The first U.S. case of Marburg hemorrhagic fever has been confirmed in Colorado

[dixiegrrrrl]

link:
http://hisz.rsoe.hu/alertmap/woalert_read.php?cid=20408&lang=eng

[Phoebe Loosinhouse]

1. Whoa! Isn't this an alternate name for Ebola?

Details as to where and how it was contracted? I know, read the link, but maybe just a quick summary?

[enlightenment]

6. Another link.

http://www.google.com/hostednews/ap/article/ALeqM5icwnbejl-iJTMsx_JWAIgMXlweOAD9671DF00

[kestrel91316]

7. NO, Marburg is NOT Ebola. It's MARBURG.

Oh, and BTW, HOLY CRAP!!!!!!!!!

http://en.wikipedia.org/wiki/Marburg_virus

Aka African Green Monkey Fever when I was in school. Holy shit. How in God's name did it get into COLORADO?????

[Individualist]

10. Info from the link in post #4

"The patient had traveled to Uganda, visited a python cave in Maramagambo Forest in Queen Elizabeth Park, and encountered fruit bats, which can carry the Marburg virus."

[backscatter712]

38. Marburg is related to Ebola, is it not?

It's in the same family of viruses, and causes a form of hemorrhagic fever which is rather nasty.

Just looking at the Wikipedia article, it's a level 4 biohazard, requiring caregivers for Marburg patients to wear those biohazard spacesuits.

This sounds like something out of The Stand... :scared:

[Barack_America]

23. Same class of virus (filovirus), but a different virus. nt

[donco6]

2. Eeek! Wheatridge is right where I work.

Hmmm...

[eleny]

8. Looks like they were treated at Lutheran

[bobbolink]

14. And I was in a room at Lutheran that hadn't been cleaned!!!

This hospital needs to go!

[Taverner]

3. Oh shit and I was just there last month..

[FLAprogressive]

4. Story on it -- it happened in Jan. 08

http://www.thedenverchannel.com/news/18663901/detail.html

[kestrel91316]

9. What I find truly disturbing is that this case, in Jan '08, was kept

secret from the public for a year. This is in direct contradiction to the role of PUBLIC health, which needs to keep the public advised of health threats in order to minimize them.

Damned secretiveness. They are lucky nobody died because of their SILENCE.

[pinto]

13. It wasn't fully diagnosed until Januray 09 -

2008: Marburg hemorrhagic fever, imported case – United States

On January 22, 2009, CDC’s Special Pathogens Branch retrospectively diagnosed a case of Marburg hemorrhagic fever in a U.S. traveler, who returned from Uganda in January, 2008. The patient developed illness four days after returning to the U.S., was hospitalized, discharged, and fully recovered. Initial testing of samples collected during the patient’s acute illness in January, 2008 did not initially show evidence of Marburg virus infection. Testing of a convalescent sample indicated a possible previous infection, and more detailed testing of both samples at CDC confirmed that the patient’s illness was due to Marburg hemorrhagic fever.

The recovered patient had visited the “python cave” in Maramagambo Forest, Queen Elizabeth Park, western Uganda. This is a popular destination among tourists to see a cave inhabited by thousands of bats; a fatal case of Marburg hemorrhagic fever occurred in a Dutch tourist in July 2008 who had entered this cave. Both patients likely acquired their infections as a result of contact with cave-dwelling fruit bats, which are capable of harboring Marburg virus. Marburg virus is a zoonotic virus that occurs in tropical areas of Africa, and causes a severe, often fatal, hemorrhagic fever in humans and nonhuman primates. It can also be transmitted through direct contact with a symptomatic patient or materials contaminated with infectious body fluids. The Ugandan Ministry of Health officially closed the cave to visitors in August 2008, after the Dutch case.

http://www.cdc.gov/ncidod/dvrd/spb/outbreaks/index.htm

[kestrel91316]

17. Yeah, I finally got that part. I first thought they never tested for it until

July. But they DID test in Jan '08 - it must have been such a weak positive they called it negative. Then they did followup in July and got a positive.

