Marburg virus disease: the paradox of Nigeria's preparedness and priority effects in co-epidemics

The Current Pathogenicity and Potential Risk Evaluation of Marburg Virus to Cause Mysterious "Disease X"-An Update on Recent Evidences

The World Health Organization (WHO) defined Disease X as an upcoming disease with the potential to cause a pandemic. Pathogen X is responsible for Disease X. Marburg virus disease (MVD) is one of the diseases from the priority disease list published by WHO. Marburg virus is a filamentous, negative-sense RNA virus that belongs to the same filovirus family as the lethal Ebola virus. Since the first discovery of this virus in 1967, 17 outbreaks occurred sporadically till 2023. Rousettus aegyptiacus acts as the natural reservoir of the virus. With an average incubation period of 5 to 10 days, its first target is the mononuclear phagocytic system cells. It is highly contagious and can be easily transmitted from animal to human and human to human via direct contact with blood or body fluid, feces, and semen of the infected host. Although Marburg disease has a high case fatality rate of close to 90%, unfortunately, there is no approved vaccines or treatments are available. The most recent outbreak of Marburg virus in Equatorial Guinea and Tanzania in 2023 caused an alert for global health. However, based on the last global pandemic of COVID-19 and the sudden re-emerging of monkeypox around the world, we can assume that the Marburg virus has the potential to cause a global pandemic. Our modern world depends on globalization, which helps the virus transmission among countries. The Marburg virus can easily be transmitted to humans by fruit bats of the Pteropodidae family. This virus causes severe hemorrhagic disease, and there are no specific vaccines and treatments available to combat it. Therefore, community engagement and early supportive care for patients are keys to successfully controlling MVD.

Rise of Marburg virus in Africa: a call for global preparedness

The Marburg virus disease (MVD) is caused by a rare RNA virus that can result in severe hemorrhagic fever in humans and other primates. The disease was first discovered in 1967 in Marburg Frankfurt in Germany and since then, sporadic cases have been reported in southeastern Africa. The Egyptian fruit bat is considered a reservoir for the virus, which can be transmitted through direct contact with infected bat or monkey tissue, bodily fluids, or contaminated objects. The Marburg virus disease shares clinical features with the Ebola virus disease, and there are no widely accepted vaccines or antiviral medications to treat it. The article provides an overview of Marburg virus (MARV) outbreaks in Africa, including the most recent outbreaks in Guinea, Ghana, Equatorial Guinea, and Tanzania. The authors discuss the recent outbreaks and the implications of the spread of MARV to Africa's healthcare systems. The authors also present key recommendations for both multicountry and global preparedness efforts in order to better prevent and respond to future MARV outbreaks and other viruses with an epidemic potential.

Emergence of Marburg virus: a global perspective on fatal outbreaks and clinical challenges

The Marburg virus (MV), identified in 1967, has caused deadly outbreaks worldwide, the mortality rate of Marburg virus disease (MVD) varies depending on the outbreak and virus strain, but the average case fatality rate is around 50%. However, case fatality rates have varied from 24 to 88% in past outbreaks depending on virus strain and case management. Designated a priority pathogen by the National Institute of Allergy and Infectious Diseases (NIAID), MV induces hemorrhagic fever, organ failure, and coagulation issues in both humans and non-human primates. This review presents an extensive exploration of MVD outbreak evolution, virus structure, and genome, as well as the sources and transmission routes of MV, including human-to-human spread and involvement of natural hosts such as the Egyptian fruit bat (Rousettus aegyptiacus) and other Chiroptera species. The disease progression involves early viral replication impacting immune cells like monocytes, macrophages, and dendritic cells, followed by damage to the spleen, liver, and secondary lymphoid organs. Subsequent spread occurs to hepatocytes, endothelial cells, fibroblasts, and epithelial cells. MV can evade host immune response by inhibiting interferon type I (IFN-1) synthesis. This comprehensive investigation aims to enhance understanding of pathophysiology, cellular tropism, and injury sites in the host, aiding insights into MVD causes. Clinical data and treatments are discussed, albeit current methods to halt MVD outbreaks remain elusive. By elucidating MV infection's history and mechanisms, this review seeks to advance MV disease treatment, drug development, and vaccine creation. The World Health Organization (WHO) considers MV a high-concern filovirus causing severe and fatal hemorrhagic fever, with a death rate ranging from 24 to 88%. The virus often spreads through contact with infected individuals, originating from animals. Visitors to bat habitats like caves or mines face higher risk. We tailored this search strategy for four databases: Scopus, Web of Science, Google Scholar, and PubMed. we primarily utilized search terms such as "Marburg virus," "Epidemiology," "Vaccine," "Outbreak," and "Transmission." To enhance comprehension of the virus and associated disease, this summary offers a comprehensive overview of MV outbreaks, pathophysiology, and management strategies. Continued research and learning hold promise for preventing and controlling future MVD outbreaks. GRAPHICAL ABSTRACT.

