Such straightforward measures are complicated by the distinct features of this disease. The sudden onset, dramatic symptoms, and rapid deterioration of patients, and the absence of a vaccine and effective treatment, invariably incite great anxiety in affected populations. This anxiety, in turn, can interfere with control operations, especially when communities begin hiding cases and bodies because of suspicions about the safety of hospitals.
In the current outbreak, such suspicions are understandable. Very few patients with laboratory-confirmed Marburg haemorrhagic fever have survived; most hospitalized patients have died within a day or two following admission. For affected communities, staff from the mobile teams, fully suited in protective gear, are seen as taking away relatives and loved ones who may never again be seen alive.
WHO staff in Uige have today reported further signs that community attitudes are improving, though hostility towards the mobile teams remains of concern in one area known to have recent cases and deaths. Efforts to sensitize affected communities are continuing, with local volunteers supported by Portuguese-speaking experts from Brazil and Mozambique.
Conditions in Angola ?a country weakened by almost three decades of civil unrest ?have presented additional challenges. Supplies of water and electricity are intermittent, also in health care facilities. Weakened infrastructures, including those for communications and transportation, are another problem. Yesterday, the WHO office in Uige was informed of a death in another municipality, but was unable to collect the body for safe burial because of poor road conditions.
Fortunately, spread of the disease beyo