Introduction
Health Authorities in Guinea on the 2nd of August, 2021 confirmed the first case of Marburg virus in West Africa. The man whose sample tested positive for the virus has since died in southern Gueckedou, Guinea where recent Ebola virus outbreak in the sub-region begun.
Marburg virus is of the same family with Ebola virus and responsible for a highly virulent Marburg virus disease (MVD). According to the World Health Organization (WHO), the case fatality ratio of previous cases of MVD varied from 24% to 88%.
Source: https://www.gavi.org/vaccineswork/next-pandemic/marburg
Signs and Symptoms
The disease presents with sudden onset of symptoms such as high fever, severe headache, severe malaise and muscle aches. By day three of disease onset, patients may experience severe diarrhea, abdominal pains and cramping, nausea and vomiting.
Within seven days, hemorrhagic symptoms appears with bleeding from the gums, gastrointestinal tract, nose and vagina. Death results from severe blood loss and shock by the eighth to ninth day.
How is this virus transmitted
A cave-dwelling Egyptian fruit bat is the primary natural reservoir of the virus through which human transmission occurs. Scientists say the highly infectious virus can be found in the saliva, urine, spleen and lymph nodes of infected people for several weeks. This makes human-to-human transmission possible via direct contact (broken skin or mucus membranes) with blood, secretions, organ or bodily fluids of infected people, and with surfaces and materials (example bedding, clothing) contaminated with these fluids. Marburg virus has an incubation period of 2-21days.
Origin
Until the recently confirmed case in Guinea, West Africa has been spared of the viral outbreak and sporadic cases since it was first reported in 1967 in Germany and Serbia.
Since then, it has been reported in Angola, Democratic Republic of the Congo, Kenya, South Africa and Uganda.
World Health Organization informed
Dr Matshidiso Moeti, WHO Regional Director for Africa who applauded the Guinea health workers for their prompt response noted that the highly infectious virus needs to be stopped in its tracks because of its potential to spread far and wide. Dr Matshidiso Moeti, also noted that the virus will be stopped by employing the Ebola virus experience in the Region.
At present, there are no WHO approved drug treatments or vaccines for MVD and treatment is only supportive. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated.
Ghana Health Service recommendation
MVD can be prevented and the Ghana Health Service recommends the following;
- Avoid contact with body fluids (such as urine, saliva, sweat, feces, vomit, breastmilk and semen) of people who show any signs or symptoms of MVD
- Practice hand hygiene like you do for COVID-19: frequent hand washing with soap and under running water or use an alcohol-based hand sanitizer
- Do not handle items that may have come in contact with an infected person’s body fluids
- Avoid contact with dead bodies, including participating in funeral or burial rituals of suspected or confirmed Marburg virus case [it will be smart to avoid contact with dead bodies of people who died with feverish illness that have no doctor’s certification of cause of dead]
- Seek medical care immediately (nearest health facility) if one develops fever (body temperature 38℃ or above) or other symptoms such as severe headache, fatigue, muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising
What Health Practitioners need to Note
If you’re a health care practitioner, look out for the standard case definition for MVD:
Suspected case: Acute onset of fever of less than 3 weeks duration in a severely ill patient/or a dead person AND any 2 of the following: hemorrhagic or purpuric rash; epistaxis (nose bleed); hematemesis (blood in vomitus); hemoptysis (blood in sputum); blood in stool; other hemorrhagic symptoms and no known predisposing factors for hemorrhagic manifestations. A person with sudden onset of fever, general weakness, severe headache and no response to treatment (antimalarial, antibiotics etc.)
Probable case: A suspected case with epidemiologic link to confirmed cases or outbreak, but laboratory specimens are not available or awaited.
Confirmed case: A suspected case with laboratory confirmation (positive IgM antibody, Positive PCR or viral isolation), or epidemiological link to confirmed cases or outbreak.
By Kwame Sherrif Awiagah
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If you wish to read further, please find useful information from some of my references below.
- https://www.who.int/health-topics/marburg-virus-disease#tab=tab_1
- https://www.afro.who.int/news/west-africas-first-ever-case-marburg-virus-disease-confirmed-guinea
- https://www.gavi.org/vaccineswork/next-pandemic/marburg
- Monath TP. Lassa fever and Marburg virus disease. WHO Chron 1974; 28:212–9
- Ghana Health Service (2021): New Marburg Alert. Press Release, 11th August, 2021: GHS/DG..11.8.21. Ghana
- Shoemaker, T. (2019). Surveillance and Epidemiology of Viral Hemorrhagic Fevers (VHFs): identification of emergence, seroprevelance, and risk factors of VHFs in Uganda (Doctoral dissertation, Université Montpellier).
- Reynolds, P., & Marzi, A. (2017). Ebola and Marburg virus vaccines. Virus Genes, 53(4), 501-515.
- Amman, B. R., Bird, B. H., Bakarr, I. A., Bangura, J., Schuh, A. J., Johnny, J., … & Lebbie, A. (2020). Isolation of Angola-like Marburg virus from Egyptian rousette bats from West Africa. Nature communications, 11(1), 1-9