I wonder how many contacts will turn up with a titer??

Fortunately, it is not the most highly contagious disease out there..........people with it don't shed lots of virus. But that 35-80% mortality is nothing to take lightly.

[ddeclue]

15. Yeah but how contagious is this disease?

Probably not very...

[kestrel91316]

18. Contagious enough that medical staff must take precautions like mask and gloves.

http://www.cdc.gov/ncidod/dhqp/bp_vhf_interimGuidance.html

Transmission Risk
In Africa, transmission of VHF in healthcare settings has been associated with reuse of contaminated needles and syringes and with provision of patient care without appropriate barrier precautions to prevent exposure to virus-containing blood and other body fluids (including vomitus, urine, and stool) (1-3). The transmission risks associated with various body fluids have not been well defined because most caregivers who have acquired infection had contacts with multiple fluids.

The risk for person-to-person transmission of hemorrhagic fever viruses is greatest during the latter stages of illness when virus loads are highest; latter stages of illness are characterized by vomiting, diarrhea, shock, and, in less than half of infected patients, hemorrhage. No VHF infection has been reported in persons whose contact with an infected person occurred only during the incubation period (i.e., before onset of fever). The incubation period for VHF ranges from 2 days to 3 weeks, depending on the viral agent (1). There are reports of Ebola virus transmission occurring within a few days after onset of fever; however, the presence of other symptoms in the source patients and the level of exposure to body fluids among secondary cases are unknown in these instances (CDC, unpublished data, 1995). In studies involving three monkeys experimentally infected with Ebola virus (Reston strain), fever and other systemic signs of illness preceded detection of infectious virus in the animals’ pharynx by 2-4 days, ,in the conjunctivae and on anal swabs by 5-6 days, and in the nares by 5-10 days (8).

