Forbes The World Health Organization has urged African health authorities to be vigilant to the spread of the deadly Marburg virus, following reports of a new outbreak in Tanzania and a slew of new cases in Equatorial Guinea, as experts in multiple countries scramble to contain the highly infectious Ebola-like disease for which there is no approved vaccine or treatment.
Marburg is a highly infectious viral hemorrhagic fever in the same family as Ebola.
The virus is initially transmitted to people from fruit bats and spreads among humans through contact with the bodily fluids of infected people, according to the WHO.
Illness begins suddenly and symptoms include high fever, muscle pains, bleeding, severe headaches, diarrhea and vomiting blood.
Marburg causes serious illness and can be lethal, with fatality rates from past outbreaks varying from 24% to 88% depending on virus strain and quality of care provided.
There are no vaccines or treatments approved to treat the virus—several are in early stages of development—though supportive care like rehydration and the treatment of specific symptoms can improve outcomes.
Experts recommend people avoid eating or handling bush meat—or to thoroughly cook it before consumption—and to avoid caves and mines that might be occupied by bats to minimize the risk of catching and spreading the virus.
Tanzania announced its first-ever outbreak of Marburg virus disease in late March, reporting eight cases, including five deaths. The announcement comes a month after Equatorial Guinea confirmed its own outbreak of Marburg, a first for the West African nation. New information released by the WHO in late March indicates the outbreak in Equatorial Guinea is significantly larger than previously thought and the distance between cases hints at a “wider transmission of the virus.” So far, nine cases have been confirmed with laboratory studies, including seven deaths, and there are 20 “probable cases.” The WHO said it considers the risk of spread to be “very high” at the national level for both countries but described the risk of global spread as “low.” The agency said the risk of international spread “cannot be ruled out,” however, noting frequent crossings through porous borders. The outbreak comes months after Ghana reported its very first Marburg outbreak, which was only the second time the disease has been detected in West Africa, and after Cameroon detected two suspected cases of the Ebola-like disease.
KEY BACKGROUND
Marburg is an extremely rare but serious disease. African fruit bats are the natural hosts of the virus—they do not show obvious signs of illness—but it sometimes spills over into primates, including humans, with devastating effect. The cave-dwelling bat is found widely across Africa and many past outbreaks have been traced back to people working in mines where the bats live. The CDC says further research is needed to determine whether other species also host the virus. The virus was first identified in 1967 after several simultaneous cases linked to infected laboratory monkeys in the German cities of Marburg and Frankfurt and the then capital of Yugoslavia, Belgrade. There have been a number of Marburg virus disease outbreaks since then, notably in Angola during 2004-2005 and the Democratic Republic of Congo during 1998-2000, which killed hundreds of people. The Centers for Disease Control and Prevention notes that diagnosis of Marburg virus disease “can be difficult” as many signs and symptoms are similar to other infectious diseases like malaria or typhoid fever or other hemorrhagic fevers like Lassa or Ebola.
WHAT TO WATCH FOR
Though there are no specific treatments or vaccines on the market for Marburg, a number are under development. The WHO has suggested treatments and vaccines authorized for use in or undergoing tests for use in Ebola patients could also be used in Marburg patients given the similarities between the two diseases and dearth of options for Marburg. Researchers at the U.S. National Institute of Allergy and Infectious Diseases reported promising results from an early-stage clinical trial for a Marburg vaccine in January and plans to expand trials to Ghana, Kenya, Uganda and the U.S. Following an urgent meeting to outline and direct research priorities in light of the outbreak, the WHO said it is coordinating efforts to establish a standard of care for Marburg patients as soon as possible and supporting research efforts into possible treatments and vaccines.
WHAT WE DON’T KNOW
It’s not clear whether the outbreaks of Marburg in Tanzania and Equatorial Guinea are linked. Dr. Ahmed Ogwell Ouma, the acting director of the African Centers for Disease Control and Prevention, told the Telegraph the agency plans to genetically sequence virus samples to see if they are related.