TALKING ABOUT MARBURG VIRUS DISEASE

Talking about marburg virus disease which has been in the news lately especially with the outbreak in Ghana where two persons are said to have died from the disease.

Marburg virus disease is a highly virulent disease that causes haemorrhagic fever. It is in the same family as the virus that causes Ebola virus disease. It has a fatality ratio of about 88% according to the WHO.

It is a genetically unique zoonotic virus which belongs to the RNA virus of the filovirus family (six species of Ebola virus belongs to this family)

First Outbreak

The initial recognition of the disease was following a large outbreak in 1967 which occurred simultaneously in Marburg and Frankfurt in Germany, and in Belgrade, Serbia. This occurrence was associated with laboratory work using African green monkeys known as Cercopithecus aethiops which were imported from Uganda.

Marburg virus diseases

Subsequent Outbreaks

Other outbreaks and sporadic cases have been reported in countries like Angola, Democratic Republic of the Congo, Kenya, South Africa (in a person with recent travel history to Zimbabwe) and Uganda.

In the year 2008, two independent cases were reported in travelers who visited a cave inhabited by Rousettus bat colonies in Uganda.

Recent out break

On the 18th of July 2022, the World Health Organisation (WHO) confirmed the outbreak of the virus in Ghana. Blood samples from two unrelated patients in the southern Ashanti region, both of whom later died, tested positive.
This incidence is the second case of the second time the virus will be detected in West Africa, after the occurrence in August 2021 in Guinea.

Keeping Alert

The Nigeria Centre for Disease Control (NCDC) says it is on a high alert following the first outbreak of the Marburg virus in the country’s neighbouring Ghana.

Transmission

Talking about the marburg virus disease, one can become infected from prolonged exposure to mines or caves inhabited by Rousettus bat colonies

Exposure to bat colonies can predispose to marburg virus disease

It can spread 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

Symptoms of marburg virus disease

The incubation period is 2-21 days.
The onset of symptom is sudden and marked by fever, chills, headache, and myalgia(muscle pain). Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur.

Other symptoms include nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhea
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.

Diagnosis

Clinical diagnosis of Marburg virus disease can be difficult. This is because it shares similar signs and symptoms to other infectious diseases (such as malaria or typhoid fever) or viral hemorrhagic fevers that may be endemic in the area (such as Lassa fever or Ebola). This is especially true if only a single case is involved.

Confirmation that symptoms are caused by Marburg virus infection are made using the following diagnostic methods:
– antibody-capture enzyme-linked immunosorbent assay (ELISA)
antigen-capture detection tests
serum neutralization test
– reverse transcriptase polymerase chain reaction (RT-PCR) assay
electron microscopy
– virus isolation by cell culture.

Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions.

All biological specimens should be packaged using the triple packaging system when transported nationally and internationally.

Treatment

Currently there are no specific treatment for marburg virus disease. What is offered is mainly supportive therapy(symptomatically). These therapy include hydration, blood transfusion to replace blood loss due to haemorrhage, maintaining oxygen status and blood pressure, and treatment for any complicating infections.

There are monoclonal antibodies (mAbs) under development and antivirals still under research.

Prevention

Avoid prolonged exposure to mines or caves inhabited by fruit bat colonies

Avoid direct or close contact with infected patients, particularly with their body fluids.

Thoroughly cook all animal products (blood and meat) very well before consumption

For health care worker

Practice strict infection control measures. This includes isolating infected individuals and using personal protective equipment (gowns, masks, goggles and gloves).

Properly use and disinfect instruments and equipment used to treat or care for patients with Marburg–like needles and thermometers–before throwing them out.

Talking about marburg virus disease should be taken as serious as other hemorrhagic diseases like Ebola. This is because even though it is not common, the fatality rate is high.

Sources

https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease
https://www.cdc.gov/vhf/marburg/symptoms/index.html
https://www.who.int/health-topics/marburg-virus-disease#tab=tab_1