BY JESS THOMSON ON 3/23/23 AT 12:43 PM EDT
A stock image shows a Marburg virus blood sample. A new outbreak of the virus has been reported in Tanzania, with eight cases and five deaths.ISTOCK / GETTY IMAGES PLUS
Tanzania has announced its first-ever cases of Marburg virus
disease, a deadly infection that has a fatality rate of around 50 percent.
The World Health Organization
(WHO) said in a
statement that Tanzania's National Public Health Laboratory has confirmed that
eight people so have contracted the virus, of which five have died. In
addition, 161 people who have been in contact with these patients have been
identified and are being monitored. The patients were tested for the virus
after they developed such symptoms as fever, vomiting, bleeding and renal
failure.
Since February, there has also been an ongoing outbreak in
Equatorial Guinea, which has had nine confirmed cases and 20 suspected cases of
the virus, according to the WHO.
Marburg
virus is a hemorrhagic fever virus, classified as a Risk Group 4 pathogen by
the WHO along with smallpox, Nipah virus and
Ebola. Marburg is in the same viral family as Ebola,
the Filoviridae family.
"The disease caused by
Marburg and Ebola are virtually indistinguishable," Thomas Geisbert, a
professor of microbiology and immunology at the University of Texas Medical
Branch in Galveston, told Newsweek.
The virus first came to the attention of the international
medical community in 1967 after two simultaneous outbreaks in Belgrade, Serbia,
and Germany's Frankfurt and Marburg, which the virus was named after. These
outbreaks were thought to have resulted from medical work using African green
monkeys that had been imported from Uganda, although the exact route of
transmission is unknown. Fruit bats are a natural host of the virus and can
transmit the disease via their feces.
Since
its first outbreak, the virus has had outbreaks in Uganda, Kenya, the
Democratic Republic of Congo and Angola. The most recent outbreaks were in
Guinea in 2021 and Ghana in 2022.
The most deaths occurred in Angola, between 2004 and 2005, when 227 people died
out of 252 cases.
Death rates have varied
between 24 and 88 percent in past outbreaks, the WHO says,
depending on the strain of the virus and how the cases were managed, but the
average was around 50 percent.
Between humans, the virus is transmitted via the contact of
broken skin or mucous membranes with infected body fluids, including urine,
saliva, sweat, feces, vomit, breast milk, amniotic fluid and semen, according
to the U.S. Centers for Disease Control and Prevention.
Even if a man has recovered from the virus, his semen can still
spread the disease if he has unprotected sex, as the virus has been found to
persist inside the testicles. Additionally, the virus can be spread via objects
contaminated with the body fluids of an infected person, such as clothes,
bedding and needles.
"First responders and family members with an infected
member are most at risk," Demetrius Matassov, director of viral vaccine
development at Auro Vaccines, told Newsweek. "[Marburg virus disease]
doesn't spread like COVID. However, if improper biosafety practices occur, then
the risk of infection increases."
Clinically, the Marburg virus is rather similar to Ebola, its
close relative.
Symptoms begin after
an incubation period of between two and 21 days and
become increasingly severe five days after the first ones occur.
"Symptoms occur abruptly and include
fever, headache and myalgia," Geisbert said. "This progresses to
symptoms that can include nausea, vomiting, chest and abdominal pain, sore
throat and diarrhea. Macular rashes can also occur.
"Symptoms in severe cases include
jaundice, liver failure, shock, hemorrhage and multi-organ dysfunction. So
similar to DIC [disseminated intravascular coagulation] in septic shock,"
he said.
Because of Marburg's similarity to Ebola,
Lassa fever and other infectious diseases including malaria, typhoid fever or
dengue fever, it can be hard to identify, especially if a small number of cases
are involved. Often, health care professionals are infected by patients.
#Tanzania 🇹🇿 has confirmed
its first-ever cases of #Marburg virus disease.
Here’s everything you need to know about what it is, its symptoms, and how it
spreads 👇🏿#ViralFactsAfrica @viralfacts pic.twitter.com/qV1tDQ8to5
— WHO
African Region (@WHOAFRO) March 22, 2023
There are no specific treatments for the
virus. Health care providers are only able to help the patient rehydrate with
oral or intravenous fluids and treat specific symptoms.
"There is currently no vaccine for
Marburg virus disease licensed for human use," Geisbert said. "There
are several vaccines that have shown strong potential in preclinical, nonhuman
primate models that are being advanced for human use.
"These include a Sabin chimpanzee
adenovirus-based Marburg vaccine and the IAVI VSV-based Marburg vaccine, which
are probably the lead candidates," he continued. "A particular
advantage of the IAVI VSV-based Marburg vaccine is that it has shown protection
in nonhuman primates even if given shortly after virus exposure, like the
rabies vaccine.
"This VSV-based vaccine employs the same
technology of the licensed Merck ERVEBO vaccine that was successfully used to
combat the 2013-16 Ebola outbreak in West Africa," Geisbert said.
The Tanzanian outbreak is expected to not spread to other countries, but a concerted effort must be made to minimize the virus's transmission.
"If identification and subsequent
isolation of infected people are done properly, then the spread of the MARV
virus would be limited," Matassov said. "However, being that the
outbreaks occur in rural areas and medical facilities are limited, any outbreak
of MARV should be taken seriously to minimize its spread."
In a statement, Ahmed Ogwell Ouma, acting
director of the Africa Centers for Disease Control and Prevention, said,
"These emerging and reemerging infectious diseases are a sign that the
health security of the continent needs to be strengthened to cope with the
disease threats.
"We urge members of the public to
continue sharing information in a timely manner with the authorities to enable
a most effective response," Ouma said.
https://www.newsweek.com/marburg-virus-outbreak-tanzania-africa-ebola-1789944
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