Marburg virus infection is a serious infectious disease with high fever and bleeding of internal organs. To date, only the symptoms of this tropical disease can be treated and the mortality rate is high.
What is Marburg virus infection?
Marburg virus infection is a viral disease with severe internal bleeding. It is one of the notifiable diseases because of the high risk of infection. The incubation period is generally reported to be 4 to 17 days. The infection begins flu-like, and later symptoms include internal bleeding and organ dysfunction. Like the related Ebola, the Marburg virus infection belongs to the tropical diseases. The first cases in Germany occurred as early as 1967, when the viruses reached Germany via imported guenons from Africa. Since 1967, no further cases have occurred in Germany, but in 2004, 150 people died in Angola from the, still common in Africa, Marburg virus infection.
Causes
Marburg virus infection is caused by filoviruses, which include the Ebola virus. Therefore, both diseases share common characteristics, including incubation period, symptoms, and affected organs. To date, it is not clear in which animals the causative virus occurs; bats are suspected to be carriers. Since the mortality rate is at least 25%, scientists suspect that the virus has not yet adapted sufficiently to humans, since viruses are not interested in fatal damage to their host, which is detrimental to them. Infection occurs through direct physical contact with affected persons and via virus-containing body fluids and excretions. A risk of infection exists in dried blood for up to five days, and for several months after recovery, convalescents of Marburg virus infection are contagious.
Symptoms, complaints, and signs
The symptoms of Marburg virus infection usually occur acutely. The sufferer suddenly feels ill, suffers from fever and chills, and has severe headache, sore throat, and muscle pain. At the beginning, the infection is also manifested by nausea and vomiting, abdominal pain and diarrhea. Affected people are physically very weak at this stage. After five to seven days of illness, other symptoms may develop. Bleeding of the oral and pharyngeal mucosa, the gastrointestinal tract and the lungs are possible. In severe cases, body temperature continues to rise, causing a severe feeling of illness with flushing, sweating, and impaired consciousness. Sick individuals appear confused and aggressive, and sometimes paralysis and sensory disturbances set in. In the last stage, severe organ bleeding occurs. Anemia may result from this complication, which is manifested by blood in the stool and persistent stomach cramps, among other symptoms. Finally, cardiovascular failure and death of the patient may occur. In a positive course, the symptoms of Marburg virus infection subside after about three to five days. Consequential symptoms do not usually occur, although fever may linger for several days to weeks in some patients.
Diagnosis and course
If flu-like symptoms occur up to three weeks after travel to an infectious area, the patient should contact a tropical medicine specialist immediately and refer to the trip. A special blood test can be used to determine the presence of Marburg virus. The first symptoms of Marburg virus infection, such as high fever with chills, headache, sore throat and aching limbs, appear suddenly and violently. After three days, nausea, abdominal pain, vomiting and diarrhea are added and the affected person is very weakened. The viruses also affect the central nervous system, causing paralysis, confusion and, in severe cases, shock. Complications are common with Marburg virus infection; after five to seven days, most affected individuals suffer from severe internal bleeding that can lead to cardiovascular failure. Antibodies are formed only after a week, which can be detected with a blood test, and can be found in the body for years. The prognosis is poor, and the mortality rate is high. However, there are reports of mild and symptom-free courses of Marburg virus infection.
Complications
Marburg virus infection causes those affected to experience the usual complaints and symptoms of flu or a cold. Patients suffer from severe fever and also chills. There is pain in the head and neck and the affected persons feel tired and weary. It is not uncommon to experience aching limbs and muscle pain, which can significantly reduce the patient’s quality of life. Sufferers also suffer from rashes and itching on the skin. However, Marburg virus infection must be treated by a physician in any case. Without treatment, it usually causes discomfort to the patient’s heart and entire circulatory system, which can also cause them to lose consciousness. In the worst case, this leads to the death of the patient. Life expectancy is reduced if treatment for Marburg virus infection is not started early. The treatment itself takes place with the help of medication and a vaccine. Complications do not occur and symptoms can be relatively well limited.
When should you go to the doctor?
