International health experts said on Monday they feared Angola's deadly Marburg epidemic might escalate and spread quickly, although Angolan officials said the outbreak was under control. The Ebola-like disease has killed 235 people and infected 22 more, the health ministry said late on Sunday, and World Health Organisation (WHO) officials said the world's worst outbreak of the virus was far from over. "We haven't contained it. We haven't broken the transition cycle. We are still finding cases," WHO spokesman Dave Daigle told Reuters in Uige, the northern province which has borne the brunt of the Marburg outbreak.
"We are quite terrified that this could still really take off. It could spread very quickly in Uige or it could spread somewhere like Luanda," he said.
Doctors and nurses tackling the epidemic in Uige province have come up against local mistrust with some people accusing them of spreading the disease, but Angolan officials said they believed they were winning the fight against the virus.
"We already have it under control," Deputy Health Minister Jose Van Dunem told Reuters in an interview in the capital Luanda late on Sunday.
"There have been no new cases in other provinces. We know exactly how to cut the epidemiological chain of transmission."
Marburg is transmitted through bodily fluids such as sweat, blood and saliva. Symptoms include high fever, vomiting, diarrhoea and internal bleeding.
A handful of cases have been reported elsewhere in the country, but all among people who had recently visited Uige, the health ministry said.
Nearly three decades of civil war has wrecked the oil-producing country's transport and health systems, hobbling medical efforts to fight the disease.
But Van Dunem said the country's war-battered transport infrastructure had proved a blessing in disguise as poor roads between Uige and the rest of the country had slowed the spread of the Marburg outbreak.
Residents say the main road out of the city is often all but impassable with flooding, potholes, and landmines still common along the route - stopping all but the most intrepid travellers.
Health workers from the UN and Medicines Sans Frontieres are working with Angolan civilian and military staff to control the disease, but some WHO staff have been attacked by locals.
"Early in the outbreak some of the health professionals died and some of the people have lost confidence in them," Van Dunem said.
The government is now turning to traditional healers and leaders to help spread the message, hoping to boost local trust in disease prevention strategies, he said.
Victims are most contagious in the final stages of the disease, and Van Dunem said the virus could be defeated if contact with the sick and dead was reduced.
But many Angolans kiss and clean the body of dead relatives before burial, and this had to be stopped, he said.
So far, the outbreak has had little impact on foreign companies operating in Angola - sub-Saharan Africa's second largest oil producer after Nigeria - but expatriate workers say they are worried.
"With this, if you shake the wrong person's hand you're dead," one Scottish oil worker said.
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