Marburg virus disease is characterized by a hemorrhagic fever. There have been past outbreaks of this illness as well as isolated cases that have resulted in high mortality. The clinical presentation typically consists of a progressive disease with fever, hemorrhagic manifestations, multiorgan failure, shock, and other serious complications.
Presentation
Marburg virus disease, also known as Marburg hemorrhagic fever, is a severe illness with a high mortality rate. The responsible pathogen, Marburg virus, is a member of the filoviridae family along with the Ebola virus [1]. The first documented outbreak of this disease was in 1967 in Germany and Yugoslavia (which is currently known as Serbia) [2]. Outbreaks have also occurred between 1998 to 2000 in the Democratic Republic of Congo, Angola in 2004 to 2005 [3] [4] and most recently in Uganda in 2012. Additionally, there have been sporadic cases over the years. The African fruit bat acts as a reservoir for this zoonotic virus affecting human as well as non-human primates. The transmission occurs from human to human contact. The incubation period may range from 2 days to 3 weeks [5].
There are three stages of this illness, which are described as the 1) generalization phase, 2) early organ phase, and 3) late organ or convalescence phase [6]. The first phase lasts about 5 days and is characterized by a high fever, headache, chills, malaise, myalgia, and possibly nausea, emesis, watery diarrhea, abdominal pain, pharyngitis, conjunctivitis, and a rash [2] [7] [8]. As the illness progresses, the patient enters the early organ phase, which involves the liver, kidneys, and pancreas. It features neurological symptoms, impaired mental status, hematemesis, bloody diarrhea, and bleeding from other sites [2] [9]. The final phase is critical and often leads to death secondary to critical manifestations such as multiorgan failure, seizures, coagulopathy, cardiovascular collapse, and shock [1].
Physical exam
Assessment of the vital signs typically reveals fever, hypotension and other abnormalities. Also, the patient appears ill and exhibits mental status changes such as confusion, delirium, and dementia [1]. Other notable findings include conjunctival injection, pharyngitis, petechia, ecchymoses, and palatal exanthem. Bleeding from mucosal sites and orifices is observed in severe cases.
Entire Body System
- Fever
Marburg Hemorrhagic Fever View PDF (132KB) What is Marburg hemorrhagic fever? Marburg hemorrhagic fever is a rare, severe type of hemorrhagic fever which affects both humans and non-human primates. [web.archive.org]
Imported case of Marburg hemorrhagic fever - Colorado, 2008. Morbidity and Mortality Weekly Report. 2009; 58(49):1377-1381. World Health Organization. Case of Marburg Haemorrhagic Fever Imported into the Netherlands from Uganda. 10 July 2008. [cdc.gov]
[…] plus at least 3 general symptoms or fever plus unexplained hemorrhage). [doi.org]
- Malaise
According to the global health body, the illness caused by Marburg virus begins abruptly, with severe headache and malaise. [china.org.cn]
A doctor who attempted resuscitation developed symptoms 9 days later but recovered [ 3 ]. 1987 Kenya Kenya 1 1 (100%) A 15-year-old Danish boy was hospitalized with a 3-day history of headache, malaise, fever, and vomiting. [web.archive.org]
The first phase lasts about 5 days and is characterized by a high fever, headache, chills, malaise, myalgia, and possibly nausea, emesis, watery diarrhea, abdominal pain, pharyngitis, conjunctivitis, and a rash. [symptoma.com]
On 13 August 1987, a 15-year old Danish male, who had been in Kenya for one month, was admitted to hospital with a three-day history of headache, malaise, fever, and vomiting. [allcountries.org]
The cardinal clinical symptoms were marked malaise, headache, impairment of consciousness, high fever, vomiting, diarrhoea, a characteristic cutaneous and mucosal rash, conjunctivitis, lymphadenopathy, an haemorrhagic diathesis and signs of involvement [doi.org]
- Anorexia
