Marburg fever

Marburg fever is a severe and highly fatal disease caused by a virus from the same family as the one that causes Ebola virus disease. Both viruses are native to Africa, where sporadic outbreaks have occurred for decades. Marburg virus is among the most virulent pathogens known to infect humans. Both diseases are rare, but have a capacity to cause dramatic outbreaks with high fatality.

History

Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (now Serbia). A total of 31 people became ill, including laboratory workers as well as several medical personnel and family members who had cared for them. The first people infected had been exposed to African green monkeys or their tissues. In Marburg, the monkeys had been imported for research and to prepare polio vaccine.

Transmission

Marburg virus is transmitted to people from fruit bats and spreads among humans through human-to-human transmission. The Marburg virus is transmitted through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected fruit bats.

Human-to-human transmission is possible, particularly in the health care setting, through direct contact with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.

Symptoms

The onset of the disease is sudden, with high fever, severe headache, joint and muscle aches, and chills. A rash, red eyes, hiccups and internal and external bleeding may be seen in some patients. Severely ill patients may develop shock, nervous system malfunctions, and multi-organ dysfunction.

Diagnosis

Diagnosis poses a number of challenges. In the early course of disease, it can be difficult to distinguish Marburg fever from other infectious diseases such as malaria, typhoid fever and shigellosis. Definitive diagnosis requires testing that is only available in a few high-containment laboratories worldwide.

Treatment

Supportive care with rehydration and symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralize the virus but a range of blood, immunological and drug therapies are under development.

Prevention

Prevention includes reducing the risk of wildlife-to-human transmission and human-to-human transmission. Protective measures include wearing gloves and other appropriate protective clothing when handling sick animals or their tissues and avoiding the consumption of raw meat products.