FAST FACTS: Things to know about the Marburg virus

MANILA, Philippines – A Marburg virus outbreak was confirmed in Equatorial Guinea on Sunday, February 12, following the death of at least nine people, one testing positive for the virus, and 16 others being suspected of being infected.

Rare severe hemorrhagic fever is caused by the Marburg virus. It is a zoonotic disease with fruit bats as its natural hosts. Similar to the Ebola virus, the Marburg virus came from the filovirus family. Both cause severe hemorrhagic fever and are highly fatal. 

According to the World Health Organization (WHO), persons infected with the Marburg virus could have a mortality rate of up to at least 88%.

Is there cause for alarm, given news of the recent outbreak? Here’s what you need to know about the Marburg virus. 

How it spreads

The Marburg virus spreads through direct contact. The WHO listed direct contact “through the skin or mucous membranes with blood, secretions, organs or other bodily fluids of an infected person, and with contaminated surfaces and materials” as possible means of transmission. 

Urine, saliva, sweat, feces, vomit, breast milk, amniotic fluid, and semen are among the bodily fluids that the Centers for Diseases Control and Prevention (CDC) listed.

How to know if you have the Marburg virus

Signs and symptoms of Marburg virus infection are not so unique from other infectious diseases and other viral hemorrhagic fevers. 

The WHO listed the following signs and symptoms of infection, which may appear after the virus’ incubation period of two to 21 days from infection. 

• high fever
• severe headache
• severe fatigue
• muscle pain
• diarrhea 
• abdominal pain and cramping 
• nausea and vomiting 
• presence of non-itchy rash
• hemorrhagic manifestations such as bleeding of nose, gums, and vagina, and blood in vomit and feces

Diarrhea, along with symptoms concerning the stomach, usually begin on the third day of the infection and can last up to a week. Bleeding and other hemorrhagic manifestations develop on the fifth to seventh day.

The WHO said deaths mostly occurred on the eighth and ninth day of the onset of the infection, after severe blood loss and shock. 

A person can confirm infection through the following tests: antibody-capture enzyme-linked immunosorbent assay (ELISA), antigen-capture detection tests, serum neutralization test, reverse transcriptase polymerase chain reaction (RT-PCR) test, electron microscopy, and virus isolation by cell culture.

As it is transmitted through direct contact, samples for testing collected from suspected infected persons are considered a “biohazard risk.” 

How it can be cured

Unfortunately, there is no treatment nor a vaccine for Marburg virus infection. 

Both the WHO and CDC identified supportive care or therapy to help patients manage the disease. This includes rehydration with oral and intravenous fluids, maintaining oxygen status and blood pressure, replacing lost blood and clotting factors, and treatment for any complications. 

How it can be controlled

An infected person remains infectious while the virus is present in his or her blood. Although there is no treatment or vaccine available as of the moment, it is possible for someone infected to still recover. 

During the incubation period of an infected person, prevention of direct physical contact with the person can help prevent the spread of the virus. Placing an infected person in isolation is helpful in containing the spread. 

Other precautions include “wearing protective gowns, gloves and masks; and sterilization or proper disposal of needles, equipment, and patient excretions.”

Basic hand hygiene and respiratory hygiene are identified, too, as precautionary practice.

It is important for a Marburg-infected person to get medical care to recover from the virus. A recovering patient may be allowed to go home when tests find that he or she is no longer contagious. If a person’s diagnostic tests show that his or her antibodies are developed and the patient no longer has an active infection, the patient may be released. 

However, precautionary measures should still be observed upon release, as the WHO noted that the virus is “known to persist in immune-privileged sites,” even after recovery. The insides of the eye and the testicles are the areas where the virus seems to persist.

Given this, the WHO advised survivors, those who recovered, to practice safe sex or to abstain from all sexual practices altogether. It added that “male survivors of Marburg virus disease should practice safer sexual practices and hygiene for 12 months from onset of symptoms or until their semen twice tests undetected (negative) for Marburg virus.”

Both the WHO and CDC said that community awareness about Marburg infection, its symptoms, and protective measures, can help reduce human transmission. – Rappler.com