The Atlanta Journal-Constitution
What to know about the Marburg virus
The deadly Marburg virus has surfaced this past week for the first time in Equatorial Guinea, causing at least nine deaths in the west African nation, according to the World Health Organization.
A handful of Marburg cases were identified in Ghana late last year. Although it remains “a very rare disease in people,” according to the Centers for Disease Control and Prevention, “when it occurs, it has the potential to spread,” and can be fatal.
Here’s what you need to know about the virus and the disease it causes.
Q: What is the Marburg virus?
Marburg virus disease is a highly infectious viral hemorrhagic fever, according to the CDC. It is spawned by the animal-borne RNA virus of the same Filoviridae family as the Ebola virus. Both diseases are rare but have the capacity to cause outbreaks with high fatality rates.
Fatality rates for Marburg cases in past outbreaks ranged between 24 percent to 88 percent, according to the WHO, depending on the virus strain and quality of case management.
Marburg was probably first transmitted to people from African fruit bats as a result of prolonged exposure from people working in mines and caves that have Rousettus bat colonies.
It is not an airborne disease. Instead, it spreads quickly between humans through direct contact with the bodily fluids of infected people such as blood, saliva or urine, as well as on surfaces and materials. Relatives and health workers remain most vulnerable alongside patients, and bodies can remain contagious even at burial.
It was first recognized in 1967, when outbreaks occurred among laboratory workers in Marburg and Frankfurt, Germany, and in Belgrade, Serbia, while conducting research.
Q: What are symptoms of the virus?
Symptoms can begin to show up “abruptly,” according to the WHO, and include a high fever, severe headache, chills and malaise.
Muscle aches and cramping pains are common symptoms. Others can include jaundice, nausea, abdominal pain and diarrhea.
The CDC has also noted that around day five, a non-itchy rash on the chest, back or stomach can occur. Clinical diagnosis of Marburg “can be difficult,” it says, with many of the symptoms similar to other infectious diseases such as malaria, typhoid fever and Ebola.
In fatal cases, death usually occurs between eight and nine days after onset of the disease and is generally preceded by severe blood loss and hemorrhaging, as well as multiorgan dysfunction.
The appearance of patients can be described as “ghost-like,” says the WHO, with drawn features, deep-set eyes, expressionless faces and extreme lethargy.
Q: What is the treatment for the virus?
There are no vaccines or antiviral treatments approved to treat the Marburg virus.
Supportive care can improve survival rates, such as rehydration with oral or intravenous fluids, maintaining oxygen levels, using drug therapies and treating specific symptoms as they arise. Some health experts say drugs similar to those used for Ebola could be effective but treatments have not been proven in clinical trials. Increasing awareness of its contagious nature can also help with prevention and spread, says the CDC.
Some “experimental treatments” for Marburg have been tested in animals but not in humans, the CDC said.
Q: Where is the latest outbreak?
Equatorial Guinea confirmed its first outbreak of Marburg virus disease this week. At least nine people have died and there are 16 suspected cases in the country’s western Kie-ntem province, according to the WHO.
“Further investigations are ongoing. Advance teams have been deployed in the affected districts to trace contacts, isolate and provide medical care to people showing symptoms of the disease,” the global health body said in a statement Monday.
Cases of Marburg have previously been reported elsewhere in Africa, including in Uganda, Ghana, the Democratic Republic of Congo, Sierra Leone and South Africa. The largest outbreak killed more than 350 people in Angola in 2005, according to a report from its Health Ministry.
“The virus is not known to be native to other continents, such as North America,” says the CDC.
Q: What has the WHO said about the virus?
The WHO is convening an “urgent meeting” Tuesday to discuss the newly identified Marburg outbreak in Equatorial Guinea as well as vaccine and therapeutic candidates, it said.
It will also be deploying teams to the affected areas and assigning experts in epidemiology, case management, infection prevention, laboratory and risk communication to support the national response efforts.
“Marburg is highly infectious,” said Matshidiso Moeti, WHO regional director for Africa. “Thanks to the rapid and decisive action by the Equatorial Guinean authorities in confirming the disease, emergency response can get to full steam quickly so that we save lives and halt the virus as soon as possible.”