Marburg Virus: All You Need To Know

Written by MD Bureau Published On 2021-08-14T18:45:10+05:30 | Updated On 14 Aug 2021 7:10 PM IST

According to the WHO, this is the first time that Marburg, a highly infectious virus with upto 88% fatality rate, has been identified in a West African country.

New Delhi: While the world is recovering from the COVID-19 pandemic, health authorities, on 9^th August 2021, have confirmed a case of Marburg virus in Southern Gueckedou, Guinea. According to the World Health Organisation, this is the first time that Marburg, a highly infectious virus with up to 88% fatality rate, has been identified in a West African country.

It is rather alarming to note that Marburg, which is in the same family as the virus that causes Ebola, was detected less than two months after Guinea declared an end to an Ebola outbreak that erupted earlier this year.

Samples taken from a now-deceased patient and tested by a field laboratory in Gueckedou as well as Guinea's national haemorrhagic fever laboratory turned out positive for the Marburg virus. Further analysis by the Institut Pasteur in Senegal confirmed the result. Health Authorities are now monitoring the 155 people who had had contact with the infected person.

The potential transmission of virus between bat colonies and humans poses an increased risk at the national level. However, the risk at the global level is low, as of now.

Human infection with Marburg virus disease initially results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies. Once an individual is infected with the virus, Marburg 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. The incubation period for the disease is 2-21 days.

SYMPTOMS:

Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Muscle aches and pains are a common feature. Severe watery diarrhoea, abdominal pain and 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. A non-itchy rash has been noted between 2 and 7 days after the onset of symptoms.

Many patients develop severe haemorrhagic manifestations within 7 days, and fatal cases usually have bleeding, often from multiple areas. Fresh blood in vomitus and faeces is often accompanied by bleeding from the nose, gums and vagina. Spontaneous bleeding at venepuncture sites (where intravenous access is obtained to give fluids or obtain blood samples) can be particularly troublesome. During the severe phase of illness, patients have sustained high fevers. Involvement of the central nervous system can result in confusion, irritability and aggression. Orchitis (inflammation of the testicles) has been reported occasionally in the late phase (15 days).

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

DIAGNOSIS:

Confirmation that symptoms are caused by Marburg virus infection are made using the following diagnostic methods:

antibody enzyme-linked immunosorbent assay (ELISA);
antigen detection tests;
serum neutralization tests;
reverse-transcriptase polymerase chain reaction (RT-PCR) assay; and
virus isolation by cell culture.

Samples collected from patients are an extreme biohazard risk and laboratory testing on non-inactivated samples need to be conducted under maximum biological containment conditions. All biological specimens must be packaged using the triple packaging system when transported nationally and internationally.

TREATMENT:

It is alarming to note that as of now, there is no vaccine available for the Marburg virus. Treatment is supportive in nature - rehydration with oral or intravenous fluids. Treatment of specific symptoms improves survival and treatment of specific symptoms improves survival.

Marburg virusebola

MD Bureau

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