A new outbreak of the deadly Marburg virus has infected 25 suspected people and potentially killed nine in the central African country Equatorial Guinea, the World Health Organization announced this week. There have been 15 previously confirmed Marburg outbreaks, according to to the data of centers for disease control and prevention. But the current one, whose start dates back to early January, is the first in Equatorial Guinea.
Following the official confirmation of the epidemic by the WHO on Monday, neighboring Cameroon also reported two of his own suspected cases.
What is the Marburg Virus?
The disease belongs to the same filovirus family as the more widely known Ebola virus. And similar to Ebola, Marburg is a rare but often fatal hemorrhagic fever. It has a case fatality rate between 23% and 90%, depending on the outbreak, with an average lethality rate of 50%.
Marburg was first documented transmitted to humans by African green monkeys transported to European laboratories in 1967. The reservoir host for the virus is African fruit bats, which show no overt signs of infection but can transmit the disease to humans and non-human primates, according and the CDC.
Between people, the virus is transmitted through contact with bodily fluids (including semen) or contaminated objects such as bedding, clothing and medical equipment.
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Once infected, symptoms appear suddenly after an incubation period of two and 21 days. IThe disease begins with fever, chills, headache and muscle aches. Then a rash often develops, followed by nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhea. These symptoms often become progressively more severe and can lead to system-wide problems such as inflammation and organ failure, internal bleeding, severe weight loss, jaundice, and ultimately death. .
There are currently no approved antiviral treatments or vaccines for Marburg (unlike Ebola), but supportive care like IV fluids and symptomatic treatment can greatly improve survival.
What happened in past epidemics?
The largest Marburg virus outbreak on record resulted in 252 documented cases and 227 deaths in Angola from 2004 to 2005. The second largest outbreak killed 128 known people and infected 154 in the Democratic Republic of Congo from 1998 to 2000.
However, unlike Ebola, all of Marburg’s other confirmed outbreaks have been much smaller, usually causing only a handful of infections. East Marburg a little less contagious than its viral cousin, and these past outbreaks have been managed and resolved through quarantine and containment efforts.
Prior to the current situation, the most recent known outbreak performed in Ghana in between June and September 2022. Three cases, all within the same household, have been recorded and two of the three people have died.
The current outbreak would be the fourth largest so far, if all infections are confirmed. The WHO said it had sent samples from the deceased to Senegal’s Pasteur Institute for further analysis and is awaiting the results.
How are health authorities responding now?
In addition to collecting and testing samples, WHO noted that medical and contact tracing teams have been deployed to Equatorial Guinea. The international agency said it also had epidemiologists, infectious disease prevention experts and others on the case. The United Nations organization is “further facilitating the dispatch” of laboratory equipment and personal protective equipment.
Additionally, several of Marburg’s experimental vaccines are in development, all of which have shown promising results in monkey studies. Researchers are interested in testing these vaccines amid the current outbreak, according to a report of nature. However, a successful vaccine trial is unlikely to happen as a quick and effective quarantine response could end the outbreak before vaccines can even be administered, officials and scientists from the WHO at a meeting on Tuesday.
“I can’t stress enough the need for speed,” John Edmunds, an epidemiologist at the University of London, said at the WHO meeting, according to Nature. “It’s a double-edged sword, isn’t it?” This is good news for public health and the people of Equatorial Guinea, but perhaps bad news for science.
If the WHO chooses to approve a human vaccine trial in the current outbreak, the agency will decide which of the five candidate vaccines to test. Even if this particular outbreak does not provide enough opportunity for a full test of vaccine effectiveness, it is possible that a partial trial could still provide useful data.
