Marburg Virus - another major virus Africa has to battle

LESS than two months after Guinea declared an end to its most recent Ebola outbreak, the country has confirmed a case of the Marburg virus - a highly infectious disease that causes hemorrhagic fever.

The virus was detected in Gueckedou, the very region where cases of the 2021 Ebola outbreak in Guinea as well as the 2014–2016 West Africa outbreak, were initially detected.

Although no other cases have yet been detected in other countries, the discovery of the Marburg virus comes at a time when Guinea and the continent, are struggling against the third wave of the coronavirus, raising fears of yet another major health crisis in Africa.

However, with the continent’s past experience in dealing with the virus, health experts believe it poses a minimal threat at this stage.The most recent outbreak, which occurred in Uganda, infected three people — all of whom died. The previous outbreak in 2005 resulted in over 200 infections in Angola, 90% of whom died.

According to the head of the World Health Organisation (WHO) in Guinea, Dr Georges Ki-Zerbo, the risk levels are very high in the area where the virus was first detected and moderately low in the rest of the continent.

Ki-Zerbo said: “This is a localised outbreak, the risk is very high in the area, it is also considered high in the border area, especially in countries like Liberia and Sierra Leone. It is considered moderately low at global level at this stage.”

He added that Guinea had developed capacity for response to epidemics and there were well trained rapid response teams on the ground, but expressed concern at the emergence of the virus in the same area just two months after Ebola had ended.

“The virus was found at the same place two months after Ebola ended. What we need to find out is why there’s an emergence. There’s also an intrusion factor whereby the population goes into the ecosystem and they come into contact with animals. and then they generate outbreaks of diseases. Infection, prevention and control measures also need to be intensified in these communities,” said Ki-Zerbo.

Virologist and bioinformatician, Professor Túlio De Oliveira from the KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP) at UKZN, echoed Ki-Zerbo’s calls for an increase in surveillance.

“With Guinea recording a case of the Marburg virus, it is important to increase genomics surveillance of other virus cases that could cause epidemics in Africa,” said De Oliveira.

While presently there are no vaccines or antiviral treatments for Marburg disease, virologist and researcher Ousmane Faye, says in order to prevent any further transmissions all contact cases need to be identified and isolated.

So far, about 155 people have been identified as close contacts in Guinea, and they will be monitored for three weeks.

Meanwhile, on Wednesday, WHO Director-General, Tedros Adhanom Ghebreyesus, said the organisation and its partners were supporting Guinea to investigate the source of the virus outbreak, trace contacts, and inform the local community about how to protect themselves.

Assistant Director-General of Emergency Response Dr Ibrahima Socé Fall said, that the discovery in Guinea highlighted the need for local surveillance, and research into emerging diseases.

What is Marburg Virus?

According to the World Health Organization (WHO) the Marburg virus is one of the deadliest pathogens known to exist, killing between half and 90 percent of those who get infected.The virus is carried by fruit bats but can be spread between humans through blood and bodily fluids, as well as touching contaminated surfaces.

The incubation period for the virus varies from 2 to 21 days, with symptoms including high fever, severe headaches, muscular pain, vomiting and diarrhoea, which makes Marburg difficult to diagnose initially as these are similar to typhoid and malaria symptoms.

After five days, many patients start to bleed under the skin, in internal organs or from openings such as the mouth, eyes and ears. Patients often die from nervous system failure, not blood loss.

How is it transmitted?

The natural “reservoir” or host, of the Marburg virus is the African fruit bat.

The cave-dwelling mammals carry the virus but do not fall sick from it, and can pass the virus to primates in close proximity, including humans – one suspected pathway is the killing or butchering of infected bats for eating.

Human-to-human transmission then occurs through contact with blood or other bodily fluids, or contact with surfaces such as bedding or clothing that are contaminated with these fluids.

Some infections have happened accidentally in the lab, through needle wounds.

According to the Global Alliance for Vaccines and Immunisation (GAVI) Alliance, the following are the top 10 most likely infectious disease that could be the next pandemic: