Bats congregate in the Bat Cave in Queen Elizabeth National Park on August 24, 2018. Scientists placed GPS devices on some of the bats to determine flight patterns and how they transmit Marburg virus to humans. Approximately 50,000 bats dwell in the cave. Bonnie Jo Mount/The Washington Post via Getty Images hide caption
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Bonnie Jo Mount/The Washington Post via Getty Images
Bats congregate in the Bat Cave in Queen Elizabeth National Park on August 24, 2018. Scientists placed GPS devices on some of the bats to determine flight patterns and how they transmit Marburg virus to humans. Approximately 50,000 bats dwell in the cave.
Bonnie Jo Mount/The Washington Post via Getty Images
A second country in Africa has recently reported cases of Marburg, an infectious disease that has high fatality rates and, according to the World Health Organization, epidemic potential. The news has lent urgency to ongoing efforts to develop a vaccine for Marburg — and concern among public health officials that earth's changing climate could be fueling the outbreaks.
The first outbreak this year was reported in February in Equatorial Guinea, but WHO was concerned the country was undercounting those cases. On Wednesday, Reuters reported that Equatorial Guinea had confirmed a total of 13 cases since the beginning of the pandemic. The case count update came the same day as WHO, whose staff on the ground suspected more cases, asked Equatorial Guinea to be transparent about how many cases the country had. Equatorial Guinea has also reported 20 probable cases, all of whom have died.
About 1800 miles away, across the continent, Tanzania is also reporting a Marburg outbreak and has confirmed eight cases, including five deaths in the northwest Kagera region, according to WHO.
Marburg is a hemorrhagic fever virus, which can lead to the body's organs shutting down. Symptoms vary but usually start with a headache and fever. The host animal is believed to be the fruit bat, which often is found in caves. Bats can directly infect humans or monkeys and pigs can be infected by the bats and then those animals infect humans. Marburg is spread through direct contact (through broken skin or mucous membranes) with blood, secretions, organs or other bodily fluids of infected people and through any materials such as bed sheets that become contaminated with the infected fluids.
As is the case with Ebola, burial ceremonies have sometimes been a source of infection if people come in contact with secretions of someone who died of the virus.
Goats and Soda
The Marburg outbreak in Equatorial Guinea is a concern — and a chance for progress
Diagnosis is hard, says Dr. David Freedman, professor emeritus of infectious diseases at the University of Alabama at Birmingham, because many poor countries just don't have labs to test disease samples. In fact, while the health officer in Equatorial Guinea suspected Marburg on February 7, the viral sample had to be sent to Senegal, 2,000 miles away, and was only confirmed a week later.
The outbreak in two parts of Africa could mean climate change is playing a role. "A current concern," says Dr. Lee Hampton, an epidemiologist with GAVI, the Vaccine Alliance, "is that climate change causing new [higher] average temperatures could result in host animals for the Marburg (and other) viruses moving to areas of the world they have not been before and creating outbreaks where they have not been before."
WHO's Director General General Tedros Adhanom Ghebreyesus spoke about the effects of climate change on disease at a press conference this week. "The outbreaks of Marburg virus disease are another reminder that we can only truly protect human health if we also protect the health of animals and our planet, which sustains all life," said Dr. Tedros, adding that WHO has been working on the issue with the Food and Agriculture Organization and the World Organisation for Animal Health and the UN Environment Programme. The groups participated in a meeting at WHO headquarters last week and called for countries to "[strengthen] the policies, strategies, plans, evidence, investment and workforce needed to properly address the threats that arise from our relationship with animals and the environment."
Slowing the spread
The two outbreaks have intensified efforts to develop better treatments and a possible vaccine.
Immediately after the outbreak in Equatorial Guinea began, the WHO convened a meeting of experts to discuss possible vaccines and treatments for the virus. On Wednesday the WHO Director General announced the agency "is working to begin trials of vaccines and therapeutics as soon as possible." Dr. Michael Ryan, Executive Director of WHO's Health Emergencies Programme, tells NPR that the next step is to convene a working group to develop the legal framework for the clinical trials.
Gavi's Hampton says working quickly to develop a vaccine is critical because every outbreak is a chance for the virus to spread out of control. "If the virus spreads to larger cities, many more people can be affected, and the virus is that much harder to contain. Worldwide spread becomes a distinct possibility. That's why an effective vaccine that can be deployed at the first sign of an outbreak is needed."
