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Daniel G Bausch - One of the best experts on this subject based on the ideXlab platform.
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Marburg Hemorrhagic Fever in Durba and Watsa, Democratic Republic of the Congo: clinical documentation, features of illness, and treatment.
The Journal of infectious diseases, 2007Co-Authors: Robert Colebunders, Daniel G Bausch, Modeste L. Libande, Antoine Tshomba, Maria D Van Kerkhove, Pat Campbell, Patricia Pirard, Florimond Tshioko, Simon Mardel, Sabue MulanguAbstract:The objective of the present study was to describe day of onset and duration of symptoms of Marburg Hemorrhagic Fever (MHF), to summarize the treatments applied, and to assess the quality of clinical documentation. Surveillance and clinical records of 77 patients with MHF cases were reviewed. Initial symptoms included Fever, headache, general pain, nausea, vomiting, and anorexia (median day of onset, day 1-2), followed by Hemorrhagic manifestations (day 5-8+), and terminal symptoms included confusion, agitation, coma, anuria, and shock. Treatment in isolation wards was acceptable, but the quality of clinical documentation was unsatisfactory. Improved clinical documentation is necessary for a basic evaluation of supportive treatment.
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Marburg Hemorrhagic Fever in durba and watsa democratic republic of the congo clinical documentation features of illness and treatment
The Journal of Infectious Diseases, 2007Co-Authors: Daniel G Bausch, Modeste L. Libande, Robert Colebunders, Antoine Tshomba, Maria D Van Kerkhove, Patricia Campbell, Patricia PirardAbstract:The objective of the present study was to describe day of onset and duration of symptoms of Marburg Hemorrhagic Fever (MHF), to summarize the treatments applied, and to assess the quality of clinical documentation. Surveillance and clinical records of 77 patients with MHF cases were reviewed. Initial symptoms included Fever, headache, general pain, nausea, vomiting, and anorexia (median day of onset, day 1–2), followed by Hemorrhagic manifestations (day 5–8+), and terminal symptoms included confusion, agitation, coma, anuria, and shock. Treatment in isolation wards was acceptable, but the quality of clinical documentation was unsatisfactory. Improved clinical documentation is necessary for a basic evaluation of supportive treatment. In Durba and Watsa, both situated in Watsa Health Zone, northeastern Democratic Republic of the Congo (DRC), a Marburg Hemorrhagic Fever (MHF) outbreak occurred between October 1998 and September 2000. A detailed description of the Marburg Hemorrhagic Fever outbreaks in the Durba area has been published elsewhere [1]. In summary, primary cases were found among gold miners, and secondary cases were found among family members
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studies of reservoir hosts for Marburg virus
Emerging Infectious Diseases, 2007Co-Authors: Robert Swanepoel, Sheilagh B Smit, Pierre Formenty, Antoinette A Grobbelaar, Janice E Croft, Alan Kemp, Patricia A Leman, Felicity J Burt, Pierre E Rollin, Daniel G BauschAbstract:To determine reservoir hosts for Marburg virus (MARV), we examined the fauna of a mine in northeastern Democratic Republic of the Congo. The mine was associated with a protracted outbreak of Marburg Hemorrhagic Fever during 1998–2000. We found MARV nucleic acid in 12 bats, comprising 3.0%–3.6% of 2 species of insectivorous bat and 1 species of fruit bat. We found antibody to the virus in the serum of 9.7% of 1 of the insectivorous species and in 20.5% of the fruit bat species, but attempts to isolate virus were unsuccessful.
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Development of vaccines for Marburg Hemorrhagic Fever.
Expert review of vaccines, 2007Co-Authors: Daniel G Bausch, Thomas W GeisbertAbstract:Marburg (MARV) and Ebola viruses (EBOV) emerged from the rainforests of Central Africa more than 30 years ago causing outbreaks of severe and, usually, fatal Hemorrhagic Fever. EBOV has garnered the lion's share of the attention, fueled by the higher frequency of EBOV outbreaks, high mortality rates and importation into the USA, documented in such popular works as the best-selling novel 'The Hot Zone'. However, recent large outbreaks of hundreds of cases of MARV infection in the Democratic Republic of the Congo and Angola with case fatalities approaching 90% dramatically highlight its lethal potential. Although no vaccines or antiviral drugs for MARV are currently available, remarkable progress has been made over the last few years in developing potential countermeasures against MARV in nonhuman primate models. In particular, a vaccine based on attenuated recombinant vesicular stomatitis virus was recently shown to have both preventive and postexposure efficacy.
