476 cases since Marburg was discovered, most wise pogi.
Tedros noted that while there are no vaccines for Marburg, a deadly hemorrhagic fever similar to Ebola that was recently confirmed in a patient from West Africa, "we have several effective vaccines for COVID-19, and yet cases and deaths continue to rise." (https://thehill.com/policy/healthcare/567463-who-chief-warns-100-million-more-coronavirus-cases-possible-by-early-2022) and the CDC, all hail: https://www.cdc.gov/vhf/marburg/outbreaks/chronology.html
Commonly known as Ebola's cousin, Marburg virus infection has the ability to infect individuals and keep them asymptomatic. This virus spreads just like COVID-19.
Written by Satata Karmakar | Updated : August 12, 2021 12:07 PM IST
Health authorities in Guinea have confirmed the first death due to Marburg virus disease, a highly infectious disease that causes haemorrhagic fever similar to Ebola, the World Health Organisation has said. The first case of this deadly virus infection was detected in Gueckedou, less than two months after Guinea declared an end to an Ebola outbreak that erupted earlier this year. Cases of the 2021 Ebola outbreak in Guinea, as well as the 2014-2016 west Africa outbreak, were initially detected in the same region.
According to the initial reports, the patient, a male, had onset of symptoms -- fever, headache, fatigue, abdominal pain, and gingival haemorrhage -- on July 25. He sought treatment at a small health facility on August 1. A rapid diagnostic test for malaria was performed which was negative. The patient received supportive care with rehydration, parenteral antibiotics and treatment to manage symptoms. However, he died the following day.
What is Marburg Virus?
Known as Ebola's deadly cousin, the Marburg virus is naturally hosted by Rousettus aegyptiacus or fruit bats and can be transmitted to humans very easily causing some severe complications. The virus infection can spread from human to human through body fluid. Just like the Ebola virus, the Marburg virus can also transmit from an infected person to a healthy person through cough droplets, saliva, diarrhoea, urine, etc.
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Symptoms To Look Out For
The incubation period of the virus attack may vary from 2 to 21 days and symptoms at an advanced stage may include delirium, severe weight loss, jaundice, pancreatic inflammation, massive haemorrhaging, and multiorgan failure and dysfunction. The common symptoms of Murbarg are as follows:
"The potential for the Marburg virus to spread far and wide means we need to stop it in its tracks," World Health Organisation's (WHO) Regional Director for Africa, Dr Matshidiso Moeti, said in a statement. He further added, "We are working with the health authorities to implement a swift response that builds on Guinea's past experience and expertise in managing Ebola, which is transmitted in a similar way."
West Africa has recorded the deadly disease for the first time. There have been 12 major Marburg outbreaks since 1967, mostly in southern and eastern Africa. Efforts are underway to find the people who may have been in contact with the patient. As of August 7, only one case has been confirmed and all four identified high-risk close contacts are asymptomatic. Investigations are ongoing to identify the source of the infection and additional contacts of the index case, the WHO said.
Could the Marburg Virus Start Another Outbreak? What We Know
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The Marburg virus is spread by fruit bats. Bonnie Jo Mount/The Washington Post via Getty Images
Health authorities in the West African nation of Guinea confirmed a case of Marburg virus disease earlier this month.
This is the first time this virus, which causes a highly infectious hemorrhagic fever similar to Ebola, has been detected in West Africa.
The WHO calls the disease “epidemic-prone,” meaning that it can spread easily between people if not prevented.
As the world focuses on battling COVID-19, another dangerous virus was detected in Africa this month, causing concern among health experts.
Health authorities in the West African nation of Guinea confirmed a case of Marburg virus disease on August 9, in the southern Gueckedou prefecture, according to the World Health Organization (WHO).
This is the first time this virus, which causes a highly infectious hemorrhagic fever similar to EbolaTrusted Source, has been detected in West Africa.
“We applaud the alertness and the quick investigative action by Guinea’s health workers. The potential for the Marburg virus to spread far and wide means we need to stop it in its tracks,” Dr. Matshidiso Moeti, WHO Regional Director for Africa, said in a statement. “We are working with the health authorities to implement a swift response that builds on Guinea’s past experience and expertise in managing Ebola, which is transmitted in a similar way.”