Other measures can be helpful moving forward. More consistent and comprehensive monitoring could help contain future outbreaks, says Tedros.
The approach for outbreaks such as Marburg would involve coordinating scientists to routinely monitor of the virus in populations of fruit bats, bat feces and aerosols, and human populations including hospital data, bushmeat diet, and mobility of humans and animals.
Oladele A. Ogunseitan, Ph.D., a professor of Population Health and Disease Prevention at the University of California, Irvine who is involved with the WHO effort. "We currently do not have a single platform where these data are integrated, and we don't necessarily have to do this one virus at a time."
Ogunseitan says this multi-pronged approach has been used successfully with COVID-19 with the monitoring of the virus in urban wastewater, rats and deer populations to predict trends, though he adds that "the coordination has been sporadic and not as effective as it would have been if we planned it from the get go, particularly in the early stages in Wuhan Market in China."
Marburg origins
Marburg was first identified in 1967 among lab workers in Marburg, Germany, and Belgrade, in what is now Serbia. They were exposed to the virus during research with monkeys or tissue samples of the monkeys originally from Uganda.
It is "similar to many other illnesses which is why Marburg can spread before it's identified and before infected people are isolated," says Dr. Daniel Bausch, a former U.S. Centers for Disease Control and Prevention medical officer now with the non-profit FIND, which develops diagnostic tests around the world. In fact, news reports say that the first case in the Equatorial Guinea outbreak may have emerged in early January of this year but only prompted alarm in early February, when a health worker saw patients who had severe symptoms associated with Marburg, including bloody diarrhea and blood in vomit.
Another reason that it's hard to diagnose early on: People can be infected and not show symptoms of Marburg for two to 21 days, followed by fever, chills, headache and body aches. A rash can appear around day five on a person's body, and additional symptoms such as nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea can occur in the course of the disease. The symptoms can become increasingly severe including jaundice, an inflamed pancreas, severe weight loss, delirium, massive internal bleeding, shock and multi-organ failure. The fatality rate varies widely, but the WHO puts it around 50%.
Ogunseitan finds it encouraging that with such a high potential fatality rate from Marburg virus, public health experts have several tactics to use to try to prevent outbreaks. "These activities aim to ensure that we prepare countries to develop workforce capable of interpreting a broad range of information on early warning systems, and to collaborate to prevent outbreaks from becoming pandemics."
Fran Kritz is a health policy reporter based in Washington, D.C., and a regular contributor to NPR. She also reports for The Washington Post and Verywell Health. Find her on Twitter: @fkritz
FAQs
Is there an outbreak of Marburg virus? ›
On 13 February 2023, the Ministry of Health and Social Welfare of Equatorial Guinea declared an outbreak of Marburg virus disease (MVD) after suspected viral hemorrhagic fever deaths were reported between 7 January and 7 February 2023, and a case tested positive on 12 February for Marburg virus by real-time polymerase ...
Which two African countries have the Marburg virus outbreak? ›"Though we do not know yet the origin of the Marburg outbreaks in Equatorial Guinea and Tanzania, we do know that there continues to be increased capacity in Africa to recognize and test samples for viral hemorrhagic fevers like Marburg and Ebola," the World Health Organization's Dr. Tieble Traore said Tuesday.
What is the Marburg virus in Africa? ›Marburg virus disease (MVD) is a rare but severe hemorrhagic fever that affects people and non-human primates. It is caused by an infection with Marburg virus or Ravn virus, both within genus Marburgvirus. Marburgviruses are zoonotic (or, animal-borne) RNA viruses within the virus family Filoviridae.
Where is the Marburg outbreak? ›In February and March 2023, two distinct outbreaks of Marburg virus were reported in Equatorial Guinea and Tanzania.
How many cases of Marburg virus are there? ›...
| Year(s) | 1998 to 2000 |
|---|---|
| Country | Democratic Republic of Congo (DRC) |
| Apparent or suspected origin | Durba, DRC |
| Reported number of human cases | 154 |
| Reported number (%) of deaths among cases | 128 (83%) |
United States health officials have issued warnings urging health workers and travelers to be on guard against outbreaks of the deadly Marburg virus in Africa, but so far, there are no cases in the U.S.