In studies involving nonhuman primates, monkeys could be infected by mechanically generated small-particle aerosols (4-7), but epidemiologic studies in humans do not indicate that VHF is readily transmitted from person to person by the airborne route (1,2). Airborne transmission was considered as a possible explanation for a hospital-associated cluster of Lassa fever infections in which the index patient had severe pulmonary involvement, but the mode of transmission for that outbreak was not determined (3). Although unproven, airborne transmission of VHF is a hypothetical possibility during procedures that may generate aerosols.

~~~~~~~~~~

[ddeclue]

21. If you read it, it doesn't sound very communicable like the common cold or flu is...

and barrier protection is pretty standard these days anyways. Even a lot of cops wear rubber gloves when making arrests etc. for fear of picking up a communicable disease and doctors and nurses are always wearing and changing them too.

I don't think this is really much of a real threat (nor is "bird flu"), just another way to try to scare people into giving up their civil liberties.

Doug D.

[kestrel91316]

24. Um, what about this case caused anyone to give up civil liberties????

One cannot afford to be lackadaisical about diseases with such a high mortality rate, even if they are less contagious than a cold (which is the most contagious disease on earth, lol).

And yes, I DO have a degree in microbiology. So I am less afraid of pathogens than your average person.

[ddeclue]

28. Not this one in particular but avian flu scare is ridiculous...

and the Bushies were making all sorts of plans to take away Civil liberties in the event of a bird flu pandemic (which will never happen as far as I can tell)

I too am trained in science as an engineer but I'm not a microbiologist like you.

Do you really think we stand a chance of this rare bat in cave disease becoming a pandemic in your professional opinion or is this simply interesting to you professionally in the way that analyzing a plane crash or a software bug is to me?

Curious...

Doug D.

[Fire_Medic_Dave]

29. A flu pandemic will never occur. Are you sure about that?

[ddeclue]

30. Not unless it (AVIAN flu) mutates dramatically...

considering that you seem to need to have a very rare genetic defect to be susceptible to it. Husbands don't seem to be able to spread it to wives etc. where it has very rarely occurred.

Doug D.

[Fire_Medic_Dave]

31. Yes and that's how every other influenza pandemic has occurred.

The concern isn't that the current avian flu will kill a lot of people, it's that the highly lethal strain of the avian flu will mutate so that it can be transmitted from human to human. Clearly it will weaken when it mutates but if it remains even half as lethal as H5N1 then it could change civilization as we know it. It is incumbent upon public health agencies to be prepared for the worst.

David

[ddeclue]

32. OK fine but prepared and stampeding people are two different things.

What IF is a very dangerous way to live life?

What IF a meteor hit tomorrow?

What IF the volcano under Yellowstone erupts?

What IF the Canary Islands slide into the sea and create a super tsunami that wipes out the East Coast?

What IF a 8.5 earthquake hits the Eastern U.S?

What IF a hurricane goes up the Potomac or up the Hudson River next season?

There are a lot of disaster scenarios that MIGHT happen SOME day but we shouldn't panic the whole world over them when there are plenty of much more REAL problems (even HEALTH related problems) like: 400,000 cigarette related deaths every year in the U.S., 100,000 alchohol related deaths, 70,000 diabetes related deaths.. you see where I am going right?

:eyes:

[Fire_Medic_Dave]

33. There have been 3 flu pandemics since 1900.

These were global events. We do have scientist working on some of the things you listed, we are spending millions on some of them, despite that fact that the chances of a flu pandemic are much higher. I don't know about you but I wish someone at FEMA had said what if concerning the levees in New Orleans. You see where I'm coming from right?

David

[ddeclue]

34. Um NO I think that you are blowing flu pandemic out of all reasonable proportions

A hurricane striking New Orleans is at least something that happens on a reasonably frequent basis and FINE if they (these disasters I mentioned) are being researched but we need not treat them like they are EMMINENT when they are clearly NOT so.

Government should be based on reasonable analysis not chicken little falling sky scenarios - dictators always apologize for taking away your freedoms out of the necessity of protecting you from some bogeyman.

Doug D.

[Fire_Medic_Dave]

35. So you think the WHO, CDC, etc. were just pawns under the Bush administration?

[ddeclue]

36. You REALLY need to ASK that about the people who brought you WMD's in Iraq?

:rofl:

Yeah of COURSE I believe they were Bush's pawns - he screwed with a lot of agencies to push his fear agenda where it suited him.

[Fire_Medic_Dave]

