Marburg hemorrhagic fever

Marburg hemorrhagic fever, also known as Marburg virus disease (MVD), is a rare and severe viral hemorrhagic fever that affects both people and non-human primates.

Symptoms

The symptoms of Marburg hemorrhagic fever can appear suddenly and may include:

• Fever
• Rash
• Severe bleeding
• Flu-like symptoms such as high fever, headache, chills, myalgia (muscle pain), prostration (weakness)
• Gastrointestinal symptoms such as vomiting, nausea, abdominal pain, and severe watery diarrhea

Clinical Presentation

The onset of Marburg hemorrhagic fever is abrupt, with non-specific, flu-like symptoms. Around the fifth day after the onset of symptoms, a maculopapular rash may appear. The disease can progress to more severe symptoms, including:

• Gastrointestinal bleeding
• Shock
• Multi-organ system failure

Case Fatality Rate

The average case fatality rate for Marburg hemorrhagic fever is around 50%, with rates ranging from 24% to 88% in past outbreaks.

Transmission and Source

Marburg virus disease is caused by the Marburg virus, which belongs to the Filoviridae family. The source of the virus is believed to be African green monkeys, and Egyptian fruit bats are thought to be the normal carrier in nature.

Risk Group

The World Health Organization (WHO) rates Marburg virus as a Risk Group 4 Pathogen, requiring biosafety level 4-equivalent containment.

References:

• [1] Marburg hemorrhagic fever is a severe viral hemorrhagic disease characterized by initial fever and malaise followed by gastrointestinal symptoms, bleeding, shock, and multi-organ system failure. (Source: Search result 15)
• [2] Fatigue, generalized pain and loss of appetite followed by vomiting, nausea, abdominal pain and severe watery diarrhea have all been reported. (Source: Search result 9)
• [3] Marburg virus disease is a rare but severe hemorrhagic fever which affects both people and non-human primates. (Source: Search result 11)

Diagnostic Tests for Marburg Hemorrhagic Fever

Marburg hemorrhagic fever, also known as Marburg virus disease (MVD), is a rare but severe viral hemorrhagic fever that can cause serious illness and death. Diagnosing MVD can be challenging due to its similar symptoms with other tropical diseases.

Common Diagnostic Tests:

• Reverse Transcriptase Polymerase Chain Reaction (RT-PCR): This is the most commonly used diagnostic test for Marburg virus infection, which detects the virus in blood or oral swab samples. RT-PCR has a high sensitivity and specificity, detecting the virus in 42.11% of patients [1].
• ELISA: Enzyme-linked immunosorbent assay (ELISA) is another diagnostic test used to detect antibodies against Marburg virus. ELISA was employed in four cases (21.05%) to detect antibodies [2].
• Electron Microscopy, Histochemistry, Complete Blood Count, and Urinalysis: These tests were performed in three patients each (15.79%) as part of the diagnostic workup.

Confirmatory Tests:

• A positive RT-PCR test from blood or oral swab is considered a confirmatory test for Marburg virus infection [5].
• The presence of filovirus

Current Status of Drug Treatment for Marburg Hemorrhagic Fever

Marburg hemorrhagic fever, caused by the Marburg virus, is a severe and often fatal illness with no approved treatments or vaccines available. However, researchers have been exploring various drug options to combat this disease.

• Supportive Therapy: The primary treatment approach for Marburg hemorrhagic fever is supportive therapy, which includes rehydration, symptomatic treatment, and management of complications such as bleeding and organ failure [5].
• Experimental Drugs: Several experimental drugs have shown promise in treating Marburg virus infections. These include:
  • Brincidofovir: Although it was used to treat an individual with Ebola hemorrhagic fever, its effectiveness against Marburg virus is unknown [9].
  • AVI-7287 and AVI-7288: These antisense phosphorodiamidate morpholino oligomers have completed phase I clinical trials against Marburg hemorrhagic fever and Marburg virus disease [14].
  • Galidesivir: This drug has also completed phase I clinical trials against Marburg hemorrhagic fever and Marburg virus disease [14].
• Post-Exposure Treatments: Researchers have explored post-exposure treatments for Ebola and Marburg virus infections, including the use of antiviral drugs and immunoglobulins [6].

Challenges and Future Directions

While these experimental drugs show promise, there are still significant challenges to overcome before they can be used as effective treatments for Marburg hemorrhagic fever. These include:

• Limited Availability: Many of these experimental drugs are not yet widely available or have limited production capacity.
• Efficacy and Safety: Further research is needed to determine the efficacy and safety of these drugs in treating Marburg virus infections.

References

[5] Mire CE, Feldmann H, Geisbert TW. Post-exposure treatments for Ebola and Marburg virus infections. Nat Rev Drug Discov. 2018;17(6):413-24. [9] by RW Cross · 2018 · Cited by 126 — [14] Mehedi M, Groseth A, Feldmann H, et al. Clinical aspects of Marburg hemorrhagic fever. Future Virol. 2011 Sep;6(9)