Disease was characterized by the sudden appearance of fever and anorexia within 4 to 7 days, and death by day 11. [ncbi.nlm.nih.gov]
The clinical presentation is more or less identical in all three species, showing fever (40–40.5°C), anorexia, weight loss and unresponsiveness. [dmm.biologists.org]
Variables eligible for the multivariable models were myalgia or arthralgia, anorexia, asthenia, any hemorrhage, bleeding at an injection site, bloody gingivitis and, for model 2, an epidemiological link. [doi.org]
- Veterinarian
Veterinarians and laboratory or quarantine facility workers who handle non-human primates from Africa may also be at increased risk of exposure to MVD. [rxwiki.com]
The secondary cases involved two doctors, a nurse, a post-mortem attendant, and the wife of a veterinarian. All secondary cases had direct contact, usually involving blood, with a primary case. [allcountries.org]
Veterinarians may also be at higher risk if they are exposed to African monkeys. [medicinenet.com]
Secondary cases involved two physicians, a nurse, a post-mortem attendant, and the wife of a veterinarian. All secondary cases had direct contact, usually involving blood, with a primary case. [en.wikipedia.org]
- Fatigue
Symptoms significantly associated with being a MVD case included hiccups, anorexia, fatigue, vomiting, sore throat, and difficulty swallowing. Contact with a case patient and attending a funeral were also significantly associated with being a case. [ncbi.nlm.nih.gov]
On physical examination, she appeared pale and fatigued, and had decreased bowel sounds; the remainder of her examination was unremarkable. [cdc.gov]
Symptoms include the following: Maculopapular rashes that develop in the head, neck and stomach High fever Severe headache Chills Nausea Vomiting Abdomen pain Cramping Muscle pain Sore throat Chest pain Fatigue Watery diarrhea Joint pain Excessive weight [medindia.net]
MHF presents with a high fever 104 °F (~40˚C) and a sudden, severe headache, with accompanying chills, fatigue, nausea, vomiting, diarrhea, pharyngitis, maculopapular rash, abdominal pain, conjunctivitis, & malaise. [en.wikipedia.org]
Appendix Case Definitions for Marburg Hemorrhagic Fever, Uige, Angola, 7 May 2005 Suspected case Unexplained hemorrhage Fever plus 3 of the following symptoms: headache, anorexia, fatigue, myalgia, arthralgia, dyspnea, nausea, vomiting, diarrhea, dysphagia [doi.org]
Respiratoric
- Sore Throat
Symptoms significantly associated with being a MVD case included hiccups, anorexia, fatigue, vomiting, sore throat, and difficulty swallowing. Contact with a case patient and attending a funeral were also significantly associated with being a case. [ncbi.nlm.nih.gov]
Syn: Green - monkey - disease Marburg virus disease, a severe, distinctive, hemorrhagic illness with a high rate of mortality, is heralded early by severe sore throat, a maculopapular rash, and a red exanthem on the hard and soft palate. [histopathology-india.net]
Later on, however, the symptoms can become more serious, such as nausea, vomiting, chest pain, sore throat, abdominal pain, and severe diarrhea. [newsweek.com]
The illness progresses to a sore throat, abdominal and chest pain, vomiting, diarrhea and a skin rash typically around the body trunk. [iamat.org]
A severe watery diarrhoea, abdominal pain, nausea and vomiting are early symptoms, as are severe chest and lung pains, sore throat, and cough. [who.int]
- Cough
People have muscle aches, headache, sore throat, and cough. People also become sensitive to light, and the whites of the eyes may turn red. [msdmanuals.com]
A severe watery diarrhoea, abdominal pain, nausea and vomiting are early symptoms, as are severe chest and lung pains, sore throat, and cough. [who.int]
Besides fever and weakness, early symptoms include severe diarrhea, abdominal pain, nausea and vomiting, severe chest pain, sore throat, and cough, according to the WHO. The incubation period is 3 to 9 days. [cidrap.umn.edu]
