Everything you need to know about Marburg virus in Kenya: Origin, causes, transmission, signs and symptoms, treatment, prevention and control

Kenya has recently been on high alert following suspected cases of Marburg Virus Disease in Turkana and Transnzoia Counties. The disease which is believed to have origanated from Eastern Uganda where an outbreak was reported, has Ebola-like symptoms and known to have a high fatality rate.

What is Marburg Virus Disease?

Originally known as Marburg haemorrhagic fever, MVD was first recorded in Marburg Germany in 1967 hence its name. According to the World Health Organization (WHO), Marburg Virus Disease (MVD) has a case fertality ratio of upto 88%. Both the Marburg and Ebola virus are members of the Filoviridae family (filovirus) and have similar clinical symptoms although they are caused by different viruses.

History of Marburg Virus

Marburg virus was first recorded in 1967 after a simultenous outbreak was reported in Marburg and Frankfurt Germany and in Belgrade, Serbia. This first outbreak is believed to have been spurred by laboratory experiments in Germany using African Green monkeys that were imported from Uganda. The monkeys were to be used for polio vaccine research.
After the German and Serbia cases, outbreaks have been reported in other parts of the world including Uganda, Angola, Kenya, South Africa and Democratic Republic of Congo.

Transmission of Merburg Virus Disease

African Fruit Bats and green monkeys are known to be the primary hosts of Marburg virus. In 2008 for instance, two separate travellers who had visited a cave inhabited by Rousettus bat colonies in Uganda, were reported to have contracted the MVD. The World Health Organization has also warned tourists in Kenya and Uganda against visiting the Mt Elgon National Park which has caves hosting African fruit bats known to transmit the virus.
Human to human transmission of the Marburg virus occurs when one comes into direct contact with body fluids of infected people. These fluids include blood, body secretions, mucus e.t.c.
Infection can also occur through interaction with materials or surfaces contaminated with these fluids for example cloths and beddings.
The virus is also transmitted through sexual intercourse and injuries from injection tools such as needles that had been used on infected people.
MVD is not airborne.

Signs and Symptoms of Marburg virus disease

MVD has an incubation period of 2 to 21 days. This is the time interval from infection to the onset of preliminary symptoms.
The symptoms include:

• High fever
• Severe headache 
• Muscles pains 
• Severe Diarrhoea
• Abdominal pain and cramping 
• Nausea and Vomiting 
• Sore throat

Severe symptoms include:

• Pancreatic inflammation
• Delirium 
• Liver failure
• Jaundice
• Severe weight loss
• Massive haemorrhagic with organ dysfunction 

Diagnosis for Marburg Virus

The following diagnostic tests are done to confirm symptoms of Marburg Virus Disease.

• Serum Neutralization test
• Antibody-capture enzyme linked immunosorbent assay (ELISA) test
• Antigen-capture detection tests
• Electron Microscopy 
• Reverse transcriptase polymerase chain reaction (RT-PCR) assay
• Virus Isolation by cell culture 

In Kenya these tests are usually done at the Kenya Medical and Research Institute (KEMRI) laboratories in Nairobi.

Treatment for Marburg Virus Disease

Many viral diseases do not have a specific treament. MVD is one of them. Victims of the virus are given what is known as supportive treament/care. This is done my managing the specific symptoms  and maintaining fluid and electrolyte balance , replacing lost blood and ensuring good oxygen supply.

Prevention and Control

According to CDC ( Center for Disease Control), prevention measures against Marburg Virus infection is not well defined, as transmission from wildlife to humans remains an area of ongoing research.

Various health factors, interventions, surveillance and contact tracing should be effected to ensure successful prevention and control of Marburg Virus.
Marburg Virus Infection can be prevented by;
1. avoiding prolonged exposure to mines or colonies inhabited by fruit bat colonies
2. avoiding close physical contact with Marburg patients. Wear gloves and other personal protective equipments when taking care of Marburg patients.
3. ensuring quick and safe burial of people infected with Murburg virus. Contact with the dead should also be avoided.
4. isolation of sick patients from the healthy population.
5. avoiding sexual intercourse with people affected by the Marburg virus.

References
1. The Standard Kenya, "WHO warns park visitors to be wary of Marburg"
2. WHO, "Marburg Virus Disease"
3. Medicinenet, "Marburg virus disease symptoms, treatment and history"