What is Marburg Virus?
Marburg virus or simply Marburg is the common name for the the
genus of viruses Marburgvirus, which contains one species, ''Lake
Victoria marburgvirus''. The virus causes the disease Marburg
Hemorrhagic Fever (MHF), also referred to as ''Marburg Virus
Disease''. Marburg originated in Central and East Africa, and
infects both human and nonhuman primates. The Marburg Virus is in
the same taxonomic family as Ebola, and both are identical
structurally although they elicit different antibodies.
The genera ''Marburgvirus'' and ''Ebolavirus'' were originally
classified as the species of the now nonexistent ''Filovirus''
genus. In March 1998, the Vertebrate Virus Subcommittee proposed
to the International Committee on Taxonomy of Viruses (ICTV) to
change the ''Filovirus'' genus to ''Filovirus'' family with two
specific genera: ''Ebola-like viruses'' and ''Marburg-like
viruses''. This proposal was implemented in Washington DC as of
April 2001 and in Paris as of July 2002. In 2000, another proposal
was made in Washington DC to change the "-like viruses" to
"-virus" (e.g. ''Ebolavirus'', ''Marburgvirus'') in addition to
renaming the only species in the ''Marburgvirus'' genus from
''Marburg virus'' to ''Lake Victoria Marburgvirus''.
The item "Marburg" was named after the location of the first
outbreak in 1967 in Marburg.
Marburg Virus Virology
Structure
The viral structure is typical of filoviruses, with long
threadlike particles which have a consistent diameter but vary
greatly in length from an average of 800 to 14,000 nanometers
(nm), with peak infectious activity at about 790 nm. Virions
(viral particles) contain seven known structural proteins. While
nearly identical to Ebola virus in structure, Marburg virus is
antigenically distinct from Ebola virus; in other words, it
triggers different antibodies in infected organisms. It was the
first filovirus to be identified.
Genome
Marburg contains a single molecule of linear negative-sense, 19100
nucleotides long, single-stranded RNA.
Natural reservoir
In September 2007, ''New Scientist'' magazine reported that the
virus has been found in cave-dwelling African fruit bats in Gabon,
the first time the virus has been found outside primates. The
virus has now also been confirmed in bats in a Uganda mineafter
two miners contracted Marburg in August 2007. Ebola antibodies (a
close relative to Marburg) were found in three species of fruit
bats in 2005. Marburg antibodies have been found in healthy bats,
suggesting that the bats had been previously infected. Although no
one has yet found complete live viruses from a bat, the team
suggest that "[I think we can be sure that these fruit bats are
the reservoir of Marburg virus".
The same techniques used to identify those genes were also used to
identify Marburg genes found in Egyptian fruit bats, ''Rousettus
aegyptiacus''.
Marburg Virus Epidemiology
Prevalence
Outbreaks of Marburg are centered in Africa, where the natural
reservoir is believed to be located.
Transmission
The disease is spread through bodily fluids, including blood,
excrement, saliva, and vomit. Early symptoms are often
non-specific, and usually include fever, headache and myalgia
after an incubation period of three to nine days. After five days,
a maculopapular rash is often present on the trunk. Later-stage
Marburg infection is acute and can include jaundice, pancreatitis,
weight loss, delirium and neuropsychiatric symptoms, haemorrhaging,
hypovolemic shock and multi-organ dysfunction, with liver failure
most common. Accounts of external haemorrhaging from bodily
orifices are pervasive in popular references to the disease but
are in fact rare. Time course varies but symptoms usually last for
one to three weeks until the disease either resolves or kills the
infected host. The fatality rate is from 23% to over 90%.
Marburg Virus Medical aspects
Prevention
Caregivers require barrier infection control measures including
double gloves, impermeable gowns, face shields, eye protection,
leg and shoe coverings.
Marburg is a biosafety level-four agent, and thus requiring the
highest level of precautions.
A few research groups are working on drugs and vaccines to fight
the virus. In 1998, a group at the United States Army Medical
Research Institute of Infectious Diseases (USAMRIID) published the
first peer reviewed article detailing the development of the first
experimental Marburg virus vaccine demonstrated to completely
protect animals from lethal Marburg virus infection Following, in
2002, Genphar, a company doing research for the United States
Army's biodefense program, announced that an experimental vaccine
protected animals from a high dose of Marburg virus. The tests
were conducted by the United States Army Medical Research
Institute of Infectious Diseases (USAMRIID). According to the
company, all animals in the control group died within days whereas
all animals that received the regular dosage of the vaccine were
fully protected.
In June 2005 scientists at Canada's National Microbiology
Laboratory announced that they had also developed vaccines for
both Marburg and Ebola that showed significant promise in primate
testing. Studies on mice also suggested that the vaccine might be
an effective treatment for the disease if it is administered
shortly after a patient is infected. To make the vaccines the
scientists fused a surface protein from the viruses they hope to
protect against onto an animal virus - vesicular stomatitis -
which is thought to be of no threat to humans. In the rhesus
macaque monkey model of the disease, the vaccine is effective even
when given after infection with the virus.
Symptoms
Many of the symptoms of Marburg haemorrhagic fever are similar to
those of other infectious diseases, such as malaria or typhoid,
but are most similar to those of Ebola strains.
Diagnosis
Diagnosis of Marburg is similar to Ebola using the Enzyme-Linked
ImmunoSorbent Assay (ELISA) test.
Prognosis
If a patient survives, recovery is usually prompt and complete,
though it may be prolonged in some cases, with inflammation or
secondary infection of various organs, including: orchitis
(testicles), hepatitis (liver), transverse myelitis (spinal cord),
uveitis (eyes), and parotitis (salivary glands).
Treatment
There is no specific antiviral therapy indicated for treating
Marburg, and hospital care is usually supportive in nature.
Hypotension and shock may require early administration of
vasopressors and haemodynamic monitoring with attention to fluid
and electrolyte balance, circulatory volume, and blood pressure.
Viral haemorrhagic fever (VHF) patients tend to respond poorly to
fluid infusions and may develop pulmonary edema.
Research Team
Global Health
Healthcare Provider
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