NewsDesk @bactiman63

In a follow-up on the Marburg virus disease (MVD) outbreak in Equatorial Guinea, health officials report a cumulative number of nine confirmed and 20 probable cases have been recorded since the beginning of the outbreak and as of  March 21.

Image/CDC

Of the eight new confirmed cases, two were reported from the province of Kié-Ntem, four from the Litoral,  and two from Centre- Sur provinces. The areas reporting cases are about 150 kilometers apart, suggesting wider transmission of the virus.

On 13 February 2022, the country’s authorities declared officially the Marburg virus disease (MVD) outbreak. On 16 February 2023, the sequencing report showed strains like those isolated from fruit bats in Sierra Leone.

This is the first time that Equatorial Guinea has reported an outbreak of MVD.

According to the World Health Organization, Marburg virus and the closely related Ravn virus are the causative agents of Marburg virus disease, which has a case-fatality ratio of up to 88%. Marburg virus disease was initially detected in 1967 after simultaneous outbreaks in Marburg and Frankfurt in Germany, and in Belgrade, Serbia. Rousettus aegyptiacus fruit bats are considered natural hosts for Marburg virus, from which the virus is then transmitted to people.

Marburg spreads between people via direct contact through broken skin or mucous membranes with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials such as bedding, clothing contaminated with these fluids. Healthcare workers have previously been infected while treating patients with suspected or confirmed MVD. Burial ceremonies that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg.

The incubation period varies from two to 21 days. Illness caused by Marburg virus begins abruptly, with high fever, severe headache, and severe malaise. Severe watery diarrhoea, abdominal pain and cramping, nausea, and vomiting can begin on the third day. Severe haemorrhagic manifestations may appear between five and seven days from symptom onset, and fatal cases usually have some form of bleeding, often from multiple areas. In fatal cases, death occurs most often between eight and nine days after symptom onset, usually preceded by severe blood loss and shock.

In the early course of the disease, the clinical diagnosis of MVD is difficult to distinguish from many other tropical febrile illnesses due to the similarities in the clinical symptoms. Other viral haemorrhagic fevers need to be excluded, including Ebola virus disease, as well as malaria, typhoid fever, leptospirosis, rickettsial infections, and plague.

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Laboratory confirmation is primarily made by RT-PCR. Other tests can be used such as antibody-capture enzyme-linked immunosorbent assay (ELISA), antigen-capture detection tests, serum neutralization test, electron microscopy, and virus isolation by cell culture.

Although no vaccines or antiviral treatments are approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms improve survival. A range of potential treatments are being evaluated, including blood products, immune therapies, and drug therapies.

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