Marburg Virus Outbreak Hits Rwanda, Health Workers Among the Infected
Posted 1 week ago
Marburg Virus Disease is Hemorrhagic
On September 27, 2024, Rwanda’s Ministry of Health confirmed an outbreak of the deadly Marburg virus disease (MVD), with cases spreading across several provinces. The virus, which causes a severe and often fatal hemorrhagic fever similar to Ebola, has claimed nine lives so far, with 27 reported infections as of September 30.
Marburg Virus Genomic Material is Ribonucleic Acid (RNA)
Morphologically, Marburg viruses are filamentous and have an envelope. They have a single strand of genetic material called RNA, which carries their instructions for reproduction. These viruses belong to the same family as the Ebola virus, called Filoviridae, and specifically fall under the Marburgvirus genus. There is only one species in this group, known as Marburg marburgvirus, which includes two closely related viruses: Marburg and Ravn. Though similar, these two viruses have about a 20% difference in their genetic makeup.
Contact with an Infected Person Can Transmit the Marburg Virus
The Marburg virus originates from fruit bats, which serve as its natural host. Humans can become infected through contact with these bats or, more commonly, from the bodily fluids of infected individuals. As such, healthcare professionals treating individuals suffering from the Marburg virus must be very careful.
Marburg Virus Pathogensis
The incubation period for Marburg virus disease (MVD) typically lasts 5 to 10 days, but it can range from 3 to 21 days. During this period, the virus is not contagious.
Once symptoms appear, the illness progresses in three stages: the initial phase (days 1–4), followed by the early organ phase (days 5–13), and then either a late organ phase or recovery (day 13 and beyond). In this final stage, supportive medical care can help patients survive until the virus clears naturally. Most survivors don’t experience the most severe symptoms of the disease and avoid reaching the late organ phase.
Marburg Virus Disease Symptoms
The disease begins suddenly with flu-like symptoms, such as high fever, severe headache, chills, muscle pain, fatigue, and feeling unwell. Within 2 to 5 days, 50–75% of patients experience rapid worsening, including nausea, vomiting, diarrhea, and stomach discomfort. By days 5–7, the disease intensifies, leading to a skin rash and, in some cases, bleeding from the mouth, nose, and other areas, as well as from medical puncture sites. Later stages can include neurological issues like confusion, seizures, and even coma.
Marburg Virus has High Fatality Rate
Within the first week of the illness, patients often develop conditions like clotting disorders and a drop in white blood cells and platelets. Some patients recover with supportive care, while others may die from dehydration, internal bleeding, and organ failure within 8 to 16 days of symptom onset. Early supportive care improves the chances of survival.
In early outbreaks, particularly one in Europe, Marburg was thought to be less deadly than Ebola, with a fatality rate of around 24%. However, later outbreaks, such as in the Democratic Republic of the Congo and Angola, showed much higher death rates of 83% and 88%, respectively. The exact reasons for these higher death rates are still unclear, but the strain in Angola appears to be more dangerous than those seen in earlier outbreaks.
Vaccination for Marburg Virus Disease
Several vaccine candidates are in the development phase, with trials underway in Africa and the United States. The Sabin Vaccine Institute, based in Washington, D.C., reported a vaccine that has already shown promise in early trials. This vaccine, which uses a modified chimpanzee adenovirus to trigger an immune response, is being tested in a larger trial in Uganda and Kenya. Rwanda could see the start of these trials in the coming weeks if the outbreak continues.
Ring Vaccination: Best Option for Marburg Virus Disease Control
Experts believe that “Ring Vaccination,” a strategy that proved successful during the Ebola outbreak in West Africa, involves vaccinating those who have come into contact with an infected person to contain the spread.
Conventional Treatments for Marburg Virus Disease
Researchers are also working on treatments like Remdesivir, an antiviral drug initially tested for Ebola and COVID-19, as well as promising monoclonal antibody therapies. While these solutions are still in the trial stage, the urgency is propelling efforts forward at an unprecedented speed.
The WHO has identified Marburg as one of the viruses with the potential to cause a global pandemic, putting it at the top of their priority list for vaccine development.
As Rwanda grapples with this outbreak, the hope is that the lessons learned will help the country and provide critical data for future outbreaks. Scientists are determined to make progress even if this outbreak subsides. The need for vaccines and treatments is not just a piece of this puzzle but the cornerstone of preventing future devastation.
The global community must remain vigilant in the face of such a deadly threat. The Marburg virus has proven that it can strike with little warning and cause immense suffering. But with the efforts of scientists, health officials, and the people on the front lines, there is hope that this virus will be controlled with effective vaccines and better treatments.
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