Marburg Virus: Tanzania Reports its First-Ever Outbreak

March 25, 2023

Tanzania has recently confirmed its first-ever outbreak of Marburg virus, a highly contagious and deadly virus that causes viral hemorrhagic fever. The World Health Organization (WHO) has reported that the confirmation by Tanzania’s national public laboratory followed the death of five people in the northwest Kagera region who developed symptoms, which include fever, vomiting, bleeding, and renal failure. Here’s what you need to know about the Marburg virus outbreak in Tanzania.

What is Marburg virus?

Marburg virus is an Ebola-like virus that causes viral hemorrhagic fever. The virus is the causative agent of Marburg virus disease (MVD), a disease with a case fatality ratio of up to 88%, but can be much lower with good patient care. Both Marburg and Ebola viruses are members of the Filoviridae family (filovirus), and the two diseases are clinically similar.

Transmission

Human MVD infection results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies. Marburg spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids. Health-care workers have frequently been infected while treating patients with suspected or confirmed MVD.

Symptoms of Marburg virus disease

The incubation period (interval from infection to onset of symptoms) varies from 2 to 21 days. Illness caused by Marburg virus begins abruptly, with high fever, severe headache, and severe malaise. Muscle aches and pains are a common feature. Severe watery diarrhea, abdominal pain and cramping, nausea, and vomiting can begin on the third day. Many patients develop severe hemorrhagic manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding, often from multiple areas. In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock.

Outbreak history

Marburg virus disease was initially detected in 1967 after simultaneous outbreaks in Marburg and Frankfurt in Germany; and in Belgrade, Serbia. Two large outbreaks that occurred simultaneously in Marburg and Frankfurt in Germany, and in Belgrade, Serbia, led to the initial recognition of the disease. Subsequently, outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa, and Uganda. In 2008, two independent cases were reported in travelers who had visited a cave inhabited by Rousettus bat colonies in Uganda.

Marburg virus outbreak in Tanzania

Tanzania has confirmed eight cases of MVD in its first-ever outbreak. The three who survived were getting treatment, with 161 contacts being monitored.

Prevention and control measures

Prevention and control measures for Marburg virus disease include standard infection control practices, such as wearing gloves and other protective equipment when caring for patients with suspected or confirmed MVD, and proper sterilization of medical equipment. Health-care workers should be trained on proper infection control procedures to prevent transmission. Burial ceremonies that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg.

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