Jaundice and pancreatitis are common, as is an altered mental status or even coma; pharyngitis and a nonproductive cough are less common. [upmc-cbn.org]
- Dyspnea
Symptoms include prostration, dyspnea, edema, conjunctival injection, viral exanthema, and CNS symptoms, including encephalitis, confusion, delirium, apathy, and aggression. [en.wikipedia.org]
Appendix Case Definitions for Marburg Hemorrhagic Fever, Uige, Angola, 7 May 2005 Suspected case Unexplained hemorrhage Fever plus 3 of the following symptoms: headache, anorexia, fatigue, myalgia, arthralgia, dyspnea, nausea, vomiting, diarrhea, dysphagia [doi.org]
[…] trauma, another focal disease process, or a response to antibiotics or antimalarial agents; at least three of the following signs and symptoms: fever, generalized body pains, nausea and vomiting, headache, anorexia, malaise, abdominal pain, diarrhea, dyspnea [dx.doi.org]
Gastrointestinal
- Vomiting
Later on, however, the symptoms can become more serious, such as nausea, vomiting, chest pain, sore throat, abdominal pain, and severe diarrhea. [newsweek.com]
Features of the illness included high fever, myalgia, vomiting and diarrhoea, hepatitis, a characteristic maculopapular rash, leucopenia, thrombocytopenia, and a bleeding tendency. [ncbi.nlm.nih.gov]
The bleeds can be from the gums, nose, venepuncture sites that are used to draw blood from patients for tests and in vomit and feces. [ucsdguardian.org]
A doctor who attempted resuscitation developed symptoms 9 days later but recovered [ 3 ]. 1987 Kenya Kenya 1 1 (100%) A 15-year-old Danish boy was hospitalized with a 3-day history of headache, malaise, fever, and vomiting. [web.archive.org]
- Diarrhea
Later on, however, the symptoms can become more serious, such as nausea, vomiting, chest pain, sore throat, abdominal pain, and severe diarrhea. [newsweek.com]
It features neurological symptoms, impaired mental status, hematemesis, bloody diarrhea, and bleeding from other sites. [symptoma.com]
Those include fever, headache, diarrhea and unexplained bleeding. Symptoms Patients infected with Marburg virus typically begin to show symptoms between five and 10 days after exposure. [dailyrx.com]
He complained of headache, abdominal pain, vomiting blood and diarrhea. Samples were taken and tested at the Uganda Virus Research Institute, and results confirmed the man had the Marburg virus. [reuters.com]
Beginning on day 4, mild diarrhea occurred and he started to develop a slightly clouded awareness. [dmm.biologists.org]
- Nausea
Later on, however, the symptoms can become more serious, such as nausea, vomiting, chest pain, sore throat, abdominal pain, and severe diarrhea. [newsweek.com]
Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting few days after the onset of the disease. [ktpress.rw]
She reports also having nausea and blood-tinged vomiting. She had traveled to Uganda to volunteer at a hospital and has been working there for a month. [medbullets.com]
The first phase lasts about 5 days and is characterized by a high fever, headache, chills, malaise, myalgia, and possibly nausea, emesis, watery diarrhea, abdominal pain, pharyngitis, conjunctivitis, and a rash. [symptoma.com]
Diarrhea, abdominal pain and cramping, nausea and vomiting can begin from the third day of symptoms. At this point, patients are described as having a “ghost-like” appearance, with deep set eyes and severe lethargy. [ucsdguardian.org]
- Abdominal Pain
Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting few days after the onset of the disease. [ktpress.rw]
He complained of headache, abdominal pain, vomiting blood and diarrhea. Samples were taken and tested at the Uganda Virus Research Institute, and results confirmed the man had the Marburg virus. [reuters.com]
The first phase lasts about 5 days and is characterized by a high fever, headache, chills, malaise, myalgia, and possibly nausea, emesis, watery diarrhea, abdominal pain, pharyngitis, conjunctivitis, and a rash. [symptoma.com]
Later on, however, the symptoms can become more serious, such as nausea, vomiting, chest pain, sore throat, abdominal pain, and severe diarrhea. [newsweek.com]