According to the WHO, Gueckedou, where this case of Marburg disease was identified, is the same region that experienced cases of the 2021 Ebola outbreak in Guinea, and where the 2014–2016 West Africa outbreak was initially detected.
What is Marburg virus disease?
Dr. Eric Cioe-Peña, director of global health at Northwell Health in New Hyde Park, New York, told Healthline that Marburg virus is a type of viral hemorrhagic fever.
“Hemorrhagic fever is any infectious fever that causes internal bleeding,” he explained. “Usually from an overwhelming inflammatory reaction that decreases a patient’s platelets and clotting factors.”
The Centers for Disease Control and Prevention (CDC)Trusted Source says that although some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses can cause severe, life threatening disease.
According to the CDC, viral hemorrhagic fevers (VHFs) are caused by four distinct virus families: Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae. The Marburg virus is considered a filovirus (filoviridae).
“Filovirus is the same family of viruses that Ebola belongs to,” said Cioe-Peña. “Symptoms are virtually identical to Ebola and mortality ranges widely from less than Ebola — about 28 percent is the lowest mortality and 88 percent is the highest recorded mortality.”
Cioe-Peña said symptoms include fever, malaise, body aches, nausea, vomiting, diarrhea, and internal hemorrhaging.
Marburg virus is ‘epidemic prone,’ says WHO
The WHO calls the disease “epidemic-prone,” meaning that it can spread easily between people if not prevented. There have been previous Marburg outbreaks in other parts of Africa, including Angola, Uganda, and South Africa.
“The filoviruses are not as contagious as what we’re used to with COVID-19,” said Cioe-Peña. “Infection usually occurs with direct contact with the body fluids of an infected individual, usually close family members, or people participating in funeral rituals that involve close contact with the body.”
The good news, he added, is that awareness of preventing viral hemorrhage and fever is “very fresh” on the minds of those in Guinea, due to the Ebola outbreak in 2014.
“The fact that this was detected after one case speaks to the surveillance and commitment of the governments of West African countries to prevent another epidemic like 2014,” he said.
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Where the Marburg virus comes from
A 2012 article publishedTrusted Source in the journal Viruses found that the first reported filovirus hemorrhagic fever outbreak took place in Germany and the former Yugoslavia in 1967.
It began when lab workers in Marburg and Frankfurt, Germany, in Belgrade, and Yugoslavia (now Serbia), contracted a “previously unknown infectious agent.”
Of 31 patients that developed severe disease, it caused death in 7 cases. According to the article, the source of infection was traced back to African green monkeys imported from Uganda and shipped to all three locations.
Decades later, we understand that monkeys weren’t the primary source of the virus.
“The host of Marburg virus is the fruit bat,” said Cioe-Peña. “They don’t show signs of illness, however, and can carry the virus.”
He explained that the virus can then jump to an intermediate host, like a monkey, which can transmit to humans, or it can transmit to humans directly by contact with fruit bats or their guano.
Signs and symptoms of Marburg disease
Dr. Teresa Murray Amato, chair of emergency medicine at Long Island Jewish Forest Hills, in New York, said the signs and symptoms of Marburg HF (hemorrhagic fever) are experienced within 5 to 10 days of exposure and include:
sudden onset of high fever
“After about 5 days of the initial symptoms, a rash develops mostly on the chest and back,” she said. “ Additional symptoms then occur that include nausea, vomiting and diarrhea, chest pain, and abdominal pain.”
She pointed out that after this, there may be skin color changes where the skin appears yellow (jaundice).
“The pancreas and the liver become inflamed leading to liver failure and massive bleeding,” continued Amato.
Treating Marburg disease
Amato explained that while there’s no specific treatment for Marburg disease, most people seeking care will require intravenous (IV) fluids, replacement of electrolytes, supplemental oxygen, and replacement of blood and blood products.
She confirmed that there’s currently no vaccine against this virus.
“About 25 to 30 percent of people who contract Marburg HF will succumb to the disease,” she continued, and warned that the disease isn’t easy to identify.
“Marburg HF may be difficult to diagnose initially, as the presentation initially resembles many more common viral infections,” she said.
Amato emphasized that it’s very important for patients to tell their doctor if they’ve traveled to an area that may be associated with an exposure to the virus that causes Marburg disease.
