Marburg virus comes from the Filoviridae family, with similar clinical presentations and outbreak potential with Ebola virus. The virus already caused three deaths in Uganda.

The Ugandan Ministry of Health confirmed that Marburg virus, similar to Ebola virus, already claimed three lives. The World Health Organization (WHO) released an outbreak report detailing the circumstances including public health response and risk assessment.

The Kween District in Eastern Uganda declared an outbreak of Marburg virus last Oct. 19. Three of the five cases reported succumbed to the complications of the disease, which increased the overall case-fatality rate to 100 percent. The deaths come from only one family — two brothers and one sister.

The WHO noted that one of the confirmed cases had a history of travel to Kenya before his death. Contact tracing and active case search spanning Kapchorwa district in Uganda, including West Pokot and Kitale district in Kenya are ongoing.

The confirmed case had a high-risk contact, a Kween health care worker who also developed symptoms of the disease. This patient is now at a treatment center in Kween.

An additional close contact of the second confirmed case reportedly traveled to Kampala. The team of the Kampala City Authority now traces the contact and plans to do a 21-day follow up.

What Is Marburg Virus Disease?

Marburg Virus Disease (MVD) is a viral illness caused by Marburg virus, first detected in 1967 after outbreaks occurred in Marburg and Frankfurt in Germany, and in Belgrade, Serbia.

Although Ebola and Marburg have two different causative agents, both of them belong to the Filoviridae family and have the same clinical presentations. Like Ebola virus, Marburg has the potential to cause outbreaks with an 88 percent fatality rate. The human infection of Marburg virus is secondary to prolonged exposures to areas frequented by Rousettus bat colonies.

Marburg virus has an incubation period of two to 21 days.The initial clinical presentation can start abruptly, with patients complaining of severe headache, body malaise, and high-grade fever. On the third day of the illness, many of the patients notably have “ghost-like” features as a result of severe watery diarrhea, nausea, and vomiting.

Severe bleeding usually occurs from the 5th to the 7th day of illness. Blood may come from multiple areas such as nose, gums, and vagina. Some patients vomit and excrete fresh blood. The sensitivity of their blood vessels often causes problems when doctors need to provide intravenous hydration and medicines.

While the sexual transmission of Ebola virus remains possible up to nine months, Marburg virus transmission by infected semen still needs additional surveillance data. However, WHO recommends patients to abstain from sexual intercourse or to practice safe sex for one year after the onset of symptoms.

Deaths associated with the disease occur about eight to nine days after the onset of the symptoms. Cause of fatality is often secondary to severe blood loss and shock.

At present, the only treatment option available for Marburg virus disease is symptomatic treatment such as control of fever and hydration.

Health practitioners hope that Marburg virus disease will not become the next Ebola virus capable of claiming thousands of lives.

Key facts about Marburg Virus

  • Marburg virus disease (MVD), formerly known as Marburg hemorrhagic fever, is a severe, often fatal illness in humans.
  • Rousettus aegyptiacus, fruit bats of the Pteropodidae family, are considered to be natural hosts of Marburg virus. The Marburg virus is transmitted to people from fruit bats and spreads among humans through human-to-human transmission.
  • The Marburg virus causes severe viral hemorrhagic fever in humans.
  • The average MVD case fatality rate is around 50%. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management.
  • Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, infection prevention and control practices, surveillance and contact tracing, a good laboratory service, safe burials and social mobilization.
  • Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralize the virus but a range of blood products, immune therapies, and drug therapies are currently under development.

Reference: WHO