Marburg is a virus originating from fruit bats in Africa, transmitted from person to person through respiratory secretions, causing a hemorrhagic fever known as “zombie disease” with a mortality rate of nearly 90%.
Important Facts About the Marburg Virus
During the recent outbreak of the Marburg virus on February 7, Equatorial Guinea reported 9 deaths and 16 suspected cases. Meanwhile, Cameroon also reported its first two suspected cases.
On the afternoon of February 14, the WHO convened a meeting to discuss the progress of vaccines and treatment candidates.
What is the Marburg Virus?
Marburg is a virus from the Filoviridae family (the same family as Ebola), genetically unique and capable of causing severe hemorrhagic disease in humans, with a mortality rate ranging from 24% to 88%, depending on the virus strain and the quality of medical care provided.
The Marburg virus disease was first recognized in 1967 when outbreaks occurred simultaneously in laboratories in Marburg, Frankfurt, Germany, and Belgrade, Serbia.
Infections stemmed from Grivet monkeys imported from Uganda for research and polio vaccine production. Subsequently, sporadic outbreaks were reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa, and Uganda.
In 2008, the first independent case was recorded among tourists visiting caves inhabited by Rousettus bats in Uganda.
The virus is believed to have been transmitted from African fruit bats to individuals working in mines and caves. It is not an airborne pathogen. The virus spreads between people through bodily fluids such as blood, saliva, or urine.
Symptoms of Marburg Virus Infection
After a incubation period of 2 to 21 days, individuals infected with the virus begin to show symptoms of high fever, severe headache, discomfort, accompanied by muscle aches. By the third day, they experience watery diarrhea, abdominal pain, cramps, nausea, and vomiting. The diarrhea typically lasts about a week.
During this stage, many doctors describe patients as appearing lethargic, “zombie-like,” with sunken eyes, expressionless faces, and extreme apathy.
In the outbreak recorded in 1967, most patients developed a rash that was not itchy from 2 to 7 days after the onset of initial symptoms. Many patients experienced severe bleeding or hemorrhaging by the seventh day. Fresh blood appeared in vomit and stool, often accompanied by symptoms of nosebleeds, gum bleeding, and vaginal bleeding. Spontaneous bleeding occurred at sites with intravenous lines for fluid administration or blood sampling.
In the severe phase, patients experience high fever, confusion, irritability, and aggression. Men may sometimes suffer from orchitis in the third week.
Patients typically die 8 to 9 days after the onset of symptoms, following severe blood loss and shock.
The Marburg Virus originates from African fruit bats. (Photo: Washington Post)
Diagnosis
Without testing, it is difficult to distinguish Marburg from malaria, typhoid fever, meningitis, Ebola, and other forms of viral hemorrhagic fevers.
High-Risk Individuals
Individuals at the highest risk of infection are usually family members and friends who have close contact with patients, healthcare workers, and caregivers of confirmed virus cases without using personal protective equipment.
Veterinarians and laboratory staff at quarantine facilities handling primates from Africa are also at risk of exposure.
The Marburg virus can spread through the bodies of deceased patients. Therefore, individuals involved in burial practices or having direct contact with deceased patients are also at risk of contracting the virus.
Response Measures
In response to the current outbreak, Equatorial Guinea has isolated over 200 individuals and restricted movement in the Kie-Ntem province, where the cases were first reported.
Authorities in both Equatorial Guinea and Cameroon are addressing the outbreak by combining border closures and monitoring contacts. This method has previously been successful in preventing the spread of the Marburg and Ebola viruses during earlier outbreaks.
Currently, there is no vaccine or antiviral treatment available for the Marburg virus. According to the WHO, methods such as rehydration and treatment of individual symptoms may increase survival rates among patients.
Previously, some treatment methods were successfully tested on animals. However, these methods have not been certified for human use.
According to a report by Helen Braswell during an emergency meeting of the World Health Organization, although there is no specific vaccine for the Marburg virus, several hundred doses of experimental vaccines are available. This vaccine has only been minimally tested due to the rarity of Marburg outbreaks. Testing the vaccine at this time needs to be implemented immediately. However, in a very small-scale outbreak, scientists also find it challenging to verify the vaccine’s efficacy.