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Marburg Hemorrhagic Fever associated with multiple genetic lineages of virus
The New England Journal of Medicine, 2006Co-Authors: Daniel G Bausch, Jeanjacques Muyembetamfum, Matthias Borchert, Pierre E Rollin, Stuart T. Nichol, Patricia Campbell, Hilde Sleurs, Florimund K TshiokoAbstract:BACKGROUND An outbreak of Marburg Hemorrhagic Fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998. METHODS We investigated the outbreak of Marburg Hemorrhagic Fever most intensively in May and October 1999. Sporadic cases and short chains of human-to-human transmission continued to occur until September 2000. Suspected cases were identified on the basis of a case definition; cases were confirmed by the detection of virus antigen and nucleic acid in blood, cell culture, antibody responses, and immunohistochemical analysis. RESULTS A total of 154 cases (48 laboratory-confirmed and 106 suspected) were identified (case fatality rate, 83 percent); 52 percent of cases were in young male miners. Only 27 percent of these men reported having had contact with other affected persons, whereas 67 percent of patients who were not miners reported such contact (P<0.001). Most of the affected miners (94 percent) worked in an underground mine. Cessation of the outbreak coincided with flooding of the mine. Epidemiologic evidence of multiple introductions of infection into the population was substantiated by the detection of at least nine genetically distinct lineages of virus in circulation during the outbreak. CONCLUSIONS Marburg Hemorrhagic Fever can have a very high case fatality rate. Since multiple genetic variants of virus were identified, ongoing introduction of virus into the population helped perpetuate this outbreak. The findings imply that reservoir hosts of Marburg virus inhabit caves, mines, or similar habitats.
Matthias Borchert - One of the best experts on this subject based on the ideXlab platform.
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Use of protective gear and the occurrence of occupational Marburg Hemorrhagic Fever in health workers from Watsa health zone, Democratic Republic of the Congo.
The Journal of infectious diseases, 2007Co-Authors: Matthias Borchert, Modeste L. Libande, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Pierre Lefèvre, Patrick Van Der StuyftAbstract:Occupational transmission to health workers (HWs) has been a typical feature of Marburg Hemorrhagic Fever (MHF) outbreaks. The goal of this study was to identify cases of occupational MHF in HWs from Durba and Watsa, Democratic Republic of the Congo; to assess levels of exposure and protection; and to explore reasons for inconsistent use of protective gear. A serosurvey of 48 HWs who cared for patients with MHF was performed. In addition, HWs were given a questionnaire on types of exposure, use of protective gear, and symptoms after contact. Informal and in-depth interviews with HWs were also performed. We found 1 HW who was seropositive for MHF, in addition to 5 cases of occupational MHF known beforehand; 4 infections had occurred after the introduction of infection control. HWs protected themselves better during invasive procedures (injections, venipuncture, and surgery) than during noninvasive procedures, but the overall level of protection in the hospital remained insufficient, particularly outside of isolation wards. The reasons for inconsistent use of protective gear included insufficient availability of the gear, adherence to traditional explanatory models of the origin of disease, and peer bonding with sick colleagues. Infection control must not focus too exclusively on the establishment of isolation wards but should aim at improving overall hospital hygiene. Training of HWs should allow them to voice and discuss their doubts and prepare them for the peculiarities of caring for ill colleagues.
