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Marburg Virus Disease
Context:
The recent outbreak of the Marburg virus in Rwanda has raised significant global concern.
More on News:
- The virus, often referred to as the “bleeding eye disease,” has already claimed 15 lives and infected at least 66 people.
- This outbreak is particularly alarming due to the virus’s high fatality rates and rapid spread.
Background
- Disease Origin: The disease referred to is the Marburg virus, first detected in 1967 during simultaneous outbreaks in Marburg and Frankfurt in Germany, and Belgrade, Serbia.
- Laboratory Connection: The outbreaks are believed to have originated from a laboratory while working with African green monkeys (Cercopithecus aethiops) imported from Uganda.
- Global Occurrence: Since 1967, occasional cases have been reported in countries such as Angola, Democratic Republic of the Congo, Equatorial Guinea, Ghana, Guinea, Kenya, Rwanda, South Africa, Tanzania, and Uganda.
About MVD:
- Marburg virus belongs to the filovirus family, which also includes the well-known Ebola virus. Both viruses are clinically similar and cause outbreaks with high fatality rates.
- Initial Transmission: MVD is initially transmitted through exposure to mines or caves inhabited by colonies of Rousettus bats, particularly the Egyptian fruit bat.
- Human-to-Human Transmission: It can also spread through direct contact with blood or bodily fluids of infected individuals and indirectly through contaminated surfaces, bedding, or clothing.
- Symptoms:
- Incubation Period: Symptoms typically appear 2 to 21 days after exposure.
- Early Symptoms: High fever, severe headache, muscle pain, and malaise.
- Third Day Onward: Gastrointestinal symptoms like diarrhea, abdominal pain, cramping, nausea, and vomiting.
- Fifth Day Onward: Hemorrhagic symptoms including blood in vomit and feces, and bleeding from the nose, eyes, ears, mouth, gums, or vagina. Orchitis (testicular inflammation) can also occur.
- “Ghost-like” Features: Deep-set eyes and extreme lethargy in some patients.
- Critical Cases: Death can occur between eight to nine days after symptoms start due to severe blood loss and shock.
- Diagnosis: Requires advanced laboratory tests, including antigen detection, RT-PCR, and virus isolation. Early and accurate diagnosis is essential for outbreak containment.
- Treatment: No approved vaccine or antiviral treatment. Supportive care (hydration, oxygen levels, symptom management) can improve survival.
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- Experimental treatments like monoclonal antibodies are under development.
Global Concerns:
- The Marburg virus poses a significant threat to public health due to its high mortality rates, which can range from 24% to 88% depending on the strain and the availability of medical care.
- The rapid onset of symptoms and the potential for human-to-human transmission make it a formidable challenge to contain.
- The World Health Organization (WHO) has classified Marburg as one of the pathogens that pose the greatest threat to public health.
Response and Prevention:
- Rwanda has taken swift action to contain the outbreak, including isolating infected individuals, conducting extensive contact tracing, and implementing strict hygiene practices.
- Public health officials emphasise the importance of protective equipment for healthcare workers and community education about the virus’s symptoms and transmission routes.
- Rwanda has sought experimental vaccines and treatments, with the Sabin Vaccine Institute providing 700 doses of an experimental Marburg vaccine to healthcare workers. The vaccine’s efficacy is still unclear.
