The Marburg Virus Disease, often known as MVD, is a form of severe hemorrhagic fever that can be transmitted between humans and non-human primates.
The Marburg virus is the causative agent of MVD, a disease with a high mortality rate (up to 88 per cent) that can be significantly reduced with proper medical treatment.
Both the Marburg virus and the Ebola virus belong to the family of viruses known as Filoviridae (filovirus). The two diseases share clinical features while having different viral causes. Both diseases are rare and capable of causing outbreaks with significant mortality rates.
It wasn’t until 1967 that the Marburg virus was identified, following an outbreak that occurred simultaneously in Marburg and Frankfurt in Germany, as well as in Belgrade, Serbia.
The outbreak was linked to research involving Ugandan imports of African green monkeys (Cercopithecus Aethiops) in laboratories. Angola, the Democratic Republic of the Congo, Kenya, South Africa (in a person with recent travel history to Zimbabwe), and Uganda have all reported outbreaks or isolated cases since then.
In 2008, two separate incidents involving tourists who had visited a cave in Uganda that had a colony of Rousettus bats were reported.
Transmission
The virus is transmitted via direct physical contact (including through cuts or mucous membranes).
- Marburg virus sickness is transmitted through contact with infected blood or body fluids (urine, saliva, perspiration, faeces, vomit, breast milk, amniotic fluid, and semen) from a sick or deceased individual.
- Objects infected with bodily fluids from a person who has the Marburg virus sickness or who has already passed away (such as clothes, bedding, needles, and medical equipment).
- Semen from a cured MVD patient (through oral, vaginal, or anal sex).
- Although information about the Marburg virus is scarce, it, like ebolaviruses, is thought to be persistent in the testicles and the eye.
- The persistence of the Marburg virus in other immunologically protected areas (placenta, central nervous system) may be similar to that of the Ebola virus, given that the two viruses are members of the same family (Filoviridae).
- There is no proof that a woman with MVD can transmit the virus through sexual interaction or other contact with her vaginal fluids.
- Close quarters and personal contacts have been most responsible for the spread of the illness. Caregivers in the home or in the hospital are typical settings in which this occurs (nosocomial transmission).
- Those who have handled infected nonhuman primates or come into touch with their bodily fluids have been known to contract the Marburg virus during prior outbreaks. Researchers that work with live Marburg virus are also at risk of exposure.
Signs and symptoms
- After a 2-21 day incubation period, symptoms such as fever, chills, headache, and myalgia appear suddenly.
- A maculopapular rash, especially noticeable on the trunk (chest, back, stomach), may appear around the fifth day after the onset of symptoms.
- Nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhoea are all possible symptoms.
- There is a progressive worsening of symptoms, which may include jaundice, inflammation of the pancreas, extreme weight loss, psychosis, shock, liver failure, extensive bleeding, and multi-organ malfunction.
Marburg virus disease (MVD) is notoriously challenging to diagnose clinically.
The symptoms of MVD can be easily mistaken for those of other infectious diseases (such as malaria or typhoid fever) or viral hemorrhagic fevers that may be common in the area (such as Lassa fever or Ebola). This is especially the case when there is only one scenario to consider.
Fatality rate
The death rate for MVD cases ranges from 23-90%.
Diagnosis
Due to the clinical difficulty in distinguishing MVD from other infectious disorders, the following diagnostic procedures are performed to determine that symptoms are caused by Marburg virus disease:
- 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
Note: Laboratory testing on non-inactivated samples acquired from patients is done under maximal biological containment settings due to the high biohazard risk they pose. The triple packaging strategy is used for all national and international transfers of biological items.
Treatment
The Marburg virus causes an illness for which there is currently no cure.
The use of blood transfusions, replacement of blood and clotting factors, maintenance of oxygenation and blood pressure, and the treatment of any secondary infections are all examples of the types of supportive hospital therapy that are used.
Although several experimental treatments have been shown to be effective in animal models, they have never been tested on humans.
Prevention
There are several ways to protect oneself and stop the spread of Marburg viruses in areas where they may be prevalent.
- Avoid contact with sick people’s blood and body fluids, including urine, faeces, saliva, perspiration, vomit, breast milk, amniotic fluid, semen, and vaginal fluids.
- Avoid contact with semen from Marburg survivors until testing proves the virus is gone.
- Avoid touching anything that has come into contact with an infected person’s blood or bodily fluids (such as clothes, bedding, needles, and medical equipment).
- Avoid touching Marburg-infected corpses at funerals or burials.
- Avoid fruit bats and nonhuman primates like monkeys and chimpanzees, as well as their blood, fluids, and uncooked meat.
- Avoid fruit bat habitats (such as mines or caves).
- Living or travelling in a Marburg-infected area requires these same precautions.
- Anyone returning from an outbreak should monitor their health for 21 days and seek medical attention if they develop Marburg symptoms.
