The World Health Organization (WHO) has reported two suspected cases of Ebola-like Marburg virus disease in Ghana.
The Noguchi Memorial Institute for Medical Research in Ghana has analyzed samples from two people suspected of having Marburg virus disease. The two patients belonged to the southern Ashanti region. Both patients, who are now deceased, had complained of fever, headache, nausea, vomiting, and diarrhoea. They had been taken to a district hospital in the area where they later passed away. As per the preliminary analysis of the two samples, both patients tested positive for Marburg. However, officials are currently waiting on confirmation from the WHO-linked lab in Senegal, Institut Pasteur.
The current standard procedure requires that all samples be sent to the WHO Collaborating Centre for confirmation
WHO has sent a team of experts to Ghana. The team will help local authorities with disease surveillance, tracing contacts, testing, spreading awareness, and treating patients.
If confirmed, these will be the first cases of Marburg virus disease reported in the country. Previously, outbreaks and cases of the disease have occurred in Kenya, South Africa, Angola, Uganda, and the Democratic Republic of Congo. Most recently, Guinea confirmed a case of Marburg, a first for West Africa. The confirmation of cases in Ghana will make this the second time that the virus has caused infection in West Africa.
Guinea Reports West Africa’s First Case
In August of last year, health officials in Guinea confirmed the detection of the Ebola-like Marburg virus in samples from a deceased patient. Thus, making it West Africa’s first case of Marburg virus disease.
The patient had begun experiencing symptoms in late July. His symptoms included fever, abdominal pain, headache, fatigue, and bleeding from the gums. Despite undergoing treatment at a local clinic, he passed away a few days later.
Just a few months prior to the case, West Africa had declared an end to an Ebola outbreak in the region. Therefore, due to a suspicion of Ebola, health officials immediately alerted authorities of the case. A team of experts from WHO then collected samples and confirmed the detection of the Marburg virus.
Soon after confirmation of the diagnosis, health officials began tracing contacts of the patient. Moreover, they also closely monitored 4 high-risk close contacts: three family members and a healthcare worker. Fortunately, none of the patient’s 150 contacts developed any signs or symptoms of the disease.
Prior to the case in Guinea, outbreaks of the disease had occurred in parts of eastern, southern, and central Africa. However, it is the first case to appear in West Africa.
What is Marburg-Virus Disease?
The Marburg virus belongs to the same family of viruses as Ebola. Hence, both the diseases are similar clinically. Moreover, they have high case fatality rates.
Fruit bats are considered the natural hosts for the Marburg virus. However, previous outbreaks have been linked to African green monkeys. Human-to-human transmission occurs from direct contact with infected organs, bodily fluids, and contaminated surfaces. Healthcare workers are generally at a higher risk of infection when treating patients suspected of the disease. Needle-stick injuries and contaminated equipment can transmit a more severe infection to healthcare workers; thus, increasing the fatality rate. Moreover, contact with the deceased body during burial processions can also transmit the disease.
Symptoms typically begin 2-21 days after exposure. Initially, the person may have a high fever, headache, muscle aches, severe watery diarrhoea, nausea, vomiting, and abdominal pain. By the fifth or seventh day, many patients develop the severe hemorrhagic disease. This is characterized by blood in stool or vomit, and bleeding from the gums, nose, and vagina. Confusion, irritability, and aggression may also set in as the central nervous system becomes involved. Death occurs within 8 to 9 days of symptom onset, mostly due to severe blood loss. Case fatality rates for Marburg vary from 24-88%, with an average of 50%.
There are currently no vaccines or treatments for Marburg. However, supportive care such as rehydration with oral or intravenous fluids can help improve disease outcomes and increase survival rates. Researchers are currently investigating potential treatments including antivirals and monoclonal antibodies.