Mobile surveillance teams in Uige were forced to suspend operations yesterday when vehicles were attacked and damaged by local residents. As the situation has not improved, no surveillance teams were operational today in this province, which remains the epicentre of the outbreak.
WHO staff in Uige were notified today of several fatalities but teams were unable to investigate the cause of death or collect the bodies for safe burial. Discussions have been held with provincial authorities to find urgent solutions.
The dramatic symptoms of Marburg haemorrhagic fever and its frequent fatality are resulting in a high level of fear, which is further aggravated by a lack of public understanding of the disease. Moreover, because the disease has no cure, hospitalization is not associated with a favourable outcome, and confidence in the medical care system has been eroded.
WHO is familiar with such reactions, which have been seen during previous outbreaks of the closely related Ebola haemorrhagic fever. Two medical anthropologists are already in Uige and will be joined shortly by experts in social mobilization from Angola, the Democratic Republic of Congo, and Mozambique. Public compliance with control measures is not expected to improve in the absence of intense campaigns to educate the public about the disease.
In African countries, the single most important factor in controlling viral haemorrhagic fevers is the engagement of affected communities as partners in control. To achieve this engagement, local belief systems about the causes of disease and traditional rituals for mourning the dead must be respected. When the public understands and accepts a few simple messages ?av