Marburg virus disease: Symptoms, causes, treatment, all you need to know

• The Marburg virus is a severe hemorrhagic fever virus that often leads to fatality.
  
• The incubation period for the disease is from 2-21 days.
  
• Until now, no vaccines have been available to treat the disease.

Marburg virus is highly infectious, with a fatality rate of up to 88%. It is a dangerous disease that causes hemorrhagic fever, and WHO has rated it a Risk Group 4 Pathogen (high individual and community risk). The virus belongs to the same family as the Ebola virus – Filoviridae.

It was first detected in 1967 in the German cities of Marburg and Frankfurt and the Yugoslav capital Belgrade. While conducting the laboratory research, people were exposed to Ugandan-imported African green monkeys or their tissues. Thirty-one people were infected, and seven deaths were reported.

Transmission
The virus spreads via human-to-human transmission or direct contact through broken skin or mucous membranes with infected people’s bodily fluids and surfaces/materials infected with these fluids.
Similar to the Ebola virus, the Marburg virus is known to persist in the testicles and inside of the eye. The disease saw various outbreaks over the years. In 2008, unprotected contact with infected bat feces or aerosols was also listed as a cause of the infection.

Symptoms
Within an incubation period of 2-21 days, infected individuals get fever, chills, headache, and myalgia (muscle pain).
Symptoms become increasingly severe from mild symptoms like maculopapular rash, nausea, vomiting, chest pain, sore throat, diarrhea, and abdominal pain. They can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.
Death usually occurs eight to nine days after symptoms appear, preceded by severe blood loss and shock.

Diagnosis
The Marburg virus disease has symptoms similar to Ebola, malaria, typhoid fever, or dengue; hence, diagnosis becomes difficult.

Tests required to confirm a case of Marburg virus disease are-

• antibody enzyme-linked immunosorbent assay (ELISA);
• antigen detection tests;
• serum neutralization tests;
• reverse-transcriptase polymerase chain reaction (RT-PCR) assay; and
• virus isolation by cell culture.

Cure or vaccine
There is no defined treatment or vaccine for the Marburg virus disease. However, giving supportive care by rehydration with oral or intravenous fluids can improve the chances of survival.

Equatorial Guinea confirms a Marburg virus outbreak with at least nine deaths and 16 suspected cases. Symptoms like fever, fatigue, blood-stained vomit, and diarrhea were reported. Equatorial Guinean health authorities sent samples to determine the cause of the disease, and a district health official alert was made on 7 February 2023.

After the disease outbreak in Equatorial Guinea, WHO R&D Blueprint arranged an urgent meeting with the MARVAC partners to discuss the vaccine and therapeutic candidates.

Dr. Matshidiso Moeti, WHO Regional Director for Africa, said, “Marburg is highly infectious. Thanks to the rapid and decisive action by the Equatorial Guinean authorities in confirming the disease, emergency response can get to full steam quickly so that we save lives and halt the virus as soon as possible”.
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