Marburg virus disease or Marburg hemorrhagic fever outbreak in Guinea has been reported recently.
Authorities of West Africa have confirmed the first death case due to Marburg virus disease (MVD) on 2nd August in the capital of Guinea i.e. Conakry. Marburg disease is also known as hemorrhagic fever disease. On Monday (9th August) the World Health Organization (WHO) also declared that this was the region’s first case.
According to WHO, the Marburg virus disease is caused by the Marburg virus (MARV) and is considered to be extremely dangerous. The Marburg virus belongs to the same family the Filoviridae as the Ebola virus and previous outbreaks have erupted elsewhere across Africa in Angola, Congo, Kenya, South Africa, and Uganda.
Like the COVID-19 virus, it is also transmitted from animal hosts to humans and causes very severe viral hemorrhagic fever, and has a fatality rate of up to 88 percent, that’s why it is considered a lethal virus.
According to Dr. Matshidiso Moeti, WHO Regional Director for Africa, “The potential for the Marburg virus to spread far and wide means we need to stop it in its tracks,”.
“We are working with the health authorities to implement a swift response that builds on Guinea’s past experience and expertise in managing Ebola, which is transmitted in a similar way.”
The Marburg virus belongs to the same family as Ebola, and previous outbreaks have erupted elsewhere across Africa in Angola, Congo, Kenya, South Africa, and Uganda.
According to WHO, the new West African case was confirmed by a laboratory in Guinea and again by the Institut Pasteur in nearby Senegal.
Key facts about Marburg virus disease
- The virus causes severe viral hemorrhagic fever in humans.
- Marburg virus disease (MVD) is a highly virulent, epidemic-prone disease associated with high case fatality rates (CFR 24-90%).
- The Marburg virus was first recognized in 1967.
- The African fruit bat, Rousettus aegyptiacus is the reservoir host of the Marburg virus.
- The Marburg virus is transmitted from fruit bats and spreads among humans through human-to-human transmission.
- There is as yet no licensed treatment proven to neutralize the virus, but a range of blood products, immune therapies, and drug therapies are currently under development.
All you need to know about the latest virus
History of Marburg hemorrhagic fever Outbreaks
The Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever (Marburg Virus Disease) occurred simultaneously in laboratories in Marburg and Frankfurt, Germany, and in Belgrade, Yugoslavia (now Serbia).
The first people infected in these two laboratories had been exposed to imported African green monkeys or their tissues while conducting research.
Initially, 31 laboratory workers in these laboratories became ill, followed by several medical personnel and family members who had cared for them. There were 7 death cases were reported, which was a 23% fatality rate among these 31 patients.
Again in 2005, the worst epidemic was in Angola (a Southern African nation), with 252 infections and a 90% fatality rate.
This epidemic was spread through the reuse of contaminated transfusion equipment in a pediatric ward. The transmission can occur at funerals and in handling bodies as with Ebola. There was also one report of sexual transmission of this Marburg Virus Disease.
According to a report in Forbes (an American business magazine) In 2009, two notable illnesses occurred among tourists who had gone caving in Uganda.
The first patient was a Dutch woman who died after being “bumped” by a bat. The second was a Colorado woman who developed a febrile illness and became critically ill after a trip to Uganda.
Colorado woman patient didn’t diagnose initially, and when she came to know about the first Dutch woman patient case she requested retesting as both had been in the same cave. Subsequently, she was diagnosed with Marburg.
There have been 12 major Marburg Once caught by a human, it is spread through contact with bodily fluids of infected people, or with contaminated surfaces and materials, according to the WHO.
Since 1967, there have been 12 major Marburg virus disease outbreaks mostly in southern and eastern Africa.
According to European Centre for Disease Prevention and Control, there are 571 cases of Marburg virus disease cases including 470 deaths reported From 1967–2012.
How does Marburg Virus Disease or Marburg hemorrhagic fever spread?
Experts suspect that as both Ebola and Marburg Viruses belong to the same family Filoviridae, there are the highest chances of a similar mode of transmission. Marburg virus infection usually occurs due to exposure to Rousettus bats or caves/mines housing colonies of Rousettus bats.
