Scanning electron micrograph of Marburg virus particle
NIAID
Rwanda is facing its first-ever Marburg virus outbreak. Starting from the end of September, As of October 17, 62 cases and 15 deaths had been reported.It mainly occurs among health workers in the capital, Kigali.
In an effort to identify infections early and prevent further transmission, more than 800 people who had been in contact with infected people were traced, two of whom had traveled to Belgium and Germany, but all were confirmed. As of October 21st, There have been no new cases or deaths reported in six days.But the threat of an outbreak has not gone away.
What is Marburg virus and what are the symptoms?
Marburg virus is a member of the same family of viruses as the virus that causes Ebola, “one of the deadliest pathogens known to infect humans.” According to the Perspective article: New England Journal of Medicine.
It can cause similar symptoms such as fever, chills, and headaches, as well as muscle aches and pains. A rash may appear on the chest, back, and abdomen within a few days. You may also experience nausea, vomiting, and diarrhea.
Marburg virus damages blood vessels and interferes with clotting.This can cause blood in vomit and stool, as well as bleeding from the nose and gums. In extreme cases, infection can cause internal bleeding and sepsis, leading to organ failure and death.
Where do outbreaks usually occur?
The virus was first identified in 1967 after one-off outbreaks in Marburg and Frankfurt in Germany and the Serbian capital Belgrade. These cases involve laboratory experiments to improve the polio vaccine in African green monkeys.Chlorocebus itiops) in Uganda.
Since then, the virus has caused several outbreaks, typically every decade, in East African countries such as Uganda and the 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 various parts of the continent. For example, Ghana had its first outbreak in 2022 and Equatorial Guinea had its first outbreak last year. Egyptian fruit bat (Rousettus aegyptiacus) live in many parts of Africa and are said to be capable of transmitting the Marburg virus. emma thompson from the University of Glasgow, UK.
The exact reason why outbreaks are occurring more frequently is unclear. Thompson said this is possible as case surveillance improves and people come into more regular contact with Egyptian fruit bats. Miles Carroll Oxford University feels the same way.
People can become infected with the Marburg virus If you visit a cave where bats live or work in a mine. This may be happening more, but increased deforestation is also bringing people closer to these animals, Carroll says.
How deadly is it?
The fatality rate of Marburg virus is 24% to 88% As in past outbreak cases, Ebola fatality rate: 25-90%.
The range in mortality rates is probably due to differences in case detection capabilities and hospital resources across countries, Thomson says.
October 20, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus The agency released a statement saying it was moved. The level of critical care people are receiving in Rwanda. He mentioned two people suffering from multi-organ failure, on life support and on mechanical ventilation. “I think this is the first time a Marburg virus patient has been extubated in Africa,” he said. “These patients would have died in previous outbreaks.”
The ongoing outbreak in Rwanda is the third largest to date in both cases and deaths. This is the background of the Democratic Republic of Congo (DRC) from 1998 to 2000. When 154 cases were recorded and 128 people died.In Angola, from 2004 to 2005, 252 people were infected and 227 died.
Who is most at risk?
Because there have been relatively few known cases of Marburg virus since it was identified, it is difficult to know who is most at risk of serious infection, Thompson said. But people with suppressed immune systems, such as older people and pregnant women, are probably more vulnerable, she says.
Although few cases have been reported during pregnancy, the European Center for Disease Prevention and Control Infections are generally said to be more serious during pregnancyIn any case, if the immune function is altered.
Ebola too More severe in older peopleSo the same may be true for the Marburg virus, says Thomson.
How do I catch it?
Analysis of the genetic sequence of the Rwandan case revealed that the virus had only been transmitted to humans once, from animals such as Egyptian fruit bats or African green monkeys. Minister of Health of Rwanda tweeted October 20th.
Therefore, the remaining transmission occurred between people. This can happen if virus particles in someone’s blood or other body fluids enter another person’s body through broken skin, eyes, nose, or mouth. Funerals where the body of an infected person is touched also increases the risk of infection.
There is no evidence that the Marburg virus spreads through droplets expelled when an infected person breathes, talks, coughs or sneezes, Carroll says.
How is it treated?
There are no drugs approved to specifically treat Marburg virus. People who need hospital care are usually given intravenous fluids to replace fluids lost through vomiting and diarrhea. Pain relievers may also help relieve discomfort.
In 2021, researchers discovered that the antiviral drug remdesivir binds to antibodies against the virus. Four out of five rhesus monkeys were protected from a lethal dose of infection.. October 15th, Rwanda is starting to test the approach on people..
Is there a vaccine?
There is no approved vaccine for Marburg virus, but researchers experimental In Rwanda Where 1,700 doses were delivered As of October 14, 669 doses have been administered.
The vaccine regimen consists of a single injection containing an engineered genetic sequence of the adenovirus, which causes cold-like symptoms. The researchers modified the adenovirus to contain a protein that the Marburg virus uses to infect cells. Once injected, the adenovirus enters cells and produces copies of viral proteins so the immune system can learn to recognize them.
Vaccinating people who have been in contact with infected people is probably the most efficient use of vaccine doses to slow the spread of the virus, Thompson said.
What is the risk of this outbreak leaving Rwanda?
Rwanda has stepped up testing for contacts of quarantined infected people, but there is still always a chance the virus can spread, Carroll said.
“We are currently very concerned about the potential for regional spread within the region to neighboring countries,” Thomson said. Rwanda shares borders with Uganda, Tanzania, Burundi, and the Democratic Republic of Congo. She said the virus could spread further in Africa and occasionally cause cases elsewhere in the world if people travel to the region.
Early October, The Hamburg train station platform was subsequently closed. Two passengers with suspected Marburg symptoms who had recently visited Rwanda boarded a train from Frankfurt. It was later confirmed that they were not infected with the virus.
Carroll said countries should warn people traveling from Rwanda about the risks and signs of Marburg infection. If someone develops symptoms, he says, they can be quickly tested and isolated before an outbreak begins elsewhere.
subject:
