What do we know about the Marburg virus, which killed two men in Ghana?

Marburg virus disease is transmitted to humans by bats and spreads among humans through direct contact with the bodily fluids of infected people (Illustration ©Pixabay)

The health authorities of Ghana have officially confirmed that two people who died at the beginning of July 2022 were affected by Marburg virusa highly contagious hemorrhagic fever, similar to Ebola.

The first case: a 26-year-old man who presented to the hospital on June 26 and died the following day. The second was a 51-year-old man who presented to the hospital on June 28 and died the same day, reports the World Health Organization (WHO).

These two patients, unrelated, had symptoms such as diarrhea, fever, nausea and vomiting.

“The Marburg virus can easily spiral out of control”

“Health authorities reacted quickly, getting a head start in preparing for a possible outbreak. This is a good thing because without immediate and decisive action, the Marburg can easily spiral out of control,” commented Dr Matshidiso Moeti, WHO Regional Director for Africa, in a statement.

Nearly 100 contact cases have been placed in quarantine. The WHO has entered into contact with neighboring countries which are on alert and will send a team of experts “to ensure coordination and assess the risks and measures to prevent infection”.

What do we know about this virus?

The medical history of the Marburg virus begins in Europe, in a laboratory. It was first discovered in 1967simultaneously in Germany, in the city of Marburg as well as in Frankfurt, and in Yugoslavia (now Serbia), in Belgrade.

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Laboratory workers were infected after being in contact with monkeys from Uganda. 29 people fell ill in Germany, seven died. The patients were initially the laboratory staff, then the infection spread to the members of the medical staff who had treated the first patients, as well as to their families.

So these are the African green monkeys (Cercopithecus aethiops) imported from Uganda which were the source of human infection in this first Marburg outbreak.

Very present in Africa

These viruses, Marburg and Ebola, both belong to the family of Filoviridae (filovirus). Although caused by different viruses, these two diseases are clinically similar. They have the ability to cause epidemics with high mortality rates.

This is the first time that Ghana has confirmed the presence of the Marburg virus. The WHO announced in September 2021 the end of the first episode of the Marburg virus in West Africa, 42 days after the identification of a single case in Guinea.

Sporadic outbreaks and cases had in the past been reported elsewhere in Africa, including South Africa, Angola, Kenya, Uganda and the Democratic Republic of Congo. 128 people died of it in the Democratic Republic of the Congo in 1998, 329 in Angola in 2005.

How is the Marburg virus transmitted?

Marburg virus disease is transmitted to humans by bats frugivores, considered as natural hosts of this virus, and is spreading in the human species through direct contact with bodily fluids of infected peopleor with surfaces and materials, according to the WHO.

Thus, one can become infected through broken skin or mucous membranes with the blood, secretions, organs or other bodily fluids of infected persons, and with bedding, clothing etc.

What symptoms and how to treat?

The disease begins suddenly, with high fever, intense headaches and possible malaise. Case fatality rates have ranged from 24% to 88% in previous outbreaks, depending on virus strain and case management, according to the WHO. Many patients develop severe bleeding signs within seven days.

Although there is no no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improve survival.

According to the WHO, a range of potential treatments, including blood products, immune therapies and drug treatments, are being evaluated.

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