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Marburg virus is a hemorrhagic fever virus of the Filoviridae family of viruses and a member of the Marburg marburgvirus genus Marburgvirus species. Marburg virus causes Marburg virus disease in humans and primates, a form of viral hemorrhagic fever. The virus is considered to be extremely dangerous.

Marburg virus disease (MVD), formerly known as Marburg hemorrhagic fever, is a severe human disease caused by Marburg marburgvirus (MARV). Although MVD is uncommon, MARV has the potential to cause epidemics with significant case fatality rates. All recorded MVD outbreaks have originated in Africa. MVD is not an airborne disease and is considered not to be contagious before symptoms appear. Direct contact with the blood and other body fluids of infected people and animals or indirect contact with contaminated surfaces and materials like clothing, bedding, and medical equipment is required for MARV transmission [1]. As a result, if proper infection prevention and control precautions are strictly followed, the risk of infection is regarded as minimal. There is no approved vaccine for MVD; however, several candidate MVD vaccines are in clinical trials.

The incubation period of MVD is from 2 to 9 days. Transmission does not occur during the incubation period. The transmission of the virus from person to the person requires extremely close contact with a patient. Infection results from contact with blood or other body fluids (feces, vomitus, urine, saliva, and respiratory secretions) with high virus concentration, especially when these fluids contain blood. Transmission via infected semen can occur up to seven weeks after clinical recovery.

The symptom onset is sudden and marked by fever, chills, headache, and myalgia. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea may appear. Symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.

There is no specific treatment for Marburg hemorrhagic fever. Early supportive care with rehydration and symptomatic treatment improve survival. There is as yet no licensed treatment proven to neutralize the virus but a range of blood, immunological and drug therapies are under development.

Preventive measures against Marburg virus infection are not well defined, as transmission from wildlife to humans remains an area of ongoing research. However, avoiding fruit bats, and sick non-human primates in central Africa, is one way to protect against infection. Measures for prevention of secondary, or person-to-person, transmission are similar to those used for other hemorrhagic fevers. If a patient is either suspected or confirmed to have Marburg hemorrhagic fever, barrier nursing techniques should be used to prevent direct physical contact with the patient.

Signs and Symptoms​

After an incubation period of 2-21 days, symptom onset is sudden and marked by fever, chills, headache, and myalgia. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea may appear. Symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.
Clinical diagnosis of Marburg virus disease (MVD) can be difficult. Many of the signs and symptoms of MVD are similar to other infectious diseases (such as malaria or typhoid fever) or viral hemorrhagic fevers that may be endemic in the area (such as Lassa fever or Ebola). This is especially true if only a single case is involved.
The case-fatality rate for MVD is between 23-90%. For a complete listing of the case fatality rates for each outbreak, please see the History of Outbreaks table.

Prevention​

Preventive measures against Marburg virus infection are not well defined, as transmission from wildlife to people remains an area of ongoing research. However, avoiding fruit bats (Rousettus aegyptiacus), and sick non-human primates is one way to protect against infection.
Measures for prevention of secondary, or person-to-person, transmission are like those used for other hemorrhagic fevers. If a patient is either suspected or confirmed to have Marburg virus disease (MVD), infection prevention and control measures should be used to prevent direct physical contact with the patient. These precautions include wearing protective gowns, gloves, and masks; placing the infected individual in strict isolation; and sterilizing or properly disposing of needles, equipment, and patient excretions.
MVD is a sporadic disease in people. However, when it occurs, it has the potential to spread to other people, especially healthcare staff and family members who care for the patient. Increasing awareness in communities and among healthcare providers of the clinical symptoms of patients with MVD is critical. Better awareness can lead to earlier and stronger precautions against the spread of the Marburg virus among both family members and healthcare providers.
Improving the use of diagnostic tools is another priority. With modern means of transportation giving access even to remote areas, it is possible to obtain rapid testing of samples in disease control centers equipped with Biosafety Level 4 laboratories (laboratories equipped with the highest level of biosafety precautions) to confirm or rule out Marburg virus infection.

Treatment​

There is no specific treatment for Marburg virus disease. Supportive hospital therapy should be utilized, which includes balancing the patient’s fluids and electrolytes, maintaining oxygen status and blood pressure, replacing lost blood and clotting factors, and treatment for any complicating infections.
Experimental treatments are validated in non-human primate models but have never been tried in humans.

 
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