Could the Marburg Virus Start Another Outbreak? What We Know

Dr. Eric Cioe-Peña, director of global health at Northwell Health in New Hyde Park, New York, told Healthline in an earlier interview that Marburg virus is a type of viral hemorrhagic fever.

“Hemorrhagic fever is any infectious fever that causes internal bleeding,” he explained. “Usually from an overwhelming inflammatory reaction that decreases a patient’s platelets and clotting factors.”

The Centers for Disease Control and Prevention (CDC) says that although some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses can cause severe, life threatening disease.

According to the CDC, viral hemorrhagic fevers (VHFs) are caused by four distinct virus families: Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae. The Marburg virus is considered a filovirus (filoviridae).

“Filovirus is the same family of viruses that Ebola belongs to,” said Cioe-Peña. “Symptoms are virtually identical to Ebola and mortality ranges widely from less than Ebola — about 28 percent is the lowest mortality and 88 percent is the highest recorded mortality.”

Cioe-Peña said symptoms include fever, malaise, body aches, nausea, vomiting, diarrhea, and internal hemorrhaging.

The WHO calls the disease “epidemic-prone,” meaning that it can spread easily between people if not prevented. There have been previous Marburg outbreaks in other parts of Africa, including Angola, Uganda, and South Africa.

“The filoviruses are not as contagious as what we’re used to with COVID-19,” said Cioe-Peña. “Infection usually occurs with direct contact with the body fluids of an infected individual, usually close family members, or people participating in funeral rituals that involve close contact with the body.”

The good news, he added, is that awareness of preventing viral hemorrhage and fever is “very fresh” on the minds of those in Guinea, due to the Ebola outbreak in 2014.

“The fact that this was detected after one case speaks to the surveillance and commitment of the governments of West African countries to prevent another epidemic like 2014,” he said.

A 2012 article published in the journal Viruses found that the first reported filovirus hemorrhagic fever outbreak took place in Germany and the former Yugoslavia in 1967.

It began when lab workers in Marburg and Frankfurt, Germany, in Belgrade, and Yugoslavia (now Serbia), contracted a “previously unknown infectious agent.”

Of 31 patients that developed severe disease, it caused death in 7 cases. According to the article, the source of infection was traced back to African green monkeys imported from Uganda and shipped to all three locations.

Decades later, we understand that monkeys weren’t the primary source of the virus.

“The host of Marburg virus is the fruit bat,” said Cioe-Peña. “They don’t show signs of illness, however, and can carry the virus.”

He explained that the virus can then jump to an intermediate host, like a monkey, which can transmit to humans, or it can transmit to humans directly by contact with fruit bats or their guano.

Dr. Teresa Murray Amato, chair of emergency medicine at Long Island Jewish Forest Hills, in New York, said in an earlier interview the signs and symptoms of Marburg HF (hemorrhagic fever) are experienced within 5 to 10 days of exposure and include:

• sudden onset of high fever
• chills
• headache
• body aches

“After about 5 days of the initial symptoms, a rash develops mostly on the chest and back,” she said. “ Additional symptoms then occur that include nausea, vomiting and diarrhea, chest pain, and abdominal pain.”

She pointed out that after this, there may be skin color changes where the skin appears yellow (jaundice).

“The pancreas and the liver become inflamed leading to liver failure and massive bleeding,” continued Amato.

Amato explained that while there’s no specific treatment for Marburg disease, most people seeking care will require intravenous (IV) fluids, replacement of electrolytes, supplemental oxygen, and replacement of blood and blood products.

She confirmed that there’s currently no vaccine against this virus.

“About 25 to 30 percent of people who contract Marburg HF will succumb to the disease,” she continued, and warned that the disease isn’t easy to identify.

“Marburg HF may be difficult to diagnose initially, as the presentation initially resembles many more common viral infections,” she said.

Amato emphasized that it’s very important for patients to tell their doctor if they’ve traveled to an area that may be associated with an exposure to the virus that causes Marburg disease.

The WHO confirmed that health authorities in the West African nation of Ghana have recently identified two cases of Marburg virus disease.

This virus causes symptoms similar to Ebola. It’s a type of hemorrhagic fever that causes internal bleeding and originates in a species of fruit bat.