Marburg virus disease (MVD)

Notes
  • MVD (family Filoviridae) is caused by two marburgviruses Marburg virus and Ravn virus.
  • The disease was first discovered in Marburg, Germany, in 1967. It was contracted from the imported African green monkeys from Uganda.
  • The clinical symptoms of MVD are very similar to those of Ebola virus disease.
  • Statistics: Incubation period- 2 to 21 days; occurrence of death – day 8 to 16; fatality rate – up to 100%.
  • Outbreak history: 2004 – 2005 in Angola (the worst ever outbreak in history) with 252 cases and 227 deaths (90%); 1998 – 2000 in Democratic Republic of Congo with 154 cases and 128 deaths (83%); 1980 & 1987 in Kenya 5 cases and 2 deaths (40%).
  1. Transmission
  • The first human infection occurs through contact with an infected animal e.g. fruit bat and primate. This is followed by the person-to-person transmissions.
Symptoms
  • Severe fever
  • Chills
  • Headache
  • Red eyes
  • Hiccups
  • Joint pain
  • Myalgia
  • Diarrhea
  • Nausea
  • Vomiting
  • Sore throat
  • Confusion
  • fAggression
  • Delirium
  • Expressionless facies
  • Hepatic and renal disorders
  • External and internal hemorrhage
  • Myocarditis
  • Pulmonary edema
  • Anuria
  • Coma
  • Death is caused by multiple organ dysfunction syndrome as a result of fluid redistribution, hypotension, disseminated intravascular coagulation (DIC), and focal tissue necroses.
Diagnosis
  • ELISA - for antigens or for IgM and IgG antibodies
  • RT-PCR
  • Cell & culture viral isolation
  • General tests – Full blood counts, urea, pH, BUN and liver tests.
Differential
  • Malaria
  • Typhoid fever
  • Meningitis
Management
  • Supportive treatment that include rehydration
  • MVD survivors and their sexual partners should use condom or abstain from sex until their semen has twice tested negative.
  • Non-inactivated samples to be tested under maximum biological containment conditions.
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