Even as a coronavirus continues to plague countries worldwide with a seemingly never-ending pandemic, every now and then, we see a contender trying to usurp its throne. Just this year, we had the Monkeypox virus sending the world into a frenzy since May, and now the World Health Organisation (WHO) has confirmed another outbreak — the deadly Marburg Virus Disease (MVD).
Two unrelated patients (ages 26 and 51) from Ghana’s Ashanti region had been shifted to the hospital earlier this month after they exhibited symptoms of the disease, succumbing to the illness soon after. A series of tests conducted on the samples from the patients have confirmed that they have been infected with MVD. Ghana has taken swift action and put nearly 100 contacts of the infected people under quarantine. None have developed any symptoms so far.
What is the Marburg Virus Disease?
The Marburg Virus Disease (MVD), which is a member of the Ebola family, resembles the Ebola Virus Disease in terms of its clinical manifestations. Similar to Ebola, it has a very high fatality rate, ranging from 24 per cent to 88 per cent on average. The rates change depending on virus strains and the quality of case management.
It is a highly infectious viral haemorrhagic fever and was previously detected in Guinea in September 2021. Outbreaks of MVD have been reported in multiple African countries in the past, including Angola, Congo, Kenya, South Africa and Uganda. A large number of deaths have accompanied several outbreaks, with most of them taking place in southern and eastern Africa.
How is it transmitted?
MVD is a zoonotic disease initially transmitted by African fruit bats, which are natural hosts for the virus, and can infect primates.
In human-to-human contact, MVD spreads through direct contact of the body (through broken skin or mucous membranes) with the bodily secretions of an infected person and with materials such as beddings and clothing contaminated with their fluids.
Since people remain infectious as long their blood harbours the virus, even contact with the deceased during burial ceremonies can spread the illness to healthy people.
What are the symptoms of MVD?
Infected people display symptoms between 2 days to 3 weeks after the initial infection. Initial symptoms of MVD include high fever, severe headaches, muscle aches and pains along with a general feeling of discomfort. From the third day, the patient might observe abdominal pain, cramping, nausea and vomiting. Severe watery diarrhoea may also begin at this stage and persist for a week.
This disease is also characterised by severe haemorrhagic manifestations a week after infection. Bleeding can occur from the nose, gums and vagina in severe cases, which can lead to death around 8 to 9 days after symptom onset.
How is it diagnosed and treated?
Diagnosis is only conducted in laboratories via many different types of tests, including RT-PCR or cell culture tests.
There are no vaccines available for MVD. Treatment for the diseased includes supportive care in the form of rehydration with oral and intravenous fluids and treatment of specific symptoms.
Since the virus can persist in people even after recovery, transmission via infected sexual transmission is possible up to seven weeks after clinical recovery. Survivors can resume their sexual lives after 12 months of recovery or after their semen tests negative twice for the Marburg virus.
What prevention and precautionary measures are being taken now?
The WHO has reached out to neighbouring high-risk countries and has placed them on alert. It recommends outbreak control using timely intervention as the best type of precaution against the virus, especially in the communities where the disease has been reported. Proper information dissemination of the nature of the disease and transmission must be observed to mitigate further spread.
"This is good because, without immediate and decisive action, Marburg can easily get out of hand. WHO is on the ground supporting health authorities, and now that the outbreak is declared, we are marshalling more resources for the response," said Dr Matshidiso Moeti, the WHO's Africa director.
WHO said that it has been supporting Ghana’s health authorities in the Ashanti Region by deploying experts, providing personal protective equipment, bolstering disease surveillance, testing, tracing contacts and spreading awareness about the risks and dangers of the disease.
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