Muscle aches and pains are also fairly common in beginning symptoms. Diarrhea, abdominal pain and cramping, nausea and vomiting can begin from the third day of symptoms. [ucsdguardian.org]
- Hematemesis
It features neurological symptoms, impaired mental status, hematemesis, bloody diarrhea, and bleeding from other sites. [symptoma.com]
[…] days, the virus will disseminate via the lymphatics and cause multiorgan failure Prevention vaccines are under development Prognosis high mortality rate Presentation Symptoms flu-like symptoms high fever myalgia headache nausea and vomiting may have hematemesis [medbullets.com]
On 21 September he presented to a health center in a suburb of Kyebando, located on the outskirts of Kampala, with fever, headache, arthralgia, anorexia, and hematemesis. [doi.org]
Bleeding from the nose, gums, and eyes is common, and extensive gastrointestinal hemorrhage will often manifest as frank blood in the stool or hematemesis. [infectionlandscapes.org]
Symptoms include bloody stools, ecchymoses, blood leakage from venipuncture sites, mucosal & visceral hemorrhaging, and possibly hematemesis. Late Organ Phase: Day 13 up to Day 21+. [en.wikipedia.org]
Liver, Gall & Pancreas
- Jaundice
More severe symptoms can also develop such as jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, and liver failure. Eventually victims may experience massive bleeding from the orifices and finally multi-organ dysfunction. [newsweek.com]
Signs and symptoms include fever, headache, myalgias, chest and abdominal pain, jaundice, liver failure, massive hemorrhaging, and multiple organ failure. An rna virus infection of rhesus, vervet, and squirrel monkeys transmissible to man. [icd10data.com]
Signs and symptoms include fever, headache, myalgias, chest and abdominal pain, jaundice, liver failure, massive hemorrhaging, and multiple organ failure. [fpnotebook.com]
There is functional evidence of liver damage but clinical jaundice has not been reported. Renal damage occurs and is manifested by proteinuria, oliguria and viruria. [europeanmedical.info]
Symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, and multi-organ dysfunction. [rxwiki.com]
Cardiovascular
- Chest Pain
Later on, however, the symptoms can become more serious, such as nausea, vomiting, chest pain, sore throat, abdominal pain, and severe diarrhea. [newsweek.com]
The illness progresses to a sore throat, abdominal and chest pain, vomiting, diarrhea and a skin rash typically around the body trunk. [iamat.org]
People travelling to share information with local and health authorities in case of any suspicion, Anyone with the following symptoms: Sudden fever accompanied with chills, headache and muscle pain, nausea, vomiting, chest pain, a sore throat, abdominal [ktpress.rw]
Besides fever and weakness, early symptoms include severe diarrhea, abdominal pain, nausea and vomiting, severe chest pain, sore throat, and cough, according to the WHO. The incubation period is 3 to 9 days. [cidrap.umn.edu]
Symptoms • Fever / Severe headache • Joint and muscle aches • Chills /Weakness • Nausea and vomiting. • Diarrhea (may be bloody) • Red eyes. • Raised rash. • Chest pain and cough. • Stomach pain. • Severe weight loss. • Bleeding, usually from the eyes [slideshare.net]
Eyes
- Conjunctival Injection
Other notable findings include conjunctival injection, pharyngitis, petechia, ecchymoses, and palatal exanthem. Bleeding from mucosal sites and orifices is observed in severe cases. [symptoma.com]
injection Studies Labs thrombocytopenia hepatic transaminitis detection of viral RNA on reverse-transcriptase polymerase chain reaction (RT-PCR) Making the diagnosis diagnosis based on clinical presentation and detection of viral RNA on RT-PCR Differential [medbullets.com]
Photophobia, conjunctival injection, jaundice, and lymphadenopathy also occur. Vomiting and diarrhea may soon follow. Delirium, stupor, and coma may occur, indicating CNS involvement. [merckmanuals.com]
