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Doctors go bat-hunting to find the source of Uganda's Marburg outbreak
Published in Saudi Press Agency on 09 - 08 - 2007


Virus hunters swathed in protective gear
plan to enter a lead and gold mine in a remote part of
western Uganda this week to search for bats they believe
may be the source of the latest outbreak of a deadly
Ebola-like disease, according to AP.
Wearing gowns, boots, masks, goggles and leather gloves,
the medical investigators will attempt to catch 1,000 bats
to be transported to a nearby mobile laboratory, where they
will take blood samples to look for antibodies of the
Marburg virus, before killing the animals and removing
their livers and spleens.
«It's quite dangerous work, but we hope it will help us
answer some important questions about Marburg,» Dr. Pierre
Formenty, a hemorrhagic fever expert at the World Health
Organization, said in a telephone interview Tuesday from
Kampala, Uganda. «It will be a very delicate operation.»
Last week, WHO confirmed one case of Marburg in a
29-year-old man who worked at the mine and who died July
14. Thursday, Ugandan Health Minister Dr. Stephen Mallinga
said the 21-day maximum incubation period has passed with
no new cases reported, allowing him to declare «the
outbreak contained.»
Marburg is a rare and virulent disease for which there are
no cures or effective treatments. It causes headaches,
nausea, diarrhea and vomiting. In severe cases, the central
nervous system is attacked, and patients may bleed from the
eyes, ears and elsewhere.
Scientists are not sure how it is transmitted to humans,
but believe people may become infected by being bitten by
bats or by insects or other animals that have been infected
by bats. Another possibility is that people catch it by
breathing in air carrying virus particles from bat feces.
Since Marburg was first identified in 1967, large outbreaks
have been reported in Congo, Angola and other countries.
«If we knew what the animal reservoir was, we would have
a better chance of stopping the infection,» Formenty said,
adding that experts could then more precisely warn people
about which behaviors _ and animals _ were particularly
risky. That «would open up new avenues for future
treatments and developing vaccines.»
Formenty and about two dozen other experts from WHO, the
U.S. Centers for Disease Control and Prevention in Atlanta,
Medecins Sans Frontieres, the Ugandan Ministry of Health
and other agencies will be involved in the effort to
collect bats from the mine.
The team may also take blood samples from miners and
villagers in the area, to check for antibodies that would
indicate they might have been exposed to Marburg. Experts
think that sporadic cases of hemorrhagic fever in the
region are not uncommon, and that cases of Marburg have
probably gone undetected for years.
«We are learning new tricks from each outbreak,» said
Dr. Pierre Rollin, a Marburg expert from the CDC, who was
on his way to Uganda on Tuesday. «If we cannot go to the
outbreak site immediately after it happens, we are losing a
chance.»
Unlike previous Marburg outbreaks, when doctors have been
preoccupied with trying to save peoples' lives, the number
of patients in the current outbreak appears to be limited.
In addition to the confirmed Marburg death, one other
«highly probable» case is still alive, and health
authorities are monitoring about 100 contacts of the two
men, who both worked in the mine.
«In the past, the early teams that have gone out have
been busy establishing isolation wards to prevent further
infections and following up case contacts,» said Dr.
Stuart Nichol, a CDC Marburg expert.
By the time doctors were able to shift from treating
patients to investigating the outbreak, many months had
passed. «In this outbreak, we have a chance to focus on
the ecological side soon after the outbreak to see where
the disease may actually come from,» Nichol said.
Some 5 million bats, as well other animals and insects,
live in and around the mine at the center of the outbreak.
Bats have long been suspected of playing a role in
transmitting Ebola and Marburg to humans. «There have been
anecdotal reports in each outbreak that bats have been
around,» Rollin said.
After past Marburg outbreaks, scientists have trapped bats
in surrounding caves and mines, but they have never found
the smoking gun necessary to prove the bats' role in
transmission: antibodies against the virus.
«Diseases like Marburg are very complex and take time to
understand,» Formenty said. «Every outbreak is an
opportunity for us to prevent future infections.»


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