Does the US have Marburg virus? ›The Centers for Disease Control and Prevention today issued a Health Alert Network Health Advisory to inform clinicians and public health departments in the United States about two confirmed outbreaks of Marburg virus disease.
Who is most likely to get the Marburg virus? ›Historically, the people at highest risk include family members and hospital staff who care for patients with Marburg virus disease and have not used proper infection prevention and control measures.
Why Marburg virus is an increasing threat in Africa? ›Encroachment into forested areas and direct interaction with wildlife, such as “bush meat” consumption, facilitate the spread of Marburg and other filoviruses from animals to humans.
How do you get the Marburg virus? ›The virus spreads through contact (such as through broken skin or mucous membranes in the eyes, nose, or mouth) with: Blood or body fluids (urine, saliva, sweat, feces, vomit, breast milk, amniotic fluid, and semen) of a person who is sick with or died from Marburg virus disease (MVD), or.
How can we prevent Marburg virus? ›
Avoid contact with blood and body fluids (such as urine, feces, saliva, sweat, vomit, breast milk, amniotic fluid, semen, and vaginal fluids) of people who are sick. Avoid contact with semen from a person who has recovered from MVD, until testing shows that the virus is gone from their semen.
Can the Marburg virus be cured? ›There is no specific treatment for Marburg virus disease. 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.
Is Marburg virus worse than Ebola? ›Ebola virus infection is slightly more virulent than Marburg virus infection. Ebola virus isolates have been differentiated into 5 species: Zaire Ebola virus. Sudan Ebola virus.
Is Marburg virus very contagious? ›Wen: Marburg virus disease is extremely deadly and is highly contagious when engaging in direct contact with an infected person. With previous outbreaks, case fatality rates have ranged from 24% to 88%, with an average fatality rate of around 50%.
Is there a vaccine for Marburg virus? ›No approved vaccines or specific therapies are available for MARV disease, aside from supportive care. While some experimental vaccines have previously been tested, none have proven to be both highly effective and to provide durable protection.
Who survived Marburg virus? ›Michelle Barnes survived Marburg, an Ebola-like virus, in 2007.
Is the Marburg virus in Africa 2023? ›On 21 March 2023, the MoH officially declared the first MVD outbreak in the country. As of 22 March, eight cases, including five deaths (case fatality ratio [CFR]: 62.5%) have been reported from Kagera region.
Is Marburg more contagious than Ebola? ›Symptoms of both infections are similar, though differences include: Ebola virus is slightly more contagious than Marburg virus.
Can humans get Marburg? ›Marburg virus disease (MVD), formerly known as Marburg haemorrhagic fever, is a severe disease in humans caused by Marburg marburgvirus (MARV). Although MVD is uncommon, MARV has the potential to cause epidemics with significant case fatality rates.
How long does the Marburg virus last? ›In fatal cases, death may occur 8-9 days after the onset of symptoms, typically due to severe blood loss and shock. Individuals who survive MVD typically undergo a slow recovery as the Marburg virus usually remains in the body for several weeks.
Does Marburg virus affect humans? ›
Marburg virus disease (MVD) is a rare but severe hemorrhagic fever which affects both people and non-human primates. MVD is caused by the Marburg virus, a genetically unique zoonotic (or, animal-borne) RNA virus of the filovirus family.
Can Marburg virus mutate? ›Compared to other viral species, the Marburg virus is quite slow to mutate and does not have a comparatively large variation between strains.
What is the deadliest virus on earth? ›The most dangerous virus is the Marburg virus. It is named after a small and idyllic town on the river Lahn - but that has nothing to do with the disease itself. The Marburg virus is a hemorrhagic fever virus. As with Ebola, the Marburg virus causes convulsions and bleeding of mucous membranes, skin and organs.
Can Marburg virus spread through air? ›You cannot catch the Ebola or Marburg virus just by breathing the same air as an infected person. For the virus to spread to you, body fluids from an infected person have to enter your body.
What are the first symptoms of Marburg virus? ›After an incubation period of 2-21 days, symptom onset is sudden and marked by fever, chills, headache, and myalgia. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur.
What was the worst virus in Africa? ›Ebola virus disease is caused by four of six viruses classified in the genus Ebolavirus.