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Use of Protective Gear and the Occurrence of Occupational Marburg Hemorrhagic Fever in Health Workers from Watsa Health Zone, Democratic Republic of the Congo
The Journal of Infectious Diseases, 2007Co-Authors: Matthias Borchert, Modeste L. Libande, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Pierre Lefèvre, Patrick Van Der StuyftAbstract:Background. Occupational transmission to health workers (HWs) has been a typical feature of Marburg Hemorrhagic Fever (MHF) outbreaks. The goal of this study was to identify cases of occupational MHF in HWs from Durba and Watsa, Democratic Republic of the Congo; to assess levels of exposure and protection; and to explore reasons for inconsistent use of protective gear. Methods. A serosurvey of 48 HWs who cared for patients with MHF was performed. In addition, HWs were given a questionnaire on types of exposure, use of protective gear, and symptoms after contact. Informal and indepth interviews with HWs were also performed. Results. We found 1 HW who was seropositive for MHF, in addition to 5 cases of occupational MHF known beforehand; 4 infections had occurred after the introduction of infection control. HWs protected themselves better during invasive procedures (injections, venipuncture, and surgery) than during noninvasive procedures, but the overall level of protection in the hospital remained insufficient, particularly outside of isolation wards. The reasons for inconsistent use of protective gear included insufficient availability of the gear, adherence to traditional explanatory models of the origin of disease, and peer bonding with sick colleagues. Conclusions. Infection control must not focus too exclusively on the establishment of isolation wards but should aim at improving overall hospital hygiene. Training of HWs should allow them to voice and discuss their doubts and prepare them for the peculiarities of caring for ill colleagues.
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Marburg Hemorrhagic Fever associated with multiple genetic lineages of virus
The New England Journal of Medicine, 2006Co-Authors: Daniel G Bausch, Jeanjacques Muyembetamfum, Matthias Borchert, Pierre E Rollin, Stuart T. Nichol, Patricia Campbell, Hilde Sleurs, Florimund K TshiokoAbstract:BACKGROUND An outbreak of Marburg Hemorrhagic Fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998. METHODS We investigated the outbreak of Marburg Hemorrhagic Fever most intensively in May and October 1999. Sporadic cases and short chains of human-to-human transmission continued to occur until September 2000. Suspected cases were identified on the basis of a case definition; cases were confirmed by the detection of virus antigen and nucleic acid in blood, cell culture, antibody responses, and immunohistochemical analysis. RESULTS A total of 154 cases (48 laboratory-confirmed and 106 suspected) were identified (case fatality rate, 83 percent); 52 percent of cases were in young male miners. Only 27 percent of these men reported having had contact with other affected persons, whereas 67 percent of patients who were not miners reported such contact (P<0.001). Most of the affected miners (94 percent) worked in an underground mine. Cessation of the outbreak coincided with flooding of the mine. Epidemiologic evidence of multiple introductions of infection into the population was substantiated by the detection of at least nine genetically distinct lineages of virus in circulation during the outbreak. CONCLUSIONS Marburg Hemorrhagic Fever can have a very high case fatality rate. Since multiple genetic variants of virus were identified, ongoing introduction of virus into the population helped perpetuate this outbreak. The findings imply that reservoir hosts of Marburg virus inhabit caves, mines, or similar habitats.
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Marburg Hemorrhagic Fever associated with multiple genetic lineages of virus.
The New England journal of medicine, 2006Co-Authors: Daniel G Bausch, Matthias Borchert, Pierre E Rollin, Stuart T. Nichol, Patricia Campbell, Hilde Sleurs, Florimund K Tshioko, J. J. Muyembe-tamfum, Catherine Roth, Robert ColebundersAbstract:BACKGROUND An outbreak of Marburg Hemorrhagic Fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998. METHODS We investigated the outbreak of Marburg Hemorrhagic Fever most intensively in May and October 1999. Sporadic cases and short chains of human-to-human transmission continued to occur until September 2000. Suspected cases were identified on the basis of a case definition; cases were confirmed by the detection of virus antigen and nucleic acid in blood, cell culture, antibody responses, and immunohistochemical analysis. RESULTS A total of 154 cases (48 laboratory-confirmed and 106 suspected) were identified (case fatality rate, 83 percent); 52 percent of cases were in young male miners. Only 27 percent of these men reported having had contact with other affected persons, whereas 67 percent of patients who were not miners reported such contact (P
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Marburg Hemorrhagic Fever associated with multiple genetic lineages of virus
The New England Journal of Medicine, 2006Co-Authors: Daniel G Bausch, Jeanjacques Muyembetamfum, Matthias Borchert, Pierre E Rollin, Stuart T. Nichol, Patricia Campbell, Hilde Sleurs, Florimund K Tshioko, Catherine RothAbstract:Background An outbreak of Marburg Hemorrhagic Fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998. Methods We investigated the outbreak of Marburg Hemorrhagic Fever most intensively in May and October 1999. Sporadic cases and short chains of human-to-human transmission continued to occur until September 2000. Suspected cases were identified on the basis of a case definition; cases were confirmed by the detection of virus antigen and nucleic acid in blood, cell culture, antibody responses, and immunohistochemical analysis. Results A total of 154 cases (48 laboratory-confirmed and 106 suspected) were identified (case fatality rate, 83 percent); 52 percent of cases were in young male miners. Only 27 percent of these men reported having had contact with other affected persons, whereas 67 percent of patients who were not miners reported such contact (P<0.001). Most of the affected miners (94 percent) worked in an underground mine. Cessation of the ...