Since Marburg virus infection has a fatal course in many cases, a visit to the doctor should be initiated immediately at the first signs. Often, there are sudden and acute symptoms that require treatment. Fever, malaise, pain in the muscles, chills, nausea and vomiting indicate a health impairment. If abdominal pain, disturbances of the digestive tract, headache and pain in the limbs occur, a doctor should be consulted immediately. As this is a tropical disease transmitted by viruses, people who have been guests in tropical regions in particular should consult a doctor. Also particularly at risk are people who have been, or until recently have been, in physical contact with people or animals from that region. The attending physician must be informed immediately so that the best possible medical care can be given. Hot flashes, sweating, bleeding of the mucous membranes in the mouth and throat, and problems of the digestive tract should be presented to a physician. If stomach cramps, paralysis or sensory disturbances occur, a physician is needed. If the affected person shows mental confusion, this is an alarming signal. He must be presented to a physician as soon as possible. Cardiovascular disorders, changes in blood pressure, a strong feeling of illness and internal weakness should be medically examined.
Treatment and therapy
There is no causative therapy for Marburg virus infection; only symptoms can be treated. For this reason, Marburg virus has been classified as a potential biological warfare agent of the highest hazard class. Patients are prescribed isolated bed rest, usually in a specialized hospital, and receive medications to reduce pain, sedate and decongest, usually intravenously. Since patients lose a lot of fluids due to the high fever, vomiting and diarrhea, and oral intake of water and food is difficult due to the symptoms, the disturbed mineral and water balance must be compensated by fluid administration through infusions. With early and intensive medical treatment of the patients, up to 75% survive the Marburg virus infection and severe courses can be prevented. It is therefore recommended that persons contacted during the incubation period and during the first symptoms of the disease should also be isolated as a preventive measure and blood analyses should be performed on them in order to be able to treat the symptoms of Marburg virus at an early stage.
Outlook and prognosis
Currently, only the symptoms can be treated. However, physicians cannot address the causes of the disease. Thus, medical facilities in the area of spread play a major role in the success of the cure. This can also be proven historically: only a good 15 percent of those infected survived an outbreak in Angola; in Europe, the figure was over 75 percent in 1960. The comparatively better medical system was able to cure significantly more people. However, since severe internal bleeding can hardly be prevented and poses serious challenges to physicians, the prognosis for Marburg virus infection is poor. This is not least due to the fact that the state of research is still insufficient. If no treatment is started, death usually follows sooner or later.Although there are also mild viruses, they also trigger certain symptoms that require therapy. The risk of Marburg virus infection in western countries is low. This is also due to reliable hygiene standards. Transmission via urine, saliva, feces, or blood cannot be ruled out; however, awareness of this in the population is very high.
Prevention
The risk of contracting Marburg virus infection is relatively low for African vacationers, as the main epidemic areas are not tourist destinations. The virus poses a risk to development workers and missionaries who work in close contact with the population in the affected areas. People who work with African monkeys are also at risk. At-risk groups should pay increased attention, for example by complying with European safety regulations for animal importation, but they can hardly protect themselves from Marburg virus infection.
Follow-up
Marbus virus infection is a serious disease that holds no promise of cure. Therefore, consistent aftercare is required by the treating physician, focusing mainly on alleviating symptoms. Since the disease usually ends in death, follow-up care is virtually impossible in this case. At most, the measures can prolong life.
This is what you can do yourself
For this tropical disease, conventional medicine can currently only treat the symptoms. The best form of self-help is to avoid the infection. Marburg virus infection is common in central Africa, although typical tourist destinations such as Kenya and South Africa are rarely affected. Areas at risk include Angola, Nigeria, Congo and Chad in particular. The disease also occurs in Ghana and the Ivory Coast. Private travel to these countries should be avoided. Anyone who has to travel to a risk area for professional reasons and has close contact with the local population there can hardly protect themselves from infection. It is then all the more important to know the symptoms so that adequate medical help can be sought in good time. Anyone who is in a risk area or develops flu-like symptoms such as fever, chills or headache, sore throat and aching limbs shortly after returning home should immediately consult a doctor, preferably a specialist in tropical medicine, and explicitly point out the possibility of infection with Marburg virus. Rapid diagnosis as well as adequate treatment are enormously important, since the disease very quickly develops life-threatening internal bleeding and organ dysfunction. In the case of an acute infection, affected persons must remain on bed rest. Frequently, symptoms include severe diarrhea, with much fluid being lost. In this situation, it is important to pay attention to fluid and electrolyte balance. Because of its high salt content, vegetable broth is a particularly good drink, along with water and tea.