37. I wasn't aware that the CDC or WHO had anything to do with WMD, please fill me in.

[ddeclue]

39. The biological weapons aspect is pretty self-evident

do you NOT remember ANTHRAX?

:eyes:

[Fire_Medic_Dave]

40. Yes it's a naturally occurring bacteria that killed 5 of the 22 people exposed in the 2001 attacks.

Did you have a point?

David

[ddeclue]

42. That the Bushies looked for any excuse to make people very very afraid.

and Birf Flu was one of those excuses.

[Fire_Medic_Dave]

43. That may be true, that doesn't mean that a mutated avian flu isn't a real threat.

[ddeclue]

44. "Real" is the debate here isn't it...

To ME real is 400,000 cigarette deaths EVERY year.

That's far more "real" to me than the possibility of one year in 100 with a 500,000 death rate from a pandemic flu (as in 1919). I would sincerely doubt that were another flu pandemic like the 1919 one were to sweep the US today that there would be similar death rates given 90 years of progress in medical science in the interval.

[Fire_Medic_Dave]

45. Of course.

The Spanish Flu killed between 12 and 25% of the people that contracted it. As of last week the avian flu had killed 63% of the people that had been diagnosed with it. I'll give you my county as an example when we started looking at pandemic flu depending on the virulence of the flu it was estimated that we would need between 700 and 2500 ventilators for patients. At that time we had 70 among 7 different hospitals. So we started looking at cost effective ways to get more vents. If I might also add the vast majority of cigarette deaths are from people who choose to smoke. Most people don't choose to get the flu.

David

[ddeclue]

46. Yeah but AGAIN it is extraordinarily HARD to contract it in the first place

so those mortality statistics really don't have a lot of value do they given how rare it is to contract? Ever hear of students-T?

The people who are dying of Avian Flu right now are dying because they have a very specific genetic defect relative to the virus- 99.99999%+ of us are immune to it.

Doug D.

[Fire_Medic_Dave]

47. Again we aren't talking about the current H5N1 strain but a mutation..

that is transmissible human to human. Yes it will likely weaken when it mutates but if it loses 50% of it's virulence it could still kill 30% of the people that contract it. Given how easily that flu is transmitted it's a much greater threat than viruses like ebola, that may be more deadly but are more difficult to contract.

David

[ddeclue]

48. And again you really have no reasonable way to predict the likelihood of such a virulent mutation do

you? It's about as likely as any of the What IF scare tactic events I mentioned previously.

In the mean time it is a rare disease that is extraordinarily hard to contract.

If you want to worry about a REAL viral threat how about AIDS? That one has already made the jump you are speculating about.

Doug D.

[Fire_Medic_Dave]

49. Most of the past pandemics have been mutations of zoonotic influenza strains.

So it's wrong to prepare for a highly lethal strain of a disease that we know routinely mutates from animals to become transmissible from human to human and that if it mutates in such a fashion it will likely rapidly spread throughout the world like the flu does every year. History has shown us that these pandemics seem to occur every 30 to 50 years. Do you honestly think that it is as easy to contract AIDS as it is the flu?

David

[ddeclue]

50. Routinely? 3 times in 100 years isn't "routine"

it's once in a couple of generations.

NO I don't think AIDS is as transmissable as the flu not even close but it is FAR more transmissible than the current HN51 virus which is apparently only going to affect a small number of people who actually live with their chickens in their home while simultaneously having a specific genetic defect.

It's OK to do research on HN51 but it's not OK to be Chicken Little (pardon my pun) about the Avian Flu and plan internment camps and flushing the Constitution down the toilet as the Bush administration was talking about.

Doug D.

[Fire_Medic_Dave]

51. How is every year for routinely?

I didn't say pandemics were routine, the influenza virus routinely mutates. Every 40 or 50 years it's a really bad strain that mutates and then it kills 10 of millions of people. That is the concern with H5N1. I've never seen any planning that involved interment camps. Regardless, I'm sure Obama immediately nixed any nefarious plans. My guess is that this administration still puts quite a bit of stock in a mutated H5N1 being a significant human threat. Thanks for the lively chat.

David

[ddeclue]

52. OK, mutates in a significantly threatening way...

it's NOT routine if it's once in a lifetime and let's be realistic about it, we know a lot more about treating these things than we did even 20 years ago much less 40, 50 ot 90 years ago. Tens of millions won't die the next time around.

Doug D.

[Fire_Medic_Dave]

53. You are probably correct but that many people being sick will overwhelm the healthcare system.

