There are probably two separate outbreaks, which just happen to be happening almost at the same time. In February, the disease closely related to Ebola emerged for the first time ever in Equatorial Guinea. Now there is also an outbreak in Tanzania: the virus has infected eight people there, five of whom have died.
In Equatorial Guinea – 29 infections, 7 deaths – the disease has reached a major city for the first time. Four cases came to light in Bata, a port city in Equatorial Guinea of about 200,000 inhabitants. Neighboring countries Cameroon and Gabon are on high alert and Equatorial Guinea has imposed travel restrictions and additional controls.
No fear of a pandemic
‘An ugly virus’, is how virologist Ron Fouchier (Erasmus MC) describes the Marburg virus. ‘It can make you terribly ill, and many patients die.’ However, we don’t have to be afraid of a pandemic as far as he is concerned. “I don’t really see that threat. You can see from a distance if someone has it. That makes the virus reasonably manageable: you can take timely precautions to avoid getting it, or keep your distance from the patient.’
Marburg occurs naturally in Egyptian fruit bats, which do not become ill themselves, but sometimes transmit the virus to humans, including through their faeces. The virus is then transferable from person to person through saliva, blood, sweat and diarrhoea. As a rule, those infected are healthcare workers or family members who care for a patient.
Major concerns
Still, the WHO is very concerned. In an earlier outbreak in Angola in 2005, 374 people became infected, of whom 329 died – a death rate of no less than 88 percent. The last significant outbreak of Marburg was ten years ago, in Uganda: fifteen sick, four of whom died. But just last year in Ghana, two people who had contracted the virus died.
In rare cases, travelers also fall victim to the virus. Fifteen years ago, for example, a 41-year-old woman from Milheeze became infected with the virus after a visit to a cave in Uganda. Back in the Netherlands she developed a high fever and died.
The WHO has now advised the countries concerned to be extra vigilant and to contain the disease by isolating patients and tracing and quarantining their contacts as quickly as possible. There is no vaccine or cure for the disease, although hydration improves survival.
Swellings
Marburg is named after a city in central Germany, where the disease first emerged in 1967. The virus appeared to hitch a ride with some test monkeys from Africa. After an incubation period of several days to several weeks, the disease starts abruptly and violently, with high fever and severe headache. After a few days cramps, nausea, diarrhea and vomiting follow, often with blood. Patients may experience bleeding in the nose, gums and vagina. This can be accompanied by bruising, swelling and confusion. The disease is usually fatal after more than a week, due to organ failure and blood loss.
The WHO hopes that the outbreak, like previous outbreaks, will eventually die out. “The confirmation of the new cases is a critical signal to step up efforts to break the chains of transmission,” WHO Africa Director Matshidiso Moeli said in a statement a few days ago.
It is annoying that the virus can still lag behind. For example, there are documented cases of men who passed the virus on to others seven weeks after their recovery, through their semen.