Is the Marburg virus a threat? It might be more widespread than we think

In July 2022, Ghana confirmed its first two cases of the deadly Marburg virus, a highly contagious disease in the same family as the virus that causes Ebola. The Conversation of Africa Wale Fatade and Usifo Omozokpea asked the virologist Oyewale Tomori about the origin and how people can protect themselves from the disease.

What is the Marburg virus and where does it come from?

Marburg virus causes Marburg virus disease (MVD), formerly known as Marburg hemorrhagic fever. The virus, which belongs to the same family as the Ebola virus, causes severe viral hemorrhagic fever in humans with an average mortality rate of about 50 percent. It varied between 24 percent and 88 percent in different outbreaks, depending on the virus strain and case management.

It was first reported in 1967 in a city called Marburg in Germany and in Belgrade, Yugoslavia (now Serbia). Eruptions occurred in both cities at the same time. It came from monkeys imported from Uganda for laboratory testing in Marburg. The laboratory staff became infected through working with the material (blood, tissue and cells) from the monkeys. Out of 31 cases related to these outbreaks, seven people died.

After the first outbreaks, more cases were reported in different parts of the world. Most were in Africa – Uganda, the Democratic Republic of the Congo, Kenya, South Africa and more recently Guinea and Ghana. Serological studies have also revealed evidence of past infection with Marburg virus in Nigeria.

While the host or reservoir of the virus cannot be positively identified, the virus has been linked to fruit bats. In 2008, two independent cases were reported in travelers who had visited an inhabited cave Rousettus Bat colonies in Uganda.

How is it spreading?

It is spread through contact with materials (fluids, blood, tissues, and cells) from an infected host or reservoir. With the monkeys imported to Marburg from Uganda, laboratory workers apparently became infected through contact with the tissue and the blood of the monkeys.

Human-to-human transmission can also occur through direct contact (through broken skin or mucous membranes) with blood, secretions, organs, or other bodily fluids of infected people, as well as with surfaces and materials. This includes materials such as bedding and clothing contaminated with these liquids.

But there’s a lot we don’t know. For example, contact with bat droppings in caves can lead to infection in humans.

What are the symptoms? And how bad can they be?

After an incubation period of two to 21 days, the onset of the disease is sudden and is characterized by fever, chills, headache and muscle pain.

A maculopapular rash, most noticeable on the trunk (chest, back, abdomen), may appear about five days after the onset of symptoms. Nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhea may occur. Symptoms become progressively more severe and may include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive bleeding, and multiple organ dysfunction.

Mortality is around 50 percent and can be as high as 88 percent or as high as 20 percent.

That tells us it’s a pretty serious infection. The two people infected in Ghana both died.

Can it be treated?

Not really, but early supportive care with rehydration and symptomatic treatment improves survival.

What can people do to protect themselves?

Avoid contact with the virus as much as possible and protect yourself from infection from infected people.

Also because of the similarities in the symptoms of many hemorrhagic fevers, particularly in the early stages, there is a need for reliable laboratory confirmation of Marburg virus infection. And once that’s done – like with Ebola – the person must be isolated immediately and avoid contact with other people.

This leads me to suspect that the virus is probably more widespread than we think. We need an improvement in diagnostics that can help us perform detection as quickly and efficiently as possible.

What can be done to prevent the virus from spreading?

There is no vacation in the event of an outbreak. This means that monitoring as a country cannot pause or go on vacation.

With the cases in Ghana, it’s time to be vigilant. Proper shielding is required. Travelers from Ghana and other West African countries must be checked at the ports of entry.

Unfortunately, it doesn’t look like anyone’s thinking about it now. The attitude seems to be, “Oh, there are only two cases in Ghana.”

But I think it’s the best time to be vigilant at ports of entry, especially for people from countries where cases are reported. Studies conducted in Nigeria in the 1980s and more recently the 1990s provide evidence of possible past infection with Marburg virus – or a related virus – in certain Nigerian populations. This leads me to suspect that the virus is probably more widespread than we think. We need an improvement in diagnostics that can help us perform detection as quickly and efficiently as possible.

In addition, countries need to improve their disease surveillance and laboratory diagnosis to expand and improve the capacity for more definitive diagnosis of viral hemorrhagic fever infections.

This article was originally published on The conversation by Oyewale Tomori at the Nigerian Academy of Science. Read the original article here.