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- Marburg virus disease is endemic in Africa (likely in African green monkeys and certain bats) and can be transmitted to humans.
- The disease can be transmitted from person to person by exposure to blood and other bodily secretions.
- Marburg virus disease is caused by viruses that produce symptoms of fever, chills, headaches and muscle aches early in the disease; symptoms worsen and may lead to hemorrhagic fever and death.
- Risk factors include exposure to African green monkeys and certain bats; in addition, exposure to an infected human is high risk factor.
- The diagnosis of Marburg virus disease is usually done by specialized laboratories.
- Treatment is limited to supportive care, usually in an intensive-care unit.
- Specialists that may be consulted include critical-care specialists, infectious-disease specialists, hematologists, lung specialists, and others.
- Prevention of Marburg viral disease involves avoiding contact with African animals that may carry the disease and using strict isolation procedures to avoid any bodily fluids or tissues from humans infected with Marburg viruses.
- The prognosis for Marburg virus disease is only fair to poor; fatality rates vary from about 23%-90%.
- Complications of Marburg virus infections include eye, nerve, and bleeding problems.
- Research is ongoing; Africa is experiencing more problems with viral diseases as humans increase their contact with African animals that previously had little contact with humans.
What is Marburg virus: In 1967, laboratory workers, all in the same lab in Marburg, Germany, were hospitalized with an unknown disease. The laboratory workers were exhibiting the same symptoms, including fever, diarrhea, vomiting, massive bleeding from many different organs, shock, and collapse of the circulatory system. In this outbreak, 31 people were infected, and seven died. The source of the infection was traced to a virus infecting African green monkeys that were imported from Uganda, Africa, and were being used for polio vaccine research. This new virus was eventually designated as a new virus family termed Filoviridae. The other members of the family are Ebola viruses (five different species). Filoviridae contain one negative-sense RNA strand and have a covering or envelope composed of a lipid membrane. The disease Marburg virus causes is termed Marburg virus disease.
Initially, human MVD infection results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies.
Marburg spreads through human-to-human transmission 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 (e.g. bedding, clothing) contaminated with these fluids.
Health-care workers have frequently been infected while treating patients with suspected or confirmed MVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced. Transmission via contaminated injection equipment or through needle-stick injuries is associated with more severe disease, rapid deterioration, and, possibly, a higher fatality rate.
Burial ceremonies that involve direct contact with the body of the deceased can also contribute in the transmission of Marburg.
People remain infectious as long as their blood contains the virus.
It can be difficult to clinically distinguish MVD from other infectious diseases such as malaria, typhoid fever, shigellosis, meningitis and other viral haemorrhagic fevers. Confirmation that symptoms are caused by Marburg virus infection are made using the following diagnostic methods:
- antibody-capture enzyme-linked immunosorbent assay (ELISA)
- antigen-capture detection tests
- serum neutralization test
- reverse transcriptase polymerase chain reaction (RT-PCR) assay
- electron microscopy
- virus isolation by cell culture.
Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions. All biological specimens should be packaged using the triple packaging system when transported nationally and internationally.
|Year||Country||Cases||Deaths||Case fatality Rate|
|2008||United States of America (ex-Uganda)||1||0||0%|
|1998 to 2000||Democratic Republic of the Congo||154||128||83%|
Dengue virus first appeared in the 1950s in the Philippines and Thailand, and has since spread throughout the tropical and subtropical regions of the globe. Up to 40% of the world’s population now lives in areas where dengue is endemic, and the disease — with the mosquitoes that carry it — is likely to spread farther as the world warms.
Dengue sickens 50 to 100 million people a year, according to WHO. Although the mortality rate for dengue fever is lower than some other viruses, at 2.5%, the virus can cause an Ebola-like disease called dengue hemorrhagic fever, and that condition has a mortality rate of 20% if left untreated. “We really need to think more about dengue virus because it is a real threat to us,” Muhlberger said.
A vaccine for Dengue was approved in 2019 by the U.S. Food and Drug Administration for use in children 9-16 years old living in areas where dengue is common and with a confirmed history of virus infection, according to the CDC. In some countries, an approved vaccine is available for those 9-45 years old, but again, recipients must have contracted a confirmed case of dengue in the past. Those who have not caught the virus before could be put at risk of developing severe dengue if given the vaccine.
Two vaccines are now available to protect children from rotavirus, the leading cause of severe diarrheal illness among babies and young children. The virus can spread rapidly, through what researchers call the fecal-oral route (meaning that small particles of feces end up being consumed).
Although children in the developed world rarely die from rotavirus infection, the disease is a killer in the developing world, where rehydration treatments are not widely available.
The WHO estimates that worldwide, 453,000 children younger than age 5 died from rotavirus infection in 2008. But countries that have introduced the vaccine have reported sharp declines in rotavirus hospitalizations and deaths.
The virus that causes severe acute respiratory syndrome, or SARS, first appeared in 2002 in the Guangdong province of southern China, according to the WHO. The virus likely emerged in bats, initially, then hopped into nocturnal mammals called civets before finally infecting humans. After triggering an outbreak in China, SARS spread to 26 countries around the world, infecting more than 8000 people and killing more than 770 over the course of two years.
The disease causes fever, chills and body aches, and often progresses to pneumonia, a severe condition in which the lungs become inflamed and fill with pus. SARS has an estimated mortality rate of 9.6%, and as of yet, has no approved treatment or vaccine. However, no new cases of SARS have been reported since the early 2000s, according to the CDC.
SARS-CoV-2 belongs to the same large family of viruses as SARS-CoV, known as coronaviruses, and was first identified in December 2019 in the Chinese city of Wuhan. The virus likely originated in bats, like SARS-CoV, and passed through an intermediate animal before infecting people.
Since its appearance, the virus has infected tens of thousands of people in China and thousands of others worldwide. The ongoing outbreak prompted an extensive quarantine of Wuhan and nearby cities, restrictions on travel to and from affected countries and a worldwide effort to develop diagnostics, treatments and vaccines.
The disease caused by SARS-CoV-2, called COVID-19, has an estimated mortality rate of about 2.3%. People who are older or have underlying health conditions seem to be most at risk of having severe disease or complications. Common symptoms include fever, dry cough and shortness of breath, and the disease can progress to pneumonia in severe cases.
The virus that causes Middle East respiratory syndrome, or MERS, sparked an outbreak in Saudi Arabia in 2012 and another in South Korea in 2015. The MERS virus belongs to the same family of viruses as SARS-CoV and SARS-CoV-2, and likely originated in bats, as well. The disease infected camels before passing into humans and triggers fever, coughing and shortness of breath in infected people.
MERS often progresses to severe pneumonia and has an estimated mortality rate between 30% and 40%, making it the most lethal of the known coronaviruses that jumped from animals to people. As with SARS-CoV and SARS-CoV-2, MERS has no approved treatments or vaccine.