Symptoms include prostration, dyspnea, edema, conjunctival injection, viral exanthema, and CNS symptoms, including encephalitis, confusion, delirium, apathy, and aggression. [en.wikipedia.org]
injection, postural hypotension, edema) and neurologic (headache, confusion, seizure, coma) manifestations. [dmm.biologists.org]
Musculoskeletal
- Myalgia
078.89 converts approximately to: 2015/16 ICD-10-CM A98.3 Marburg virus disease Or: 2015/16 ICD-10-CM A98.4 Ebola virus disease Or: 2015/16 ICD-10-CM B33.8 Other specified viral diseases Approximate Synonyms Acute infectious lymphocytosis Cervical myalgia [icd9data.com]
Of the generalized symptoms, myalgia or arthralgia was the strongest predictor of MHF but had intermediate sensitivity and specificity. [doi.org]
RESULTS: A MHF case definition comprising (1) an epidemiological link or (2) the combination of myalgia or arthralgia and any hemorrhage could potentially serve as an alternative to current case definitions. [ncbi.nlm.nih.gov]
- Arthralgia
RESULTS: A MHF case definition comprising (1) an epidemiological link or (2) the combination of myalgia or arthralgia and any hemorrhage could potentially serve as an alternative to current case definitions. [ncbi.nlm.nih.gov]
Of the generalized symptoms, myalgia or arthralgia was the strongest predictor of MHF but had intermediate sensitivity and specificity. [doi.org]
Survivors of Marburg hemorrhagic fever experience a prolonged convalescence characterized by myalgia, muscle weakness, arthralgia, myelitis, hepatitis, ocular disease, hearing loss, and in some instances even psychosis. [news-medical.net]
Skin
- Petechiae
Other notable findings include conjunctival injection, pharyngitis, petechia, ecchymoses, and palatal exanthem. Bleeding from mucosal sites and orifices is observed in severe cases. [symptoma.com]
Hemorrhagic symptoms begin within the first few days and include petechiae, ecchymoses, and frank bleeding around puncture sites and mucous membranes. A maculopapular rash, primarily on the trunk, begins around day 5. [merckmanuals.com]
Hemorrhagic manifestations may develop during the peak of the illness and include petechiae, ecchymoses, uncontrolled bleeding from venipuncture sites, epistaxis and other mucosal hemorrhages, and postmortem evidence of visceral hemorrhagic effusions. [dmm.biologists.org]
A maculopapular rash, petechiae, purpura, ecchymoses, and hematomas (especially around needle injection sites) are typical hemorrhagic manifestations. [en.wikipedia.org]
Hemorrhagic signs (including petechiae) were found to occur in 42% of hospitalized patients in Uige, Angola (P.R., unpublished data), and in 69% of all patients in Durba and Watsa, Democratic Republic of the Congo [ 1 ]. [doi.org]
- Skin Rash
The illness progresses to a sore throat, abdominal and chest pain, vomiting, diarrhea and a skin rash typically around the body trunk. [iamat.org]
In humans, marburgviruses are responsible for Marburg virus disease (MVD), a zoonotic disease that is characterized by high fever, malaise, nausea, vomiting, diarrhea, skin rash, and hemorrhage (bleeding). [britannica.com]
Rhesus macaques in particular develop petechial skin rashes, resembling human cases where rashes have been described on the arms and thighs, and to a lesser extend on the thorax, face and neck. [dmm.biologists.org]
- Eczema
Forest disease A98.3 Marburg virus disease A98.4 Ebola virus disease A98.5 Hemorrhagic fever with renal syndrome A98.8 Other specified viral hemorrhagic fevers A99 Unspecified viral hemorrhagic fever B00 Herpesviral [herpes simplex] infections B00.0 Eczema [icd10data.com]
Face, Head & Neck
- Epistaxis
Hemorrhagic manifestations may develop during the peak of the illness and include petechiae, ecchymoses, uncontrolled bleeding from venipuncture sites, epistaxis and other mucosal hemorrhages, and postmortem evidence of visceral hemorrhagic effusions. [dmm.biologists.org]
Epistaxis and hematemesis were observed in 29 ] but not, typically, in certain diseases for which FHF can be mistaken (eg, typhoid and shigellosis). [doi.org]
