Marburg Virus: Shocking Facts About A Deadly Illness

By Maimuna Katuka Aliyu,

Marburg Virus Disease (MVD), a rare and deadly viral hemorrhagic fever, has once again surfaced in Africa, with recent cases reported in Rwanda. The disease is caused by the Marburg virus, which is transmitted to humans by fruit bats and spreads among humans through direct contact with bodily fluids.

With a terrifying case fatality rate ranging from 23% to 90%, Marburg virus is among the most dangerous viruses known to man.

What Is Marburg Virus Disease?

Marburg Virus Disease (MVD) is a severe illness that begins with flu-like symptoms, such as high fever, severe headache, muscle pain, and fatigue, appearing between 2 to 21 days after exposure. In its early stages, it can be mistaken for other viral infections, including Ebola, which also causes hemorrhagic fever.

However, as the disease progresses, patients experience more severe symptoms, including gastrointestinal bleeding (vomiting blood and bloody diarrhea), bleeding from the gums and nose, rashes, and in some cases, internal bleeding.

The virus attacks multiple organs, leading to complications such as organ failure, shock, and death. The rapid progression of the disease makes it particularly challenging to manage, and many patients succumb within a week or two of symptom onset.

History of the Marburg Virus

The Marburg virus was first identified in 1967 during simultaneous outbreaks in Marburg, Frankfurt, Germany, and Belgrade, Yugoslavia (now Serbia), where laboratory workers were exposed to infected African green monkeys imported from Uganda.

The virus was isolated from the monkeys, and a new viral agent was identified and named “Marburg virus” after the city where the outbreak occurred. Subsequent outbreaks have occurred sporadically in sub-Saharan Africa, with significant cases reported in countries such as Uganda, Angola, and the Democratic Republic of Congo (DRC). For instance:

2022, Ghana: 3 cases, 2 deaths

2004-2005, Angola: 374 cases, 329 deaths

1998-2000, DRC: 154 cases, 128 deaths

1975, South Africa: 3 cases, 1 death

Each outbreak highlights the virus’s deadly nature and the difficulty in containing it, especially in areas with limited healthcare resources.

How Is Marburg Virus Transmitted?

The Marburg virus primarily spreads through close contact with the bodily fluids of infected animals or humans. Fruit bats (specifically Rousettus species) are natural reservoirs of the virus, and humans can become infected through exposure to bat saliva, urine, or feces.

Human-to-human transmission occurs when a person comes into direct contact with infected bodily fluids such as blood, vomit, urine, saliva, or semen. Healthcare workers, family members, and anyone caring for an infected person are at the highest risk of exposure, especially if proper infection control measures are not followed.

Transmission can also happen indirectly if a person comes into contact with contaminated surfaces or objects, such as medical equipment or bedding, which have been contaminated with the virus.

Symptoms of Marburg Virus Disease

The initial symptoms of MVD are similar to many other viral infections, which can make diagnosis difficult in the early stages. However, within days, the severity of the symptoms becomes apparent. These symptoms can be classified into three stages:

Early Symptoms (2-21 days after exposure):

Sudden high fever (up to 104°F/40°C)

Severe headache

Muscle pain (myalgia)

Fatigue

Nausea and vomiting

Diarrhea

Abdominal pain

Progressive Symptoms

Severe bleeding, including:

Gastrointestinal bleeding (vomiting blood, bloody diarrhea)

Bleeding from the gums, nose, and vagina

Rash (maculopapular or petechial)

Inflammation of the pancreas (pancreatitis) and liver (hepatitis)

Inflammation of the brain (encephalitis)

Severe weight loss

Organ failure (kidney, liver, respiratory)

Late-Stage Symptoms:

Shock

Severe organ failure

Coma

Death

Due to the severity and rapid progression of symptoms, the mortality rate of Marburg virus remains high, with most deaths occurring within 8 to 16 days after the onset of symptoms.

Diagnosis and Treatment

Diagnosing MVD can be challenging because its early symptoms mimic those of other diseases, such as malaria and Ebola. Diagnostic tests include Polymerase Chain Reaction (PCR) to detect the virus’s genetic material, as well as antigen-capture ELISA and virus isolation in high-containment laboratories.

Currently, there is no specific antiviral treatment or vaccine for Marburg virus. Supportive care remains the main form of treatment, focusing on alleviating symptoms and stabilizing patients. This includes:

Hydration and electrolyte balance

Pain management

Respiratory support

Antipyretics to manage fever

Blood transfusions if necessary

In addition to supportive care, experimental treatments are being tested, including antiviral drugs such as Brincidofovir and Remdesivir, as well as monoclonal antibody treatments like ZMapp. However, these treatments are still undergoing trials and are not yet widely available.

Preventing Marburg Virus Outbreaks

While there is no vaccine available, prevention of Marburg virus disease largely relies on avoiding exposure to infected animals and humans. Key prevention strategies include:

Avoiding contact with fruit bats and primates in endemic areas.

Using personal protective equipment (PPE) for healthcare workers.

Practicing good hygiene, including frequent handwashing and disinfecting surfaces.

Isolating infected patients in healthcare settings to prevent further transmission.

Preventing Marburg outbreaks also requires international cooperation to ensure that rapid response measures are put in place in the event of an outbreak. This includes improving public health infrastructure, enhancing diagnostic capabilities, and educating the public about the risks and symptoms of the virus.

The Way Forward: Vaccine Development

Currently, several Marburg virus vaccines are in various stages of development, including:

rVSV-Marburg vaccine

cAd3-Marburg vaccine

MVA-Marburg vaccine

These vaccines have shown promise in animal studies, and clinical trials are underway. Developing a safe and effective vaccine is crucial for preventing future outbreaks and mitigating the global health threat posed by the Marburg virus.

Last Line

The Marburg virus is a persistent and deadly threat, especially in sub-Saharan Africa, where outbreaks continue to occur sporadically. While no specific antiviral treatment or vaccine exists, ongoing research into experimental treatments and vaccine development offers hope for future prevention and treatment.

By strengthening global health security, improving diagnostic capabilities, and investing in public health infrastructure, the world can better combat Marburg outbreaks and save lives. The challenge remains, but with collective action, the devastating impact of Marburg virus disease can be reduced.