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Blandenier M, Jacquerioz F. [Marburg virus disease in travellers]. Rev Med Suisse 2024; 20:881-885. [PMID: 38693801 DOI: 10.53738/revmed.2024.20.872.881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Marburg virus disease (MVD) is a dreadful but exceptional disease. Formerly mainly identified in Uganda, Angola and the Democratic Republic of Congo, it has recently appeared in the Republic of Guinea, Ghana, Equatorial Guinea and Tanzania, adding West Africa to the affected regions. Humans become infected through exposure to bats Roussettus aegyptiacus or during unprotected care of infected people. Five cases are linked to travellers, the last one dates to 2008 and involved a visit to caves colonized by bats. At present, there is no specific treatment or vaccine. Despite its rarity, adventurous travelers should be aware of the risks of exposure and avoid entering places inhabited by bats.
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Affiliation(s)
| | - Frédérique Jacquerioz
- Service de médecine tropicale et humanitaire, Département de médecine de premier recours, Hôpitaux universitaires de Genève, 1211 Genève 14
- Centre des maladies virales émergentes, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14
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2
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Schmiedel S, Wolf T. [Ebola and Marburg virus disease]. Dtsch Med Wochenschr 2023; 148:1437-1442. [PMID: 37918428 DOI: 10.1055/a-1966-9615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Viral hemorrhagic fevers (VHF) are serious, often fatal diseases that affect humans and non-human primates. The nomenclature of these diseases has changed in that they are now referred to as viral diseases because the previously named symptoms of fever or hemorrhages are not obligatory. In this article, the focus will be on the VHFs Ebola and Marburg viral disease with the potential for human-to-human transmission; these diseases are so-called high-consequence infectious diseases (HCID), some with considerable potential for epidemic spread and the risk of nosocomial transmission.
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Affiliation(s)
- Stefan Schmiedel
- Sektion Infektiologie, I. Medizinische Klinik und Poliklinik, Universitätsklinikum Eppendorf (UKE), Hamburg, Hamburg
| | - Timo Wolf
- Infektiologie, Zentrum für Innere Medizin 2, Klinikum der Johann-Wolfgang Goethe-Universität Frankfurt, Frankfurt
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3
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Elsheikh R, Makram AM, Selim H, Nguyen D, Le TTT, Tran VP, Elaziz Khader SA, Huy NT. Reemergence of Marburgvirus disease: Update on current control and prevention measures and review of the literature. Rev Med Virol 2023; 33:e2461. [PMID: 37208958 DOI: 10.1002/rmv.2461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 04/13/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
In 1967, the very first case of the Marburgvirus disease (MVD) was detected in Germany and Serbia sequentially. Since then, MVD has been considered one of the most serious and deadly infectious diseases in the world with a case-fatality rate between 23% and 90% and a substantial number of recorded deaths. Marburgvirus belongs to the family of Filoviridae (filoviruses), which causes severe viral hemorrhagic fever (VHF). Some major risk factors for human infections are close contact with African fruit bats, MVD-infected non-human primates, and MVD-infected individuals. Currently, there is no vaccine or specific treatment for MVD, which emphasizes the seriousness of this disease. In July 2022, the World Health Organization reported outbreaks of MVD in Ghana after two suspected VHF cases were detected. This was followed in February and March 2023 with the emergence of the virus in two countries new to the virus: Equatorial Guinea and Tanzania, respectively. In this review, we aim to highlight the characteristics, etiology, epidemiology, and clinical symptoms of MVD, along with the current prevention measures and the possible treatments to control this virus.
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Affiliation(s)
- Randa Elsheikh
- Deanery of Biomedical Sciences, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
- Online Research Club, Nagasaki, Japan
| | - Abdelrahman M Makram
- Online Research Club, Nagasaki, Japan
- School of Public Health, Imperial College London, London, UK
| | - Hager Selim
- Online Research Club, Nagasaki, Japan
- Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt
| | - Dung Nguyen
- Online Research Club, Nagasaki, Japan
- Faculty of Health Sciences, University of the People, Pasadena, California, USA
| | - Thi Thu Thao Le
- Online Research Club, Nagasaki, Japan
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Van-Phu Tran
- Online Research Club, Nagasaki, Japan
- Tra Vinh University, Tra Vinh City, Vietnam
| | - Sarah Abd Elaziz Khader
- Online Research Club, Nagasaki, Japan
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nguyen Tien Huy
- Online Research Club, Nagasaki, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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4
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Koundouno FR, Kafetzopoulou LE, Faye M, Renevey A, Soropogui B, Ifono K, Nelson EV, Kamano AA, Tolno C, Annibaldis G, Millimono SL, Camara J, Kourouma K, Doré A, Millimouno TE, Tolno FMB, Hinzmann J, Soubrier H, Hinrichs M, Thielebein A, Herzer G, Pahlmann M, Ki-Zerbo GA, Formenty P, Legand A, Wiley MR, Faye O, Diagne MM, Sall AA, Lemey P, Bah A, Günther S, Keita S, Duraffour S, Magassouba N. Detection of Marburg Virus Disease in Guinea. N Engl J Med 2022; 386:2528-2530. [PMID: 35767445 PMCID: PMC7613962 DOI: 10.1056/nejmc2120183] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Fara R Koundouno
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | | | - Annick Renevey
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | - Kékoura Ifono
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Emily V Nelson
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Aly A Kamano
- World Health Organization Guinea, Conakry, Guinea
| | | | | | - Saa L Millimono
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | - Karifa Kourouma
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | | | | | - Julia Hinzmann
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Hugo Soubrier
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Mette Hinrichs
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Anke Thielebein
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Glaucia Herzer
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Meike Pahlmann
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | | | | | | | | | | | | | | | | | - Stephan Günther
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Sakoba Keita
- Agence Nationale de Sécurité Sanitaire, Conakry, Guinea
| | - Sophie Duraffour
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - N'Faly Magassouba
- Laboratoire des Fièvres Hémorragiques Virales de Guinée, Conakry, Guinea
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5
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Asad A, Aamir A, Qureshi NE, Bhimani S, Jatoi NN, Batra S, Ochani RK, Abbasi MK, Tariq MA, Diwan MN. Past and current advances in Marburg virus disease: a review. Infez Med 2020; 28:332-345. [PMID: 32920568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Marburg Virus (MARV), along with the Ebola virus, belongs to the family of Filovirus and is cause of a lethal and severely affecting hemorrhagic fever. The Marburgvirus genus includes two viruses: MARV and Ravn. MARV has been recognized as one of utmost importance by the World Health Organization (WHO). The case fatality rate of the virus ranges from 24.0 to 88.0% which demonstrates its lethal nature and the need for its widespread information. The first case of the Marburgvirus disease (MARD) was reported in 1967 when lab personnel working with African green monkeys got infected in Germany and Serbia simultaneously. Following the initial case, many more outbreaks occurred around the world such as Uganda, Angola, Congo, Kenya and even in the United States in 2008. It was soon found out that the MARV was a zoonotic virus and mainly contracted from animal-to-human contact and further transmitted via human-to-human contact. The Egyptian fruit bat (Rousettus aegyptiacus) is known to be one of the significant sources of the infection and tourists visiting caves inhabited by these bats or workers accessing mines, populated by the bats, are at an increased risk of contracting the illness. The incubation period ranges from 2-21 days and the clinical outcome can be broken down into three phases: initial generalized phase (day 1-4), early organ phase (day 5 to 13) and either a late organ/convalescence phase (day 13 onwards). Furthermore, the treatment of MARD is solely based on supportive care. Much has been investigated in over the past half-century of the initial infection but only a few treatment options show promising results. In addition, special precaution is advised whilst handling the patient or the biospecimens. Disease-modifying agents and inhibitors of viral replications show constructive outcomes. It is crucial to identify the host of the virus and educate the populations that are greatly at risk of the disease. While much is being investigated to devise a vaccine, it is important to educate Health Care Workers (HCWs) and close contacts facing the illness. Stopping the transmission remains the best measure that can be taken.
