The New York Times > International > Africa > Stalking a Deadly Virus, Battling a Town's Fears

A detailed account of the devastation brought on by the virus and a dseserved tribute to Maria Bonino, an Italian pediatrician, who initially brought world attention to the epidemic before dying of hemorrhagic fever herself...

The New York Times > International > Africa > Stalking a Deadly Virus, Battling a Town's Fears: "UiGE, Angola, April 16 - For nearly four weeks, teams of health experts have been trying to set up a rescue operation in this town of windowless, crumbling buildings with no running water, intermittent electricity, poor sanitation and a perennially jammed telephone network..."

A cousin of Ebola, the Marburg virus has erupted periodically in Africa in sudden, gruesome epidemics, only to disappear just as mysteriously. This time it has struck with a vengeance, killing 9 out of 10 people infected - a total of 230 people so far, including 14 nurses and 2 doctors who cared for the sick.

The virus is highly contagious, making any outbreak a cause for widespread fear and fascination in a world shrunk by international travel and trade. Marburg spreads through blood, vomit, semen and other bodily fluids. Even a cough can prove fatal for someone hit by a few drops of spittle. Corpses, teeming with the virus, are especially dangerous. A contaminated surface can be deadly - the virus can find its way into someone's eyes, nose or mouth, or enter the bloodstream through a cut.

Once in the body, it moves with terrifying speed, invading white blood cells essential to fighting infection. On Day 3 of the infection, fewer than 200 viruses are in a drop of blood. By Day 8, there are five million.

"That's why dead bodies are kind of like bombs..."

There is no specific treatment, but more patients would probably survive if they could get the kind of intensive care available in developed countries.

In what is probably the only recorded outbreak outside Africa, in 1967, among laboratory workers in Germany and Yugoslavia, the death rate was only 23 percent...

Dr. Bonino, from the charity Doctors With Africa, began suspecting that there was something dreadful in the children's ward of the sprawling regional hospital in March of last year, months before anyone else became alarmed...Dr. Bonino had worked for 15 years in Africa, including a spell in Uganda during an Ebola outbreak, and understood hemorrhagic fevers. She moved to Uíge in 2003, and won the loyalty of the children's ward nurses with her hard work, compassion and expertise in illnesses unique to Africa...
Dr. Bonino gave the arriving teams a list of 39 suspected cases of hemorrhagic fever. The investigators found two dozen more. New samples were flown to Atlanta.

On March 21, 9 of 12 came back positive.

Less than a week later, Dr. Bonino died of Marburg virus. Fourteen nurses and a Vietnamese surgeon who worked at the hospital have also died. The surgeon was probably infected while performing an autopsy on a Marburg victim, Dr. Pisani said.

On the whiteboard mounted on a wall in the pediatric ward, Dr. Bonino's cellphone number is still scrawled...