What is Marburg virus disease? What percentage of death does it cause? And what are the ways of infection with it? What are its symptoms?

What is Marburg virus disease?

Marburg virus disease, formerly known as Marburg haemorrhagic fever, is a severe disease that often affects humans. The virus causes acute viral hemorrhagic fever in humans, according to the World Health Organization.

What is the mortality rate in Marburg virus patients?

The average death rate from Marburg virus disease is around 50%. Case death rates varied from 24% to 88% in previous outbreaks depending on virus strain and case management.

Early supportive care, combined with dehydration and symptomatic treatment, increases the chances of survival. There is still no licensed treatment that has been shown to neutralize the virus, but a range of blood products, immunotherapies and drug therapies are currently being developed.

Marburg virus in animals

Rosettus aegyptiacus bats, fruit bats of the Pteropodidae family, are natural hosts of the Marburg virus. Marburg virus is transmitted to humans from fruit bats and spreads between humans through human-to-human transmission.

African green monkeys (Cercopithecus aethiops) imported from Uganda were the source of infection for humans during the first Marburg virus outbreak.

Is there a relationship between Marburg and Ebola?

Marburg virus and Ebola are both members of the family of "filamentous virus" (Filoviridae). Although these two diseases (Marburg and Ebola) are caused by different viruses, they are clinically similar; both are rare and have the potential to cause outbreaks with high mortality rates.

When was the Marburg virus identified?

Two major outbreaks simultaneously in Marburg and Frankfurt, Germany, and in Serbia in 1967, led to the initial identification of the disease. The outbreak has been linked to laboratory work using African green monkeys imported from Uganda.

Marburg virus transmission

Marburg spreads through human-to-human transmission through direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other body fluids of infected people, and with surfaces and materials (such as bedding and clothing) contaminated with these fluids.

Health-care workers have often become infected while treating patients with suspected or confirmed Marburg virus. This happened through close contact with patients when infection control precautions are not strictly applied. Transmission through contaminated injection equipment or through needle-prick injuries is associated with a more serious and rapidly deteriorating disease, possibly with a higher mortality rate.

Burial ceremonies involving direct contact with the body of the deceased can also contribute to the transfer of Marburg.

Marburg virus incubation period

The incubation period (the interval from infection to the onset of symptoms) ranges from two days to 21 days.

Symptoms of Marburg virus disease

  • The disease caused by Marburg virus begins suddenly, with a high fever, headache and severe malaise. Muscle pain is a common feature.
  • Acute watery diarrhea, abdominal pain, cramps, nausea and vomiting can begin on the third day, and diarrhea may last for a week.
  • During the 1967 European outbreak, non-itchy rashes were noticeable in most patients between two and seven days after symptom onset.
  • Many patients experience severe bleeding manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding.
  • Fresh blood in vomit and feces is often accompanied by bleeding from the nose, gums and vagina.
  • During the severe phase of the disease, patients have a high fever.
  • Central nervous system intervention can lead to confusion, irritability, and aggressiveness.
  • Orchitis (inflammation of one or both testicles) has sometimes been reported in the late stage of the disease (15 days).

When does death usually occur in a patient with Marburg virus?

In fatal cases, death often occurs between 8 and 9 days after symptom onset, and is usually preceded by severe blood loss and shock.

Treatment and vaccines for Marburg virus

There are currently no approved vaccines or antiviral treatments. However, supportive care (oral or intravenous dehydration therapy) and treatment of certain symptoms increase the chances of survival.

New outbreak

Last Sunday, the World Health Organization announced an outbreak of the Marburg virus, and it was declared 11 months after the first case was recorded in Ghana, according to Anatolia.

Two people have tested positive for the virus in Ghana, and more than 90 contacts, including health workers and community members, have been monitored, WHO said.

There have been 12 outbreaks of Marburg virus since 1967, mostly in southern and eastern Africa, in places including Angola, Congo, Kenya and Uganda.

WHO Regional Director for Africa Dr Matshidiso Moeti said health authorities had responded quickly to the new virus.