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Affiliation(s)
- Ameema Asad
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Alifiya Aamir
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Nazuk Eraj Qureshi
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Simran Bhimani
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Nadia Nazir Jatoi
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Simran Batra
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Rohan Kumar Ochani
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Muhammad Ali Tariq
- Department of Internal Medicine, Dow International Medical College, DUHS, Karachi, Pakistan
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Nyakarahuka L, Schafer IJ, Balinandi S, Mulei S, Tumusiime A, Kyondo J, Knust B, Lutwama J, Rollin P, Nichol S, Shoemaker T. A retrospective cohort investigation of seroprevalence of Marburg virus and ebolaviruses in two different ecological zones in Uganda. BMC Infect Dis 2020; 20:461. [PMID: 32611400 PMCID: PMC7329513 DOI: 10.1186/s12879-020-05187-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 06/22/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Uganda has experienced seven Ebola Virus Disease (EVD) outbreaks and four Marburg Virus Disease (MVD) outbreaks between 2000 and 2019. We investigated the seroprevalence and risk factors for Marburg virus and ebolaviruses in gold mining communities around Kitaka gold mine in Western Uganda and compared them to non-mining communities in Central Uganda. METHODS A questionnaire was administered and human blood samples were collected from three exposure groups in Western Uganda (gold miners, household members of miners, non-miners living within 50 km of Kitaka mine). The unexposed controls group sampled was community members in Central Uganda far away from any gold mining activity which we considered as low-risk for filovirus infection. ELISA serology was used to analyse samples, detecting IgG antibodies against Marburg virus and ebolaviruses (filoviruses). Data were analysed in STATA software using risk ratios and odds ratios. RESULTS Miners in western Uganda were 5.4 times more likely to be filovirus seropositive compared to the control group in central Uganda (RR = 5.4; 95% CI 1.5-19.7) whereas people living in high-risk areas in Ibanda and Kamwenge districts were 3.6 more likely to be seropositive compared to control group in Luweeero district (RR = 3.6; 95% CI 1.1-12.2). Among all participants, filovirus seropositivity was 2.6% (19/724) of which 2.3% (17/724) were reactive to Sudan virus only and 0.1% (1/724) to Marburg virus. One individual seropositive for Sudan virus also had IgG antibodies reactive to Bundibugyo virus. The risk factors for filovirus seropositivity identified included mining (AOR = 3.4; 95% CI 1.3-8.5), male sex (AOR = 3.1; 95% CI 1.01-9.5), going inside mines (AOR = 3.1; 95% CI 1.2-8.2), cleaning corpses (AOR = 3.1; 95% CI 1.04-9.1) and contact with suspect filovirus cases (AOR = 3.9, 95% CI 1.04-14.5). CONCLUSIONS These findings indicate that filovirus outbreaks may go undetected in Uganda and people involved in artisan gold mining are more likely to be exposed to infection with either Marburg virus or ebolaviruses, likely due to increased risk of exposure to bats. This calls for active surveillance in known high-risk areas for early detection and response to prevent filovirus epidemics.
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Affiliation(s)
- Luke Nyakarahuka
- Arbovirology, Emerging and Re-emerging Diseases, Uganda Virus Research Institute , Entebbe, Uganda
- Department of Biosecurity, Ecosystems and Veterinary Public Health, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | | | - Stephen Balinandi
- Arbovirology, Emerging and Re-emerging Diseases, Uganda Virus Research Institute , Entebbe, Uganda
| | - Sophia Mulei
- Arbovirology, Emerging and Re-emerging Diseases, Uganda Virus Research Institute , Entebbe, Uganda
| | - Alex Tumusiime
- Arbovirology, Emerging and Re-emerging Diseases, Uganda Virus Research Institute , Entebbe, Uganda
| | - Jackson Kyondo
- Arbovirology, Emerging and Re-emerging Diseases, Uganda Virus Research Institute , Entebbe, Uganda
| | - Barbara Knust
- Centres for Disease Control and Prevention, Atlanta, USA
| | - Julius Lutwama
- Arbovirology, Emerging and Re-emerging Diseases, Uganda Virus Research Institute , Entebbe, Uganda
| | - Pierre Rollin
- Centres for Disease Control and Prevention, Atlanta, USA
| | - Stuart Nichol
- Centres for Disease Control and Prevention, Atlanta, USA
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7
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Mattiuzzo G, Bentley EM, Page M. The Role of Reference Materials in the Research and Development of Diagnostic Tools and Treatments for Haemorrhagic Fever Viruses. Viruses 2019; 11:E781. [PMID: 31450611 PMCID: PMC6783900 DOI: 10.3390/v11090781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/15/2019] [Accepted: 08/21/2019] [Indexed: 11/16/2022] Open
Abstract
Following the Ebola outbreak in Western Africa in 2013-16, a global effort has taken place for preparedness for future outbreaks. As part of this response, the development of vaccines, treatments and diagnostic tools has been accelerated, especially towards pathogens listed as likely to cause an epidemic and for which there are no current treatments. Several of the priority pathogens identified by the World Health Organisation are haemorrhagic fever viruses. This review provides information on the role of reference materials as an enabling tool for the development and evaluation of assays, and ultimately vaccines and treatments. The types of standards available are described, along with how they can be applied for assay harmonisation through calibration as a relative potency to a common arbitrary unitage system (WHO International Unit). This assures that assay metrology is accurate and robust. We describe reference materials that have been or are being developed for haemorrhagic fever viruses and consider the issues surrounding their production, particularly that of biosafety where the viruses require specialised containment facilities. Finally, we advocate the use of reference materials at early stages, including research and development, as this helps produce reliable assays and can smooth the path to regulatory approval.
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MESH Headings
- Africa, Western/epidemiology
- Animals
- Antigens, Viral/blood
- Dengue Virus/immunology
- Dengue Virus/isolation & purification
- Dengue Virus/pathogenicity
- Diagnostic Techniques and Procedures
- Disease Outbreaks/prevention & control
- Ebolavirus/immunology
- Ebolavirus/isolation & purification
- Ebolavirus/pathogenicity
- Epidemics/prevention & control
- Hemorrhagic Fever Virus, Crimean-Congo/immunology
- Hemorrhagic Fever Virus, Crimean-Congo/isolation & purification
- Hemorrhagic Fever Virus, Crimean-Congo/pathogenicity
- Hemorrhagic Fever, Crimean/diagnosis
- Hemorrhagic Fever, Crimean/immunology
- Hemorrhagic Fever, Crimean/prevention & control
- Hemorrhagic Fever, Ebola/diagnosis
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/prevention & control
- Humans
- Information Services
- Lassa Fever/diagnosis
- Lassa Fever/immunology
- Lassa Fever/prevention & control
- Lassa virus/immunology
- Lassa virus/isolation & purification
- Lassa virus/pathogenicity
- Marburg Virus Disease/diagnosis
- Marburg Virus Disease/immunology
- Marburg Virus Disease/prevention & control
- Marburgvirus/immunology
- Marburgvirus/isolation & purification
- Marburgvirus/pathogenicity
- RNA Virus Infections/diagnosis
- RNA Virus Infections/immunology
- RNA Virus Infections/prevention & control
- RNA Viruses/immunology
- RNA Viruses/isolation & purification
- RNA Viruses/pathogenicity
- RNA, Viral/isolation & purification
- Rift Valley Fever/diagnosis
- Rift Valley Fever/immunology
- Rift Valley Fever/prevention & control
- Rift Valley fever virus/immunology
- Rift Valley fever virus/isolation & purification
- Rift Valley fever virus/pathogenicity
- Severe Dengue/diagnosis
- Severe Dengue/immunology
- Severe Dengue/prevention & control
- Vaccines/standards
- World Health Organization
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Affiliation(s)
- Giada Mattiuzzo
- Division of Virology, National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK.
| | - Emma M Bentley
- Division of Virology, National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK.
| | - Mark Page
- Division of Virology, National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK.
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8
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Kajihara M, Hang'ombe BM, Changula K, Harima H, Isono M, Okuya K, Yoshida R, Mori-Kajihara A, Eto Y, Orba Y, Ogawa H, Qiu Y, Sawa H, Simulundu E, Mwizabi D, Munyeme M, Squarre D, Mukonka V, Mweene A, Takada A. Marburgvirus in Egyptian Fruit Bats, Zambia. Emerg Infect Dis 2019; 25:1577-1580. [PMID: 31146800 PMCID: PMC6649326 DOI: 10.3201/eid2508.190268] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We detected Marburg virus genome in Egyptian fruit bats (Rousettus aegyptiacus) captured in Zambia in September 2018. The virus was closely related phylogenetically to the viruses that previously caused Marburg outbreaks in the Democratic Republic of the Congo. This finding demonstrates that Zambia is at risk for Marburg virus disease.
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9
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Nyakarahuka L, Kankya C, Krontveit R, Mayer B, Mwiine FN, Lutwama J, Skjerve E. How severe and prevalent are Ebola and Marburg viruses? A systematic review and meta-analysis of the case fatality rates and seroprevalence. BMC Infect Dis 2016; 16:708. [PMID: 27887599 PMCID: PMC5124280 DOI: 10.1186/s12879-016-2045-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 11/17/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Ebola and Marburg virus diseases are said to occur at a low prevalence, but are very severe diseases with high lethalities. The fatality rates reported in different outbreaks ranged from 24-100%. In addition, sero-surveys conducted have shown different seropositivity for both Ebola and Marburg viruses. We aimed to use a meta-analysis approach to estimate the case fatality and seroprevalence rates of these filoviruses, providing vital information for epidemic response and preparedness in countries affected by these diseases. METHODS Published literature was retrieved through a search of databases. Articles were included if they reported number of deaths, cases, and seropositivity. We further cross-referenced with ministries of health, WHO and CDC databases. The effect size was proportion represented by case fatality rate (CFR) and seroprevalence. Analysis was done using the metaprop command in STATA. RESULTS The weighted average CFR of Ebola virus disease was estimated to be 65.0% [95% CI (54.0-76.0%), I2 = 97.98%] whereas that of Marburg virus disease was 53.8% (26.5-80.0%, I2 = 88.6%). The overall seroprevalence of Ebola virus was 8.0% (5.0%-11.0%, I2 = 98.7%), whereas that for Marburg virus was 1.2% (0.5-2.0%, I2 = 94.8%). The most severe species of ebolavirus was Zaire ebolavirus while Bundibugyo Ebolavirus was the least severe. CONCLUSIONS The pooled CFR and seroprevalence for Ebola and Marburg viruses were found to be lower than usually reported, with species differences despite high heterogeneity between studies. Countries with an improved health surveillance and epidemic response have lower CFR, thereby indicating need for improving early detection and epidemic response in filovirus outbreaks.
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Affiliation(s)
- Luke Nyakarahuka
- Norwegian University of Life Sciences, Oslo, Norway
- Makerere University, Kampala, Uganda
- Uganda Virus Research Institute, Entebbe, Uganda
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10
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Ewers EC, Pratt WD, Twenhafel NA, Shamblin J, Donnelly G, Esham H, Wlazlowski C, Johnson JC, Botto M, Hensley LE, Goff AJ. Natural History of Aerosol Exposure with Marburg Virus in Rhesus Macaques. Viruses 2016; 8:87. [PMID: 27043611 PMCID: PMC4848582 DOI: 10.3390/v8040087] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/20/2016] [Accepted: 02/20/2016] [Indexed: 12/04/2022] Open
Abstract
Marburg virus causes severe and often lethal viral disease in humans, and there are currently no Food and Drug Administration (FDA) approved medical countermeasures. The sporadic occurrence of Marburg outbreaks does not allow for evaluation of countermeasures in humans, so therapeutic and vaccine candidates can only be approved through the FDA animal rule—a mechanism requiring well-characterized animal models in which efficacy would be evaluated. Here, we describe a natural history study where rhesus macaques were surgically implanted with telemetry devices and central venous catheters prior to aerosol exposure with Marburg-Angola virus, enabling continuous physiologic monitoring and blood sampling without anesthesia. After a three to four day incubation period, all animals developed fever, viremia, and lymphopenia before developing tachycardia, tachypnea, elevated liver enzymes, decreased liver function, azotemia, elevated D-dimer levels and elevated pro-inflammatory cytokines suggesting a systemic inflammatory response with organ failure. The final, terminal period began with the onset of sustained hypotension, dehydration progressed with signs of major organ hypoperfusion (hyperlactatemia, acute kidney injury, hypothermia), and ended with euthanasia or death. The most significant pathologic findings were marked infection of the respiratory lymphoid tissue with destruction of the tracheobronchial and mediastinal lymph nodes, and severe diffuse infection in the liver, and splenitis.
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Affiliation(s)
- Evan C Ewers
- Department of Medicine, Tripler Army Medical Center, Honolulu, HI 96859, USA.
| | - William D Pratt
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA.
| | - Nancy A Twenhafel
- Department of Medicine, Tripler Army Medical Center, Honolulu, HI 96859, USA.
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA.
| | - Joshua Shamblin
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA.
| | - Ginger Donnelly
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA.
| | - Heather Esham
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA.
| | - Carly Wlazlowski
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA.
| | - Joshua C Johnson
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21702, USA.
| | - Miriam Botto
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA.
| | - Lisa E Hensley
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21702, USA.
| | - Arthur J Goff
- Department of Medicine, Tripler Army Medical Center, Honolulu, HI 96859, USA.
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA.
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11
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Rougeron V, Feldmann H, Grard G, Becker S, Leroy EM. Ebola and Marburg haemorrhagic fever. J Clin Virol 2015; 64:111-9. [PMID: 25660265 PMCID: PMC11080958 DOI: 10.1016/j.jcv.2015.01.014] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 01/15/2015] [Accepted: 01/16/2015] [Indexed: 01/02/2023]
Abstract
Ebolaviruses and Marburgviruses (family Filoviridae) are among the most virulent pathogens for humans and great apes causing severe haemorrhagic fever and death within a matter of days. This group of viruses is characterized by a linear, non-segmented, single-stranded RNA genome of negative polarity. The overall burden of filovirus infections is minimal and negligible compared to the devastation caused by malnutrition and other infectious diseases prevalent in Africa such as malaria, dengue or tuberculosis. In this paper, we review the knowledge gained on the eco/epidemiology, the pathogenesis and the disease control measures for Marburg and Ebola viruses developed over the last 15 years. The overall progress is promising given the little attention that these pathogen have achieved in the past; however, more is to come over the next decade given the more recent interest in these pathogens as potential public and animal health concerns. Licensing of therapeutic and prophylactic options may be achievable over the next 5-10 years.
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Affiliation(s)
- V Rougeron
- Laboratoire MiVEGEC, UMR IRD 224 CNRS 5290 UMI, 911 Av. Agropolis, 34394 Montpellier, Cedex 5, France; International Center for Medical Research of Franceville, BP769, Franceville, Gabon.
| | - H Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - G Grard
- International Center for Medical Research of Franceville, BP769, Franceville, Gabon
| | - S Becker
- Institut für Virologie, Philipps-Universität Marburg, Hans-Meerwein-Str. 2, Marburg 35037, Germany
| | - E M Leroy
- Laboratoire MiVEGEC, UMR IRD 224 CNRS 5290 UMI, 911 Av. Agropolis, 34394 Montpellier, Cedex 5, France; International Center for Medical Research of Franceville, BP769, Franceville, Gabon
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12
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Daaboul GG, Lopez CA, Chinnala J, Goldberg BB, Connor JH, Ünlü MS. Digital sensing and sizing of vesicular stomatitis virus pseudotypes in complex media: a model for Ebola and Marburg detection. ACS Nano 2014; 8:6047-6055. [PMID: 24840765 PMCID: PMC4466106 DOI: 10.1021/nn501312q] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Rapid, sensitive, and direct label-free capture and characterization of nanoparticles from complex media such as blood or serum will broadly impact medicine and the life sciences. We demonstrate identification of virus particles in complex samples for replication-competent wild-type vesicular stomatitis virus (VSV), defective VSV, and Ebola- and Marburg-pseudotyped VSV with high sensitivity and specificity. Size discrimination of the imaged nanoparticles (virions) allows differentiation between modified viruses having different genome lengths and facilitates a reduction in the counting of nonspecifically bound particles to achieve a limit-of-detection (LOD) of 5 × 10(3) pfu/mL for the Ebola and Marburg VSV pseudotypes. We demonstrate the simultaneous detection of multiple viruses in a single sample (composed of serum or whole blood) for screening applications and uncompromised detection capabilities in samples contaminated with high levels of bacteria. By employing affinity-based capture, size discrimination, and a "digital" detection scheme to count single virus particles, we show that a robust and sensitive virus/nanoparticle sensing assay can be established for targets in complex samples. The nanoparticle microscopy system is termed the Single Particle Interferometric Reflectance Imaging Sensor (SP-IRIS) and is capable of high-throughput and rapid sizing of large numbers of biological nanoparticles on an antibody microarray for research and diagnostic applications.
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Affiliation(s)
- George G. Daaboul
- Electrical & Computer Engineering Dept., Boston University, Boston, MA 02215
| | - Carlos A. Lopez
- Electrical & Computer Engineering Dept., Boston University, Boston, MA 02215
| | - Jyothsna Chinnala
- Electrical & Computer Engineering Dept., Boston University, Boston, MA 02215
| | - Bennett B. Goldberg
- Electrical & Computer Engineering Dept., Boston University, Boston, MA 02215
- Biomedical Engineering Dept., Boston University, Boston, MA 02215
- Physics Department, Boston University, Boston, MA 02215
| | - John H. Connor
- Department of Microbiology and National Emerging and Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA 02118
- Boston University Photonics Center, Boston University, Boston, MA 02215
| | - M. Selim Ünlü
- Electrical & Computer Engineering Dept., Boston University, Boston, MA 02215
- Biomedical Engineering Dept., Boston University, Boston, MA 02215
- Physics Department, Boston University, Boston, MA 02215
- Corresponding Author:
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13
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Rybka A, Szanyi J, Kapla J, Plíšek S. [Highly contagious diseases with human-to-human transmission]. Klin Mikrobiol Infekc Lek 2012; 18:180-183. [PMID: 23386507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Highly contagious diseases are caused by various biological agents that pose a risk to individuals and may have a potential for public health impact. They result in high mortality and morbidity rates, might cause public panic and therefore require special measures. The pathogens that can be easily disseminated or transmitted from person to person are the riskiest for clinicians (Ebola virus, Marburg virus, Lassa virus, Crimean-Congo hemorrhagic fever virus, Variola major, SARS virus and Yersinia pestis). Human-to-human transmission has not been confirmed for the other biological agents and therefore they pose a very low risk for population.
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Affiliation(s)
- Aleš Rybka
- Department of Infectious Diseases, Charles University, Czech Republic.
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14
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Abstract
BACKGROUND Since the year 2000, Uganda has experienced repeated outbreaks of viral hemorrhagic fevers (VHF). Ebola VHF outbreak occurred in the districts of Gulu in 2000, Bundibugyo, 2007, Luwero, 2011, Kibaale in July 2012, Luwero in November 2012. Marburg VHF was earlier reported in Ibanda in 2007. More recently in 2012, two outbreaks of Marburg VHF have occurred in Ibanda and Kabale districts. OBJECTIVE To present the epidemiological picture of the Marburg VHF recently reported in Ibanda and Kabale districts and propose research questions to generate evidence to mitigate future epidemics. METHODS A case definition for a VHF was developed. A frequency distribution of symptoms of confirmed and probable cases was done. Descriptive analyses of reported cases using simple percentages, percent distributions and computation of means was performed. RESULTS The Marburg epidemic was reported in early September and by November 2012, a cumulative of 14 cases (9 confirmed and 5 probable) including 7 deaths had been registered, giving a case fatality rate (CFR) of 50%. A total of 202 contacts had been listed; out of which 193 had completed the 21-day follow-up period. The index case was a 33-year old male, a teacher at Nyakatukura Secondary School in Ibanda district. He travelled to Ibanda from Kabale, his home district on 31st August 2012, reportedly healthy. He fell sick on 3rd September 2012 with complaints of fever, headache, loss of appetite and general body weakness. Overall, the dominant symptoms for all cases were fever, vomiting, loss of appetite, headache, abdominal pain, fatigue, diarrhea, and the least in occurrence was bleeding which accounted for 35.5% of all the cases. CONCLUSION The source of infection for all the five Ebola Hemorrhagic fever outbreaks in Uganda and the recent Marburg VHF outbreak in Ibanda and Kabale is not known. Currently there is suspicion that there could be an animal reservoir of the Ebola and Marburg viruses from where occasional spillage into the human population occurs resulting in disease outbreaks. This and other hypotheses require further investigation.
