Marburg virus, a rare but serious infectious disease, was recently detected in the West African country of Ghana for the first time, and the World Health Organization (WHO) has been quick to act against the outbreak since "without immediate and decisive action, Marburg can easily get out of hand," according to WHO's regional director for Africa.
What is Marburg virus?
According to CDC, Marburg is a "genetically unique zoonotic … RNA virus of the filovirus family" and is related to the Ebola virus. It was first identified in 1967 after simultaneous outbreaks occurred in laboratories in Marburg and Frankfurt, Germany, and Belgrade, Serbia, and were later traced back to green monkeys imported from Uganda for research.
Since then, outbreaks of Marburg virus have periodically occurred in areas of Central and Southern Africa, including Angola and the Democratic Republic of Congo. The virus is often transmitted to humans by African fruit bats after prolonged exposure in mines or caves that house large colonies of the animals. Once a person is infected, they can spread the virus to other humans through direct contact with bodily fluids or from surfaces contaminated with these fluids.
Marburg is highly infectious and has an incubation period of two to 21 days. Some symptoms include high fever, severe headache, severe malaise, muscle aches and pain, diarrhea, abdominal pain and cramping, nausea, and vomiting. In many cases, patients also develop severe bleeding or hemorrhaging at the end of their first week of symptoms.
Because Marburg shares many symptoms with other similar infectious diseases, including malaria, typhoid fever, and meningitis, it "can be difficult" to diagnosis without laboratory testing, CDC said.
Based on the specific strain of the virus and how cases are managed, the fatality rate of Marburg virus can range between 24% and 88%. Among fatal cases, death typically occurs eight or nine days after symptom onset and is preceded by severe blood loss and multiorgan dysfunction.
Currently, there are no vaccines or antiviral treatments approved to treat Marburg virus. However, supportive care, including oral or intravenous rehydration and specific symptom treatments, can improve a patient's chance of survival.
WHO declares an outbreak in Ghana after 2 deaths
WHO on Sunday declared a Marburg outbreak in Ghana after laboratory testing confirmed two cases of the virus in patients who died in late June.
One case was a 26-year-old man who was hospitalized on June 26 before dying a day later, while the other was a 51-year-old man who checked into the same hospital on June 28 and died the same day. According to the Washington Post, these two cases of Marburg in Ghana are only the second time the virus has been detected in West Africa, with the first being a case identified in Guinea last year.
Currently, WHO is assisting health authorities in Ghana in a joint investigation of the country's southern region where the two cases occurred. The organization has also sent personal protective equipment and is working to bolster both surveillance testing and contact tracing. So far, more than 90 contacts, including community members and health workers, have been identified and are being monitored for potential symptoms.
In addition, the Ghana Health Service has recommended the public avoid mines and caves where fruit bats live and thoroughly cook all meat products before consumption to reduce the risk of spreading the virus
"Health authorities have responded swiftly, getting a head start preparing for a possible outbreak," said Matshidiso Moeti, WHO's regional director for Africa. "This is good because without immediate and decisive action, Marburg can easily get out of hand. WHO is on the ground supporting health authorities and now that the outbreak is declared, we are marshalling more resources for the response."
According to Jimmy Whitworth, an international public health expert and professor at the London School of Hygiene and Tropical Medicine, it is "a worry that the geographical range of this viral infection appears to have spread" outside of where it is usually detected in Central and Southern Africa, but the current "risk of spread of the outbreak outside of Ashanti region of Ghana is very low." (Gale, Bloomberg/Washington Post, 7/19; Suliman, Washington Post, 7/18; Hart, Forbes, 7/18; Nasser/Princewill, CNN, 7/18; Associated Press, 7/17)