Marburg And Ebola, The Two Close Cousins Of Same Family

  • 30 Jul 2022

What is MARV?

Marburg virus (MARV) is a hemorrhagic fever virus that belongs to the Filoviridae family of viruses and causes Marburg virus disease in primates, a form of viral hemorrhagic fever. It is a genetically unique RNA zoonotic virus of this family.

Is It A Biological Weapon?

 The World Health Organization rates it as Risk Group 4 pathogen (requiring biosafety level for equal containment). This is an extremely dangerous virus. In the United States, the National Institute of Allergy and Infectious Diseases ranks it as Category A Priority pathogen while Center for Disease Control and Prevention lists it as the Category A Bioterrorism Agent. It is also listed as a biological agent for export control by the Australia group. It has also been considered a biological weapon for bioterrorism.

How Is Someone Infected By Marburg Virus Or How Does Marburg Disease Spread?

Transmission of virus is by exposure to a species of African fruit bats or transmitted between people via body fluids by unprotected sex and broken skin. Symptoms of Marburg Virus disease are bleeding, fever, diarrhea, nausea, emesis, abdominal pain, and cramping, non-itchy rashes etc., which are very similar to Ebola. There is no approved  marburg virus vaccine or antiviral treatment for Marburg virus. Health care workers who treat MVD are at risk of getting infected while treating patients with suspected or confirmed MVD.

What Are Two Types Of MARV Infection?

Two diseases caused in humans by Marburg virus (MARV) is –

  • Marburg virus disease (MVD) - is a highly virulent epidemic prone disease with case fatality ratio of 24-90% in past cases. Around 14 outbreaks of this disease have been reported since 1967 worldwide but most cases were from sub-Saharan Africa. MVD occurs by direct contact with body fluids of infected individuals.
  • Marburg hemorrhagic fever (MHF) – similar to MVD but rare and spreads to non-human primates also. It appears in sporadic outbreaks throughout Africa. 

More About The MARV Outbreak In Ghana

In the year 2022, MARV cases have been out from the Ashanti region of Ghana. Two cases have been reported so far with preparations for a possible outbreak being made. On 17 July, 2022 both cases were confirmed from Ghana. The case fatality rate is 100% and two cases reported could not survive so died. These cases were revealed positive after testing on 8 July, 2022 and outbreak was confirmed on 17 July, 2022. Death occurs after 8-9 days of symptom onset.

The WHO is preparing for a possible outbreak and deploying experts to assist Ghana’s public health efforts. 

Chances of outbreak spreading worldwide are less unless people affected from Ghana travel to other countries carrying the virus in their bodies. If this happens, India will too be a victim!

Diagnosis Of MARV

  • Antibody-capture ELISA test
  • Antigen- capture detection test
  • Serum neutralization test
  • RT-PCR assay
  • Electron microscopy
  • Virus isolation by cell culture

Who All Are At Risk Of MARV Infection?

  • Health care workers 
  • Laboratory workers who take MARV samples for testing
  • Sexual partners of survivors of MARV
  • Non-vegetarians 
  • Those who come in contact with body fluids via any route

What Is The Treatment Of MVD?

  • Early supportive care with rehydration and symptomatic treatment improves approval. There is no licensed treatment yet to neutralize the virus but a range of blood products, immune therapies and drug therapies are currently under development. 
  • Community engagement is the key to successfully controlling outbreaks.
  • There are monoclonal antibodies and antivirals under development
  • Some vaccines are also under development that could protect against MVD but their efficacy has not been proved under clinical trials.
  • It’s important to lessen the bat-to-human transmission and during outbreak all animal products should be thoroughly cooked before consumption
  • Communities affected by MARV should be well informed about nature of disease and containment methods
  • It has also been found that this virus occurs by sexual transmission so it is recommended that survivors of MARV should practice safer sex from onset of symptoms until they test twice negative
  • Good hand hygiene should be taken care of to avoid contact with body fluids.

Does MARV Persist In People Who Recover From MVD Or Survive MVD?

It is believed to persist in immune-privileged sites in some people who have recovered from MVD. These sites in males include testicles, eyes. In pregnant females, it is persistent in placenta, amniotic fluid and fetus. In breastfeeding women, it persists in breast milk. Hence chances of reinfection and transmission are high even if one survives the MARV.

For more info, visit WHO page to get insights on the persistence of MARV.

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