First-ever Marburg virus disease outbreak in Equatorial Guinea and Tanzania: An imminent crisis in West and East Africa

The Marburg virus, which is a member of the same virus family as the Ebola virus called Filoviridae, causes the severe infectious disease known as Marburg virus disease (MVD). Previously, different outbreaks of MVD have appeared in different African countries, including Ghana, Guinea, Uganda, Angola, the Democratic Republic of the Congo, Kenya, and South Africa. For the first time, Equatorial Guinea and Tanzania are experiencing MVD outbreaks. A total of 17 laboratory-confirmed cases of MVD and 23 probable cases have been reported in Equatorial Guinea since the confirmation of the outbreak on February 13, 2023. The first MVD outbreak in the United Republic of Tanzania was formally confirmed by the Ministry of Health on March 21, 2023. As of 22 March, there were eight cases and five fatalities (case fatality ratio [CFR]: 62.5%). Due to the facts that Ebebiyin and Nsock Nsomo districts, the affected regions of Equatorial Guinea, borders Cameroon and Gabon, and Kagera region, the affected region of Tanzania, borders Uganda, Rwanda, and Burundi, there is fear of cross-border spread of MVD due to cross-border migrations, and this can be a great crisis in West and East Africa. Although there are currently outbreaks of MVD in Equatorial Guinea and Tanzania, there is currently no proof of an epidemiological connection between the two outbreaks. The aim of this article is to describe MVD, describe its first outbreak in Equatorial Guinea and Tanzania, explain the efforts being used and the challenges being faced in MVD mitigation, and recommend different measures to be taken to cope with the outbreak of MVD in Equatorial Guinea and Tanzania.

Marburg virus disease outbreak in Tanzania: current efforts and recommendations - a short communication

On 21 March 2023 the Tanzania's Ministry of Health reported the first Marburg virus disease (MVD) outbreak in Bukoba District reporting a total of eight cases and five fatalities including one health care worker with a case fatality ratio of 62.5%. MVD is a filoviral infection with an estimated incubation of 3-21 days and causes severe hemorrhagic fever in humans. Fruit bats are significant reservoir host leading to animal-to-human transmission and human-to-human transmission by direct contact of body fluids from an infected person. Symptoms and signs include fever, vomiting, diarrhea, body malaise, massive hemorrhage, and multiorgan failure. Currently, no definitive treatment or licensed vaccines are available to date but only supportive care. This outbreak is an alarming concern to the neighboring countries to contain the outbreak. Within 3 years from 2020 to 2023 Tanzania has already recorded one pandemic, which is the novel coronavirus disease 2019 and two epidemics, which are Cholera, Dengue, and now MVD. Tanzanian's Ministry of Health is drawing lessons from the previous health emergencies to contain this particular epidemic. To impede the MVD outbreak in Tanzania, the focus of this commentary is on highlighting the efforts performed and the significant recommendations provided to relevant organizations and the general public.

Disinfection, Sterilization, and Decontamination of Pathogens in Medicine

The ongoing coronavirus disease (COVID-19) pandemic caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is putting our public health services under enormous strain [...].