Marburg virus disease

What is marburg virus disease (MVD)?

Marburg virus disease (MVD), formerly known as Marburg haemorrhagic fever, is a rare disease which causes severe illness, often leading to death. MVD was initially detected in 1967 when two simultaneous outbreaks occurred in Germany and Serbia, arising from laboratory research on monkeys from Africa. Since then, there have been several MVD outbreaks, all of which have occurred in Central and East Africa, primarily in Uganda.

How is MVD transmitted?

Egyptian fruit bats native to Africa are considered the natural carriers of MVD. MVD is introduced to human populations through close contact with contaminated tissues and bodily fluids of infected animals. This may occur during prolonged exposure to mines or caves inhabited by bat colonies. Other animal-to-human transmission may occur from contact or consumption of tissue and bodily fluids from infected monkeys and apes without appropriate protective equipment or thorough cooking.

Human-to-human transmission can occur through direct contact with blood, bodily fluids, or secretions from an infected person. Contact with infected corpses or environments that have been contaminated with an MVD patient’s bodily fluids may also spread the infection.

What are the symptoms of MVD? 

Initial symptoms include:

• Fever

• Headache

• Sore throat

• General weakness

• Muscle and joint pain

This can be followed by:

• Rash

• Abdominal pain, nausea and vomiting

• Diarrhoea

• Gum bleeding

• Gastrointestinal bleeding

• Orchitis (Inflammation of the testicles)

• Confusion

• Agitation

• Seizures

• Coma

What are the risk factors?

Risk factors include exposure to:

• African fruit bats, or their saliva, urine or excretions

• Infected non-human primates, including handling of bush meat

• Blood and body fluids from infected persons, or contaminated environment and materials

How is MVD treated?

There are currently no approved vaccines or antiviral treatments for MVD.

Patients with MVD are managed with symptomatic treatment and supportive care. This includes diagnosis and treatment of concomitant infections such as malaria or bacterial infections, management of fluids and electrolytes, managing nausea and vomiting, blood product support, and support for multi-organ dysfunction.

How to prevent MVD?

To reduce risk of exposure to MVD, travellers are advised to maintain vigilance and adopt the following health precautions:

• Always observe and practice good personal hygiene

• Wash hands regularly with soap. If water is not available, use an alcohol-based sanitiser that contains at least 60% alcohol

• Reduce exposure to mines or caves inhabited by fruit bats

• Avoid close contact and sharing common items with persons who are unwell or have symptoms of MVD

• Avoid direct contact with body of people who have died from MVD

• Returning travellers from countries with reported MVD activity (refer to World Health Organization for latest information) or travellers who suspect that they have been exposed to MVD should seek immediate medical attention if they develop any symptoms. They should inform their doctor of their recent travel or contact history.

Please refer to Health Advice for Travellers for the full list of precautions to take when travelling.