Urogenital
- Vaginal Bleeding
She had no signs of gross hemorrhage other than vaginal bleeding attributed to menses. During her hospitalization, she underwent cholecystectomy for acalculous cholecystitis. [cdc.gov]
Neurologic
- Headache
He complained of headache, abdominal pain, vomiting blood and diarrhea. Samples were taken and tested at the Uganda Virus Research Institute, and results confirmed the man had the Marburg virus. [reuters.com]
According to the global health body, the illness caused by Marburg virus begins abruptly, with severe headache and malaise. [china.org.cn]
On 21 September he presented to a health center in a suburb of Kyebando, located on the outskirts of Kampala, with fever, headache, arthralgia, anorexia, and hematemesis. [doi.org]
A doctor who attempted resuscitation developed symptoms 9 days later but recovered [ 3 ]. 1987 Kenya Kenya 1 1 (100%) A 15-year-old Danish boy was hospitalized with a 3-day history of headache, malaise, fever, and vomiting. [web.archive.org]
On 8 January 1980, a 56-year-old Frenchman, employed in Western Province, developed a sudden febrile illness, followed by headache, diarrhoea and vomiting. [allcountries.org]
- Confusion
Also, the patient appears ill and exhibits mental status changes such as confusion, delirium, and dementia. Other notable findings include conjunctival injection, pharyngitis, petechia, ecchymoses, and palatal exanthem. [symptoma.com]
During the last and most severe phase of Marburg, patients have a constant high fever and an affected central nervous system that results in confusion, irritability and aggression. [ucsdguardian.org]
Symptoms include prostration, dyspnea, edema, conjunctival injection, viral exanthema, and CNS symptoms, including encephalitis, confusion, delirium, apathy, and aggression. [en.wikipedia.org]
In the earliest stage of infection, symptoms are non-specific and may be easily confused with more common diseases, including malaria, yellow fever, and typhoid fever. [who.int]
- Seizure
The final phase is critical and often leads to death secondary to critical manifestations such as multiorgan failure, seizures, coagulopathy, cardiovascular collapse, and shock. [symptoma.com]
On 13 July, he developed confusion, seizures, hematemesis, and hematochezia, and died later that day. A blood sample collected on 13 July was sent on 23 July to CDC for testing. [doi.org]
[…] prostration, lethargy), gastrointestinal (anorexia, nausea, vomiting, abdominal pain, diarrhea), respiratory (chest pain, shortness of breath, cough), vascular (conjunctival injection, postural hypotension, edema) and neurologic (headache, confusion, seizure [dmm.biologists.org]
- Stupor
Delirium, stupor, and coma may occur, indicating CNS involvement. Hemorrhagic symptoms begin within the first few days and include petechiae, ecchymoses, and frank bleeding around puncture sites and mucous membranes. [merckmanuals.com]
- Apathy
Symptoms include prostration, dyspnea, edema, conjunctival injection, viral exanthema, and CNS symptoms, including encephalitis, confusion, delirium, apathy, and aggression. [en.wikipedia.org]
Workup
Patients presenting with the above symptoms warrant a thorough evaluation consisting of a detailed personal and travel/exposure history, physical exam, and the appropriate studies.
Laboratory tests
A complete blood count (CBC) and complete metabolic panel (CMP) including liver function tests (LFTs) will feature typical findings such as leukopenia, thrombocytopenia, and elevated liver transaminases. Furthermore, a coagulation panel and disseminated intravascular coagulation profile will reveal abnormalities about the patient's critical state.
Diagnostic tests
Viral detection studies such as reverse transcription polymerase chain reaction (RT–PCR) and enzyme-linked immunosorbent assay (ELISA) are the first-line tests [10]. In addition to conventional RT-PCR, quantitative real-time RT-PCR is also used [1] [11].
Other studies such as immunoglobulin (Ig) M and IgG ELISA are used to identify antibodies against the virus [1]. Moreover, IgM–capture ELISAs are commonly performed for the diagnosis of acute disease while IgG antibodies are used retrospectively post-disease [12]. Additionally, there is a promising future for the reverse transcription–loop–mediated isothermal amplification method in diagnosing Marburg virus [13].
There are two other techniques, virus isolation, and electron microscopy, but these are limited to specialized sites [1].
Treatment
Guided tours of the Marburg treatment units in Kapchorwa and Kween were organized in order to dispel fear of the treatment center and rumours of wrong practices by healthcare workers that cause death of admitted patients. [who.int]
"The difference is that that study examined treatment shortly after exposure. It did not look at initiating treatment at signs of illness." [news.nationalgeographic.com]
Postexposure protection against MARV in non-human primates provides a paradigm for the treatment of MARV haemorrhagic fever. [ncbi.nlm.nih.gov]
Patients expect injections and iv treatment in this area of Angola, and the number of individuals presenting to the Marburg ward for assessment increased after these treatment measures were introduced. [doi.org]
Prognosis
Pages 1-9 Clinical Course and Prognosis of Marburg Virus (“Green-Monkey”) Disease Stille, W. (et al.) Pages 10-18 Clinical Picture of Two Patients Infected by the Marburg Vervet Virus Todorovitch, K. (et al.) [springer.com]
What is the prognosis for a Marburg virus infection? What complications may occur with Marburg infections? The prognosis for Marburg infection ranges from fair to poor. The fatality rate varies from about 23%-90%. [medicinenet.com]
Marburg Virus Disease Prognosis The case-fatality rate for Marburg virus disease (MVD) is between 23-90%. [rxwiki.com]
Pathogenesis the virus targets endothelial cells, hepatocytes, phagocytes, and dendritic cells after an incubation period up to 21 days, the virus will disseminate via the lymphatics and cause multiorgan failure Prevention vaccines are under development Prognosis [medbullets.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
It was soon apparent that the infectious agent was neither bacterial nor rickettsial in origin but that a viral etiology was probable. [books.google.com]
The admission diagnosis was acute hepatitis, nausea, and vomiting of unknown etiology. On admission, the patient was afebrile (temperature 96.2°F [35.7°C]). [cdc.gov]
Only six secondary infections (five nosocomial and one sexually transmitted) were noted of the 32 cases reported during the original MHF outbreak in 1967 in Europe, despite the fact that the etiologic agent was unknown at the time of the outbreak and [doi.org]
Epidemiology
This underlines the importance of a community surveillance system that provides epidemiological data on prior patient contacts and of integrating epidemiological data into the clinical assessment when deciding on isolation or PCR testing. [doi.org]
The analysis was severely hampered by a lack of completeness in epidemiologic data. [ncbi.nlm.nih.gov]
The WHO and international partners, including the CDC, the Uganda Red Cross, African Field Epidemiology Network and Médecins-Sans-Frontières, are supporting the national authorities in outbreak investigation and response. [healio.com]
The response was supported by WHO, UNICEF, USAID, World Vision, Uganda Red Cross, Médecins Sans Frontières (MSF), the African Field Epidemiology Network (AFENET) and the US Centers for Disease Control and Prevention (CDC). [who.int]
Pathophysiology
Pathophysiology Once the virus enters the body though breaks in the skin or mucous membranes, it infects dendritic cells and macrophages which then carry it to lymph nodes. [upmc-cbn.org]
Pathophysiology The three viruses are intracellular pathogens capable of infecting many different cell types. [patient.info]
