Marburg virus

Background

Microbiology

• Negative-sense single-stranded RNA virus in the Filoviridae family
• Genus contains two species
  • Marburg virus
  • Ravn virus

Epidemiology

• Rare, with 11 outbreaks since discovery in 1967, totalling 470 cases
• Animal reservoir is fruit bat, with a sylvian cycle that occasionally spills over into human populations
  • The range of the reservoir extends into Middle East, South Asia, and south Pacific, but the virus is essentially limited to subsaharan Africa

Clinical Manifestations

• Incubation period 2 to 21 days
• Starts with high fever, severe headache malaise
• Followed by multi-system involvement as early as day 3
  • Nausea, vomiting, anorexia, abdominal pain, diarrhea (can persist for a week)
  • Chest pain, dyspnea, cough
  • Hypotension, edema, maculopapular rash
  • Headache, confusion
• Mortality 23 to 90%

Diagnosis

• RT-PCR at the National Microbiology Laboratory
  • Inform microbiology lab beforehand and contact Public Health for collection instructions

Management

• Good supportive care decreases mortality substantially
• Experimental therapies include favipiravir and monoclonal antibodies

Prevention

Vaccination

• Vaccination is under investigation

Infection Prevention and Control

• Isolate patient
• Droplet precautions and face protection within 1 meter of patient
• Limit hospital staff who have contact