Insights On Marburg Virus Disease, A Deadly Hemorrhagic Fever
Introduction
Marburg virus disease (MVD) is a rare yet deadly hemorrhagic fever, known for its high fatality rates and potential to cause large outbreaks. It is caused by a highly virulent pathogen called the Marburg virus, which is a member of the Filoviridae family and is closely related to the Ebola virus. [1, 2] The Marburg virus is primarily found in sub-Saharan Africa. [3]
This article aims to explain how the virus spreads, identify its symptoms, and outline preventive measures, all of which are vital for minimizing its public health impact.
What is Marburg Virus (MVD)?
Marburg virus disease (MVD), previously known as Marburg hemorrhagic fever, is a severe illness with an average fatality rate of 50% that often leads to death in humans. [1] This disease initially presents with flu-like symptoms, which can later progress to severe vomiting, bleeding, and neurological issues affecting the brain and nerves. Outbreaks typically begin with transmission from bats or primates, such as monkeys, to humans. It can then spread between people, triggering further outbreaks. [2]
Marburg virus was first identified in 1967 during simultaneous outbreaks in Marburg and Frankfurt in Germany and Belgrade, Serbia. The outbreaks were linked to African green monkeys imported from Uganda for laboratory research, with sporadic cases reported in various African countries, including Angola, the Democratic Republic of Congo, Kenya, and Ghana. [1]
How is Marburg Virus Transmitted?
Urine, excretory wastes (faeces), and saliva of infected Egyptian fruit bats (Rousettus aegyptiacus) serve as the natural reservoir for the virus. Once the virus has transferred from wildlife to humans, it spreads through direct contact with an infected person. [3]
Once the Marburg infection is transmitted to humans, it spreads further through:
- Direct exposure to infected body fluids (blood, saliva, urine, feces, breast milk, semen, vaginal fluids, human milk).
- Contaminated surfaces or materials, such as bedding, clothing, medical devices, and equipment.
- Coming into contact with the seminal fluid of a man who has recovered from Marburg virus disease. [2, 3]
Signs and Symptoms of Marburg Virus Disease
Signs and symptoms of the disease appear in two phases, which include:
- First Phase of MVD
- High fever
- Severe headache
- Chills
- Muscle aches and pains
- Sore throat
- Maculopapular rash
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- Second Phase of MVD
An infected individual may feel slightly better for one to two days, after which additional symptoms may appear, including hemorrhagic manifestations such as:
- Abdominal pain and diarrhea
- Chest pain
- Nausea and vomiting
- Blood in vomit and feces
- Bleeding from nose, gums, and vagina
- Confusion and dizziness
It is advised to seek immediate medical help on the appearance of these advanced symptoms.
Risk Factors for Marburg Virus Disease?
Individuals that are considered to be at highest risk for Marburg include:
- Individuals exposed to Egyptian rousette bats through work in mines or caves
- Caregivers of people infected with the disease who lack proper protective equipment
- Individuals who are exposed to animals that could carry the disease
Risk Factors for Marburg Virus Disease?
Diagnosing and distinguishing Marburg virus disease based solely on clinical symptoms can be difficult, as MVD resembles infectious diseases such as malaria, typhoid fever, shigellosis, meningitis, yellow fever, and other viral hemorrhagic fevers. Symptoms of Marburg virus disease can be confirmed through the following diagnostic tests:
- Polymerase chain reaction (PCR)
- IgM-capture ELISA
- Antigen-capture enzyme-linked immunosorbent assay (ELISA)
- Isolation of the virus in high-containment laboratories
Treatment and Vaccines for Marburg Virus
There is no licensed antiviral treatment or vaccine for Marburg virus disease (MVD). Supportive care plays a crucial role in improving survival rates, including:
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- Maintaining hydration and electrolyte balance
- Oxygen therapy to improve breathing
- Symptomatic treatment such as pain-relieving medications
Experimental treatments, including monoclonal antibodies and antiviral drugs, are under development and have shown promise in preclinical studies.
Can Marburg virus disease (MVD) be prevented?
Marburg virus disease is a public health threat that requires a combination of personal and community measures. Communities impacted by MVD should prioritize educating the population about the disease and the crucial measures needed to contain the outbreak. These measures involve conducting safe and respectful burials for the deceased, identifying and monitoring individuals who may have had contact with an infected person for 21 days, and isolating the healthy individuals from the infected ones to prevent further transmission of the disease. [1]
It is important to avoid contact with the blood and body fluids of individuals who are sick. People should refrain from touching the body of someone who has died from MVD or use protective equipment if handling the body is necessary. This includes funeral customs too. Furthermore, contact or exposure to semen from a person who has recovered from Marburg should be avoided until diagnostic tests confirm that the virus is no longer detectable. Practicing strict personal hygiene, such as frequent handwashing, is essential in reducing the risk of infection. Using protective gear when handling animals or caring for infected patients also helps minimize exposure. In healthcare settings, adhering to infection control protocols is crucial to prevent the human-to-human transmission of the virus. [2, 3]
Marburg Virus and Public Health
Although outbreaks are rare, the Marburg virus represents a significant public health threat due to its epidemic potential. The World Health Organization (WHO) and global health agencies are prioritizing research into vaccines and therapeutic options. Current efforts also focus on improving surveillance systems to detect outbreaks early. Strengthening healthcare infrastructure and rapid response mechanisms in endemic regions is vital to containing future outbreaks.
Conclusion
National Handwashing Awareness Week is a reminder that something as simple as washing your hands can have a profound impact on health. Let’s use this week to cultivate better habits, educate others, and commit to making hand hygiene a priority every day.
