乐动体育登录Human infection with Marburg virus disease (MVD) initially results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies.
Once an individual is infected with the virus, Marburg can spread through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.
The incubation period (the time that passes from infection to onset of symptoms) varies from 2 to 21 days.
Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Muscle aches and pains are a common feature. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Diarrhoea can persist for a week. The appearance of patients at this phase has been described as showing “ghost-like” drawn features, deep-set eyes, expressionless faces, and extreme lethargy. In the 1967 European outbreak, non-itchy rash was a feature noted in most patients between 2 and 7 days after the onset of symptoms.
Many patients develop severe haemorrhagic manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding, often from multiple areas. Fresh blood in vomitus and faeces is often accompanied by bleeding from the nose, gums, and vagina. Spontaneous bleeding at venepuncture sites (where intravenous access is obtained to give fluids or obtain blood samples) can be particularly troublesome. During the severe phase of illness, patients have sustained high fevers. Involvement of the central nervous system can result in confusion, irritability, and aggression. Orchitis (inflammation of one or both testicles) has been reported occasionally in the late phase of the disease (15 days).
In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock.
乐动体育登录It can be difficult to clinically distinguish Marburg virus disease (MVD) from other infectious diseases such as malaria, typhoid fever, shigellosis, meningitis and other viral haemorrhagic fevers. Confirmation that symptoms are caused by Marburg virus infection are made using the following diagnostic methods:
- antibody enzyme-linked immunosorbent assay (ELISA);
- antigen detection tests;
- serum neutralization tests;
- reverse-transcriptase polymerase chain reaction (RT-PCR) assay; and
- virus isolation by cell culture.
Samples collected from patients are an extreme biohazard risk and laboratory testing on non-inactivated samples need to be conducted under maximum biological containment conditions. All biological specimens must be packaged using the triple packaging system when transported nationally and internationally.
TreatmentSupportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. There is as yet no proven treatment available for Marburg virus disease. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated.
Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe and dignified burials, and social mobilization. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Marburg infection and protective measures that individuals can take is an effective way to reduce human transmission.
乐动体育登录Healthcare workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe and dignified burial practices.
2 - 21 days
The incubation period for Marburg virus disease varies from 2 to 21 days