Marburg Hemorrhagic Fever – Forensics Epidemiology Alert
The International College of Disaster Management and Forensics Studies and JJTC Consulting Limited wishes to inform alert you of a hemorrhagic fever as stated below:
Marburg hemorrhagic fever (Marburg HF) is a rare but highly infectious viral infection that caused the death of a patient on 2nd August 2021 in Guinea. It is the first case of the Ebola-like virus in West Africa.
ABOUT THE VIRUS
It affects both humans and non-human primates. Marburg HF is caused by the Marburg virus, a zoonotic (animal-borne) RNA virus of the filovirus family. Marburg virus was first recognized in 1967, when there were outbreaks in Marburg and Frankfurt, Germany, and in Belgrade, Yugoslavia (now Serbia). Thirty-one people became ill, Seven deaths were reported. The first people infected had been exposed to imported African green Monkeys in research.
The harboring host of the Marburg virus is the African fruit bat, called Rousettus aegyptiacus found in caves distributed across Africa specifically Uganda. Fruit bats infected with the Marburg virus do not show obvious signs of illness.
TRANSMISSION
It is unknown how the Marburg virus first transmits from its animal host to humans; however, unprotected contact with infected bat feces or aerosols are the most likely routes of infection.
After this initial crossover of the virus from the host animal to humans, transmission occurs through:
(I) person-to-person contact. This may happen in several ways: direct contact to droplets of body fluids from infected persons, or contact with materials and other objects contaminated with infectious blood or tissues.
(Ii) persons who have handled infected non-human primates or have come in direct contact with their fluids.
(III). caregivers in the home or in a hospital of an infected person.
SIGNS AND SYMPTOMS
It has an incubation period of 5-10 days.
- sudden onset of marked fever, chills, headache, and muscle pain.
(Ii). Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur.
(III). Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea may then appear.
Symptoms become increasingly severe and can include jaundice, infection of the pancreas, severe weight loss, confusion, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.The case-fatality rate is between 23-90%.
RISK
- People who have close contact with African fruit bats, humans patients, or non-human primates infected with the Marburg virus are at risk.
(Ii). family members and hospital staff who care for patients infected with the Marburg virus and have not used proper barrier nursing techniques.
(III). Particular occupations, such as veterinarians and laboratory or quarantine facility workers who handle non-human primates from Africa, may also be at increased risk.
(iv). travelers visiting endemic regions in Africa, including Uganda and other parts of central Africa, and have contact with fruit bats, or enter caves or mines inhabited by fruit bats.
DIAGNOSIS
Many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other more frequent infectious diseases, such as malaria or typhoid fever, making the diagnosis of the disease difficult. This is especially true if only a single case is involved.
However, if a person has the early symptoms of Marburg HF and there is reason to believe that Marburg HF should be considered, the patient should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.
TREATMENT
There is no specific treatment for Marburg hemorrhagic fever. Supportive hospital therapy is utilized.
No vaccine has been developed yet nor an antiviral medication used to treat this virus. Experimental treatments are validated in non-human primates models but have never been tried in humans.
PREVENTION
Preventive measures against Marburg virus infection are: (I). Avoiding fruit bats, and sick non-human primates especially in central Africa.
(Ii). Practice hand hygiene by washing hands frequently with soap and under running water
(iii). Avoid contact with body fluids- urine, saliva, sweat, feces, semen, breast milk, etc. of anyone who shows symptoms as stated above.
(iv). Avoid contact with dead bodies or including participating in funerals and rituals of suspected or confirmed Marburg cases
(v). Do not handle items that came into contact with any confirmed or suspected cases.
(vi) place the infected individual in strict isolation; and sterilization or proper disposal of needles, equipment, and patient excretions.
(vii). Seek medical attention if you develop any of the symptoms above.
REFERENCES
- Towner JS, Khristova ML, Sealy TK, et al. Marburgvirus genomics and association with a large hemorrhagic fever outbreak in Angola. Journal of Virology. 2006; 80(13):6497-516.
- Warren TK, Warfield KL, Wells J, et al. Advanced antisense therapies for postexposure protection against lethal filovirus infections. Nature Medicine. 2010;16(9):991-994.
- Centers for Disease Control and Prevention. Imported case of Marburg hemorrhagic fever – Colorado, 2008. Morbidity and Mortality Weekly Report. 2009;58(49):1377-1381.
- Gear JHS. Hemorrhagic fevers of Africa: an account of two recent outbreaks. Journal of the South African Veterinary Association. 1977;48(1):5-8.
