of the region's main hospital. Italian physician Maria Bonino, 51, also contracted the virus in Uige, unwittingly carrying it with her on a flight to Luanda, and died a short time later. Infected Angolans also carried the virus to the capital, a city of three million.

The arrival of the pathogen in a major city was a wake-up call for Western virus hunters. "I received a call from the WHO on Good Friday, and I was on a plane to Luanda by six o'clock Easter Sunday morning," says Kitz.

Panic has taken hold in the country, already ravaged and impoverished by civil unrest. People from the north, including nurses and doctors, are fleeing from the epidemic's epicenter, pushing its already strained healthcare system to the brink of total collapse.

Even the isolation unit Kitz and her colleagues built is a makeshift operation. "We dug ditches where we burn waste and fecal matter," she says, adding, "we simply cannot allow any contaminated material to leave this place."

Looking for the origins

Not all Angolans understand the purpose of preventive measures. Vehicles used by Doctors Without Borders and the WHO have been attacked in the Uige epidemic region, where the sight of doctors dressed in protective gear taking family members to isolation units has triggered anxiety and resentment. But despite the risks involved, the doctors are now being joined by researchers anxious to discover the origin of the virus in the local human population. "We can't expect to find Patient Number One," says Matthias Borchert, a German epidemiologist who teaches at a London medical school and expects to be asked to fly to the crisis region soon, "because a great deal of time has passed since his or her death."

Doctors from around the world are trying to contain the deadly outbreak in Angola.
DDP

Doctors from around the world are trying to contain the deadly outbreak in Angola.

Based on his experience with earlier outbreaks, Borchert knows exactly what to look for: a cave. In the past, epidemics seem to have originated in caves. "It's highly likely that the Marburg virus has been living in cave-dwelling animals for years, and that that's where it made the leap to humans," Borchert explains.

This was exactly what happened in an outbreak of the Marburg virus in the Democratic Republic of Congo, where Borchert and his team of experts discovered that most of the victims had worked in gold mines. "The ceilings were plastered with tens of thousands of bats," Borchert recalls.

Wearing protective suits, the researchers captured hundreds of animals and took blood and tissue samples. But the laboratory analyses, some done at Hamburg's Bernhard Nocht Institute, turned out to be disappointing. There was no sign of the pathogen that causes the virus. "That's how we know that bats can be infected with Marburg but not become ill," says Borchert. The bat is what's called a reservoir host, in which the virus lies dormant until it can attack elsewhere.

But the best way to back up Borchert's theory would be to find a Marburg-infected bat in the wild. "Perhaps the virus will reveal itself this time," says Borchert, "and we'll have found what we're looking for in Angola."

Translated from the German by Christopher Sultan

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DER SPIEGEL 15/2005
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