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Marburg virus: Everything you need to know about the outbreak

Ghana recently announced its first case of Marburg virus disease, caused by a filovirus that leads to haemorrhagic fever and diarrhoea in humans

Dr. Matshidiso Moeti, the head of the World Health Organization's Africa office, says that without decisive, immediate action, the Marburg Virus Disease outbreak in Ghana can get out of hand.  (AP)

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Ghana announced the country’s first outbreak of Marburg virus disease on Monday after a World Health Organization laboratory confirmed earlier test results, according to a Bloomberg report. 

The Institut Pasteur in Dakar, Senegal, received samples from two unrelated deceased patients, the WHO said in an emailed statement. Both patients showed symptoms including diarrhea, fever, nausea and vomiting and sought treatment at the same hospital within days of each other. The WHO is supporting a joint national investigative team in Ghana’s Ashanti region and alerting neighboring high-risk countries, Bloomberg reported.

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“Health authorities have responded swiftly, getting a head start,” Matshidiso Moeti, the WHO’s director for Africa, said in a statement. “Without immediate and decisive action, Marburg can easily get out of hand.”

According to the World Health Organisation's fact sheet on the disease, Marburg is a highly infectious viral hemorrhagic fever in the Filoviridae family. Like the more well-known Ebola virus disease, it is a filovirus. Though caused by different viruses, the two diseases are both rare and have the capacity to cause outbreaks with high fatality rates.

The natural hosts of the Marburg virus disease are Rousettus aegyptiacus, fruit bats of the Pteropodidae family. The Marburg virus is transmitted to people from these fruit bats and spreads among humans through human-to-human transmission. The WHO fact sheet elaborates that this transmission can occur through direct contact with blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials like bedding or clothing contaminated with these fluids. Marburg virus can also be transmitted by contaminated injection needles which is associated with a more severe infection, rapid deterioration, and a higher fatality rate.

Marburg virus disease was initially discovered in 1967, when two large simultaneous outbreaks occurred in Marburg and Frankfurt in Germany, and in Belgrade, Serbia. The outbreak was associated with laboratory work using African green monkeys (Cercopithecus aethiops) imported from Uganda. Subsequently, outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa (in a person with recent travel history to Zimbabwe) and Uganda.

The World Health Organisation estimates that the incubation period of the virus ranges from 2 to 21 days. Infected patients experience high fever, severe headaches, severe malaise, muscle aches and pains. Watery diarrhoea, abdominal pain and cramping, nausea and vomiting generally begins on the third day. Diarrhoea can persist for a week. Many patients develop severe haemorrhagic manifestations between day 5 and 7. Fatal cases usually have some form of bleeding, often from multiple areas. Patients remain infectious as long as their blood contains the virus.

The fatality rate of Marburg virus disease has varied from 24% to 88% in past outbreaks, depending on virus strain and the quality of case management according to the WHO. Although there are no vaccines or antiviral treatments approved to treat the virus, a range of blood products, immune therapies and drug therapies are currently under development. Supportive care like rehydration, and symptomatic treatment improves survival.

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