Marburg virus

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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%

Management

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

Prevent

  • Vaccination is under investigation