Patrick Van Der Stuyft - One of the best experts on this subject based on the ideXlab platform.
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Use of protective gear and the occurrence of occupational Marburg Hemorrhagic Fever in health workers from Watsa health zone, Democratic Republic of the Congo.
The Journal of infectious diseases, 2007Co-Authors: Matthias Borchert, Modeste L. Libande, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Pierre Lefèvre, Patrick Van Der StuyftAbstract:Occupational transmission to health workers (HWs) has been a typical feature of Marburg Hemorrhagic Fever (MHF) outbreaks. The goal of this study was to identify cases of occupational MHF in HWs from Durba and Watsa, Democratic Republic of the Congo; to assess levels of exposure and protection; and to explore reasons for inconsistent use of protective gear. A serosurvey of 48 HWs who cared for patients with MHF was performed. In addition, HWs were given a questionnaire on types of exposure, use of protective gear, and symptoms after contact. Informal and in-depth interviews with HWs were also performed. We found 1 HW who was seropositive for MHF, in addition to 5 cases of occupational MHF known beforehand; 4 infections had occurred after the introduction of infection control. HWs protected themselves better during invasive procedures (injections, venipuncture, and surgery) than during noninvasive procedures, but the overall level of protection in the hospital remained insufficient, particularly outside of isolation wards. The reasons for inconsistent use of protective gear included insufficient availability of the gear, adherence to traditional explanatory models of the origin of disease, and peer bonding with sick colleagues. Infection control must not focus too exclusively on the establishment of isolation wards but should aim at improving overall hospital hygiene. Training of HWs should allow them to voice and discuss their doubts and prepare them for the peculiarities of caring for ill colleagues.
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Use of Protective Gear and the Occurrence of Occupational Marburg Hemorrhagic Fever in Health Workers from Watsa Health Zone, Democratic Republic of the Congo
The Journal of Infectious Diseases, 2007Co-Authors: Matthias Borchert, Modeste L. Libande, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Pierre Lefèvre, Patrick Van Der StuyftAbstract:Background. Occupational transmission to health workers (HWs) has been a typical feature of Marburg Hemorrhagic Fever (MHF) outbreaks. The goal of this study was to identify cases of occupational MHF in HWs from Durba and Watsa, Democratic Republic of the Congo; to assess levels of exposure and protection; and to explore reasons for inconsistent use of protective gear. Methods. A serosurvey of 48 HWs who cared for patients with MHF was performed. In addition, HWs were given a questionnaire on types of exposure, use of protective gear, and symptoms after contact. Informal and indepth interviews with HWs were also performed. Results. We found 1 HW who was seropositive for MHF, in addition to 5 cases of occupational MHF known beforehand; 4 infections had occurred after the introduction of infection control. HWs protected themselves better during invasive procedures (injections, venipuncture, and surgery) than during noninvasive procedures, but the overall level of protection in the hospital remained insufficient, particularly outside of isolation wards. The reasons for inconsistent use of protective gear included insufficient availability of the gear, adherence to traditional explanatory models of the origin of disease, and peer bonding with sick colleagues. Conclusions. Infection control must not focus too exclusively on the establishment of isolation wards but should aim at improving overall hospital hygiene. Training of HWs should allow them to voice and discuss their doubts and prepare them for the peculiarities of caring for ill colleagues.
