What you should know about Marburg virus disease

Ghana announced the first outbreak of Marburg virus disease in the country after two unrelated people died on June 27 and 28. News of a new outbreak of a deadly disease caused by viral infections heightened the concern of a public weary from battling the coronavirus pandemic, and recently alarmed by the spread of monkeypox and a new case of polio.

Doctors and public health experts in the country immediately began searching for people exposed to the virus and investigating the cause of the spread in an attempt to contain the infection. For the time being, health researchers in Ghana and other parts of the world said there was no evidence the virus had spread further.

Marburg was first discovered in 1967 when simultaneous outbreaks of hemorrhagic fever occurred in laboratories in Marburg and Frankfurt in Germany and in Belgrade in present-day Serbia – in cases linked to African green monkeys imported from Uganda. According to the World Health Organization, additional cases have since been identified in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda. Last month’s cases in Ghana were the first to be recorded in that country.

Marburg virus is the pathogen that causes Marburg virus disease in humans, health experts said.

There are no vaccines or antiviral treatments for the disease, medical experts said, but keeping patients hydrated and treating their specific symptoms can improve their chances of survival.

The disease is clinically similar to Ebola in terms of spread, symptoms and course, although according to the WHO it is caused by a different virus. In the case of Marburg, fruit bats are thought to be hosts of the virus, although researchers say it doesn’t make them sick. Researchers believe Ebola is likely transmitted by bats or nonhuman primates, according to the Centers for Disease Control and Prevention. Although it hasn’t spread widely, Marburg has been deadly, with death rates ranging from 24 to 88 percent, depending on which strain people contract and how cases are treated, according to the WHO. The death rates from Ebola cases are nearly the same.

According to the WHO, the Marburg virus can spread through direct contact with the blood, secretions or other body fluids of infected people. According to the WHO, it can also spread through contact with contaminated surfaces and materials such as bedding or clothing.

Marburg can cause severe viral hemorrhagic fever that affects the blood’s ability to clot. The incubation period ranges from two to 21 days, and symptoms begin abruptly with high fever, severe headache and severe malaise, according to the WHO. Other symptoms may include muscle pain, diarrhea, nausea, lethargy, and bleeding from vomit, feces, and from other body parts.

“Mortality is very high,” said Dr. John Amuasi, who heads the Global Health and Infectious Diseases Research Group at the Kumasi Center for Collaborative Research in Tropical Medicine in Kumasi, Ghana. “And there is no asymptomatic Marburg.”

A patient can confirm their condition in Marburg through antibody, antigen and polymerase chain reaction tests, health organizations said.

Only two cases of Marburg virus disease have been reported this year, both of which have been reported in Ghana. The people who contracted the virus were not related and lived in different parts of Ghana’s Ashanti region, said Dr. Amuasi. They both died.

Both patients were men who worked on farms, he said. One was a 26-year-old farmhand who had recently been to work in another part of the country and the other was a 56-year-old subsistence farmer. Contact tracing by local authorities led to the conclusion that the men had not been in the same places.

Fruit bats, which are known to carry the virus, are widespread in the Ashanti region.

More than 200 people died from the disease in an outbreak in Angola in 2004-2005 and more than 100 died from the disease in 1998-2000 in the Democratic Republic of the Congo, according to the CDC. Other outbreaks in Marburg were not as many cases.

In 2021, there was a case in Guinea that resulted in the death of that person, and three out of four people who had the disease in Uganda in 2017 also died, according to the CDC

Experts want to know how the two people in Ghana contracted the virus, said Dr. Francis Kasolo, the WHO representative in the country.

“The current investigation does not only focus on contacts,” said Dr. Kasolo. “We also look to medical records in these areas to see if there have been any unusual events in relation to cases with symptoms. That’s why we hold back when we say that this is just a one-off event.”

The CDC’s office in Ghana is working with local health authorities to assist with testing and epidemiological investigations, said Dr. Jonathan Towner, who heads the virus host ecology division at the CDC

People in the United States are not at high risk of exposure, said Dr. towner

“At the moment there is a very, very low risk probability that some travelers will come to the country with Marburg, for example,” he said.

So far, said Dr. Amuasi, the public health response has been appropriate and transparent. The contacts of the two infected were monitored, especially in the 21 days after the death of the two.

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