The African fruit bat, Rousettus aegyptiacus is the reservoir host of the Marburg virus. Fruit bats infected with the Marburg virus do not show obvious signs of illness.
According to WHO, once a human comes in contact with these infected fruit bats he/she gets infected with this highly contagious virus. Then it spreads through contact with body fluids of infected people, or with contaminated surfaces and materials, etc.
In summary, these two viruses can be transmitted from animals to humans as well as from person to person in various ways. For example, the viruses can spread through blood, body fluids, or contaminated items such as bedding, clothing, or needles. Family members can be infected as they care for sick relatives or prepare the dead for burial.
Till now there’s no evidence of the spread of these two viruses via insect bites. The use of specialized personal protective equipment that covers them from head to toe is highly recommended for medical personnel and they can also be infected if they don’t use it.
What are the symptoms of Marburg hemorrhagic fever or Marburg virus disease (MVD)?
The incubation period (the number of days between when a person gets infected and the appearance of symptoms) varies from 2 to 21 days.
The symptoms include;
- Initiates with high fever, severe headache, and severe malaise.
- Muscle aches and pain (common features)
- Severe watery diarrhea, abdominal pain, cramping, nausea, and vomiting can begin on the third day and diarrhea can persist for a week.
- Within 5 – 7 days, many patients develop severe hemorrhagic signs. In fatal cases usually have some form of bleeding, often from multiple areas.
- Fresh blood in vomitus and feces is often accompanied by bleeding from the nose, gums, and vagina.
- Patients have sustained high fevers During the severe phase of illness.
- The central nervous system can get involved due to the severity which results in confusion, irritability, and aggression.
- Development of Orchitis, in which inflammation of one or both testicles occurs. Orchitis has been reported occasionally in the late phase of the disease (15 days).
- In fatal cases, death occurs most often between 8 – 9 days after symptoms are observed.
What are the Complications of Marburg virus disease (MVD) Marburg hemorrhagic fever?
People also experience slow survival and recovery processes. They may take months to regain weight and strength, and the viruses remain in the body for weeks. People may experience:
- Hair loss
- Sensory changes
- Eye inflammation
- Liver inflammation (hepatitis)
- Testicular inflammation
How does a Marburg virus-infected person get a diagnosis?
It’s very difficult to clinically distinguish MVD from other infectious diseases such as malaria, typhoid, shigellosis, meningitis & other viral hemorrhagic fevers.
The signs and symptoms of Marburg hemorrhagic fever and these diseases are very similar. The Marburg virus infection is confirmed by using the following diagnostic methods;
- antibody-capture enzyme-linked immunosorbent assay (ELISA)
- antigen-capture detection tests
- serum neutralization test
- reverse transcriptase polymerase chain reaction (RT-PCR) assay
- electron microscopy
- virus isolation by cell culture.
- immunohistochemistry (in deceased patients)
Treatments of Marburg hemorrhagic fever
Till now there are no specific treatments available for Marburg hemorrhagic fever or Marburg virus disease. Supportive hospital therapy is mostly utilized as per the patient’s condition and doctor’s advice.
Supportive hospital therapy for Marburg virus disease includes, balancing the patient’s fluids and electrolytes, maintaining oxygen status and blood pressure, replacing lost blood and clotting factors, and treatment for any complicating infections.
According to WHO, antivirals such as Remdesivir and Favipiravir have been used in clinical studies for Ebola Virus Disease (EVD) that could also be tested for Marburg virus disease or Marburg hemorrhagic fever or used under compassionate use.
Vaccines for Marburg hemorrhagic fever
According to WHO, currently, there are no potential vaccines or antiviral treatments approved for MVD. There are some monoclonal antibodies (mAbs) under development.
How to Prevent
According to the Centers for Disease Control and Prevention, till now there are no well-defined preventive measures available against Marburg virus infection.
As the transmission of the virus from wildlife to humans remains an area of ongoing research. However, avoiding fruit bats, and sick non-human primates in central Africa, is one way to protect against infection.
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