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Serosurvey on Household Contacts of Marburg Hemorrhagic Fever Patients
Emerging infectious diseases, 2006Co-Authors: Matthias Borchert, Modeste L. Libande, Robert Swanepoel, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Patrick Van Der StuyftAbstract:The first major outbreak of Marburg Hemorrhagic Fever (MHF) outside a laboratory environment occurred in the subdistrict of Watsa, Democratic Republic of Congo, from October 1998 to August 2000. We performed a serosurvey of household contacts of MHF patients to identify undetected cases, ascertain the frequency of asymptomatic Marburg infection, and estimate secondary attack risk and postintervention reproduction number. Contacts were interviewed about their exposure and symptoms consistent with MHF. Blood samples were tested for anti–Marburg immunoglobulin G (IgG). One hundred twenty-one (51%) of 237 identified contacts participated; 72 (60%) were not known to the health authorities. Two participating contacts were seropositive and reported becoming ill after the contact; no serologic evidence for asymptomatic or mild Marburg infection was found. The secondary attack risk was 21%; the postintervention reproduction number was 0.9, consistent with an outbreak sustained by repeated primary transmission, rather than large-scale secondary transmission.
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Pygmy populations seronegative for Marburg virus.
Emerging infectious diseases, 2005Co-Authors: Matthias Borchert, Robert Swanepoel, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Afongenda Afounde, Patrick Van Der StuyftAbstract:To the Editor: A serosurvey was conducted in Durba, a mining village near Watsa, northeastern Democratic Republic of Congo, the epicenter of Marburg Hemorrhagic Fever (MHF) outbreaks in 1994 and 1998–2000 (1–3). In this survey, Bausch et al. found a prevalence of anti-Marburg immunoglobulin (Ig) G of 0.35% (2 of 565) in the nonmining population, but a prevalence of 3.75% (13 of 347) in miners. Mine work was an independent risk factor for seropositivity for anti-Marburg IgG (1). Given that widespread secondary transmission could not be documented in the seropositive miners, primary transmission from the unknown reservoir likely occurred in the mines where rodent, shrew, bat, and other fauna were abundant. No evidence of Marburg virus (MBGV) infection was found in samples from small mammals, amphibians, and arthropods collected in and around Gorumbwa mine (R. Swanepoel, pers. comm.); the origin of the MHF outbreak remained unknown. We hypothesized that the MBGV reservoir's habitat might not be limited to gold mines around Durba, but may exist in caves or forests in the wider Watsa area. As hunter-gatherers, pygmies enter caves for shelter and are in frequent contact with wild animals and body fluids of butchered game. Earlier studies found that pygmies were seropositive for filoviruses significantly more often than subsistence farmers (for filoviruses [4,5], for Ebola but not Marburg [6]). We conducted a seroprevalence study to verify whether pygmies living in the Watsa area constitute another population at risk for primary transmission of MBGV. The Watsa area's population (≈180,000) includes 4,000 pygmies living predominantly in its southern parts (1). The pygmies live seminomadically in the forest, occasionally leaving to exchange goods with the sedentary Bantu population. We invited the pygmy population to meet with our study representatives at sites 50–90 km from Durba. Three hundred persons volunteered during a 5-day period. After informed verbal consent was obtained, the study participants were interviewed, and a blood sample was taken from each volunteer. For operational reasons, we excluded children
Modeste L. Libande - One of the best experts on this subject based on the ideXlab platform.
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Marburg Hemorrhagic Fever in Durba and Watsa, Democratic Republic of the Congo: clinical documentation, features of illness, and treatment.
The Journal of infectious diseases, 2007Co-Authors: Robert Colebunders, Daniel G Bausch, Modeste L. Libande, Antoine Tshomba, Maria D Van Kerkhove, Pat Campbell, Patricia Pirard, Florimond Tshioko, Simon Mardel, Sabue MulanguAbstract:The objective of the present study was to describe day of onset and duration of symptoms of Marburg Hemorrhagic Fever (MHF), to summarize the treatments applied, and to assess the quality of clinical documentation. Surveillance and clinical records of 77 patients with MHF cases were reviewed. Initial symptoms included Fever, headache, general pain, nausea, vomiting, and anorexia (median day of onset, day 1-2), followed by Hemorrhagic manifestations (day 5-8+), and terminal symptoms included confusion, agitation, coma, anuria, and shock. Treatment in isolation wards was acceptable, but the quality of clinical documentation was unsatisfactory. Improved clinical documentation is necessary for a basic evaluation of supportive treatment.
