Probable case of Ebola-type Marburg virus in Guinea

A probable case of Marburg virus was reported in Guinea in Tèmessadou M’boke, Guéckédou prefecture, on 8/5/21. This is important because the virus causes hemorrhagic fever, similar to Ebola, another filovirus. It would be the first time that Marburg would be identified in West Africa. Guéckédou is also the same region that suffered an Ebola outbreak this year.

Two national laboratories based in Guéckédou and Conakry have confirmed the identification. The samples were sent to the Pasteur Institute in Dakar, Senegal, a higher level laboratory, for confirmation.

As with Ebola, bats are the reservoir of Marburg. In this case, it is the Egyptian fruit bat (Rousettus aegyptiacus), a cave bat present all over the continent. Non-human primates are also susceptible to infection.

Symptoms include headache, fever, and muscle pain, followed by nausea and vomiting, shock, and sometimes bleeding. As with Ebola, transmission occurs through contact with infectious tissue or bodily fluids.

There have been 12 major epidemics of Marburg since 1967.

The first outbreak occurred in Germany and Yugoslavia after the importation of infected green monkeys into these countries. There was a 23% mortality rate among 31 patients. The worst epidemic occurred in Angola in 2005, with 252 infections and a death rate of 90%. This epidemic apparently spread through the reuse of contaminated transfusion equipment in a pediatric ward. As with Ebola, transmission can occur during funerals and when handling bodies. There was a report of sexual transmission.

Two notable illnesses occurred in tourists who went caving in Uganda in 2009. The first was a Dutch woman who died after being “hit” by a bat. The second was a Colorado woman who developed a febrile illness and became seriously ill after a trip to Uganda. Although initially no diagnosis had been made, she asked for a new test after learning of the Dutchwoman’s existence; both had been in the same cave. She was then diagnosed with Marburg. This illustrates the importance of a careful history, especially among returning travelers.

Treatment consists of aggressive supportive care. There are no known effective antivirals or vaccines and Ebola treatments are not efficient in Marburg.

The only good news about this is that the Marburg epidemics have historically been smaller and better contained than Ebola.

This case serves as an important reminder of what happens when we encroach on wildlife and how human and animal health are inexorably linked.