Earlier this year, in June 2021, Guinea declared the end to the Ebola virus outbreak. However, just in case of a resurgence, some community health workers remained in Guinea to help if needed. According to the World Health Organization (WHO), this was beneficial considering the recent diagnosis – and subsequent death – of a Guinea man from Marburg virus disease. Now, these same workers can be repurposed to attempt to coordinate a response and stop this highly fatal epidemic-prone disease before it spreads further.
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Initially, the man who unfortunately died began having symptoms on July 25, 2021. By August 1, his symptoms were too much to bear, so he visited a small health facility for help. Upon arrival, the man was presenting with:
- Abdominal pain
- Fever
- Headache
- Severe fatigue
- Gingival hemorrhage (bleeding from the gums)
Due to his symptoms, he was tested for malaria, though this test came back negative. Later, the man received rehydration support and antibiotics. However, these were not enough and he passed away the next day. The health clinic that he visited alerted the Guéckédou Department of Health of potential issues. An oral swab, taken later, tested negative for Ebola and positive for Marburg Virus Disease. On August 6, Guinea’s Ministry of Health reported the case to the WHO, making it the first known and reported Marburg Virus Disease case in Guinea – or in all of West Africa!
Following the man’s death and subsequent diagnosis, a variety of organizations stepped in to help contain the outbreak. As Guinea is fairly close to both Sierra Leone and Liberia, it is imperative to prevent it from spreading, especially right now with the additional threat of COVID-19. Four potential “high-risk” contacts of the man are now being monitored. However, at this time, none of the four are showing any symptoms associated with Marburg virus disease.
Marburg Virus Disease Containment Measures
Currently, Guinea’s Ministry of Health is working to quickly and appropriately respond to the problem, as well as enact containment measures. To begin, Guinea has contacted leadership in Sierra Leone and Liberia to help stop the spread across borders through certain screening measures. Additional containment measures include:
- Activating a public health emergency operations center in Koundou
- Investigating “patient zero” and attempting to determine where the source of the outbreak began
- Surveilling the community to address potential early Marburg virus disease cases
- Ensuring that healthcare workers continue using PPE – and that PPE is available for these workers
- Communicating to local communities regarding risk and what actions community members can take to lower exposure and protect themselves
- Note: For example, this may describe how to hygienically handle wildlife to prevent cross-contamination or species-to-species transmission; thoroughly cooking animal products; how to prevent stigmatization and encourage patients to seek help; and how to transfer sick patients from their home to a treatment facility while limiting close contact.
At this time, people should also avoid traveling to or from Guinea to avoid potentially spreading the virus across borders.
Marburg Virus Disease (MVD)
In 1967, Marburg virus disease was first discovered after subsequent outbreaks in Belgrade, Serbia; Frankfurt, Germany; and Marburg, Germany. According to the World Health Organization (WHO), Marburg virus is part of the Filoviridae family (filovirus), just like Ebola. The WHO continues that:
Marburg virus disease is a highly virulent disease that causes haemorrhagic fever, with a fatality ratio of up to 88%. Human infection with Marburg virus disease initially results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies.
However, bats infected with this virus often do not show symptoms. Later, the virus spreads through direct contact with blood, organs, secretions, or other bodily fluids of those infected. If these get onto clothing or bedding, or other surfaces, people may also be infected this way. In early stages, Marburg virus disease may present in a similar way to Ebola or leptospirosis. Symptom onset usually occurs rapidly following a 5-10 day incubation period, although symptoms may appear any time between 2-21 days. These symptoms include:
- High fever
- Severe headache
- General malaise
- Non-itchy rash, often on the chest, back, or stomach
- Nausea and vomiting
- Extreme lethargy
- Chest, muscle, and abdominal pain
- Severe and persistent watery diarrhea
- Jaundice (yellowing of the skin and eyes)
- Organ dysfunction
- Liver failure
- Confusion or irritability
- Pancreatic or testicular inflammation
- Severe weight loss
- Bloody vomit or stool
- Bleeding from the nose, gums, or vagina
- Note: Hemorrhagic symptoms are often associated with fatal cases.
If Marburg virus disease is fatal, death usually occurs within 8-9 days following symptom onset. Currently, there are no treatment options available for Marburg virus disease. Patients may be given rehydration support and supportive care to manage symptoms and prevent organ failure. Additionally, researchers are exploring the use of monoclonal antibodies and antiviral treatments, though these are still in investigational stages.