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Marburg Hemorrhagic Fever in durba and watsa democratic republic of the congo clinical documentation features of illness and treatment
The Journal of Infectious Diseases, 2007Co-Authors: Daniel G Bausch, Modeste L. Libande, Robert Colebunders, Antoine Tshomba, Maria D Van Kerkhove, Patricia Campbell, Patricia PirardAbstract:The objective of the present study was to describe day of onset and duration of symptoms of Marburg Hemorrhagic Fever (MHF), to summarize the treatments applied, and to assess the quality of clinical documentation. Surveillance and clinical records of 77 patients with MHF cases were reviewed. Initial symptoms included Fever, headache, general pain, nausea, vomiting, and anorexia (median day of onset, day 1–2), followed by Hemorrhagic manifestations (day 5–8+), and terminal symptoms included confusion, agitation, coma, anuria, and shock. Treatment in isolation wards was acceptable, but the quality of clinical documentation was unsatisfactory. Improved clinical documentation is necessary for a basic evaluation of supportive treatment. In Durba and Watsa, both situated in Watsa Health Zone, northeastern Democratic Republic of the Congo (DRC), a Marburg Hemorrhagic Fever (MHF) outbreak occurred between October 1998 and September 2000. A detailed description of the Marburg Hemorrhagic Fever outbreaks in the Durba area has been published elsewhere [1]. In summary, primary cases were found among gold miners, and secondary cases were found among family members
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Use of Protective Gear and the Occurrence of Occupational Marburg Hemorrhagic Fever in Health Workers from Watsa Health Zone, Democratic Republic of the Congo
The Journal of Infectious Diseases, 2007Co-Authors: Matthias Borchert, Modeste L. Libande, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Pierre Lefèvre, Patrick Van Der StuyftAbstract:Background. Occupational transmission to health workers (HWs) has been a typical feature of Marburg Hemorrhagic Fever (MHF) outbreaks. The goal of this study was to identify cases of occupational MHF in HWs from Durba and Watsa, Democratic Republic of the Congo; to assess levels of exposure and protection; and to explore reasons for inconsistent use of protective gear. Methods. A serosurvey of 48 HWs who cared for patients with MHF was performed. In addition, HWs were given a questionnaire on types of exposure, use of protective gear, and symptoms after contact. Informal and indepth interviews with HWs were also performed. Results. We found 1 HW who was seropositive for MHF, in addition to 5 cases of occupational MHF known beforehand; 4 infections had occurred after the introduction of infection control. HWs protected themselves better during invasive procedures (injections, venipuncture, and surgery) than during noninvasive procedures, but the overall level of protection in the hospital remained insufficient, particularly outside of isolation wards. The reasons for inconsistent use of protective gear included insufficient availability of the gear, adherence to traditional explanatory models of the origin of disease, and peer bonding with sick colleagues. Conclusions. Infection control must not focus too exclusively on the establishment of isolation wards but should aim at improving overall hospital hygiene. Training of HWs should allow them to voice and discuss their doubts and prepare them for the peculiarities of caring for ill colleagues.
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Use of protective gear and the occurrence of occupational Marburg Hemorrhagic Fever in health workers from Watsa health zone, Democratic Republic of the Congo.
The Journal of infectious diseases, 2007Co-Authors: Matthias Borchert, Modeste L. Libande, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Pierre Lefèvre, Patrick Van Der StuyftAbstract:Occupational transmission to health workers (HWs) has been a typical feature of Marburg Hemorrhagic Fever (MHF) outbreaks. The goal of this study was to identify cases of occupational MHF in HWs from Durba and Watsa, Democratic Republic of the Congo; to assess levels of exposure and protection; and to explore reasons for inconsistent use of protective gear. A serosurvey of 48 HWs who cared for patients with MHF was performed. In addition, HWs were given a questionnaire on types of exposure, use of protective gear, and symptoms after contact. Informal and in-depth interviews with HWs were also performed. We found 1 HW who was seropositive for MHF, in addition to 5 cases of occupational MHF known beforehand; 4 infections had occurred after the introduction of infection control. HWs protected themselves better during invasive procedures (injections, venipuncture, and surgery) than during noninvasive procedures, but the overall level of protection in the hospital remained insufficient, particularly outside of isolation wards. The reasons for inconsistent use of protective gear included insufficient availability of the gear, adherence to traditional explanatory models of the origin of disease, and peer bonding with sick colleagues. Infection control must not focus too exclusively on the establishment of isolation wards but should aim at improving overall hospital hygiene. Training of HWs should allow them to voice and discuss their doubts and prepare them for the peculiarities of caring for ill colleagues.
