Equatorial Guinea confirmed the country’s first outbreak of the deadly Marburg virus on Monday, placing it on high alert months after another outbreak was reported in Ghana as experts 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.
Equatorial Guinea and the World Health Organization confirmed the country’s first-ever outbreak of Marburg virus disease on Monday after the virus was found in samples taken from deceased patients suffering from symptoms including fever, fatigue and blood-stained vomit and diarrhea. The discovery follows the country’s efforts to stem an outbreak of a hemorrhagic fever of unknown cause in early February. Nine deaths and 16 suspected cases have been reported so far. 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.
Marburg is an extremely rare but serious disease. African fruit bats are the natural hosts of the virus—infected bats do not show obvious signs of illness—but Marburg 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 if other species also host the virus. The virus was first identified in 1967 after several simultaneous cases linked to infected laboratory monkeys in Marburg and Frankfurt, Germany and Belgrade, then Yugoslavia. 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 plan to expand trials to Ghana, Kenya, Uganda and the U.S. On Tuesday, the WHO is set to hold an urgent meeting to outline and direct research priorities in light of the outbreak in Equatorial Guinea.
The Hot Zone (Richard Preston)