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Affiliation(s)
- A Mbonye
- Ministry of Health Head Quarters, P.O Box 7272 Kampala, Uganda.
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15
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Huang Y, Wei H, Wang Y, Shi Z, Raoul H, Yuan Z. Rapid detection of filoviruses by real-time TaqMan polymerase chain reaction assays. Virol Sin 2012; 27:273-7. [PMID: 23001480 DOI: 10.1007/s12250-012-3252-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 08/06/2012] [Indexed: 11/26/2022] Open
Abstract
Ebola virus (EBOV) and Marburg virus (MARV) are causative agents of severe hemorrhagic fever with high mortality rates in humans and non-human primates and there is currently no licensed vaccine or therapeutics. To date, there is no specific laboratory diagnostic test in China, while there is a national need to provide differential diagnosis during outbreaks and for instituting acceptable quarantine procedures. In this study, the TaqMan RT-PCR assays targeting the nucleoprotein genes of the Zaire Ebolavirus (ZEBOV) and MARV were developed and their sensitivities and specificities were investigated. Our results indicated that the assays were able to make reliable diagnosis over a wide range of virus copies from 10(3) to 10(9), corresponding to the threshold of a standard RNA transcript. The results showed that there were about 10(10) RNA copies per milliliter of virus culture supernatant, equivalent to 10,000 RNA molecules per infectious virion, suggesting the presence of many non-infectious particles. These data indicated that the TaqMan RT-PCR assays developed in this study will be suitable for future surveillance and specific diagnosis of ZEBOV and MARV in China.
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Affiliation(s)
- Yi Huang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China
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16
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Abstract
Ebola virus (EBOV) and Marburg virus (MARV), belonging to the Filoviridae family, emerged four decades ago and caused severe viral hemorrhagic fever in human and other primates. As high as 50-90% mortality, filoviruses can cause significant threats to public health. However, so far no specific and efficient vaccine has been available, nor have other treatment methods proved to be effective. It is of great importance to detect these pathogens specific, rapidly and sensitively in order to control future filovirus outbreaks. Here, recent progresses in the development of detection and diagnosis methods for EBOV and MARV are summarized.
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Affiliation(s)
- Yun-peng Wang
- Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China
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17
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Leroy E, Baize S, Gonzalez JP. [Ebola and Marburg hemorrhagic fever viruses: update on filoviruses]. Med Trop (Mars) 2011; 71:111-121. [PMID: 21695865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The Ebola and Marburg viruses are the sole members of the Filoviridae family of viruses. They are characterized by a long filamentous form that is unique in the viral world. Filoviruses are among the most virulent pathogens currently known to infect humans. They cause fulminating disease characterized by acute fever followed by generalized hemorrhagic syndrome that is associated with 90% mortality in the most severe forms. Epidemic outbreaks of Marburg and Ebola viruses have taken a heavy toll on human life in Central Africa and devastated large ape populations in Gabon and Republic of Congo. Since their discovery in 1967 (Marburg) and 1976 (Ebola), more than 2,300 cases and 1,670 deaths have been reported. These numbers pale in comparison with the burden caused by malnutrition or other infectious disease scourges in Africa such as malaria, cholera, AIDS, dengue or tuberculosis. However, due to their extremely high lethality, association with multifocal hemorrhaging and specificity to the African continent, these hemorrhagic fever viruses have given rise to great interest on the part not only of the international scientific community but also of the general public because of their perceived potential as biological weapons. Much research has been performed on these viruses and major progress has been made in knowledge of their ecology, epidemiology and physiopathology and in development of vaccine candidates and therapeutic schemes. The purpose of this review is to present the main developments in these particular fields in the last decade.
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Affiliation(s)
- E Leroy
- Centre International de Recherches Médicales de Franceville, Franceville, Gabon.
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18
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Allaranga Y, Kone ML, Formenty P, Libama F, Boumandouki P, Woodfill CJI, Sow I, Duale S, Alemu W, Yada A. Lessons learned during active epidemiological surveillance of Ebola and Marburg viral hemorrhagic fever epidemics in Africa. East Afr J Public Health 2010; 7:30-36. [PMID: 21413569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To review epidemiological surveillance approaches used during Ebola and Marburg hemorrhagic fever epidemics in Africa in the past fifteen years. Overall, 26 hemorrhagic epidemic outbreaks have been registered in 12 countries; 18 caused by the Ebola virus and eight by the Marburg virus. About 2551 cases have been reported, among which 268 were health workers (9,3%). METHODS Based on articles and epidemic management reports, this review analyses surveillance approaches, route of introduction of the virus into the population (urban and rural), the collaboration between the human health sector and the wildlife sector and factors that have affected epidemic management. FINDINGS Several factors affecting the epidemiological surveillance during Ebola and Marburg viruses hemorrhagic epidemics have been observed. During epidemics in rural settings, outbreak investigations have shown multiple introductions of the virus into the human population through wildlife. In contrast, during epidemics in urban settings a single introduction of the virus in the community was responsible for the epidemic. Active surveillance is key to containing outbreaks of Ebola and Marburg viruses CONCLUSIONS Collaboration with those in charge of the conservation of wildlife is essential for the early detection of viral hemorrhagic fever epidemics. Hemorrhagic fever epidemics caused by Ebola and Marburg viruses are occurring more and more frequently in Sub-Saharan Africa and only an adapted epidemiological surveillance system will allow for early detection and effective response.
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Pirozhkov AP, Borisevich IV, Snetkova OI, Androshchuk IA, Syromiatnikova SI, Khmelev AL, Shatokhina IV, Kudrin VI, Timofeev MA, Pantiukhov VB, Borisevich SV, Markov VI, Bondarev VP. [Stabilization of peroxidase conjugates used in enzyme immunoassay systems to detect Ebola and Marburg virus antigens]. Vopr Virusol 2010; 55:45-48. [PMID: 20364672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The time course of changes in the activity of solutions of horseradish peroxidase conjugates with immunoglobulins against Ebola and Marburg fevers was studied in the presence of different components. The series of the conjugates of ELISA kits for the detection of Ebola and Marburg virus antigens, which were prepared on the basis of the designed stabilizing solution, preserved at less than 90% of its baseline activity during 10 months at a storage temperature of 2 to 8 degrees C.