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Serosurvey on Household Contacts of Marburg Hemorrhagic Fever Patients
Emerging infectious diseases, 2006Co-Authors: Matthias Borchert, Modeste L. Libande, Robert Swanepoel, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Patrick Van Der StuyftAbstract:The first major outbreak of Marburg Hemorrhagic Fever (MHF) outside a laboratory environment occurred in the subdistrict of Watsa, Democratic Republic of Congo, from October 1998 to August 2000. We performed a serosurvey of household contacts of MHF patients to identify undetected cases, ascertain the frequency of asymptomatic Marburg infection, and estimate secondary attack risk and postintervention reproduction number. Contacts were interviewed about their exposure and symptoms consistent with MHF. Blood samples were tested for anti–Marburg immunoglobulin G (IgG). One hundred twenty-one (51%) of 237 identified contacts participated; 72 (60%) were not known to the health authorities. Two participating contacts were seropositive and reported becoming ill after the contact; no serologic evidence for asymptomatic or mild Marburg infection was found. The secondary attack risk was 21%; the postintervention reproduction number was 0.9, consistent with an outbreak sustained by repeated primary transmission, rather than large-scale secondary transmission.
Antoine Tshomba - One of the best experts on this subject based on the ideXlab platform.
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Marburg Hemorrhagic Fever in Durba and Watsa, Democratic Republic of the Congo: clinical documentation, features of illness, and treatment.
The Journal of infectious diseases, 2007Co-Authors: Robert Colebunders, Daniel G Bausch, Modeste L. Libande, Antoine Tshomba, Maria D Van Kerkhove, Pat Campbell, Patricia Pirard, Florimond Tshioko, Simon Mardel, Sabue MulanguAbstract:The objective of the present study was to describe day of onset and duration of symptoms of Marburg Hemorrhagic Fever (MHF), to summarize the treatments applied, and to assess the quality of clinical documentation. Surveillance and clinical records of 77 patients with MHF cases were reviewed. Initial symptoms included Fever, headache, general pain, nausea, vomiting, and anorexia (median day of onset, day 1-2), followed by Hemorrhagic manifestations (day 5-8+), and terminal symptoms included confusion, agitation, coma, anuria, and shock. Treatment in isolation wards was acceptable, but the quality of clinical documentation was unsatisfactory. Improved clinical documentation is necessary for a basic evaluation of supportive treatment.
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Marburg Hemorrhagic Fever in durba and watsa democratic republic of the congo clinical documentation features of illness and treatment
The Journal of Infectious Diseases, 2007Co-Authors: Daniel G Bausch, Modeste L. Libande, Robert Colebunders, Antoine Tshomba, Maria D Van Kerkhove, Patricia Campbell, Patricia PirardAbstract:The objective of the present study was to describe day of onset and duration of symptoms of Marburg Hemorrhagic Fever (MHF), to summarize the treatments applied, and to assess the quality of clinical documentation. Surveillance and clinical records of 77 patients with MHF cases were reviewed. Initial symptoms included Fever, headache, general pain, nausea, vomiting, and anorexia (median day of onset, day 1–2), followed by Hemorrhagic manifestations (day 5–8+), and terminal symptoms included confusion, agitation, coma, anuria, and shock. Treatment in isolation wards was acceptable, but the quality of clinical documentation was unsatisfactory. Improved clinical documentation is necessary for a basic evaluation of supportive treatment. In Durba and Watsa, both situated in Watsa Health Zone, northeastern Democratic Republic of the Congo (DRC), a Marburg Hemorrhagic Fever (MHF) outbreak occurred between October 1998 and September 2000. A detailed description of the Marburg Hemorrhagic Fever outbreaks in the Durba area has been published elsewhere [1]. In summary, primary cases were found among gold miners, and secondary cases were found among family members
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Use of Protective Gear and the Occurrence of Occupational Marburg Hemorrhagic Fever in Health Workers from Watsa Health Zone, Democratic Republic of the Congo
