What is the Marburg Virus?

Transmission electron micrograph of Marburg virus
Transmission electron micrograph of Marburg virus

The Marburg virus is a deadly viral hemorrhagic fever disease caused by the marburgvirus (MARV), a member of the Filoviridae family, which can spread to humans through infected animals. Symptoms include fever, chills, headache, muscle aches, rash, chest pain, sore throat, diarrhea, vomiting, abdominal pain, and unexplained bleeding or bruising. After being detected in Rwanda in September 2024, two cases were also reported in Hamburg, Germany, in October 2024.

What is Marburg Virus Disease?

Marburg Virus Disease
Marburg Virus Disease

Marburg Virus Disease (MVD) is a rare but highly dangerous viral disease, with a fatality rate of up to 88%, causing severe vomiting, bleeding, and neurological problems. The incubation period for the Marburg virus ranges from 2 to 9 days. During the first week, initial symptoms include fever, chills, cough, headache, rash, and muscle-joint pain, followed by chest pain, diarrhea, severe blood loss, and confusion as the disease progresses.

The Marburg virus is not contagious during the incubation period. It can spread through direct contact with fruit bats, primates, or infected humans, including their blood or body fluids, as well as contact with contaminated clothing, bedding, pillows, needles, or medical equipment. Transmission between humans requires very close contact with the infected person.

How Did the Marburg Virus Emerge?

The Marburg virus was named after the city of Marburg in West Germany, where it was first identified in August 1967. The disease was initially found in 30 individuals in the cities of Marburg and Frankfurt, followed by two cases in Belgrade. Laboratory investigations revealed that the outbreak was linked to African green monkeys imported from Uganda to Europe, causing simultaneous outbreaks in two separate locations.

What Causes Marburg Disease?

The Marburg virus is caused by Orthomarburgvirus, found in the fruit bat species Rousettus aegyptiacus, known as the Egyptian fruit bat. Marburg viruses are filamentous, enveloped, single-stranded, negative-sense RNA viruses belonging to the Filoviridae family and the Marburgvirus genus.

What are the Symptoms of the Marburg Virus?

The Marburg virus causes sudden onset of fever, chills, headache, and muscle pain, leading to symptoms such as rash, nausea, vomiting, chest pain, abdominal pain, and diarrhea. In advanced stages, jaundice, pancreatitis, significant weight loss, shock, liver failure, severe bleeding, and multiple organ dysfunction may occur.

Marburg virus symptoms include:

  • Fever and chills
  • Headache
  • Muscle pain
  • Rash
  • Nausea and vomiting
  • Unexplained bleeding from the nose, stool, or vagina
  • Chest pain
  • Abdominal pain
  • Diarrhea
  • Weight loss
  • Jaundice
  • Liver failure
  • Confusion

What is the Incubation Period of the Marburg Virus?

The incubation period of the Marburg virus is typically 5 to 10 days, but it can range from 3 to 21 days. The disease’s clinical course can be divided into three phases: the initial phase (days 1-4), the early phase (days 5-13), and the late and recovery phase (beyond day 13). Survivors rarely experience the late phase.

How is the Marburg Virus Transmitted?

The Marburg virus spreads from person to person through very close contact or contact with the infected person’s blood, secretions, and other body fluids. It can also be transmitted by using contaminated personal items such as sheets, pillows, towels, and clothing. The virus can be transmitted from animals to humans, usually through contact with fruit bats or primates.

Since it is not an airborne disease, the most effective way for person-to-person transmission is through body fluids. These fluids include urine, stool, saliva, blood, semen, and vaginal fluids.

How is the Marburg Virus Diagnosed?

It is essential to differentiate the disease caused by the Marburg virus from other conditions like malaria, typhoid, shigellosis, meningitis, and other viral hemorrhagic fevers. Laboratory tests used to diagnose Marburg virus include:

  • Enzyme-Linked Immunosorbent Assay (ELISA)
  • Antigen Detection Tests
  • Serum Neutralization Tests
  • Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)

Is There a Treatment for the Marburg Virus?

There is no specific vaccine or drug treatment for the Marburg virus. Management includes monitoring the patient and controlling symptoms, utilizing oxygen support, intravenous fluids with medication, and early supportive care to help sustain the patient’s health.

How to Prevent Infection from the Marburg Virus?

As with all infectious diseases, the primary and most crucial precaution to avoid the Marburg virus is to avoid direct physical contact with individuals infected with the virus. Given that the disease can be transmitted from animals, avoiding contact with fruit bats and primates, like monkeys, is also important.

Therefore, personal hygiene, environmental cleanliness, and maintaining social distancing are primary preventive measures. Strengthening the immune system through a healthy diet, regular exercise, avoiding a sedentary lifestyle, getting quality sleep, and managing stress are also essential factors.

  • Avoid contact with the blood and body fluids of infected individuals.
  • Ensure that sperm does not enter the body until it is confirmed free of the virus, even if the individual has recovered.
  • Avoid touching items and surfaces that may have been in contact with body fluids.
  • Steer clear of fruit bats and primates in areas where the disease has been detected.

Frequently Asked Questions About the Marburg Virus

How soon do Marburg virus symptoms appear?

Symptoms typically emerge 2-21 days after infection.

What symptoms are observed during the Marburg virus course?

Initial symptoms include high fever, severe headache, and fatigue, followed by muscle pain. On the third day, severe diarrhea, abdominal pain, nausea, and vomiting are common. Diarrhea intensifies, leading to fluid loss and various metabolic disturbances. Skin rashes usually appear 2-7 days after symptoms begin. In fatal cases, bleeding in multiple areas (e.g., gums, vaginal, intestinal) can occur. Confusion and altered consciousness due to central nervous system involvement are significant signs, with fatalities often reported around days 8-9.

Is the Marburg virus fatal?

The Marburg virus is extremely dangerous and highly fatal. The mortality rate among cases ranges from 23% to 90%. Below is data from the Centers for Disease Control and Prevention (CDC) on where the virus has been found since its discovery in 1967 and how many cases resulted in death:

  • 2022, Ghana: 3 cases, 2 deaths
  • 2017, Uganda: 4 cases, 3 deaths
  • 2012, Uganda: 15 cases, 4 deaths
  • 2008, Netherlands: 1 case, 1 death
  • 2007, Uganda: 4 cases, 1 death
  • 2005, Angola: 252 cases, 227 deaths
  • 1998-2000, Democratic Republic of Congo: 154 cases, 128 deaths
  • 1990, Russia: 1 case, 1 death
  • 1987, Kenya: 1 case, 1 death
  • 1980, Kenya: 2 cases, 1 death
  • 1975, South Africa: 3 cases, 1 death
  • 1967, Germany: 31 cases, 7 deaths

This information provides a comprehensive overview of the Marburg virus, from its origins to symptoms, transmission, and prevention.

 

Marburg virus patient images