At least 6 people have died in Rwanda after being in contact with the Marburg virus, health minister Sabin Nsanzimana said.
The majority of those who succumbed to the virus were medical professionals working in a hospital’s intensive care unit.
Since the outbreak was officially declared on Friday, a total of twenty cases have been identified. Marburg virus, which belongs to the same family as Ebola, is known for its high fatality rate, reaching up to 88%.The virus is transmitted to humans from fruit bats and subsequently spreads through contact with the bodily fluids of infected persons, BBC reported.
What is Marburg virus?
Marburg virus disease, a highly dangerous illness, can lead to severe hemorrhagic fever and has a mortality rate that can reach up to 88%. It belongs to the same viral family as Ebola virus disease. The first recognition of this disease occurred in 1967 when two significant outbreaks happened concurrently in Marburg and Frankfurt, Germany, and Belgrade, Serbia, according to the world health organisation (WHO).
These outbreaks were linked to laboratory activities involving African green monkeys (Cercopithecus aethiops) that were imported from Uganda. Since then, outbreaks and isolated cases have been documented in various countries, including Angola, Democratic Republic of the Congo, Kenya, South Africa (in an individual with recent travel history to Zimbabwe), and Uganda. In 2008, two separate cases were identified in travelers who had visited a cave in Uganda inhabited by Rousettus bat colonies.
The initial human infection with Marburg virus disease stems from extended exposure to mines or caves where Rousettus bat colonies reside. Once a person is infected with the virus, it can spread from human to human through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals. This transmission can occur “through broken skin or mucous membranes.” The virus can also spread through contact with contaminated surfaces and materials, such as bedding and clothing, that have been exposed to these bodily fluids.
What are the symptoms?
The onset of Marburg virus disease is sudden, characterized by high fever, intense headache, and severe malaise. Patients often experience muscle pain and discomfort. By the third day, severe watery diarrhoea, abdominal pain and cramping, nausea, and vomiting may occur. Diarrhoea can last for up to a week. At this stage, patients have been described as exhibiting “ghost-like” drawn features, deep-set eyes, expressionless faces and extreme lethargy. Between 2 and 7 days after the initial symptoms, a non-itchy rash may appear.
Within a week, many patients develop severe haemorrhagic symptoms, and fatal cases typically involve bleeding from multiple sites. Fresh blood in vomitus and faeces often coincides with 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 especially problematic.
During the severe stage, patients maintain high fevers. The central nervous system may be affected, leading to confusion, irritability, and aggression. In some cases, orchitis (inflammation of the testicles) has been reported in the late phase (15 days).
In cases that result in death, it usually occurs between 8 and 9 days after the onset of symptoms, often preceded by severe blood loss and shock.
What are the treatments?
Treatment for Marburg virus disease (MVD) primarily involves supportive care, which includes administering oral or intravenous fluids to prevent dehydration and addressing specific symptoms to improve the patient’s chances of survival. Although there are no proven treatments for MVD at present, various potential therapies, such as blood products, immune therapies, and drug therapies, are currently under evaluation.
Diagnosing MVD can be challenging, as its symptoms resemble those of other infectious diseases, including malaria, typhoid fever, shigellosis, meningitis, and other viral haemorrhagic fevers. To confirm that the symptoms are caused by Marburg virus infection, the following diagnostic methods are employed: “antibody enzyme-linked immunosorbent assay (ELISA); antigen detection tests; serum neutralization tests; reverse-transcriptase polymerase chain reaction (RT-PCR) assay; and virus isolation by cell culture.”
Due to the extreme biohazard risk posed by samples collected from patients, laboratory testing on non-inactivated samples must be performed under maximum biological containment conditions. When transporting biological specimens nationally and internationally, it is essential to use the triple packaging system to ensure safety.