Marburg Virus, Kin to Ebola, Surfaces Near Liberia

The World Health Organization (WHO) Liberia Country Office has notified the National Public Health Institute of Liberia (NPHIL) of two confirmed cases of Marburg Hemorrhagic Fever in Gueckedou, the Republic of Guinea.  According to a statement signed by the NPHIL Director General, Madam Jane A. MaCauley, the patients are a 46-year-old male who has died and a female (age unknown), both residents of Temessadou, a Sub-Prefecture of Gueckedou. 

According to the WHO, at​​ least four people have been identified as contacts of the deceased. 

The Guinean Health Authorities were alerted by community members of Koundou Lengo Bengou, which is 54 kilometers away from Gueckedou, which is situated near Guinea’s borders with Liberia and Sierra Leone. This is the first time Marburg, a highly infectious disease that causes hemorrhagic fever, has been identified in the country, and in West Africa.

Gueckedou, where Marburg has been confirmed, is also the same region where cases of the 2021 Ebola outbreak in Guinea, as well as the 2014–2016 West Africa outbreak were initially detected. 

Marburg, which is in the same family as the virus that causes Ebola, was detected less than two months after Guinea declared an end to an Ebola outbreak that erupted earlier this year.

Efforts are underway to find the people who may have been in contact with the patient. As the disease is appearing for the first time in the country, health authorities are launching public education and community mobilization to raise awareness and galvanize support to help curb widespread infection.

“Liberia joins the World to applaud the alertness and the quick investigative action by Guinea’s health workers,” the statement from NPHIL said. “The potential for the Marburg virus to spread far and wide means we need to interrupt its transmission.” 

Gueckedou prefecture borders Liberia from Foya District, Lofa County and there are active socio-economic activities across the three countries (Sierra Leone, Liberia and Guinea).  

“With the aforementioned notification,” the NPHIL says, “Liberia has heightened cross-border surveillance to quickly detect any cases, with all neighbouring counties on HIGHEST alert. The Ebola control systems are in place in Liberia and the health sector is finalizing a Marburg Preparedness and Response plan.” 

Marburg is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials.

Illness begins abruptly, with high fever, severe headache and malaise. Many patients develop severe hemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks, depending on virus strain and case management.

Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated.

In Africa, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda.

Key Facts:

• Marburg virus disease (MVD), formerly known as Marburg hemorrhagic fever, is a severe, often fatal illness in humans
• Rousettus aegyptiacus, fruit bats of the Pteropodidae family, are considered to be natural hosts of Marburg virus
• The Marburg virus is transmitted to people from fruit bats and spreads among humans through human-to-human transmission
• The Marburg virus causes severe viral hemorrhagic fever in humans
• The average MVD case fatality rate is around 50%
• Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management
• Community engagement is key to successfully controlling outbreaks
• Early supportive care with symptomatic treatment improves survival
• The incubation period (interval from infection to onset of symptoms) varies from 2 to 21 days.