Marburg virus
About Marburg virus
On 9 August 2021, WHO published a news about outbreak of Marburg virus disease (MVD) in Guinea, a west African country. According to WHO news , on 6 August 2021 , the Ministry of Guinea informed WHO of a confirmed case of Marburg virus disease in Guinea. It is also said that case of Marburg virus disease is the first in Guinea and in West Africa.Marburg virus Disease was first documented in 1967 in Marburg and Frankfurt in Germany, and in Belgrade, Serbia.Marburg virus disease is a viral haemorrhagic fever caused by Marburg virus or Ravn virus .It is also known as Marburg haemorrhagic fever.Both Marburg and Ebola viruses are the members of Filoviridae family or filovirus.Clinical features of disease is very similar to the disease caused by Ebola. So disease is diagnosed by doing RT-PCR test in lab.Marburg virus causes severe viral haemorrhagic fever in humans, often become fatal illness in humans. The average Marburg virus disease case fatality rate is around 50 percent. Data on past outbreak of MVD showed case fatality rate variation from 24 % to 88% depending on the strain of virus and case management.
Mode of transmission of Marburg virus
Marburg virus transmitts to people from bats and then spreads among humans through human-to-human transmission via direct contact (through broken skin or mucous) with the blood ,secretions or body fluids of infected people .Transmission of virus remains more probable to health workers while treating Marburg virus disease patients due to lack of practicing infection control precautions .Direct contact with deceased body during burial ceremonies can contribute in transmission of Marburg virus. Note that people remains infectious as long as their blood contains the virus.
Sign and symptoms of Marburg virus disease
The sign and symptoms of Marburg virus disease is very similar to Ebola virus disease.The time period from infection to onset of symptoms which we called incubation period is 2 to 21 days. Marburg virus disease begins with high fever, severe headache, severe malaise, muscle aches. Abdominal pain and cramping, severe diarrhoea, nausea and vomiting are also common symptoms which are mostly observed from third day of infection.As patients reached to severe stage of disease bleeding occurs in multiple areas body . Many patients develops such haemorrhagic stage between 5 to 7 days of infection. Bleeding from nose,gums vagina causes more fatality in patients. During the severe phase of illness, patients have high fever.In fatal cases, death occurs between 8 to 9 days after onset of symptoms.
Diagnosis of MVD
It is more difficult to clinically distinguish Marburg virus disease from other infectious diseases like Ebola, malaria, typhoid fever, meningitis, shigellosis and other viral haemorrhagic disease. To confirm that symptoms seen and noticed are due to Marburg virus, the following any one or two diagnostic test methods should be done;
- RT-PCR test
- Antigen detection tests
- Serum antibody test
- Virus isolation by cell culture method
- Electron microscopy
Treatment and vaccines for MVD
As to date there are no vaccines and no antiviral treatments for Marburg virus . However, supportive care and treatment- rehydration with oral or intravenous fluids are found beneficial to patients . Supportive care is equally important to prevent secondary infections and increase survival rates in fatal cases. Antivirals drugs like remdesivir and Favipiravir have been used in clinical research.
Prevention and control of Marburg virus
Preventive and control measures of disease is same as other diseases.Spread of virus can be prevented by:
- Reducing the risk of bat-to-human transmission
- Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients.
- Reducing the risk of possible sexual transmission.
- Applying approved outbreak containment measures such as social distancing, contact tracing, isolation of infected people, proper practice of burial of deceased people .
- Taking standard precautions by health care workers while caring for patients. They should follow basic hand hygiene, respiratory hygiene, use of personal protective equipment, safe injection practices and safe and dignified burial practices.
It is more important to take precautionary measures in pig farms to avoid pigs becoming infected through contact with fruit bats. Such infection could potentially amplify the Marburg virus and could cause or contribute to Marburg virus disease outbreak .
