Two suspected cases of the Marburg virus were reported from Cameroon this week. Earlier in the week, Equatorial Guinea confirmed its first outbreak of Marburg virus disease. Authorities in Cameroon had earlier restricted movement in the region bordering Equatorial Guinea after reports of an outbreak in the country.

Marburg virus

According to the World Health Organisation (WHO), Marburg virus is the causative agent of Marburg virus disease (MVD), a disease with a case-fatality ratio of up to 88%, but can be much lower with good patient care. Marburg virus disease was initially detected in 1967 after simultaneous outbreaks in Marburg and Frankfurt in Germany; and in Belgrade, Serbia.

Marburg and Ebola viruses are both members of the Filoviridae family (filovirus). Though caused by different viruses, the two diseases are clinically similar. Both diseases are rare and have the capacity to cause outbreaks with high fatality rates.

Transmission

It is not an airborne disease. Marburg spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs, or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.

Family members and hospital staff who look after the patients infected with the Marburg virus are the people in the higher risk category.

Symptoms

As per WHO, the incubation period (interval from infection to onset of symptoms) varies from 2 to 21 days.

Illness caused by the Marburg virus begins abruptly, with high fever, severe headache, and severe malaise. Muscle aches and pains are common features. Severe watery diarrhoea, abdominal pain, cramping, nausea, and vomiting can begin on the third day. Diarrhoea can persist for a week. The appearance of patients at this phase has been described as showing “ghost-like” drawn features, deep-set eyes, expressionless faces, and extreme lethargy. 

In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock.

Treatment

Currently, there are no vaccines or antiviral treatments approved for MVD. However, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improve survival.

Raising awareness of risk factors for Marburg infection and protective measures that individuals can take is an effective way to reduce human transmission.