Deadly Marburg Virus Disease Confirmed

Deadly Marburg Virus Disease Confirmed

Tanzania confirmed its first-ever cases of Marburg Virus Disease, often fatal illness in humans, said the World Health Organization (WHO).

The country confirmed the casees after conducting laboratory tests in the northwest Kagera region, the WHO said. Lab tests were carried out after eight people in the region developed symptoms of the “highly virulent” disease, including fever, vomiting, bleeding, and kidney failure.

Five of the eight confirmed cases have died, including a health worker, and the remaining three are being treated. The agency also identified 161 contacts of those infected, who are currently being monitored.

“The efforts by Tanzania’s health authorities to establish the cause of the disease is a clear indication of the determination to effectively respond to the outbreak. We are working with the government to rapidly scale up control measures to halt the spread of the virus and end the outbreak as soon as possible,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. 

While this is the first time Tanzania has recorded a Marburg case, the country has first-hand experience responding to other crises including COVID-19, cholera, and dengue within the past three years. In September 2022, The UN health agency conducted a strategic risk assessment that revealed the country is at high to very high risk for infectious diseases outbreaks.

“The lessons learnt, and progress made during other recent outbreaks should stand the country in good stead as it confronts this latest challenge,” said Dr Moeti. “We will continue to work closely with the national health authorities to save lives.”

Marburg virus commonly causes hemorrhagic fever, with a high fatality ratio of up to 88 per cent.

It is part of the same family as the virus that causes Ebola. Symptoms associated with the Marburg virus start suddenly, with high fever, severe headache, and intense malaise, said WHO.

The virus is commonly transmitted to humans from fruit bats and spreads through direct contact with bodily fluids of infected people, surfaces, and materials.

While there are no vaccines or antiviral treatments approved to treat the virus, supportive care, rehydration, and treatment of specific symptoms increase chances of survival.

KEY FACTS ON MARBURG VIRUS DISEASE

  • Marburg virus disease (MVD), formerly known as Marburg haemorrhagic fever, is a severe, often fatal illness in humans.
  • The virus causes severe viral haemorrhagic 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.
  • Early supportive care with rehydration, and 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.
  • 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.
  • Community engagement is key to successfully controlling outbreaks.
  • Initially, human MVD infection results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies.Marburg spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.
  • People remain infectious as long as their blood contains the virus.
  • Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Muscle aches and pains are a common feature. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Diarrhoea can persist for a week.
  • Many patients develop severe haemorrhagic manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding, often from multiple areas. Fresh blood in vomitus and faeces is often accompanied by bleeding from the nose, gums, and vagina. Spontaneous bleeding at venepuncture sites (where intravenous access is obtained to give fluids or obtain blood samples) can be particularly troublesome. During the severe phase of illness, patients have sustained high fevers. Involvement of the central nervous system can result in confusion, irritability, and aggression. Orchitis (inflammation of one or both testicles) has been reported occasionally in the late phase of disease (15 days).
  • difficult to clinically distinguish MVD from other infectious diseases such as malaria, typhoid fever, shigellosis, meningitis and other viral haemorrhagic fevers. Confirmation that symptoms are caused by Marburg virus infection are made using the following diagnostic methods: antibody-capture enzyme-linked immunosorbent assay (ELISA); antigen-capture detection tests; serum neutralization test; reverse transcriptase polymerase chain reaction (RT-PCR) assay; electron microscopy; virus isolation by cell culture.
  • Currently there are no vaccines or antiviral treatments approved for MVD. However, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival.

(sourced from WHO)

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