WHAT IS MARBURG?

Marburg virus disease (MVD), formerly known as Marburg Hemorrhagic fever, is a severe, often fatal illness in humans. The Marburg virus is transmitted to people from fruit bats and spreads among humans through human-to-human transmission. It causes severe viral hemorrhagic fever in humans. The case-fatality rate for Marburg hemorrhagic fever is between 23 to 90%. Outbreaks and sporadic cases have been reported in Angola, Democratic Republic of Congo, Kenya, and South Africa (in a person with a recent travel history to Zimbabwe).

The incubation period of MVD is from 2 to 9 days. Transmission does not occur during the incubation period. The transmission of the virus from person to person requires extremely close contact with a patient. Infection results from contact with blood or other body fluids (faeces, vomitus, urine, saliva, and respiratory secretions) with high virus concentration, especially when these fluids contain blood. Transmission via infected semen can occur up to seven weeks after clinical recovery.

SYMPTOMS

The symptom onset is sudden and marked by fever, chills, headache, and myalgia. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea may then appear. Symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.

TREATMENT

There is no specific treatment for Marburg hemorrhagic fever. Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralize the virus but a range of blood, immunological and drug therapies are under development.

Preventive measures against Marburg virus infection are not well defined, as transmission from wildlife to humans remains an area of ongoing research. However, avoiding fruit bats, and sick non-human primates in central Africa, is one way to protect against infection. Measures for prevention of secondary, or person-to-person, transmission are similar to those used for other hemorrhagic fevers. If a patient is either suspected or confirmed to have Marburg hemorrhagic fever, barrier nursing techniques should be used to prevent direct physical contact with the patient.