Marburg Virus Disease: Symptoms, Transmission, Prevention & Treatment

Marburg Virus Disease (MVD) is a severe and often fatal hemorrhagic fever caused by the Marburg virus, a member of the Filoviridae family, which also includes the Ebola virus. It was first identified in 1967 after simultaneous outbreaks in Marburg and Frankfurt (Germany) and Belgrade (Serbia). The disease has a high fatality rate and spreads through contact with bodily fluids of infected individuals or animals.

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Origins and History of Marburg Virus

Marburg virus was first identified in 1967 when laboratory workers in Germany and Serbia fell ill after exposure to infected African green monkeys imported from Uganda. Since then, several outbreaks have occurred, primarily in Africa, with the largest recorded in Angola (2004–2005), which had a 90% fatality rate.

Key Outbreaks of Marburg Virus Disease:

• 1967 – Germany & Serbia: The first known outbreak with 31 cases and seven deaths.
• 1998-2000 – Democratic Republic of Congo: 154 cases with 128 deaths.
• 2004-2005 – Angola: Deadliest outbreak with 252 cases and a 90% mortality rate.
• 2017 – Uganda: A small outbreak with limited spread.
• 2022 – Ghana: First reported cases in the country.
• 2023 – Equatorial Guinea & Tanzania: Multiple outbreaks with fatalities.

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Causes and Transmission

The Marburg virus is zoonotic, meaning it originates from animals. It is believed that fruit bats (Rousettus aegyptiacus) serve as the natural reservoir of the virus. Human infection occurs through direct exposure to bat excretions or bodily fluids of infected individuals.

Modes of Transmission:

1. Human-to-Human Transmission: Occurs via direct contact with blood, saliva, urine, vomit, or other bodily fluids of infected individuals.
2. Animal-to-Human Transmission: Through contact with infected bats or non-human primates.
3. Contaminated Surfaces: Objects contaminated with infected bodily fluids can also transmit the virus.
4. Nosocomial Infections: Healthcare workers treating MVD patients are at high risk if proper precautions are not followed.

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Symptoms of Marburg Virus Disease

MVD has an incubation period of 2 to 21 days, after which symptoms appear suddenly.

Early Symptoms (Days 1-5):

• High fever
• Severe headache
• Muscle pain
• Fatigue

Progression (Days 5-10):

• Severe diarrhea
• Abdominal pain
• Nausea and vomiting
• Sore throat
• Maculopapular rash (in some cases)

Severe Symptoms and Complications:

• Hemorrhagic Manifestations: Internal and external bleeding (nose, gums, eyes, and organ failure).
• Neurological Symptoms: Delirium, confusion, and seizures.
• Multi-Organ Failure: Shock, liver failure, and kidney failure leading to death in severe cases.

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Diagnosis of Marburg Virus Disease

Since MVD shares symptoms with other hemorrhagic fevers (such as Ebola and Lassa fever), laboratory tests are essential for confirmation.

Diagnostic Methods:

• Polymerase Chain Reaction (PCR): Detects viral RNA in blood samples.
• Enzyme-Linked Immunosorbent Assay (ELISA): Detects antibodies or viral antigens.
• Virus Isolation: Performed in specialized biosafety laboratories.
• Serological Tests: Identify past infections.

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Treatment and Management

There is currently no specific antiviral treatment or approved vaccine for Marburg virus disease. Supportive care is the primary approach to managing the disease.

Supportive Treatments:

• Fluid and Electrolyte Replacement: Prevents dehydration.
• Blood Transfusions: Manages severe bleeding.
• Oxygen Therapy: Supports respiratory function.
• Pain and Fever Management: Through analgesics and antipyretics.
• Experimental Treatments: Monoclonal antibodies and antiviral drugs are under research.

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Prevention and Control Measures

Preventive Strategies:

1. Avoid Contact with Bats and Infected Animals: Minimize exposure to fruit bats in endemic areas.
2. Use Personal Protective Equipment (PPE): Healthcare workers must wear gloves, masks, and face shields when treating patients.
3. Safe Burial Practices: Prevents post-mortem transmission.
4. Isolation and Quarantine: Suspected cases should be isolated to prevent spread.
5. Public Awareness: Educating communities about the risks and symptoms.

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Global Response and Research Efforts

International health organizations, including the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC), actively monitor and respond to Marburg virus outbreaks. Research is ongoing for potential vaccines and treatments, with promising candidates like the rVSV-MARV vaccine in early trials.

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Conclusion

Marburg Virus Disease is a deadly and highly contagious hemorrhagic fever that demands urgent public health attention. With no approved cure or vaccine, prevention, early diagnosis, and supportive care are critical to controlling its impact. Continued research and global cooperation are essential in combating future outbreaks.