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Probable Case Of Ebola-Like Marburg Virus In Guinea - Forbes

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

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

Just as with Ebola, bats are the reservoir for Marburg. In this case, it is the Egyptian fruit bat (Rousettus aegyptiacus), a cave-dwelling bat present throughout the continent. Non-human primates are also susceptible to infection.

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

There have been 12 previous significant Marburg outbreaks since 1967. 

The first epidemic occurred in Germany and Yugoslavia after infected green monkeys were imported to those countries. There was a 23% fatality rate there among 31 patients. The worst epidemic was in Angola in 2005, with 252 infections and a 90% death rate. This epidemic apparently spread through the reuse of contaminated transfusion equipment in a pediatric ward. As with Ebola, transmission can occur at funerals and in handling bodies. There was one report of sexual transmission.

Two notable illnesses occurred among tourists who had gone caving in Uganda in 2009. The first was a Dutch woman who died after being “bumped” by a bat. The second was a Colorado woman who developed a febrile illness and became critically ill after a trip to Uganda. While initially no diagnosis was made, she requested retesting after learning about the Dutch woman; both had been in the same cave. She was subsequently diagnosed with Marburg. This illustrates the importance of a careful history, especially in returning travelers.

Treatment is aggressive supportive care. There are no known effective antivirals or vaccines and treatments for Ebola are not effective in Marburg.

The only good news in this is that 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 territory and how human and animal health is inexorably intertwined.

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