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Marburg virus: What you need to know about the disease outbreak

Two suspected cases of Marburg disease have been detected in Cameroon. This comes days after an outbreak was confirmed in neighbouring Equatorial Guinea – the country’s first such outbreak – after a recently deceased person tested positive for the disease. This is the first outbreak of the highly transmissible virus since June 2022 when health officials in Ghana detected three cases.

Officials suspect at least eight other people in Equatorial Guinea have died from the virus. An additional 16 most likely have the condition after exhibiting symptoms including fever, fatigue and blood-stained vomit, and 21 other people who came into contact with them are isolating at home, said Tedros Adhanom Ghebreyesus at the World Health Organization (WHO), in an emergency meeting on 14 February.

“Thanks to the rapid and decisive action by the Equatorial Guinean authorities in confirming the disease, emergency response can get to full steam quickly so that we save lives and halt the virus as soon as possible,” said Matshidiso Moeti, WHO’s regional director for Africa, during the meeting.

The WHO is working with the government of Equatorial Guinea to respond to the outbreak and has deployed experts in epidemiology, clinical care and disease prevention to the country. It is also assisting officials in Cameroon and Gabon to prepare for rapidly detecting, isolating and providing care to people who may contract Marburg virus.

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About 50 per cent of people with Marburg virus die from the disease, though fatality rates can range from 24 to 88 per cent depending on the virus strain. Marburg virus belongs to the same family of viruses as Ebola and causes similar symptoms such as severe fatigue, headache and haemorrhaging. Serious bleeding typically occurs a week into illness, with blood frequently appearing in vomit and diarrhoea. Bleeding from the nose, gums and vagina is also common.

Outbreaks tend to start when someone contracts the virus from prolonged exposure to fruit bats, usually in caves or mines. It then spreads from person to person through direct contact with bodily fluids or contaminated surfaces – it is not airborne.

“The people at the highest risk include family members and hospital staff who care for patients infected with Marburg virus,” says Harish Moorjani at Northwell Health in New York. The risk of the virus spreading to countries outside of Africa, such as the US and UK, is extremely low, he says.

There is no vaccine or approved treatment for Marburg virus, although staying hydrated through drinking or receiving fluids intravenously improves survival. Attendees at the WHO meeting discussed potential vaccine candidates, and three drug developers said they may be able to make enough doses to test vaccines in the current outbreak. The WHO and Equatorial Guinea officials are also in discussions about potentially testing experimental therapeutics in the region.

“Any decision on trials of [Marburg virus] vaccines and therapeutics will be made by national authorities and researchers in Equatorial Guinea,” said Ghebreyesus. “In the meantime, WHO is convening the vaccine prioritisation committee to identify which candidate vaccines should be evaluated first and taking steps to prepare for potential trials.”

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