That has been the main focus of all of our planning at the state and local level. Keeping that many people from dying seems to have been the focus at the federal level huge stockpiles of anti-virals etc. Of course maybe that was just a pay off to Rumsfeld.

David

[SidDithers]

5. Wow. Patient recovered, thankfully...

more info here: http://www.time.com/time/health/article/0,8599,1878041,00.html

Sid

[file83]

11. Lucky too - only 1 in 5 survive. Caught it in a Ugandan cave apparently.

[TwilightGardener]

12. Feel bad for the nurses, techs, aides, etc. who probably had no idea what

they were coming into contact with until it was too late. Lucky no one else became ill.

[uppityperson]

26. I've worked med floor hosp with people who were sick with no idea what they had.

Passed by a room in '86 and saw the patient had their IV come apart and blood everywhere. I went in, shoved the IV back together and panicked. That was the last time I touched someone, body fluids, without proper protection. Started my Hep B shots about an hour later.

If there was a possibility of contagiousness, we wore a variety of garb, from masks to gloves, gowns, full covering suits, shoe covers, etc. Had an elderly homeless guy in a room once in the mid-1970s. He had maggots keeping his elbow wounds clean, turned out he had active TB. We were all glad we'd instituted infectious precautions before we were told to by the doctor.

They are much more careful these days than back in the 70's.

[kestrel91316]

16. Here's the actual CDC report:

http://www.cdc.gov/ncidod/dvrd/spb/outbreaks/index.htm

2008: Marburg hemorrhagic fever, imported case – United States

On January 22, 2009, CDC’s Special Pathogens Branch retrospectively diagnosed a case of Marburg hemorrhagic fever in a U.S. traveler, who returned from Uganda in January, 2008. The patient developed illness four days after returning to the U.S., was hospitalized, discharged, and fully recovered. Initial testing of samples collected during the patient’s acute illness in January, 2008 did not initially show evidence of Marburg virus infection. Testing of a convalescent sample indicated a possible previous infection, and more detailed testing of both samples at CDC confirmed that the patient’s illness was due to Marburg hemorrhagic fever.

The recovered patient had visited the “python cave” in Maramagambo Forest, Queen Elizabeth Park, western Uganda. This is a popular destination among tourists to see a cave inhabited by thousands of bats; a fatal case of Marburg hemorrhagic fever occurred in a Dutch tourist in July 2008 who had entered this cave. Both patients likely acquired their infections as a result of contact with cave-dwelling fruit bats, which are capable of harboring Marburg virus. Marburg virus is a zoonotic virus that occurs in tropical areas of Africa, and causes a severe, often fatal, hemorrhagic fever in humans and nonhuman primates. It can also be transmitted through direct contact with a symptomatic patient or materials contaminated with infectious body fluids. The Ugandan Ministry of Health officially closed the cave to visitors in August 2008, after the Dutch case.

The state and local health departments are working with CDC’s Special Pathogens Branch and Traveler’s Health and Animal Importation Branch to further investigate the circumstances of this patient’s case. This includes an assessment of any persons who may have been at risk of exposure at the time the patient was ill, and an investigation of travelers potentially exposed when visiting this or other caves in Africa. There is no evidence of apparent transmission as a result of this case.

Travelers should be aware of the risk of acquiring Marburg hemorrhagic fever and other potentially fatal diseases such as rabies after contact with bats. Healthcare providers should be aware of the risk of viral hemorrhagic fever among travelers returning from endemic countries, and should report any suspected cases immediately to their health department and to CDC’s Special Pathogens Branch Branch (Tel. [phone] after hours) for diagnostic testing and further guidance

~~~~~~~~~~~~~

This case was not diagnosed until LONG after the fact. That's frightening. The hospital staff who treated the victim were at risk of infection by not knowing what they had there. This is a gruesome disease with high mortality. Lots of people dodged a bullet.

[Ian David]

19. ONE guy starts bleeding out his eyballs and they close the cave to everyone?

What party-poopers.

:sarcasm:

[pansypoo53219]

20. oh shit.

MARBURG???

i totally recommend read 'the coming plague'.

[dixiegrrrrl]

22. You guys rock.

I got the story from my link, which had a brief blur,.
You guys went to work and found out the incident happened earlier, was just now reported, and the CDC seemed kinda blase about it.
Yet what happened with this guy is the exact doomsday scenario written about so many times..
deadly virus, crowed airplane travel, unwitting hospital staff, etc.
Scary.

[JVS]

25. Isn't that a biological weapon kind of illness?

[goforit]

27. kick

[bobthedrummer]

41. K&R, once again, dixiegrrrl, you have proved your skills at researching the overlooked n/t

:hi: