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Understanding Marburg Virus: A Deadly Hemorrhagic Fever Threat

GS Paper 3: Science and Technology

Why in the news?

The deadly Marburg virus has the potential to overwhelm Rwanda’s fragile healthcare system. Since the country’s first reported Marburg case late last month, at least 46 people have been infected, with 12 deaths reported.

Alarmingly, around 80% of infections involve medical workers, posing a significant threat to Rwanda’s healthcare system, which only has 1,500 doctors serving over 13 million people.

What is the Marburg Virus?

Marburg virus is one of the deadliest pathogens known to humans, with Marburg virus disease (MVD) case fatality rates ranging from 24% to 88%, depending on the virus strain and case management. The virus was first identified in Marburg, Germany, in 1967, and outbreaks have since been predominantly reported in Africa.

  • Marburg virus disease (MVD) is a highly virulent hemorrhagic fever transmitted by bats, with a fatality rate as high as 88%.
  • It belongs to the same virus family as Ebola.
  • The first major outbreaks were reported in 1967, simultaneously in Marburg and Frankfurt, Germany, and Belgrade, Serbia, linked to laboratory work with African green monkeys imported from Uganda.

Subsequent outbreaks and sporadic cases have occurred in countries like Angola, Democratic Republic of the Congo, Kenya, South Africa, and Uganda. Since 1967, 12 major Marburg virus outbreaks have been recorded, mostly in southern and eastern Africa.

Human Infection

Human infection with Marburg virus typically results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies. These bats, commonly known as flying foxes or dog-faced fruit bats, are the natural hosts for the virus.

Transmission

Once a person is infected, Marburg virus spreads through direct human-to-human transmission. This occurs via contact with bodily fluids such as blood, secretions, organs, or contaminated materials like bedding or clothing from infected individuals.

Symptoms

Initial symptoms include headaches, muscle pains, vomiting blood, and bleeding from various body orifices. The illness worsens to include jaundice, severe weight loss, liver failure, haemorrhaging, and multi-organ dysfunction.

Diagnosis

Diagnosing Marburg virus disease can be challenging, as its symptoms are similar to diseases like malaria and typhoid fever. However, Polymerase Chain Reaction (PCR) and Enzyme-Linked Immunosorbent Assay (ELISA) tests can confirm the infection.

Treatment

There is no specific treatment or vaccine approved for Marburg virus hemorrhagic fever. Supportive hospital care, including fluid and electrolyte balance, blood pressure maintenance, and infection control, is essential.

Signs and Symptoms of Marburg Virus Disease

Marburg virus causes hemorrhagic symptoms, including rashes, bruises, and bleeding around injection sites. Contrary to popular belief, bleeding is not the primary cause of death. Mortality usually results from fluid imbalances, hypotension, and multi-organ failure due to multiple organ dysfunction syndromes (MODS).

Clinical Stages of Marburg Hemorrhagic Fever

  1. Incubation period: 2-21 days (average of 5-9 days).
  1. Generalisation phase (Days 1-5): Symptoms include high fever, nausea, vomiting, diarrhea, abdominal pain, and a rash.
  2. Early organ phase (Days 5-13): Symptoms worsen, with respiratory issues, liver problems, and nervous system involvement. Hemorrhaging may occur, signaling a worsening condition.
  3. Late organ phase (Days 13-21+): Survivors experience muscle pain and psychosis, while fatal cases result in death from shock and multi-organ failure.

Diagnosis

Marburg virus disease is hard to distinguish from Ebola or other diseases common in equatorial Africa. Diagnosis involves reviewing travel history and exposure to animals. RT-PCR, antigen-capture ELISA, and virus isolation are used for confirmation.

Transmission and Prevention

While the precise origin of Marburg infections remains unclear, it is believed to be linked to Egyptian fruit bats and possibly non-human primates. Human-to-human transmission occurs via contact with bodily fluids.

Preventative measures include isolating infected patients, using protective equipment, and sterilization practices. There is no approved vaccine, but clinical trials are underway.

Treatment of Marburg Virus Disease

Currently, there is no specific antiviral treatment for the Marburg virus. Supportive care focuses on fluid management, preventing secondary infections, and controlling bleeding.

In conclusion, the Marburg virus poses a serious threat to public health, especially in nations with limited healthcare resources like Rwanda. Preventive measures, supportive treatment, and further research are crucial to managing outbreaks effectively.

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FAQ’s

Is Marburg virus something to worry about?

In previous epidemics, the fatality rate from Marburg ranged between 23% and 90%. There are no immunisations or therapies, although supportive care can improve a person’s chances of life.

How do people get the Marburg virus?

You can contract Marburg by coming into close touch with the blood or body fluids (saliva, semen, perspiration, faeces, vomit, and other bodily fluids) of someone who is unwell or has died from Marburg.

Has anyone survived Marburg virus?

Michelle Barnes survived the Marburg virus, which is similar to Ebola, in 2007.

Is Marburg deadlier than Ebola?

The average mortality rate for combined Marburg virus and Ebola virus infections is around 50%. In previous Marburg virus epidemics, fatality rates ranged from 24% to 88%, depending on the virus type and case care.

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