Novel viruses have recently been identified. [6, 7] Pathophysiology Although common themes occur, the different viruses display variable pathophysiology. [emedicine.com]
However, their mimicry of the human diseases as well as their predictive value for therapeutic efficacy in primates is limited, thereby making them, at best, valuable initial screening tools for pathophysiology, treatment and vaccine studies. [dmm.biologists.org]
Ebola virus (EBOV) infection is characterized by an excessive inflammatory response, a loss of lymphocytes and a general paralysis of the immune system, however pathophysiological mechanisms are not fully understood. [mdpi.com]
Prevention
Training of health workers on infection prevention and control, surveillance and clinical case management is ongoing, and the first shipment of personal protective equipment arrived recently. [healio.com]
How is Marburg hemorrhagic fever prevented? Due to our limited knowledge of the disease, preventive measures against transmission from the original animal host have not yet been established. [web.archive.org]
Fever, Ebola/prevention & control Humans Macaca fascicularis Marburg Virus Disease/immunology Marburg Virus Disease/prevention & control Marburgvirus/immunology* Mice Mice, Inbred BALB C Plasmids/immunology Rabbits Reverse Transcriptase Polymerase Chain [ncbi.nlm.nih.gov]
Training of health workers on infection prevention and control, surveillance and clinical case management is ongoing. [who.int]
The wild animal mortality surveillance network can predict and might prevent human outbreaks. Medical surveillance can prevent Ebola virus propagation in the human population. [infectionlandscapes.org]
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- Martini GA, Knauff HG, Schmidt HA, Mayer G, Baltzer G. [On the hitherto unknown, in monkeys originating infectious disease: Marburg virus disease] Dtsch Med. Wochenschr. 1968;93(12):559–571.
- World Health Organization. Viral haemorrhagic fever/Marburg, Democratic Republic of the Congo. Wkly Epidemiol Rec. 1999;74(20):157–8.
- Ndayimirije N, Kindhauser MK. Marburg hemorrhagic fever in Angola--fighting fear and a lethal pathogen. N Engl J Med. 2005;352(21):2155-7.
- Slenczka WG. The Marburg virus outbreak of 1967 and subsequent episodes. Curr Top Microbiol Immunol. 1999;235:49–75.
- Stille W, Boehle E. Clinical course and prognosis of Marburg virus (‘green–monkey’) disease. In: Martini GA, Siegert R, eds. Marburg Virus Disease. New York, NY: Springer-Verlag;1971:10–18.
- Sanchez A, Geisbert T, Feldmann H. Filoviridae – Marburg and ebola viruses. In: Knipe D, ed. Fields Virology. Philadelphia, PA: Williams and Wilkins; 2007:1410–1448.
- Colebunders R, Tshomba A, Van Kerkhove MD, et al. Marburg hemorrhagic fever in Durba and Watsa, Democratic Republic of the Congo: clinical documentation, features of illness, and treatment. J Infect Dis. 2007; 196(Suppl. 2): S148–S153.
- Gear JS, Cassel GA, Gear AJ, et al. Outbreak of Marburg virus disease in Johannesburg. BMJ. 1975;4(5995):489–493.
- Grolla A, Lucht A, Dick D, Strong JE, Feldmann H. Laboratory diagnosis of ebola and Marburg hemorrhagic fever. Bull Soc Path Exot. 2005;98(3):205–209.
- Drosten C, Gottig S, Schilling S, et al. Rapid detection and quantification of RNA of ebola and Marburg viruses, Lassa virus, Crimean–Congo hemorrhagic fever virus, rift valley fever virus, dengue virus, and yellow fever virus by real–time reverse transcription–PCR. J Clin Microbiol. 2002;40(7):2323–2330.
- Bray M. Filoviruses. In: Richman DD, Whitley RJ, Hayden FG, eds. Clinical Virology. 3rd ed. Washington, DC: American Society of Microbiology; 2009: 923–941.
- Kurosaki Y, Grolla A, Fukuma A, Feldmann H, Yasuda J. Development and evaluation of a simple assay for Marburg virus detection using a reverse transcription–loop–mediated isothermal amplification method. J Clin Microbiol. 2010; 48(7):2330–2336.