Scanning electron micrograph of Marburg virus particles
NIAID
Rwanda is facing its first ever Marburg virus outbreak. From late September,
As of October 17, 62 cases and 15 deaths have been reported.The outbreak occurred mainly
among health care workers in the capital, Kigali.
More than 800 contacts of infected people are being traced to detect infections early and prevent further infections, two of whom had traveled to Belgium and Germany, and are considered normal.
. As of October 21st,
No new cases or deaths reported in 6 daysHowever, the threat of the spread of infection has not gone away.
What is Marburg virus and what are its symptoms?
Marburg virus belongs to the same family of viruses as the virus that causes Ebola and is “one of the most lethal pathogens known to infect humans.”
According to the perspective article New England Medical Journal.
In addition to muscle aches and pains, it can cause similar symptoms such as fever, chills, and headache. Within a few days, a rash may appear on the chest, back, and abdomen. You may also experience nausea, vomiting, and diarrhea.
Marburg virus damages blood vessels and disrupts clottingYou may notice blood in your vomit or stool, or bleeding from your nose or gums. In extreme cases, the infection can cause internal bleeding and sepsis, which can lead to organ failure and death.
Where do outbreaks typically occur?
The virus was first identified in 1967 after one-off outbreaks in the German cities of Marburg and Frankfurt and the Serbian capital, Belgrade. These cases were associated with laboratory experiments to improve polio vaccines for African green monkeys
(Chlorocebus aethiopus) From Uganda.
Since then, the virus has typically caused several outbreaks every decade, mostly in East African countries such as Uganda and neighboring Democratic Republic of the Congo (DRC) in Central Africa.
The virus was identified in Guinea, West Africa, in 2021. Since then, outbreaks have occurred annually in different regions of the African continent. For example, Ghana had its first outbreak in 2022, and Equatorial Guinea had its first case last year. Egyptian fruit bat
(Aedes aegypti) states that they live in various parts of Africa and can transmit the Marburg virus.
emma thomson At the University of Glasgow, UK.
The exact reason why outbreaks seem to be occurring more frequently is unknown. Thomson said this could be due to improved case surveillance and people coming into more regular contact with Egyptian free-tailed bats.
Miles Carroll Professors at Oxford University think the same thing.
people can be infected with marburg virus
Visiting a cave inhabited by bats or working in a mine. Things may be getting worse, Carroll said, but increased deforestation is also bringing people closer to these animals.
How deadly is it?
The mortality rate of Marburg virus is
24% to 88% Similarly, in past outbreaks,
Ebola hemorrhagic fever has a fatality rate of 25-90%.
The range in mortality rates is likely due to differences in each country's ability to detect cases and hospital resources, Thomson said.
On October 20, World Health Organization Director-General Tedros Adhanom Ghebreyesus said:
Officials issued a statement saying they were impressed. The level of critical care people receive in Rwanda. He mentioned two patients who had multiple organ failure and were on life support and on ventilators. “We believe this is the first time a
Marburg virus patient has been extubated in Africa,” he said. “These patients would have died in previous outbreaks.”
Rwanda's ongoing outbreak is the third largest on record, both in terms of cases and deaths. It happened after the DRC outbreak of 1998-2000.
When 154 infections were recorded and 128 people died.which occurred in Angola in 2004-2005, infected 252 people and killed 227.
Who is most at risk?
Since Marburg virus was identified, there have been relatively few known cases, making it difficult to know who is most at risk of severe infection, Thomson said. But people with suppressed immune systems, such as the elderly and pregnant people, are likely more vulnerable, she says.
Few cases have been reported during pregnancy, but the European Center for Disease Prevention and Control
It is generally said that infections become more serious during pregnancy.If your immune function changes anyway.
Ebola too
The older the person, the more severe the disease becomes.So the same is probably true for Marburg virus, Thomson says.
How do you catch it?
Genetic sequencing of Rwanda's cases revealed that the virus jumped from animals such as Egyptian free-tailed bats and African green monkeys to humans only once during the ongoing outbreak, the country's health minister said.
tweeted October 20th.
Therefore, the remaining infections occurred between people. This can occur when virus particles in someone's blood or other body fluids enter another person's body through broken skin, eyes, nose, or mouth. Burial rituals that involve touching the bodies of infected people also increase the risk of infection.
Carroll said there is no evidence that the Marburg virus is spread through droplets expelled when an infected person breathes, talks, coughs or sneezes.
How will I be treated?
There are no drugs approved to specifically treat Marburg virus. People who require hospital treatment are usually given intravenous fluids to replace fluids lost through vomiting and diarrhea. Painkillers can also help relieve discomfort.
In 2021, researchers found that combining the antiviral drug remdesivir with antibodies against the virus.
Protected 4 out of 5 rhesus macaques from lethal infection. October 15th,
Rwanda begins testing people approach.
Is there a vaccine?
There is no approved vaccine for Marburg virus, but researchers are testing one.
experimental In Rwanda,
Where 1,700 doses of vaccine were distributed As of October 14, 669 doses had been administered.
This vaccine regimen consists of a single shot containing an engineered adenovirus genetic sequence that causes cold-like symptoms. The researchers tweaked the adenovirus to incorporate proteins that Marburg virus uses to infect cells. Once injected, adenoviruses enter cells and produce copies of viral proteins so the immune system can recognize them.
Thomson said vaccinating contacts of infected people will likely be the most efficient use of vaccine doses to slow the spread of the virus.
What is the risk of this epidemic leaving Rwanda?
Although Rwanda has ramped up testing of contacts of infected people in quarantine, there is still always the possibility that the virus could spread, Carroll said.
“The potential for local transmission within the region to neighboring countries is now of great concern,” Thomson said. Rwanda shares borders with Uganda, Tanzania, Burundi, and the Democratic Republic of Congo. And if people travel to these areas, the virus could spread further into Africa or even cause occasional cases in other parts of the world, she says.
In early October,
Hamburg station platform was blocked Two passengers suspected of having Marburg syndrome who had recently traveled to Rwanda were boarding the train from Frankfurt. It was later confirmed that they were not infected with the virus.
Carroll said countries need to warn travelers from Rwanda about the risks and signs of Marburg infection. If someone then develops symptoms, they can be quickly tested and isolated before an outbreak begins elsewhere.
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Source: www.newscientist.com
