HomeHealth CareHealth Focus: What is Marburg Virus, their symptoms and what we need...

Health Focus: What is Marburg Virus, their symptoms and what we need to know about this virus?

Marburg virus is the cause of Marburg virus disease (MVD), a disease with a mortality rate of up to 88%, but with good patient care it can be much lower. Marburg virus disease was originally identified in 1967 after concurrent outbreaks in Marburg and Frankfurt, Germany; and in Belgrade, Serbia.Marburg and Ebola viruses are both members of the Filoviridae family. Although the two diseases are caused by different viruses, they are clinically similar. Both diseases are rare and have the ability to cause outbreaks with high mortality.

Two large epidemics that occurred simultaneously in Marburg and Frankfurt, Germany and in Belgrade, Serbia in 1967 led to the initial recognition of the disease. The outbreak was linked to laboratory work on African green monkeys (Cercopithecusaethiops) imported from Uganda. Subsequently, outbreaks and sporadic cases were reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa (in a person with a recent travel history to Zimbabwe), and Uganda. In 2008, two independent cases were reported in travelers visiting a cave inhabited by colonies of Rousettus bats in Uganda.

Transmission

Initially, human infection with MVD results from long-term exposure to mines or caves inhabited by colonies of Rousettus bats. Marburg is spread by person-to-person transmission through direct contact (through broken skin or mucous membranes) with the blood, secretions, organs, or other body fluids of infected people and with surfaces and materials (e.g. .

Healthcare workers were often infected while treating patients with suspected or confirmed MVD. This has occurred in close contact with patients where infection control measures are not strictly followed. Transmission through contaminated injection equipment or needle stick injury is associated with more severe disease, rapid deterioration, and potentially higher mortality. Funeral rites that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg. People remain infectious as long as their blood contains the virus.

Symptoms of Marburg virus disease

The incubation period (interval from infection to onset of symptoms) ranges from 2 to 21 days.The illness caused by the Marburg virus begins suddenly, with a high fever, severe headache and severe malaise. Muscle aches and pains are a common feature. On the third day, severe watery diarrhea, abdominal pain and cramps, nausea and vomiting may begin. Diarrhea may persist for a week. The appearance of patients at this stage has been described as exhibiting “ghost-like” features, deep-set eyes, expressionless faces, and extreme lethargy. In the 1967 European epidemic, a nonpruritic rash was a feature noted in most patients between 2 and 7 days after symptom onset.

Many patients develop severe hemorrhagic manifestations between days 5 and 7, and fatal cases usually have some form of bleeding, often from multiple sites. Fresh blood in vomit and stool is often accompanied by bleeding from the nose, gums and vagina. Spontaneous bleeding at venipuncture sites (where intravenous access is provided for administration of fluids or collection of blood samples) can be particularly problematic. During the severe phase of the disease, patients have high fevers. Central nervous system involvement can result in confusion, irritability, and aggression. Orchitis (inflammation of one or both testicles) has occasionally been reported late in the course of the disease (15 days).In fatal cases, death most often occurs between the 8th and 9th day after the onset of symptoms, usually preceded by severe blood loss and shock.

Treatment and vaccines

There are currently no vaccines or antiviral treatments approved for MVD. However, supportive care—rehydration with oral or intravenous fluids—and treatment of specific symptoms improves survival. Monoclonal antibodies (mAbs) and antivirals such as Remdesivir and Favipiravir, which have been used in clinical trials for Ebola Virus Disease (EVD), are in development and may also be tested for MVD or used in compassionate/expanded use.

In May 2020, the EMA granted registration for Zabdeno (Ad26.ZEBOV) and Mvabea (MVA-BN-Filo) against EVD. Mvabea contains a virus known as Vaccinia Ankara Bavarian Nordic (MVA) that has been modified to produce 4 proteins from Zaire ebolavirus and three other viruses of the same group (filoviridae). The vaccine could potentially protect against MVD, but its effectiveness has not been demonstrated in clinical trials.

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