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20
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Centers for Disease Control and Prevention (CDC). Imported case of Marburg hemorrhagic fever - Colorado, 2008. MMWR Morb Mortal Wkly Rep 2009; 58:1377-81. [PMID: 20019654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Marburg hemorrhagic fever (MHF) is a rare, viral hemorrhagic fever (VHF); the causative agent is an RNA virus in the family Filoviridae, and growing evidence demonstrates that fruit bats are the natural reservoir of Marburg virus (MARV). On January 9, 2008, an infectious disease physician notified the Colorado Department of Public Health and Environment (CDPHE) of a case of unexplained febrile illness requiring hospitalization in a woman who had returned from travel in Uganda. Testing of early convalescent serum demonstrated no evidence of infection with agents that cause tropical febrile illnesses, including VHF. Six months later, in July 2008, the patient requested repeat testing after she learned of the death from MHF of a Dutch tourist who had visited the same bat-roosting cave as the patient, the Python Cave in Queen Elizabeth National Park, Uganda. The convalescent serologic testing revealed evidence of prior infection with MARV, and MARV RNA was detected in the archived early convalescent serum. A public health investigation did not identify illness consistent with secondary MHF transmission among her contacts, and no serologic evidence of infection was detected among the six tested of her eight tour companions. The patient might have acquired MARV infection through exposure to bat secretions or excretions while visiting the Python Cave. Travelers should be aware of the risk for acquiring MHF in caves or mines inhabited by bats in endemic areas in sub-Saharan Africa. Health-care providers should consider VHF among travelers returning from endemic areas who experience unexplained febrile illness.
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21
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Pittalis S, Fusco FM, Lanini S, Nisii C, Puro V, Lauria FN, Ippolito G. Case definition for Ebola and Marburg haemorrhagic fevers: a complex challenge for epidemiologists and clinicians. New Microbiol 2009; 32:359-367. [PMID: 20128442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Viral haemorrhagic fevers (VHFs) represent a challenge for public health because of their epidemic potential, and their possible use as bioterrorism agents poses particular concern. In 1999 the World Health Organization (WHO) proposed a case definition for VHFs, subsequently adopted by other international institutions with the aim of early detection of initial cases/outbreaks in western countries. We applied this case definition to reports of Ebola and Marburg virus infections to estimate its sensitivity to detect cases of the disease. We analyzed clinical descriptions of 795 reported cases of Ebola haemorrhagic fever: only 58.5% of patients met the proposed case definition. A similar figure was obtained reviewing 169 cases of Marburg diseases, of which only 64.5% were in accordance with the case definition. In conclusion, the WHO case definition for hemorrhagic fevers is too specific and has poor sensitivity both for case finding during Ebola or Marburg outbreaks, and for early detection of suspected cases in western countries. It can lead to a hazardous number of false negatives and its use should be discouraged for early detection of cases.
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Affiliation(s)
- Silvia Pittalis
- Epidemiological and Pre-clinical Research Department, National Institute for Infectious Diseases (INMI) "L. Spallanzani", Rome, Italy.
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22
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Affiliation(s)
- Nigel Curtis
- Department of Paediatrics, University of Melbourne, Parkville, Australia
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23
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Towner JS, Pourrut X, Albariño CG, Nkogue CN, Bird BH, Grard G, Ksiazek TG, Gonzalez JP, Nichol ST, Leroy EM. Marburg virus infection detected in a common African bat. PLoS One 2007; 2:e764. [PMID: 17712412 PMCID: PMC1942080 DOI: 10.1371/journal.pone.0000764] [Citation(s) in RCA: 258] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Accepted: 07/12/2007] [Indexed: 11/27/2022] Open
Abstract
Marburg and Ebola viruses can cause large hemorrhagic fever (HF) outbreaks with high case fatality (80–90%) in human and great apes. Identification of the natural reservoir of these viruses is one of the most important topics in this field and a fundamental key to understanding their natural history. Despite the discovery of this virus family almost 40 years ago, the search for the natural reservoir of these lethal pathogens remains an enigma despite numerous ecological studies. Here, we report the discovery of Marburg virus in a common species of fruit bat (Rousettus aegyptiacus) in Gabon as shown by finding virus-specific RNA and IgG antibody in individual bats. These Marburg virus positive bats represent the first naturally infected non-primate animals identified. Furthermore, this is the first report of Marburg virus being present in this area of Africa, thus extending the known range of the virus. These data imply that more areas are at risk for MHF outbreaks than previously realized and correspond well with a recently published report in which three species of fruit bats were demonstrated to be likely reservoirs for Ebola virus.
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Affiliation(s)
- Jonathan S. Towner
- Centers for Disease Control and Prevention, Special Pathogens Branch, Atlanta, Georgia, United States of America
| | - Xavier Pourrut
- Centre International de Recherches Médicales de Franceville, Franceville, Gabon
- Institut de Recherche pour le Développement, UR178, Franceville, Gabon
| | - César G. Albariño
- Centers for Disease Control and Prevention, Special Pathogens Branch, Atlanta, Georgia, United States of America
| | - Chimène Nze Nkogue
- Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Brian H. Bird
- Centers for Disease Control and Prevention, Special Pathogens Branch, Atlanta, Georgia, United States of America
- School of Veterinary Medicine, University of California at Davis, Davis, California, United States of America
| | - Gilda Grard
- Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Thomas G. Ksiazek
- Centers for Disease Control and Prevention, Special Pathogens Branch, Atlanta, Georgia, United States of America
| | - Jean-Paul Gonzalez
- Institut de Recherche pour le Développement, UR178, Nakhonpathom, Thaïland
| | - Stuart T. Nichol
- Centers for Disease Control and Prevention, Special Pathogens Branch, Atlanta, Georgia, United States of America
| | - Eric M. Leroy
- Centre International de Recherches Médicales de Franceville, Franceville, Gabon
- Institut de Recherche pour le Développement, UR178, Franceville, Gabon
- * To whom correspondence should be addressed. E-mail:
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Morikawa S. [Marburg hemorrhagic fever]. Nihon Rinsho 2007; 65 Suppl 3:35-9. [PMID: 17491362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Shigeru Morikawa
- Special Pathogens Laboratory, Department of Virology 1, National Institute of Infectious Diseases
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Chlíbek R, Smetana J, Vacková M. [Ebola and Marburg fever--outbreaks of viral haemorrhagic fever]. Klin Mikrobiol Infekc Lek 2006; 12:217-23. [PMID: 17230375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
With an increasing frequency of traveling and tourism to exotic countries, a new threat-import of rare, very dangerous infections-emerges in humane medicine. Ebola fever and Marburg fever, whose agents come from the same group of Filoviridae family, belong among these diseases. The natural reservoir of these viruses has not yet been precisely determined. The pathogenesis of the diseases is not absolutely clear, there is neither a possibility of vaccination, nor an effective treatment. Fever and haemorrhagic diathesis belong to the basic symptoms of the diseases. Most of the infected persons die, the death rate is 70-88 %. The history of Ebola fever is relatively short-30 years, Marburg fever is known almost 40 years. Hundreds of people have died of these diseases so far. The study involves epidemics recorded in the world and their epidemiological relations. Not a single case has been recorded in the Czech Republic, nevertheless a sick traveler or infected animals are the highest risk of import these diseases. In our conditions, the medical staff belong to a highly endangered group of people because of stringent isolation of patients, strict rules of barrier treatment regime and high infectivity of the diseases. For this reason, the public should be prepared for possible contact with these highly virulent infections.
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Affiliation(s)
- R Chlíbek
- Katedra epidemiologie Fakulty vojenského zdravotnictví Univerzity obrany, Hradec Králové.
