Related Subjects:
|Fever in a traveller
|Malaria Falciparum
|Malaria Non Falciparum
|Viral Haemorrhagic Fevers (VHF)
|Lassa fever
|Dengue
|Marburg virus disease
|AIDS HIV
|Yellow fever
|Ebola Virus
|Leptospirosis
| Crimean-Congo haemorrhagic fever
|African Trypanosomiasis (Sleeping sickness)
|American Trypanosomiasis (Chagas Disease)
|Incubation Periods
|Notifiable Diseases UK
🦠 Marburg Virus Disease (MVD) is a severe viral haemorrhagic fever (VHF) caused by a filovirus,
closely related to Ebola. It has a high case fatality rate (24–90%) and requires immediate isolation and expert infectious disease input.
📍 About
- Caused by Marburg virus, a member of the Filoviridae family (same family as Ebola).
- First recorded in 1967 in laboratory workers in Germany and Yugoslavia exposed to imported monkeys.
🔄 Transmission
- Natural reservoir: Fruit bats (Rousettus aegyptiacus).
- Animal hosts: Monkeys and other primates are susceptible but not true reservoirs (they die rapidly once infected).
- Human-to-human: Direct contact with blood, secretions, organs, or other bodily fluids (vomit, faeces, urine, saliva, respiratory secretions).
- High viral load in blood and fluids during illness; transmission risk is greatest when bleeding occurs.
- Sexual transmission documented; virus may persist in semen for months.
- Post-mortem transmission: Contact with deceased patients’ bodies remains a high-risk exposure.
🌍 Geography
- Outbreaks reported in Angola, Democratic Republic of Congo, Kenya, Ghana, Guinea, and Uganda.
- Imported cases have occurred elsewhere (e.g., South Africa from a traveller returning from Zimbabwe).
🧬 Aetiology
- Marburg virus infects both humans and non-human primates.
- It is an enveloped, negative-sense, single-stranded RNA virus.
🩺 Clinical Features
- Incubation: 3–10 days (rarely up to 21 days).
- Early symptoms: Sudden onset fever, severe headache, malaise, myalgia, rapid debilitation.
- Day 3 onwards: Watery diarrhoea, crampy abdominal pain, nausea, vomiting (“ghost-like” drawn appearance).
- Severe disease: Haemorrhagic fever develops around day 5–7 with bleeding from mucous membranes, GI tract, venepuncture sites.
- Complications: Multi-organ failure, shock, and high mortality.
🔬 Investigations
- In the UK, diagnosis is performed at the UKHSA Rare and Imported Pathogens Laboratory (RIPL).
- Tests include RT-PCR, antigen-capture ELISA, IgM/IgG ELISA for confirmation.
- ⚠️ No routine samples should be sent to standard labs - consult infectious diseases immediately.
💊 Management
- Supportive only - no licensed antivirals currently available.
- Key measures:
- Strict isolation & PPE for healthcare workers.
- Fluid and electrolyte replacement.
- Oxygen therapy and blood pressure support.
- Replacement of clotting factors and blood products.
- Experimental therapies (monoclonal antibodies, antivirals) are under trial but not standard of care.
📚 References
