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Transcript of WHO podcast - 5 September 2007

The World Health Report 2007 on threats to global public health security; tracking a killer virus in the mines of Uganda

Iain Simpson: You’re listening to the WHO podcast for the week of 3 September 2007. I'm Iain Simpson.

In this episode: World Health Report highlights threats to global public health security, including the emerging diseases that spread from animals to humans - and tracking a killer virus in the mines of Uganda; WHO scientists believe they may have new information about Marburg fever.

Story 1

More than ever before, global public health security depends on international cooperation and the willingness of all countries to act together to tackle new and emerging threats. That's the clear message of this year's World health report - A safer future. The report concludes with a set of six key recommendations to ensure the highest possible level of global public health security. Dr Margaret Chan is the Director-General of WHO. This is what she had to say about the report.

Dr Margaret Chan: Given today’s universal vulnerability to these threats, better security calls for global solidarity, for collective action in the face of a shared threat. This is the most reliable strategy for defence. Changes in the way humanity inhabits the planet have created multiple opportunities for new diseases to emerge, and for older diseases to resurge or become established on new continents. Population growth, rapid urbanization, intensive farming practices, environmental degradation, and the misuse of antibiotics have placed enormous pressure on the microbial world.

Story 2

Iain Simpson: The World Health Report draws attention to the large number of diseases - an average of almost one a year - that have emerged over the past forty years. One of them is Marburg haemorrhagic fever. Marburg is a highly fatal disease. It's caused by a virus from the same family as the one that causes Ebola.The virus can cause high fevers and profuse bleeding. Fortunately, both diseases are rare, but they can cause dramatic outbreaks with high fatality including many health workers. There is currently no specific treatment or vaccine.

Two cases of Marburg virus infection have recently been reported in Uganda. One of the people, a miner, died in July. In recent weeks, an international team of scientists has been working to identify the source of the virus - what they call the reservoir - and how it passes from an animal to infect a person.

Dr Melville George is the WHO Representative in Uganda. He says the country's experience in the past with controlling Ebola has enabled it to deal effectively with this outbreak.

Dr Melville George: Following Ebola, Uganda has built a lot of capacity. This capacity and experience learned I think people realised that, you know that having had those lesson proved very useful in managing this outbreak. When you look at the area of social mobilizaton for example, some of the leaflets, where just modified from Ebola to Marburg.

Iain Simpson: WHO's Regional Office for Africa has also invested heavily in training health workers to deal with Ebola, says Dr Nestor Ndayimirije.

Dr Nestor Ndayimirije: We have built a lot of capacity at the district level, in the health facilities, to be able detect early enough, notify and respond to oubtreaks. People are already aware about surveillance and response, they know about any outbreak, including marburg, the only issue is to give them the ability to confirm.

Iain Simpson: Because the first cases were quickly identified, it has been possible to go back to the source of the virus to learn more about it. Dr Pierre Formenty of WHO has been studying haemorrhagic fevers for many years.

Dr Pierre Formenty: It has been a unique opportunity for us, because the outbreak was contained to be able to mobilize some international teams to come here to look at the natural history of Marburg. So we have, together with the MoH mobiized a team from CDC Atlanta, from South Africa and staff from WHO. The work that we are doing in the mine is discovering the natural resevoir of a disease like Marburg. This will help us to help for the prevention messages, but also with scientific studies on the bats themselves, if they are carrier, we will understand how the immune system of the bat is stopping the Marburg virus. in the body of the bats and maybe it will help us to develop new treatment against marburg.

Iain Simpson: Together with its partners, WHO has put together an ecological study team. The team made several night-time visits to the cave and captured more than one thousand bats of two species. And then, after nearly a week of work, another unique opportunity walked up in the shape of the two miners who had survived the disease. They led the team into a small side cavern. Pierre Formenty sets the scene:

Dr Pierre Formenty: Suddenly we enter into a tunnel, where the first thing I saw just nearby my face was dead bodies of bats lying on the floor. The two miners that was with me were already in the tunnel with the light showing me the tunnel which was 20 or 30 meters long but what the first thing I saw was cadavers of bats on the floor and my first thinking was, because I saw 5, then 6, then 12, then maybe more. Then I thought this was a place that was different from the rest of the mine.

It was like have all theory and suddenly it is right in front of you and this is it.

So with the emotion of twenty years of looking for the reservoir of Marburg and finally maybe finding the right place to find it a bit like for Egyptologists, when you discover Tutankhamen's tomb, you know this is the place that you are looking for, not for all your life but for a good part of your life.

This is it, we have probably found the place where these bats have been dying, whhere probably there are survivors, we saw very quickly that there were bats alive in the tunnel. So with the emotion of twenty years of looking for the resevoir of Marburg and finally maybe finding the right place to find it a bit like for Eyptogolists, when you discover Tutakamon's tomb, you know this is the place that you are looking for, not for all your life but for a good part of your life.

Of course we need now to go back to the lab and verify if this is really true.

Iain Simpson: Dr Pierre Formenty on what may be a significant discovery. More work is now being done in laboratories in South Africa and the United States. We will have more information on the outcome of this investigation in future podcasts.

Thanks for listening to the WHO podcast. For more information about these stories, and other global public health issues, visit the WHO website, at www.who.int.

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