Credit CDC
#16,867
Overnight the WHO announced that the West African nation of Ghana has reported their first-ever suspected cases of Marburg virus disease - a hemorrhagic virus similar to Ebola - via a press release from WHO AFRO.
While rare, Marburg was the first of the filovirus family of hemorrhagic diseases to be recognized. Normally only found in parts of eastern and central Africa, Marburg – surprisingly - was first detected in Germany in the late 1960s.
In 1967, several workers involved with Polio research at a laboratory in Marburg, Germany fell ill with an unknown illness. What began with fever, vomiting, and diarrhea progressed rapidly to internal bleeding, shock, and for 7 of the 31 victims, death.
An investigation identified the source of the virus; Green monkeys imported from Uganda for research. We now know that while monkeys and other mammals can be infected, the reservoir host of Marburg virus is the African fruit bat, Rousettus aegyptiacus.
This lead to the creation of a new virus family; the Filoviridae, of which Marburg and the six known Ebola viruses are the principal members.
- For the next three decades, the virus only showed up sporadically. In South Africa in 1975 (3 cases), Kenya in 1980 (2 cases) and again in 1987 (1 case), and in a pair of laboratory accidents in the Soviet Union in 1988 and 1990.
- Between 1998 and 2000 more than 150 cases were recorded in the Democratic Republic of the Congo, and a second marburgvirus (RAVV) was identified.
- In 2004-2005, the largest known outbreak occurred in Angola, where 90% of the 252 cases died. This from the CDC’s MMWR in 2005.
- And over the past decade we've seen several outbreaks in Uganda (see here, here and here).
- Last year (2021), Marburg was detected for the first time in West Africa (Guinea), although only 1 case was identified.
Notably, over the past decade we've seen 3 infectious diseases normally found in Central Africa - Ebola (2013), Monkeypox (2017), and Marburg (2021) - turn up in West Africa.
The WHO's announcement follows:
Ghana reports first-ever suspected cases of Marburg virus disease
07 July 2022
Accra – Ghana has announced the preliminary finding of two cases of Marburg virus disease and if confirmed these would the first such infections recorded in the country. Marburg is a highly infectious viral haemorrhagic fever in the same family as the more well-known Ebola virus disease.
Preliminary analysis of samples taken from two patients by the country’s Noguchi Memorial Institute for Medical Research indicated the cases were positive for Marburg. However, per the standard procedure, the samples have been sent to the Institut Pasteur in Senegal, a World Health Organization (WHO) Collaborating Centre for confirmation. The two patients from the southern Ashanti region – both deceased and unrelated – showed symptoms including diarrhoea, fever, nausea and vomiting. They had been taken to a district hospital in Ashanti region.
Preparations for a possible outbreak response are being set up swiftly as further investigations are underway.
“The health authorities are on the ground investigating the situation and preparing for a possible outbreak response. We are working closely with the country to ramp up detection, track contacts, be ready to control the spread of the virus,” said Dr Francis Kasolo, World Health Organization (WHO) Representative in Ghana.
WHO is deploying experts to support Ghana’s health authorities by bolstering disease surveillance, testing, tracing contacts, preparing to treat patients and working with communities to alert and educate them about the risks and dangers of the disease and to collaborate with the emergency response teams.
If confirmed, the cases in Ghana would mark the second time Marburg has been detected in West Africa. Guinea confirmed a single case in an outbreak that was declared over on 16 September 2021, five weeks after the initial case was detected.
Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda.
Marburg is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management.
Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated.