Which country has confirmed the first case of the contagious Marburg virus? ›Marburg virus was first recognized in laboratory workers in Marburg, Germany, and Belgrade, Yugoslavia, in 1967. These workers had been exposed to tissues and blood from African green monkeys (Cercopithecus aethiops) imported from Uganda. There were 25 primary cases and six secondary cases in the outbreak.
What animal started the Marburg virus? ›African green monkeys (Cercopithecus aethiops) imported from Uganda were the source of infection for humans during the first Marburg outbreak.
What animal did the Marburg virus come from? ›The source of infection was traced back to African green monkeys (Chlorocebus aethiops) that had been imported from Uganda and were shipped to all three locations.
What are 4 things about the Marburg 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.
Is Ebola now the most feared disease in the world? ›
The Ebola outbreak in West Africa is the world's deadliest to date and the World Health Organization has declared an international health emergency as more than 3,850 people have died of the virus in Guinea, Liberia, Sierra Leone and Nigeria this year.
How many people died from the Marburg virus? ›A 2005 outbreak in Angola killed more than 300 people. However, in the rest of the world, only two people have died from the Marburg virus in the past 40 years - one person in Europe and one in the US.
What is the death percentage of Marburg? ›With a death rate of as high as 88 percent, Marburg is from the same virus family responsible for Ebola and is transmitted to people from fruit bats. It then spreads through contact with bodily fluids of infected people.
Will there be another pandemic? ›Disease forecasters are convinced there's a 27% chance of another COVID-like pandemic within 10 years—but experts believe there's a silver bullet. The global health community will have to act more proactively than they did with COVID if they want to reduce the risk of another pandemic, Airfinity believes.
Does the Ebola vaccine work against Marburg? ›Although a recombinant vesicular stomatitis virus (rVSV)-based vaccine (Ervebo) is licensed for Ebola virus disease (EVD), no approved countermeasures exist against MARV. Results from clinical trials indicate Ervebo prevents EVD in 97.5–100% of vaccinees 10 days onwards post-immunization.
How do you get Marburg virus? ›The virus spreads through contact (such as through broken skin or mucous membranes in the eyes, nose, or mouth) with: Blood or body fluids (urine, saliva, sweat, feces, vomit, breast milk, amniotic fluid, and semen) of a person who is sick with or died from Marburg virus disease (MVD), or.
What kills the Marburg virus? ›There are no specific treatments or a vaccine for the virus. But a range of blood products, drug and immune therapies are being developed, the WHO says. Doctors may be able to alleviate the symptoms by giving hospital patients plenty of fluids and using transfusions to replace lost blood.
Is Marburg worse than Ebola? ›Ebola virus infection is slightly more virulent than Marburg virus infection. Ebola virus isolates have been differentiated into 5 species: Zaire Ebola virus. Sudan Ebola virus.
Can Marburg virus be prevented? ›Avoid contact with blood and body fluids (such as urine, feces, saliva, sweat, vomit, breast milk, amniotic fluid, semen, and vaginal fluids) of people who are sick. Avoid contact with semen from a person who has recovered from MVD, until testing shows that the virus is gone from their semen.
Should I be worried about Marburg virus? ›Wen: Marburg virus disease is extremely deadly and is highly contagious when engaging in direct contact with an infected person. With previous outbreaks, case fatality rates have ranged from 24% to 88%, with an average fatality rate of around 50%.
What is the life expectancy of someone with the Marburg virus? ›
In fatal cases, death usually occurs between 8 and 9 days after onset, usually preceded by severe blood loss and shock. Supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms improves survival.
How do you avoid Marburg? ›- Avoid direct contact with blood, saliva, vomit, urine and other bodily fluids (e.g. semen, breast milk, sweat) of people with Marburg virus disease or unknown illnesses. ...
- Avoid close contact with wild animals and avoid handling wild meat.
Marburg virus infection can occur in humans after close contact with an infected animal or its body fluids and through contaminated food products.
What are the chances of surviving Marburg virus? ›The case-fatality rate for MVD is between 23-90%.
How contagious is Marburg? ›The transmission of the virus from person to person requires extremely close contact with a patient. Infection results from contact with blood or other body fluids (faeces, vomitus, urine, saliva, and respiratory secretions) with high virus concentration, especially when these fluids contain blood.