Marburg virus disease (MVD) is a rare but severe hemorrhagic fever which affects both people and non-human primates. MVD is caused by the Marburg virus, a genetically unique zoonotic (or, animal-borne) RNA virus of the filovirus family. The six species of Ebola virus are the only other known members of the filovirus family.
It is unknown how Marburg virus or Ravn virus, collectively called marburgviruses, first spread from the animal host to people; however, research has shown that virus is shed in oral secretions, urine and feces from infected Egyptian rousette bats. For the 2 cases in tourists visiting Uganda in 2008, unprotected contact with infectious bat feces or urine droplets are the most likely routes of infection.
After this initial spillover of virus from host animal to people, transmission occurs through person-to-person contact. The virus spreads through contact (such as through broken skin or mucous membranes in the eyes, nose, or mouth).
Spread of marburgviruses between people has occurred in close environments and among contacts. A common example is through caregivers in the home or in a hospital (nosocomial transmission).
After an incubation period of 2-21 days, symptom onset is sudden and marked by fever, chills, headache, and myalgia. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea may appear. Symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.
Clinical diagnosis of Marburg virus disease (MVD) can be difficult. Many of the signs and symptoms of MVD are similar to other infectious diseases (such as malaria or typhoid fever) or viral hemorrhagic fevers that may be endemic in the area (such as Lassa fever or Ebola). This is especially true if only a single case is involved.
Marburg Virus Disease Outbreaks
On February 13, 2023, the Government of Equatorial Guinea (GREG) declared a Marburg virus disease (MVD) outbreak, the country’s first outbreak of the disease. Cases were reported in several provinces, including Kie-Ntem, Littoral, and Centro Sur. The government declared the outbreak over on May 15, with 16 confirmed cases and 12 deaths. One additional lab-confirmed sample was never linked to a specific patient since the sample was unlabeled. An additional 23 probable cases, all deceased, were also reported during this outbreak.
The World Health Organization declared the outbreak over on June 8, 2023, 42 days after the last patient was discharged from treatment.
Clinical diagnosis of Marburg virus disease (MVD) can be difficult. Many of the signs and symptoms of MVD are similar to other infectious diseases (such as malaria, typhoid fever, or dengue) or viral hemorrhagic fevers that may be endemic in the area (such as Lassa fever or Ebola). This is especially true if only a single case is involved.
If a person has early symptoms of MVD and a possible exposure to marburgvirus, the patient should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.
Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, polymerase chain reaction (PCR), and IgM-capture ELISA can be used to confirm a case of MVD within a few days of symptom onset. Virus isolation may also be performed but should only be done in a high containment laboratory with good laboratory practices. The IgG-capture ELISA is appropriate for testing persons later in the course of disease or after recovery. In deceased patients, immunohistochemistry, virus isolation, or PCR of blood or tissue specimens may be used to diagnose MVD retrospectively.
There is no specific treatment for Marburg virus disease. Supportive hospital therapy should be utilized, which 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.
Experimental treatments are validated in non-human primate models but have never been tried in humans.
Prevention
Marburg virus disease (MVD) is caused by a group of viruses called marburgviruses and is a rare type of viral hemorrhagic fever that can cause severe illness in people. Egyptian rousette bats (Rousettus aegyptiacus) are considered natural hosts for marburgviruses. In the areas where MVD is most common, marburgviruses are believed to spread at low rates among certain animals. Occasionally people become sick with MVD after contact with infected animals.
When living in or traveling to a region where marburgviruses are potentially present, there are a number of ways to protect yourself and prevent the spread of marburgviruses.
- Avoid contact with blood and body fluids (such as urine, feces, saliva, sweat, vomit, breast milk, amniotic fluid, semen, and vaginal fluids) of people who are sick.
- Avoid contact with semen from a person who has recovered from MVD, until testing shows that the virus is gone from their semen.
- Avoid contact with items that may have come in contact with an infected person’s blood or body fluids (such as clothes, bedding, needles, and medical equipment).
- Avoid funeral or burial practices that involve touching the body of someone who died from suspected or confirmed MVD.
- Avoid contact with Egyptian rousette bats and their habitats (caves, mines, infested buildings, etc.), and nonhuman primates (such as monkeys and chimpanzees) and the blood, fluids, or raw meat prepared from these or unknown animals. Avoid areas known to be inhabited by fruit bats (such as mines or caves).
.jpg)
.jpg)
0 Comments