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Agencies must win trust of locals to contain Marburg and Ebola outbreaks
Date:10/29/2007

addressing the psychological and spiritual needs of families in the burial and disinfection process. At first, bystanders were not always told why procedures were being carried out, which led to fear and mistrust. The process of disposing of corpses, which are a route of transmission for the infection, was initially handled by the hospital; preventing relatives from performing burial rites, or ascertaining where their loved ones were buried.

The MSF team realised that if the community was to be brought on board, burial rites would need to be adopted that, while safe, resembled traditional ones as far as possible, even though this was likely to be more time-consuming. They therefore adopted a modified version of the WHO protocol which involved the burial and disinfection team changed in and out of their protective clothing in front of household members, so they would understand that they were human beings, just like them. Burial rites now involved the use of coffins and allowed the family to identify the corpse before burial, which confirmed the death and allayed any rumours about what might have happened to their loved ones, and included songs and dancing, carrying and lowering of the coffin using gloves, and filling the grave with earth, as would normally occur.

The team also replaced or repaired items that had been damaged by the disinfection process, such as burned mattresses, which helped to make the families more accepting of the control measures.

If a filovirus outbreak is to be contained and terminated, then early detection and the subsequent isolation of patients is vital. In Uige, however, only 44 of the known cases were isolated and in the absence of obviously effective therapies for what is more often than not a fatal disease, it is difficult to persuade people to go to hospital for the purely altruistic reason of preventing transmission within their families and communities, particularly when traditional healers promise a cu
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Contact: Lindsay Wright
lindsay.wright@lshtm.ac.uk
020-792-72802
London School of Hygiene & Tropical Medicine
Source:Eurekalert

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