Marburg virus disease (MVD), commonly known as Marburg hemorrhagic fever, is a severe and often fatal virus-caused illness. The virus, like the Ebola virus, belongs to the Filoviridae family and can cause high-fatality outbreaks. In this blog article, we will examine the Marburg virus’s symptoms, transmission, prevention, and therapy, as well as some frequently asked questions concerning the disease.
Marburg Virus Origin
Fruit bats of the Pteropodidae family, Rousettus aegyptiacus, are thought to be natural hosts of the Marburg virus. In 1967, two big outbreaks in Marburg and Frankfurt, Germany, as well as Belgrade, Serbia, led to the disease’s early detection. The outbreak was linked to research with African green monkeys (Cercopithecus aethiops) imported from Uganda. Following that, outbreaks and isolated cases were recorded in Angola, the Democratic Republic of the Congo, Kenya, South Africa (in a person who had recently traveled to Zimbabwe), and Uganda. Two distinct occurrences were recorded in 2008 in visitors who visited a cave in Uganda inhabited by Rousettus bat colonies.
Symptoms of Marburg Virus
MVD normally has a 2-21 day incubation period, and the illness begins quickly with a high temperature, severe headache, and severe malaise. On the third day, muscle aches and pains, severe watery diarrhea, abdominal pain and cramping, nausea, and vomiting may occur. Individuals with “ghost-like” drawn features, deep-set eyes, expressionless faces, and excessive lethargy may appear. Within 5-7 days, many patients acquire significant hemorrhagic symptoms, and fatal cases usually have some sort of bleeding, often from multiple areas. Confusion, impatience, and violence might result from central nervous system involvement.
Diagnosis
Clinically, MVD can be difficult to identify from other infectious disorders such as malaria, typhoid fever, shigellosis, meningitis, and other viral hemorrhagic fevers. The following diagnostic procedures are used to confirm that symptoms are caused by Marburg virus infection:
- 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.
Patient samples provide an extreme biohazard risk; laboratory testing on non-inactivated samples should be performed under the highest biological containment settings. When transported domestically and internationally, all biological specimens should be packaged using the triple packing system.
Transmission of Marburg Virus
The Marburg virus is transmitted to humans by fruit bats and spreads via human-to-human transmission. Human MVD infection begins with long-term exposure to Rousettus bat colonies in mines or caves. Marburg spreads through direct contact (through broken skin or mucous membranes) with infected people’s blood, secretions, organs, or other body fluids, as well as surfaces and objects (e.g., bedding, clothing) contaminated with these fluids. While treating patients with suspected or proven MVD, healthcare workers have regularly become infected. Funeral ceremonies that entail close touch with the deceased’s body can also contribute to the spread of Marburg.
Prevention of Marburg Virus
The involvement of the community is critical to the successful containment of outbreaks. In addition, the following precautions can help prevent the spread of the Marburg virus:
- Avoiding contact with bats, primates, and their fluids, as well as refrain from eating bushmeat.
- When caring for patients with suspected or confirmed MVD, strict infection control precautions must be followed.
- Burial techniques that are both safe and dignified.
- Disposal of infectious garbage and contaminated materials as soon as possible and safely.
Treatment of Marburg Virus
Although no licensed medication has been shown to neutralize the virus, early supportive care with rehydration and symptomatic treatment improves survival. Currently, a variety of blood products, immunological treatments, and pharmacological therapies are being developed.
There are monoclonal antibodies (mAbs) under development, as well as antivirals such as Remdesivir and Favipiravir, which have been used in clinical trials for Ebola Virus Disease (EVD) and could be studied for MVD or used under compassionate use/expanded access.
Vaccines for Marburg Virus
There is no vaccine available against Marburg Virus. The EMA granted marketing authorization to Zabdeno (Ad26.ZEBOV) and Mvabea (MVA-BN-Filo) against EVD in May 2020. The Mvabea virus contains the Vaccinia Ankara Bavarian Nordic (MVA) virus, which has been modified to produce four proteins from the Zaire ebolavirus and three other viruses from the same group (filoviridae). Although the vaccine has the potential to protect against MVD, its efficacy has yet to be proved in clinical studies.
Marburg Virus Death Toll
The average MVD case fatality rate is around 50%. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management.
To summarise, the Marburg virus is a highly infectious and lethal virus capable of causing severe viral hemorrhagic fever in humans. The virus is transmitted to humans by fruit bats and spreads through human-to-human transmission. Fever, headache, malaise, diarrhea, stomach discomfort, and severe bleeding are all symptoms of Marburg virus disease. There is no authorized treatment for Marburg virus sickness at the moment, however, early supportive care, including rehydration and symptomatic medication, can improve survival. Community involvement is critical to successfully controlling outbreaks, and efforts should be directed at preventing transmission through tight infection control measures, proper burial practices, and public education.
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FAQs
Is Marburg disease airborne?
No, Marburg disease is not spread through the air. It is spread through direct contact with infected individuals’ body fluids or through contact with surfaces contaminated with these fluids. It can also be spread by infected needles or injection equipment.
What is the chance of death from Marburg?
The typical case fatality rate for Marburg virus sickness is roughly 50%, but this might vary depending on the virus strain and the patient’s quality of care. In previous epidemics, case mortality rates varied from 24% to 88%.
Who is at risk for the Marburg virus?
Anyone who lives or works in endemic areas of the virus, or who comes into touch with infected individuals or materials, is most in danger of contracting the virus. Healthcare personnel who treat patients with Marburg virus sickness are also at significant risk if infection control procedures are not carefully followed.
Is Marburg Virus DNA or RNA virus?
The Marburg virus is a type of RNA virus. It is a member of the Filoviridae family, which includes viruses such as the Ebola virus, and all members of this family have a negative-sense, single-stranded RNA genome.
References
- World Health Organization. (2019). Marburg virus disease – Uganda. https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease
- Centers for Disease Control and Prevention. (2020). Marburg virus disease. https://www.cdc.gov/vhf/marburg/index.html
- Kuhn, J. H. (2016). Filoviruses: A compendium of 40 years of epidemiological, virological, and immunological studies. Springer.
- Bausch, D. G., & Schwarz, L. (2014). The outbreak of Ebola virus disease in Guinea: where ecology meets economy. PLoS Neglected Tropical Diseases, 8(7), e3056.
- Naveca, F. G., Nascimento, V. A., Souza, V. C., & Nunes, B. T. D. (2020). Genomic and phylogenetic characterization of Marburg virus isolated from an imported case in Brazil. PLoS One, 15(4), e0231725.
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