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Marburg, a virus deadlier than Ebola

Abraham Eisenstein, M.D. |
Hidden behind the current crisis and viruses, one virus is more deadly than Ebola, it takes 9 out of 10 lives of infected people.

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Back in 1967 a new virus was recognized in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia, during an outbreak of hemorrhagic fever. 31 people became sick, first laboratory workers, then medical personnel, family members, and seven deaths were reported. Then, in 2005, 90 percent of infected people died.

To put it into perspective we should remind that ten years later, during West African Ebola outbreak, "only" 40 percent of patients died. Marburg turned out to be more dangerous than Ebola which is a synonym for a deadly disease. This year, CDC identified Marburg virus in bat colonies for the first time in Sierra Leone.

It is unknown how Marburg virus first transmitted from its animal host to humans but we know that bats are to blame. Infected bats can spread the virus to people if they eat them, or if they eat fruit contaminated with infected bat saliva or urine. Egyptian rousette bats (fruit bats) are dangerous because they eat, among others, kinds of fruit that people eat too and that's a perfect ground to spread the virus.

Unfortunately, infected bats don't show signs of illness. Primates may develop serious disease too and are there any other species that can be affected we still don't know.

The good news is that we have no evidence that Marburg virus can be spread via insect bites.

What's more, in Uganda, in 2008, two tourists more likely got infected via bat feces or aerosols, which means there are more than one infection vector.

Virus being a virus, likes to spread from human to human via droplets of body fluids or via contact with contaminated objects. In other words, usual ways of infections, but very effective from the virus' point of view.

The problem is many symptoms of Marburg hemorrhagic fever are similar to, let's call them that way, usual infectious diseases, like malaria. If you have just one case, it's easy to slip to another diagnosis. Infected people typically don't become contagious until they develop symptoms.

Symptoms appear after an incubation period of 5 to 10 days and they include fever, chills, headache, and pain muscles. Some 5 days after symptoms appeared, a characteristic maculopapular rash may appear on chest, back, and stomach.

After that, there are nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea. Then they become worse and go all the way to jaundice, pancreas inflammation, delirium, severe weight loss shock, liver failure, massive hemorrhaging, and multi-organ dysfunction. It's clear that the situation is very dangerous then. It must be noticed that first symptoms appear rapidly.

If there is any suspicion that Marburg hemorrhagic fever might be, the patient should be isolated and laboratory tests must be performed to confirm the disease. If a health institution wants to isolate the virus for which we suspect is Marburg, it must be done only in a high containment laboratory.

Depending on the patient and his condition, and of course the speed of reaction, the mortality rate for Marburg hemorrhagic fever is between 23 all the way to 90%.

Unfortunately, there is no cure that targets Marburg hemorrhagic fever. A hospital treatment must be included, and it includes keeping fluids balanced, maintaining blood pressure, replacing lost blood if needed, maintaining oxygen status, keep an eye on blood clotting factors, and we must follow is there an infection as a complication.


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