Marburg: Netherlands via Uganda

Pythoness · #1 07-11-2008, 12:13 PM

Source: European Centre for Disease Prevention and Control (ECDC) [edited]
<European Centre for Disease Prevention and Control>

On Thu 10 Jul 2008, the authorities in The Netherlands notified their
European Union partners and the World Health Organisation of one
confirmed case of Marburg fever diagnosed in the Leiden University
Medical Centre. The case involves a 40-year-old woman who had
recently returned from a holiday in Uganda. The travel included a
visit to 2 caves in the Maramagambo forest (between Queen Elizabeth
Park and Kebale), where she was exposed to fruit bats.

ECDC's initial assessment is that the threat to public health is
limited and mainly focused on the people who have been in close
contact with the patient after the onset of her symptoms. People
intending to travel to Uganda should be aware that there may be a
risk related to visiting caves in the Maramagambo forest.

ECDC is in contact with the authorities in The Netherlands and is
monitoring the situation closely.

Pythoness · #2 07-11-2008, 12:14 PM

Yes, Jess.

Yes.

Jessica · #3 07-11-2008, 12:16 PM

AHHHHHHHHHHHHHHHHHHHHHHH!

Py, you know how I feel about filoviridae!

__________________
No one can make you feel inferior without your consent.
--Eleanor Roosevelt

Pythoness · #4 07-11-2008, 12:18 PM

They really start to worry me when they start escaping from Africa.

Which, btw, Filoviridae is the major reason I would never take a trip there.

Lions? I'd love to see them.
Tse-tse flies? No big deal.
Poisonous snakes? I'm not worried.
Filovirus?

I'll stay over here, thanks.

Jessica · #5 07-11-2008, 12:37 PM

Quote:

Originally Posted by Pythoness

They really start to worry me when they start escaping from Africa.

Which, btw, Filoviridae is the major reason I would never take a trip there.

Lions? I'd love to see them.
Tse-tse flies? No big deal.
Poisonous snakes? I'm not worried.
Filovirus?

I'll stay over here, thanks.

Those damn fruit bats and monkies had to go and ruin it for the rest of us!

It's so strange that so many of the world's most horrific and fatal diseases have emegered from the Rift Valley area- the place where life first began. The filoviridae, HIV/AIDS.

Crazy.

Panama Girl · #6 07-11-2008, 12:51 PM

Fruit bat caves? HELL no.

I'm staying on the savanna; tripping over elephant turds has got to be safer...

Pythoness · #7 07-12-2008, 02:43 PM

Dutch tourist infected with Marburg virus
-----------------------------------------
Hemorrhagic fever caused by a filovirus has been confirmed by
detection of viral RNA by RT-PCR [reverse transcriptase polymerase
chain reaction] in a 41-year-old female patient, after a trip to
Uganda. The patient was traveling between 5 and 28 Jun 2008. The
patient visited a cave in Fort Portal on 16 Jun 2008. In this cave no
bats were seen. She was exposed to bats, reportedly "fruit eating
bats" during the visit to the "python cave," in the Maramagambo
Forest (between Queen Elisabeth Park and Kabale), on 19 Jun 2008.
This cave is thought to harbour bat species that on other locations
in Sub-Saharan Africa have been found to be carrying filoviruses. The
[patient's] partner recalls bats flying all around in the cave, large
amounts of droppings on the ground, and bats bumping into the
visitors. No signs or symptoms have been reported so far by other
[members of this] party.

The patient returned to the Netherlands on 28 Jun 2008 in normal
health. The 1st symptoms (fever, chills) occurred later on 2 Jul 2008
followed by hospital admission on 5 Jul 2008. Rapid deterioration
with liver failure and severe haemorrhaging occurred on 7 Jul 2008.
The patient died on 11 Jul 2008 .

Tests were carried out to identify the cause of the disease. All
possible virological and bacteriological causative agents have been
ruled out, with the exception of filoviruses. Immunofluorescence
yielded a low titre (1:16) for IgG and IgM against Marburg virus and
a low positive signal using a filovirus PCR (Lightcycler).
Confirmation was provided by the Bernard Nocht Institute for Tropical
Medicine in Hamburg, Germany by RT-PCR confirmed by sequence analysis
of the target gene (polymerase gene). They confirmed that the
infecting strain is a Marburg virus strain related to but distinct
from known isolates.

Further sequencing and attempts to isolate the virus are ongoing at
this time. A Marburg virus has been identified. Evidence suggests
that bats may be a natural reservoir for Marburg virus (Towner JS et
al., PLoS ONE. 2007, available at
<PLoS ONE: Marburg Virus Infection Detected in a Common African Bat>)
in Sub-Saharan Africa.

Contact tracing has been put in place and temperature monitoring has
been initiated for unprotected (daily mandatory reporting to health
authority) and protected contacts (weekly evaluation) with possible
exposure starting on 2 Jul 2008. Authoritative advice will be issued
to the Dutch tour operators with respect to avoiding any visits to
those caves until further information is available.

No citizens of other European countries have been involved in this
particular trip, but, the cave in the Maramagambo Forest is known to
be a tourist attraction. No further measures were issued with respect
to the flight passengers, as the flight took place 4 days before the
onset of symptoms."

--
Aura Timen <Aura.Timen@rivm.nl>
M. Koopmans
at RIVM (National Institute for Public Health and the Environment)

On behalf of:
J van Dissel, A. Vossen (Leiden University Medical Center)
J. Schmidt-Chanasit, S. Gunther (Bernhard-Nocht-Institute for
Tropical Medicine)
K. Verduin (Elkerliek Hospital)
A. Osterhaus, G. van Doornum (Erasmus Medical Center)
R. Daemen (Public Health Service Brabant-Southeast)
T. Schmitt (Public Health Service Central Holland)

[ProMED-mail thanks Aura Timen (on behalf of many colleagues) for
supplying this detailed account of the investigation into the death
of the Dutch tourist recently returned from Uganda, as a consequence
of Marburg virus infection. The involvement of cave-dwelling bats in
transmission of the disease is compelling, but still circumstantial.

The HealthMap/ProMED-mail interactive map of Uganda can be accessed at
<HealthMap - ProMED | Global disease alert map>. - Mod.CP
Maramagambo Forest in Western Uganda can be located on the map at
<Large Destination Map - RealTravel>. - CopyEd.MJ]