Marburg Virus – Symptoms, Causes and Treatment

Marburg virus and the related Ebola virus have caused large outbreaks with high case fatalities (80-90%) in humans and great apes. No vaccine or drug therapy is available presently. The paper reports detection of viral RNA from four out of 283 R. aegyptiacus bats in a collection of over 1100 bats tested, representing 10 species. Interestingly, 29 of 242 R. aegyptiacus bats also tested serologically positive for Marburg virus as evidenced by the presence of IgG antibodies in bat sera. Neither Marburg virus RNA nor specific antibody were detected in any of the other species of bats tested. All bats were trapped near caves in 2005 and 2006 in Gabon and the Republic of Congo. Genetic sequences obtained from the infected bats in this study are unique compared to other known Marburg virus sequences. R. aegyptiacus is widely distributed across sub-Saharan Africa.

Symptoms of Marburg Virus

The signs and symptoms of Marburg hemorrhagic fever strike suddenly 5 to 10 days after infection with the virus and usually include fever, chills, headache, and myalgia (muscle aches). Nausea, vomiting, and chest or abdominal pain may also occur. A maculopapular rash (with both of flat and raised lesions) appears about 5 days after symptoms have begun. The disease can worsen to include pancreatitis, jaundice, delirium, and ultimately shock and multi-organ failure.

Sudden onset of fever, chills, and malaise, with extreme prostration and weight loss.  The fever typically lasts 7 days.  On the fifth day of fever, a maculopapular petechial (tiny--pinpoint or pinhead size papula) rash appears, and hemorrhaging begins.  In survivors, the skin will eventually begin to shed or peel.  

Recovery can take 5 weeks or more, and is marked by prostration, weight loss, and amnesia for the period of acute illness.  Complications during convalescence can include recurrent hepatitis, as well as inflammation of the spinal cord, bone marrow, eyes, testes, and parotid gland. 

Causes of Marburg Virus

The virus that causes Marburg hemorrhagic fever, a disease which affects both humans and non-human primates. Caused by a genetically unique zoonotic (that is, animal-borne) RNA virus of the filovirus family, its recognition led to the creation of this virus family. The four species of Ebola virus are the only other known members of the filovirus family. 

The Marburg viruse emerged from tropical rain forests in Africa and parts of the Western Pacific. The viruses live in an animal host or "reservoir." The natural hosts for Ebola and Marburg remain a mystery, though some scientists speculate that bats are the source. The viruses that cause hemorrhagic fevers jump from animals to humans when people encroach on a native habitat and encounter the viruses for the first time. Although humans have been infected with Ebola and Marburg through contact with monkeys, chimpanzees and other primates, these animals aren't the viruses' natural reservoir. 

Treatment for Marburg Virus

There is no specific antiviral therapy indicated for treating Marburg, and hospital care is usually supportive in nature. Hypotension and shock may require early administration of vasopressors and haemodynamic monitoring with attention to fluid and electrolyte balance, circulatory volume, and blood pressure. Viral hemorrhagic fever (VHF) patients tend to respond poorly to fluid infusions and may develop pulmonary edema.

Caregivers require barrier infection control measures including double gloves, impermeable gowns, face shields, eye protection, leg and shoe coverings.