The bottom line
The WHO confirmed that health authorities in the West African nation of Guinea have recently identified a case of Marburg virus disease.
This virus causes symptoms similar to Ebola. It’s a type of hemorrhagic fever that causes internal bleeding and originates in a species of fruit bat.
Experts say that Guinea’s recent experience with an Ebola outbreak in 2014 has enabled the West African nation to quickly control the situation.
Why The Discovery Of Marburg Virus In West Africa Is A Concern
An epidemic of a very deadly disease, Marburg hemorrhagic fever, is brewing in West Africa. Or maybe not. We can’t be sure. That’s the problem. When zoonotic diseases spillover from wildlife into people it can be very difficult to tell whether what we observe is a singular event, one off and unlikely to lead to anything, or the tip of an iceberg.
On August 9, the World Health Organization (WHO) reported that a Guinean man contracted and later died from Marburg virus disease (MVD), a typically fatal disease caused by a filovirus closely related to Ebola. A few days later, Front Page Africa reported that a second person had been infected.
The circumstances of their infections have not been reported. However, it would not be surprising if the original infection resulted from contact with an Egyptian fruit bat (Rousettus aegyptiacus), a species that is a known reservoir of Marburg virus.
What is (a little) surprising is that the cases arose in West Africa. Prior to this event, fatalities from Marburg Virus Disease originated in Central and Southern Africa: Angola, Democratic Republic of the Congo (DRC), Kenya, Uganda, and Zimbabwe. Also, the virus was known to exist in fruit bat colonies in DRC, Gabon, Kenya, South Africa, Uganda, and Zambia, also all in Central and Southern Africa.
Enlarged map shows locations of caves where populations of Marburg virus-(MARV) positive Egyptian ... [+]
AMMAN, B.R., BIRD, B.H., BAKARR, I.A. ET AL. ISOLATION OF ANGOLA-LIKE MARBURG VIRUS FROM EGYPTIAN ROUSETTE BATS FROM WEST AFRICA. NAT COMMUN 11, 510 (2020).
This situation is not greatly different from where we were in December 2013, when a young Guinean boy succumbed to the Ebola virus. As in the new case with Marburg, the Ebola virus was known from other parts of the continent, but not West Africa. The long term outcome of that spillover event was an epidemic that ravaged West Africa for two years, spreading across national boundaries, pushing health care systems to their limits, taking over 10,000 lives, and exacting a multi-billion dollar toll in lives lost, health care, economic productivity, and the costs of containment.
Many people were surprised by the outbreak of Ebola in West Africa. But this is because we had ignored important warning signs.
With Marburg, we are perhaps a little less surprised. Live Marburg virus was isolated from five Egyptian fruit bats in Sierra Leone in 2018. A subsequent study found Marburg in bats from caves across Sierra Leone, including some near the border with Guinea, not far from Guéckédou where the latest case was found.
Genetic analysis of these viruses showed a surprising amount of genetic diversity. This means that Marburg virus has probably been present in West Africa for a long time. A recent introduction would have gone through a genetic “bottleneck” leading the isolated viruses to be more similar than was actually observed.
Thus, we have the conundrum. If the Marburg virus has been in West Africa for a long time, why is it only now spilling over into people? Maybe the recent cases are a rare event, too rare to be statistically meaningful. Or maybe the discovery of Marburg virus in bats is a warning sign that should be heeded.
Just knowing that a pathogen is somewhere in the world is not enough to calculate risk. Risk is the product of both the availability of the pathogen and the probability of exposure. The best defense against Marburg virus as with many other zoonoses is to allow as few shots on goal as possible.
Key facts about Marburg Virus Disease
Marburg Virus Disease is known to have infected only 475 people worldwide since it was discovered in 1967.
The case fatality rate of known cases is around 80%.
But, there may be mild cases that we don’t know anything about. A serosurvey is a kind of study that can look at population exposure to a pathogen from serum in the blood. A serosurvey in the DRC in 1999 found that 2% of the population had been exposed to the Marburg virus at some point. However, the majority of these were men who worked in gold mines, suggesting that exposure to Marburg virus was an occupational hazard, perhaps associated with working in a habitat occupied by bats.