Marburg Virus
Marburg virus is a hemorrhagic fever virus of the Filoviridae family of viruses and a member of the species Marburg marburgvirus, genus Marburgvirus. Marburg virus (MARV) causes Marburg virus disease in humans and nonhuman primates, a form of viral hemorrhagic fever.
The virus is considered to be extremely dangerous. The World Health Organization (WHO) rates it as a Risk Group 4 Pathogen (requiring biosafety level 4-equivalent containment). In the United States, the NIH/National Institute of Allergy and Infectious Diseases ranks it as a Category A Priority Pathogen and the Centers for Disease Control and Prevention lists it as a Category A Bioterrorism Agent. It is also listed as a biological agent for export control by the Australia Group.
The virus can be transmitted by exposure to one species of fruit bats or it can be transmitted between people via body fluids through unprotected copulation and broken skin. The disease can cause bleeding (hemorrhage), fever and other symptoms much like Ebola. Funeral rituals are a particular risk. The actual treatment of the virus after the infection is not possible but early, professional treatment of symptoms like dehydration considerably increases survival chances.
Marburg Virus Symptoms
The incubation period of Marburg hemorrhagic fever is 3 to 10 days.
The onset of illness is sudden, with:
- Severe headache
- Malaise
- High fever
- Progressive and rapid debilitation
By about the third-day symptoms include:
- watery diarrhea
- abdominal pain
- cramping
- nausea
- vomiting
Symptoms become increasingly severe, and many patients develop a severe hemorrhagic fever after 5 to 7 days.
Fatal cases usually exhibit some form of bleeding, often from multiple sites.
Many of the early symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases, such as malaria or typhoid. Confirmation of the disease requires laboratory testing.
Marburg Virus Transmission
The initial infection in any outbreak occurs through exposure in mines or caves inhabited by Rousettus bat colonies.
Subsequent transmission of the virus from person to the person requires close contact with an infected patient. Blood or other bodily fluids (feces, vomit, urine, saliva, and respiratory secretions) contains a high concentration of virus, particularly when these fluids contain blood.
Contact with blood or other bodily fluids transmits the virus.
Sexual transmission of the virus can occur, and the Marburg virus may remain in semen for up to 7 weeks after clinical recovery.
Transmission of the virus via contaminated injection equipment or needle-stick injuries is associated with more severe disease.
Close contact with the body or body fluids of people who have died of Marburg during preparation for burial is a recognized source of infection.
Marburg Virus Causes
Ebola virus has been found in African monkeys, chimps and other nonhuman primates. A milder strain of Ebola has been discovered in monkeys and pigs in the Philippines.
Marburg virus has been found in monkeys, chimps and fruit bats in Africa.
Transmission from animals to humans
Experts suspect that both viruses are transmitted to humans through an infected animal’s bodily fluids. Examples include:
- Blood. Butchering or eating infected animals can spread viruses. Scientists who have operated on infected animals as part of their research have also contracted the virus.
- Waste products. Tourists in certain African caves and some underground mine workers have been infected with the Marburg virus, possibly through contact with the feces or urine of infected bats.
Transmission from person to person
Infected people typically don’t become contagious until they develop symptoms. Family members are often infected as they care for sick relatives or prepare the dead for burial.
Medical personnel can be infected if they don’t use protective gear, such as surgical masks and gloves.
There’s no evidence that the Ebola virus or Marburg virus can be spread via insect bites.
Marburg Virus Risk factors
For most people, the risk of getting Ebola hemorrhagic fever or Marburg hemorrhagic fever is low. The risk increases if you:
- Travel to Africa. You’re at increased risk if you visit or work in areas where the Ebola virus or Marburg virus outbreaks have occurred.
- Conduct animal research. People are more likely to contract the Ebola or Marburg virus if they conduct animal research with monkeys imported from Africa or the Philippines.
- Provide medical or personal care. Family members are often infected as they care for sick relatives. Medical personnel also can be infected if they don’t use protective gear, such as surgical masks and gloves.
- Prepare people for burial. The bodies of people who have died of Ebola or Marburg hemorrhagic fever are still contagious. Helping prepare these bodies for burial can increase your risk of developing the disease.
Marburg Virus Treatment
There is no specific treatment available for Marburg virus disease. Patients receive supportive therapy, including:
- balancing fluids and electrolytes
- maintaining oxygen status and blood pressure
- replacing lost blood and clotting factors
Marburg Virus Complications
Both Ebola and Marburg hemorrhagic fevers lead to death for a high percentage of people who are affected. As the illness progresses, it can cause:
- Multiple organ failure
- Severe bleeding
- Jaundice
- Delirium
- Seizures
- Coma
- Shock
One reason the viruses are so deadly is that they interfere with the immune system’s ability to mount a defense. But scientists don’t understand why some people recover from Ebola and Marburg and others don’t.
For people who survive, recovery is slow. It may take months to regain weight and strength, and the viruses remain in the body for weeks. People may experience:
- Hair loss
- Sensory changes
- Liver inflammation (hepatitis)
- Weakness
- Fatigue
- Headaches
- Eye inflammation
- Testicular inflammation
Marburg Virus Prevention and control
There is no vaccine for Marburg virus disease.
Measures for prevention of secondary transmission of Marburg virus are similar to those used for other hemorrhagic fever viruses and focus on avoiding contact with infected bodily fluids.
To avoid person to person transmission of Marburg virus, healthcare workers must take great care when nursing patients, to avoid contact with infected bodily fluids.
Patients should be isolated, and healthcare workers must use strict barrier nursing techniques including wearing masks, gloves, and gowns.
Invasive procedures are a particular risk and infection control is essential for:
- Placing of intravenous lines
- Handling blood and secretions
- Inserting catheters
- Using suction devices
Hospital staff requires their own individual gowns, gloves, masks, and goggles. Staff must disinfect non-disposable protective equipment properly before re-use.
Other infection control measures include proper use, disinfection, and disposal of instruments and equipment used in caring for patients.
Marburg Virus Frequently Asked Questions
Is Marburg virus curable?
There is no specific treatment for Marburg hemorrhagic fever. Supportive hospital therapy should be utilized, which includes balancing the patient’s fluids and electrolytes, maintaining oxygen status and blood pressure, replacing lost blood and clotting factors, and treatment for any complicating infections.
How is the Marburg virus transmitted?
The Marburg virus is transmitted via direct contact with the blood, bodily fluids and tissues of infected persons. Transmission of the virus can also occur by handling ill or dead infected wild animals (monkeys and fruit bats).
Is Marburg virus the same as Ebola?
Like Ebola, Marburg belongs to the Filovirus family of viruses and is spread among humans when a person comes into contact with the bodily fluids of an infected person.
Where did the Marburg virus originate?
Marburg virus (MARV) first appeared in August 1967, when laboratory workers in Marburg and Frankfurt, Germany and Belgrade, Yugoslavia (now Serbia) were infected with a previously unknown infectious agent.