The Journal of Infectious Diseases, 2007Co-Authors: Matthias Borchert, Modeste L. Libande, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Pierre Lefèvre, Patrick Van Der StuyftAbstract:Background. Occupational transmission to health workers (HWs) has been a typical feature of Marburg Hemorrhagic Fever (MHF) outbreaks. The goal of this study was to identify cases of occupational MHF in HWs from Durba and Watsa, Democratic Republic of the Congo; to assess levels of exposure and protection; and to explore reasons for inconsistent use of protective gear. Methods. A serosurvey of 48 HWs who cared for patients with MHF was performed. In addition, HWs were given a questionnaire on types of exposure, use of protective gear, and symptoms after contact. Informal and indepth interviews with HWs were also performed. Results. We found 1 HW who was seropositive for MHF, in addition to 5 cases of occupational MHF known beforehand; 4 infections had occurred after the introduction of infection control. HWs protected themselves better during invasive procedures (injections, venipuncture, and surgery) than during noninvasive procedures, but the overall level of protection in the hospital remained insufficient, particularly outside of isolation wards. The reasons for inconsistent use of protective gear included insufficient availability of the gear, adherence to traditional explanatory models of the origin of disease, and peer bonding with sick colleagues. Conclusions. Infection control must not focus too exclusively on the establishment of isolation wards but should aim at improving overall hospital hygiene. Training of HWs should allow them to voice and discuss their doubts and prepare them for the peculiarities of caring for ill colleagues.
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Use of protective gear and the occurrence of occupational Marburg Hemorrhagic Fever in health workers from Watsa health zone, Democratic Republic of the Congo.
The Journal of infectious diseases, 2007Co-Authors: Matthias Borchert, Modeste L. Libande, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Pierre Lefèvre, Patrick Van Der StuyftAbstract:Occupational transmission to health workers (HWs) has been a typical feature of Marburg Hemorrhagic Fever (MHF) outbreaks. The goal of this study was to identify cases of occupational MHF in HWs from Durba and Watsa, Democratic Republic of the Congo; to assess levels of exposure and protection; and to explore reasons for inconsistent use of protective gear. A serosurvey of 48 HWs who cared for patients with MHF was performed. In addition, HWs were given a questionnaire on types of exposure, use of protective gear, and symptoms after contact. Informal and in-depth interviews with HWs were also performed. We found 1 HW who was seropositive for MHF, in addition to 5 cases of occupational MHF known beforehand; 4 infections had occurred after the introduction of infection control. HWs protected themselves better during invasive procedures (injections, venipuncture, and surgery) than during noninvasive procedures, but the overall level of protection in the hospital remained insufficient, particularly outside of isolation wards. The reasons for inconsistent use of protective gear included insufficient availability of the gear, adherence to traditional explanatory models of the origin of disease, and peer bonding with sick colleagues. Infection control must not focus too exclusively on the establishment of isolation wards but should aim at improving overall hospital hygiene. Training of HWs should allow them to voice and discuss their doubts and prepare them for the peculiarities of caring for ill colleagues.
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Serosurvey on Household Contacts of Marburg Hemorrhagic Fever Patients
Emerging infectious diseases, 2006Co-Authors: Matthias Borchert, Modeste L. Libande, Robert Swanepoel, Antoine Tshomba, Sabue Mulangu, Amayo Kulidri, Jean-jacques Muyembe-tamfum, Patrick Van Der StuyftAbstract:The first major outbreak of Marburg Hemorrhagic Fever (MHF) outside a laboratory environment occurred in the subdistrict of Watsa, Democratic Republic of Congo, from October 1998 to August 2000. We performed a serosurvey of household contacts of MHF patients to identify undetected cases, ascertain the frequency of asymptomatic Marburg infection, and estimate secondary attack risk and postintervention reproduction number. Contacts were interviewed about their exposure and symptoms consistent with MHF. Blood samples were tested for anti–Marburg immunoglobulin G (IgG). One hundred twenty-one (51%) of 237 identified contacts participated; 72 (60%) were not known to the health authorities. Two participating contacts were seropositive and reported becoming ill after the contact; no serologic evidence for asymptomatic or mild Marburg infection was found. The secondary attack risk was 21%; the postintervention reproduction number was 0.9, consistent with an outbreak sustained by repeated primary transmission, rather than large-scale secondary transmission.