Battling a Virus -- and Anger -- in Angola

International health officials fighting a deadly outbreak of Marburg fever in Angola said Tuesday that they had called in church leaders, social anthropologists and even a popular music group to help stop attacks on health workers clad in intimidating moon suits.

As the virus has spread, killing 194 people so far, some grieving residents have turned their anger toward relief workers, who have halted traditional burial rituals and removed bodies from villages to contain the virus.

Family members of Marburg victims have thrown rocks at health workers, and rumors have been circulating that the foreigners are spreading the disease.

“Imagine that a mother has lost her children, and then in come guys in white full-body suits and masks, and they don’t allow the families to do their ritual washing of the bodies,” said David Daigle, a spokesman for the World Health Organization in the province of Uige, northeast of the capital, Luanda.

Monica Castellarnau, emergency coordinator for Doctors Without Borders in Uige, told Reuters that fear of health workers had led some to hide Marburg victims in their homes so as not to elicit a visit from authorities.

“That means the virus keeps on spreading in the community,” she said.

Marburg, named for the German city where it was discovered in 1967, kills about 90% of victims within 10 days. Patients suffer high fever, severe diarrhea, vomiting and bleeding.

The virus is one of the most deadly pathogens and can be passed along by contact with any bodily fluid, including sweat. No vaccine or cure exists for the disease, which is similar to Ebola.

The current Marburg outbreak began in October and has claimed more victims than any previous episode, killing most of the 214 people infected, according to WHO. Most cases were in Uige, but two were in the densely populated city of Luanda.

After the attacks on health workers, WHO and Doctors Without Borders suspended the pickup of bodies for two days as they sought help from government and religious leaders.

Health workers have now changed their approach to residents, talking to survivors before donning their masks.

Marburg is most contagious near the time of death and shortly after, and transmission often occurs as Angolans engage in the ritual washing of bodies.

Anthropologists and health educators from South Africa and Mozambique are working with villagers to create alternative cleansing rituals -- having mourners wash their own hands with a water and bleach solution, for example, instead of washing the body.

“We are trying to adjust with how they are dealing with death and burial habits -- to make it as human as possible,” said Erna van Goor, head of the Doctors Without Borders mission in Luanda. “That really will reduce a lot of the misunderstanding and anger.”

A popular local music group recently lost a singer to Marburg. On Tuesday, the group recorded a song about the disease and how to work with health authorities. It will be broadcast on the radio and from trucks that will drive from village to village, Daigle said.

WHO and Doctors Without Borders have 39 volunteers in Uige, including experts in epidemiology and infection control. The groups are still uncertain about the scope of the epidemic.

“We have a better sense in the areas very close to Uige, but beyond -- we’re just getting people in the nearby provinces to do case investigations,” said Dick Thompson, a Geneva-based WHO representative.