The World Health Organization this week confirmed an outbreak of the Marburg virus in Equatorial Guinea — the first time the tiny country in Central Africa has seen cases of the deadly illness.
Marburg, which is related to Ebola, is already being blamed for at least nine deaths in the country, and another 16 suspected cases are being investigated.
Without treatment, Marburg can be fatal in up to 88 per cent of people.
A 2004-05 outbreak in Angola killed 90 per cent of the 252 confirmed cases.
Here is what you need to know about this rare but dangerous virus.
What is Marburg virus?
Marburg virus is believed to have originated in African fruit bats. It was first identified in 1967 in Germany and the former Yugoslavia, according to the U.S. Centers for Disease Control and Prevention, among people who had been working with green monkeys that had been imported from Uganda.
According to the World Health Organization (WHO), people can contract the virus through prolonged exposure in mines or caves where the bat colonies live.
The virus spreads between humans through direct contact with blood or other bodily fluids of an infected individual, or with surfaces contaminated with the virus, such as clothing or bed sheets.
Marburg is not airborne.
What are the symptoms?
Symptoms may begin “abruptly,” according to WHO, and include high fever, severe headache and malaise. Muscle aches and pains are also common.
“It can impact every organ, and it essentially will cause a shock-like syndrome,” said Dr. Isaac Bogoch, an infectious diseases specialist at Toronto General Hospital.
He said the virus can also cause gastrointestinal complications and a predilection to easy bleeding.
WHO says a rash can appear in the first seven days, and the central nervous system can be affected, resulting in confusion, aggression and irritability.
If death occurs, it generally happens eight to nine days after onset, following severe blood loss and shock.
How is it treated?
There is currently no vaccine for Marburg and no therapeutics to treat it. But patients can be helped.
“They need supportive care,” Bogoch said, including intravenous fluids, as well as electrolyte balance and monitoring. “That can significantly lower the mortality rate,” he said.
Where are the confirmed cases now?
Cases connected to the current outbreak in Equatorial Guinea were first detected in the northern province of Kie-Ntem, near the border with Cameroon.
The outbreak was confirmed after samples were sent to a lab in Senegal. Suspected cases from Cameroon and Gabon were also investigated but found not to be Marburg, WHO said.
But that doesn’t mean there aren’t more Marburg cases.
“When new diseases appear in new locations, we are often just seeing a piece of the picture,” said Dr. Kamran Khan, the founder and CEO of Toronto-based BlueDot, a company that tracks infectious diseases around the world.
He said there are probably more cases and more contacts than the official numbers would indicate, noting that Equatorial Guinea is one of the most resource limited countries in the world.
“Its capabilities in terms of its health-care system, its public health infrastructure for countering an outbreak, are pretty limited,” he said.
WHO said it is sending medical experts to help local officials in Equatorial Guinea, along with protective equipment for hundreds of workers.
“Surveillance in the field has been intensified,” said George Ameh, WHO’s country representative in Equatorial Guinea.
“Contact tracing, as you know, is a cornerstone of the response. We have … redeployed the COVID-19 teams that were there for contact tracing and quickly retrofitted them to really help us out.”
WHO director general Tedros Adhanom Ghebreyesus said the agency is also supporting the governments of Cameroon and Gabon “to prepare, to rapidly detect, isolate and provide care for any suspected cases.”
WHO director general Tedros Adhanom Ghebreyesus says the agency is sending teams and supplies to the Central African country of Equatorial Guinea to try to contain the current outbreak of the deadly Marburg virus.
Is there a concern about spread?
The current Marburg outbreak appears to be regional, but Bogoch notes that infection on one part of the Earth can quickly land on another part in a very short time frame.
“We saw that with, for example, the West African Ebola virus epidemic — which started off as a very small outbreak, turned into a multi-country, multi-year outbreak that took a long time to get under control.”
Khan of BlueDot said Equatorial Guinea is going to need international assistance to be able to get ahead of this outbreak. “Today, it’s a concern for the region and some of the neighbouring countries. But if we don’t get ahead of this, this could become a broader concern for the global community.”
Should people living in Canada be worried?
There’s probably no immediate concern about a case of Marburg being found in Canada.
“I think this is important for Canadians to understand that the likelihood of a case of Marburg showing up in Canada right now is exceedingly low,” Kahn said. But he said it’s important to be aware of the larger issue — which is that “there are more outbreaks appearing in the world today, they are becoming larger, they are becoming more dangerous and disruptive.”
Bogoch said while the current Marburg outbreak is small, now is the time to jump on it so that it doesn’t expand.
Canadians should always care when people anywhere, even far away, are being affected by a deadly illness, he said. “But we should also care about it because, of course, we know that it can impact areas far beyond that as well.”
