- The World Health Organization is reporting an outbreak of the Marburg virus in both Equatorial Guinea and Tanzania.
- The CDC is now warning travelers to take precautions if they visit countries where the virus is spreading.
- For the first time it has appeared in Tanzania
- The news comes weeks after the disease was reported for the first time in Equatorial Guinea.
The U.S. Centers for Disease Control and Prevention (CDC) has issued a warning for travelers to two countries where the Marburg virus is spreading.
The CDC recommends enhanced travel precautions for people going to Equatorial Guinea and Tanzania.
Both countries have reported recent cases of Marburg virus infection.
The CDC says travelers can take different precautions including the following:
- Avoid contact with people who appear ill and who have symptoms including fever, muscle pain, and rash.
- Avoid being in contact with
- Avoid visiting healthcare facilities in the outbreak area for nonurgent medical care or for nonmedical reasons.
- Avoid being near or in contact with certain animals including
fruit batsand nonhuman primates.
The country of Tanzania reported its first outbreak of the Marburg virus in March 2023 according to the World Health Organization (WHO).
The news comes just over a month after Equatorial Guinea confirmed its first outbreak of the viral disease.
“The efforts by Tanzania’s health authorities to establish the cause of the disease is a clear indication of the determination to effectively respond to the outbreak. We are working with the government to rapidly scale up control measures to halt the spread of the virus and end the outbreak as soon as possible,” Dr. Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa said in a statement.
In a statement, the WHO said that eight people had developed symptoms of Marburg including vomiting, fever, and bleeding. Five of those with symptoms have died and the other three are getting treatment.
At least 161 contacts are currently being monitored to see if they develop symptoms.
Officials in Equatorial Guinea first reported Marburg cases had been detected in February.
At least 20 probable cases have been detected.
Nine cases have been laboratory confirmed, and at least seven of those confirmed to have had the disease have died.
Here’s what to know about this virus and the disease it causes.
Marburg virus disease is a “rare but severe hemorrhagic fever” caused by Marburg virus,
While both diseases are rare, they can cause outbreaks with high death rates.
In past outbreaks, case fatality rates for Marburg virus have varied from 24% to 88%,
Marburg virus can be transmitted to people from infected
The virus can spread between people through direct contact with the blood, secretions, organs or other bodily fluids of infected people, as well as from contaminated surfaces and materials.
Healthcare workers and relatives of infected patients are at risk if strict infection control precautions are not taken. Direct contact with the body of the deceased can also contribute to transmission of the virus.
The first known outbreaks of Marburg virus disease occurred in 1967 in Marburg and Frankfurt in Germany; and in Belgrade, Serbia. These outbreaks were associated with laboratory work using African green monkeys imported from Uganda.
Illness caused by Marburg virus can occur “abruptly,” according to the WHO, with high fever, severe headache and severe malaise.
Other common symptoms include muscle aches and pains, abdominal pain and cramping, nausea, vomiting and diarrhea.
During this phase, patients have a “ghost-like” appearance, says the WHO, with drawn features, deep-set eyes, expressionless faces and extreme lethargy.
In fatal cases, death usually occurs between eight and nine days after the start of symptoms. This is usually preceded by severe loss of blood and resulting damage to multiple organs.
No vaccines or antiviral therapies have been approved to treat Marburg virus disease.
Supportive care — such as rehydrating with oral or intravenous fluids, and maintaining oxygen levels — and treating specific symptoms can help improve survival rates, says the WHO.
The WHO says monoclonal antibodies being developed or antivirals that have been used in clinical trials for Ebola virus disease could also potentially be tested for Marburg virus disease.
In addition, “there are several experimental treatments that have been shown to protect animals against lethal Marburg virus infection,” said Thomas Geisbert, PhD, a professor in the Department of Microbiology and Immunology at the University of Texas Medical Branch in Galveston.
This includes a monoclonal antibody from Mapp Biopharmaceutical, Inc., and Gilead Sciences, Inc.’s antiviral remdesivir.
“Remdesivir is currently approved for human use for treating COVID-19,” said Geisbert, “and the possible off-label use for Marburg is probably the most realistic and quickest intervention that could be deployed.”
The WHO held a
Erica Ollmann Saphire, PhD, a professor of the La Jolla Institute for Immunology, says all outbreaks of Marburg and Ebola viruses are concerning.
“The greatest threat occurs when the outbreaks are in areas with dense populations, a lot of movement of people and a greater interaction with the natural world,” she said.
For example, “the Ebola
However, “with only one confirmed case [in the current Marburg outbreak], it is too early to predict whether the outbreak will be small like the two cases in
The best option to “break the train of transmission” is contact tracing and medical management of the cases, he said.
In addition, “there are some vaccines that could potentially be used in a ring vaccination approach,” he noted.
This approach was used during the
Saphire said probably the most surprising aspect of this is that Equatorial Guinea has not had an outbreak of Marburg virus disease before.
But in other ways, the appearance of the virus now is not that surprising.
“These viruses are out there, lurking in the forests, sometimes without known spillovers into humans,” she said. “As climate changes and people encroach more on wild areas, emergence of viruses and re-emergence of viruses is sort of inevitable.”
Given this ongoing threat, what’s needed, she said, is continued efforts to develop vaccines for different kinds of viruses.
Effective treatments are also needed, she added, because some people will get infected before health officials can get vaccines to them, or there will be breakthrough cases among people already vaccinated.
“The world is teeming with different viruses, and they spill over frequently [into humans], and will continue to do so,” she said.