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Saijo M, Niikura M, Ikegami T, Kurane I, Kurata T, Morikawa S. Laboratory diagnostic systems for Ebola and Marburg hemorrhagic fevers developed with recombinant proteins. Clin Vaccine Immunol 2006; 13:444-51. [PMID: 16603611 PMCID: PMC1459631 DOI: 10.1128/cvi.13.4.444-451.2006] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Masayuki Saijo
- Department of Virology 1, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama, Tokyo 208-0011, Japan.
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27
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Affiliation(s)
- David L Heymann
- Polio Eradication Initiative, World Health Organization, Geneva 27, Switzerland.
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Smetana J, Chlíbek R, Vacková M. [Outbreak of Marburg hemorrhagic fever in Angola]. Epidemiol Mikrobiol Imunol 2006; 55:63-7. [PMID: 16617843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Marburg hemorrhagic fever is a rare acute viral fever illness with a serious clinical course often leading to a fatal outcome. The lethality rate ranges between 25 and 80 %. Both the virus reservoir and mode of transmission to humans are unknown. Close contact with body fluids of infected persons is prerequisite for secondary human to human transmission. Seriousness of the infection is underlined by the unavailability of specific treatment and vaccination. The outbreak in Angola in 2004-2005 accounted for the highest prevalence of the disease recorded to date. As many as 374 cases were reported by August 23, 2005, 329 of these were fatal; the lethality rate was 88%. In comparison with the previous outbreaks, the afflicted area is unusually vast, includes populated zones, and intensive secondary transmission is observed.
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Affiliation(s)
- J Smetana
- Katedra epidemiologie Fakulty vojenského zdravotnictví Univerzity obrany, Hradec Králové.
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Abstract
The viral haemorrhagic fevers are a group of diseases that share many clinical features. Ebola, Marburg and Lassa are diseases that cause a relatively small number of deaths globally, but pose special risks to medical staff due to the ease of transmission, and can have a profound impact to the communities they affect. This article gives a brief overview of diseases caused by the Ebola, Marburg and Lassa viruses. It gives some practical advice to the clinician on the diagnosis and management of these diseases.
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Marburg haemorrhagic fever. Nurs Times 2006; 102:25. [PMID: 16566182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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31
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Merk H, Giesecke J. [Marburg fever in Angola--the epidemic is over, but the disease is still there]. Lakartidningen 2005; 102:3034, 3036-7. [PMID: 16294528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Hanna Merk
- Avdelningen för epidemiologi, Smittskyddsinstitutet, Solna.
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32
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Grolla A, Lucht A, Dick D, Strong JE, Feldmann H. Laboratory diagnosis of Ebola and Marburg hemorrhagic fever. Bull Soc Pathol Exot 2005; 98:205-9. [PMID: 16267962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The control of Filovirus outbreaks can be greatly enhanced by timely laboratory confirmation of infection or the identification of alternative disease processes. The status of current laboratory diagnostics for Ebola and Marburg virus infections is discussed in terms of the assays available and their interpretation. In addition, the role of field-based laboratory support and its limitations and capabilities in an outbreak response setting, especially in regards to real-time PCR and immunofiltration assays, is presented.
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Affiliation(s)
- A Grolla
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
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Saijo M, Niikura M, Maeda A, Sata T, Kurata T, Kurane I, Morikawa S. Characterization of monoclonal antibodies to Marburg virus nucleoprotein (NP) that can be used for NP-capture enzyme-linked immunosorbent assay. J Med Virol 2005; 76:111-8. [PMID: 15778962 DOI: 10.1002/jmv.20332] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
After the first documented outbreak of Marburg hemorrhagic fever identified in Europe in 1967, several sporadic cases and an outbreak of Marburg hemorrhagic fever have been reported in Africa. In order to establish a diagnostic system for Marburg hemorrhagic fever by the detection of Marburg virus nucleoprotein, monoclonal antibodies to the recombinant nucleoprotein were produced. Two clones of monoclonal antibodies, MAb2A7 and MAb2H6, were efficacious in the antigen-capture enzyme-linked immunosorbent assay (ELISA). At least 40 ng/ml of the recombinant nucleoprotein of Marburg virus was detected by the antigen-capture ELISA format. The epitope of the monoclonal antibody (MAb2A7) was located in the carboxy-terminus of nucleoprotein from amino acid position 634 to 647, while that of the MAb2H6 was located on the extreme region of the carboxy-terminus of the Marburg virus nucleoprotein (amino acid position 643-695). These monoclonal antibodies strongly interacted with the conformational epitopes on the carboxy-terminus of the nucleoprotein. Furthermore, these two monoclonal antibodies were reacted with the authentic Marburg virus antigens by indirect immunofluorescence assay. These data suggest that the Marburg virus nucleoprotein-capture ELISA system using the monoclonal antibodies is a promising technique for rapid diagnosis of Marburg hemorrhagic fever.
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Affiliation(s)
- Masayuki Saijo
- Special Pathogens Laboratory, Department of Virology 1, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan.
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Eggertson L. In the field, Canadians diagnose Marburg. CMAJ 2005; 172:1430. [PMID: 15911848 PMCID: PMC557968 DOI: 10.1503/cmaj.050505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Abstract
The term viral hemorrhagic fever refers to a clinical syndrome characterized by acute onset of fever accompanied by nonspecific findings of malaise, prostration, diarrhea,and headache. Patients frequently show signs of increased vascular permeability, and many develop bleeding diatheses. The hemorrhagic fever viruses represent potential agents for biologic warfare because of capability of aerosol transmission, high morbidity,and mortality associated with infection, and ability to replicate in cell culture in high concentrations. Herein we discuss the Filoviridae, the agents of Ebola and Marburg hemorrhagic fevers.
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Affiliation(s)
- Michelle R Salvaggio
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, 1900 University Boulevard, 229 Tinsley Harrison Tower, Birmingham, AL 35294, USA
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Abstract
BACKGROUND The incidence of filovirus disease outbreaks has been increasing in recent years. Although there have been advances in the developments of diagnostics, field tests are rare. Apart from family members of infected patients, health care workers are at high risk of being infected during the initial phase of an outbreak. RT-PCR has been shown to be helpful in containing outbreaks. OBJECTIVES To develop Taqman-RT-PCR for the detection of Ebola-Zaire virus (EBOV-Z), Ebola-Sudan virus (EBOV-S) and Marburg virus (MBGV). STUDY DESIGN Quantitative Taqman-RT-PCRs for the detection of these viruses were developed and established on a portable Smartcycler TD. RESULTS AND CONCLUSIONS All three assays were highly sensitive and specific. The mobility of the assay system may help to contain future outbreaks.
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Affiliation(s)
- Manfred Weidmann
- Department of Virology, Institute of Medical Microbiology and Hygiene, University of Freiburg, Hermann-Herder-Street 11, 79104 Freiburg, Germany.
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38
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39
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Case definitions. Ebola-Marburg viral diseases. Epidemiol Bull 2003; 24:4-5. [PMID: 15112622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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40
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Morikawa S. [Ebola virus and Marburg virus]. Nihon Rinsho 2003; 61 Suppl 3:544-9. [PMID: 12718026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Shigeru Morikawa
- Department of Virology I, National Institute of Infectious Diseases
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Abstract
The filoviruses, Marburg and Ebola, are classified as Category A biowarfare agents by the Centers for Disease Control. Most known human infections with these viruses have been fatal, and no vaccines or effective therapies are currently available. Filoviruses are highly infectious by the airborne route in the laboratory, but investigations of African outbreaks have shown that person-to-person spread requires direct contact with virus-containing material. In consequence, filovirus epidemics can be halted by isolating patients and instituting standard infection control and barrier nursing procedures. The filovirus disease syndrome resembles that caused by other hemorrhagic fever viruses, necessitating studies in a biocontainment laboratory to confirm the diagnosis. Some progress has been made in developing vaccines and antiviral drugs, but efforts are hindered by the limited number of maximum containment laboratories. Terrorists might have great difficulty acquiring a filovirus for use as a weapon, but my attempt to do so because of the agents' ability to inspire fear. Accurate information is the best tool to prevent panic in the event of an attack.
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Affiliation(s)
- Mike Bray
- Medical Officer, Biodefense Clinical Research Branch, OCR/OD/NIAID/NIH, 6700A Rockledge Drive, Room 5132, Bethesda, MD 20892, USA.
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Visser LG, Schippers EF, Swaan CM, van den Broek PJ. [How to treat a patient with indications for an infectious viral hemorrhagic fever]. Ned Tijdschr Geneeskd 2002; 146:2183-8. [PMID: 12467160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Lassa, Ebola, Marburg and Crimean-Congo haemorrhagic fever viruses are the most important causes of viral haemorrhagic fever which is transmitted from person to person through contact with blood or excreta. A non-specific fever may be the initial symptom of viral haemorrhagic fever. By means of carefully noting where the patient has travelled, possible exposure to ill persons, vectors or an animal reservoir, and the incubation period (< or = 21 days versus longer), it is possible to estimate the risk of infection with one of these viruses. Using this approach it is possible to diagnose high-risk patients in good time and to take appropriate measures.
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Affiliation(s)
- L G Visser
- Leids Universitair Medisch Centrum, afd. Infectieziekten, Postbus 9600, 2300 RC Leiden
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Borchert M, Muyembe-Tamfum JJ, Colebunders R, Libande M, Sabue M, Van Der Stuyft P. Short communication: a cluster of Marburg virus disease involving an infant. Trop Med Int Health 2002; 7:902-6. [PMID: 12358627 DOI: 10.1046/j.1365-3156.2002.00945.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A noteworthy cluster of six cases of Marburg haemorrhagic fever (MHF) was identified in the Democratic Republic of Congo. One of the cases is the first infant Marburg fever patient ever documented. Three of six cases presented surprisingly mild symptoms. The results of epidemiological and virological investigations are compatible with person-to-person transmission through body fluids and with mother-to-child transmission while nurturing. The findings show that mild cases of MHF have to be expected during an outbreak and point out the difficulty to base patient management decisions on clinical case definitions alone.
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Affiliation(s)
- Matthias Borchert
- Epidemiology Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
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Affiliation(s)
- U Schwarz
- Neurologische Klinik, Universitätsspital, Zürich, Schweiz.
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Colebunders R, Van Esbroeck M, Moreau M, Borchert M. Imported viral haemorrhagic fever with a potential for person-to-person transmission: review and recommendations for initial management of a suspected case in Belgium. Acta Clin Belg 2002; 57:233-40. [PMID: 12534129 DOI: 10.1179/acb.2002.047] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Viral haemorrhagic fevers are caused by a wide range of viruses. There are 4 types of viruses well known to spread from person to person and able to cause nosocomial outbreaks with a high case fatality rate: an arenavirus (Lassa fever and more exceptionally the Junin and Machupo virus), a bunyavirus (Crimean-Congo haemorrhagic fever) and the Filoviridae (Ebola and Marburg viruses). So far there have been only a limited number of imported cases of viral haemorrhagic fever in industrialized countries. In recent years an increasing number of outbreaks of filovirus infections have occurred in Africa and in 2000 5 cases of Lassa fever were brought from Sierra Leone to Europe. Therefore European physicians should consider the possibility of a viral haemorrhagic fever in an acutely ill patient just returning from Africa or South-America with fever for which there is no obvious cause. Such patients should be questioned for risk factors for viral haemorrhagic fever. Using universal precautions for handling blood and body fluids and barrier nursing techniques there is little risk that if a patient with viral haemorrhagic fever arrives in Belgium there will be secondary cases.
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Affiliation(s)
- R Colebunders
- Departement Klinische Wetenschappen, Instituut voor Tropische Geneeskunde Nationalestraat 155, B-2000 Antwerpen.
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46
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Abstract
The ability to rapidly recognize Marburg virus infections is critical to quickly institute proper barrier nursing precautions and limit further spread of the disease. A rapid, sensitive, and specific laboratory diagnostic test is necessary to confirm outbreaks of Marburg virus and to distinguish it from other diseases that can present with similar clinical symptoms. A one-tube reverse transcriptase-polymerase chain reaction (RT-PCR) assay for the identification of Marburg virus was developed and evaluated using the ABI PRISM 7700 Sequence Detection System and TaqMan chemistry. The sensitivity and specificity of the newly designed primer/probe set (MBGGP3) was evaluated. MBGGP3 was equivalent to or 10-100-fold more sensitive than previously designed primer sets as determined by limit of detection experiments. In addition, the MBGGP3 assay was able to detect all strains of Marburg virus tested, but gave negative results with other haemorrhagic fever and genetically related viruses. The results of this study indicate that the MBGGP3 primer/probe set is both sensitive and specific. In addition, this assay is compatible with emerging rapid nucleic acid analysis platforms and therefore may prove to be a useful diagnostic tool for the control and management of future outbreaks.
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Affiliation(s)
- T R Gibb
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702-5011, USA
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47
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Affiliation(s)
- A Roberts
- Louise Herrington School of Nursing, Baylor University, USA.
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48
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Saijo M, Niikura M, Morikawa S, Ksiazek TG, Meyer RF, Peters CJ, Kurane I. Enzyme-linked immunosorbent assays for detection of antibodies to Ebola and Marburg viruses using recombinant nucleoproteins. J Clin Microbiol 2001; 39:1-7. [PMID: 11136739 PMCID: PMC87670 DOI: 10.1128/jcm.39.1.1-7.2001] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2000] [Accepted: 10/16/2000] [Indexed: 11/20/2022] Open
Abstract
The full-length nucleoprotein (NP) of Ebola virus (EBO) was expressed as a His-tagged recombinant protein (His-EBO-NP) by a baculovirus system. Carboxy-terminal halves of NPs of EBO and Marburg virus (MBG) were expressed as glutathione S-transferase-tagged recombinant proteins in an Escherichia coli system. The antigenic regions on the NPs of EBO and MBG were determined by both Western blotting and enzyme-linked immunosorbent assay (ELISA) to be located on the C-terminal halves. The C-terminal 110 and 102 amino acids of the NPs of EBO and MBG, respectively, possess strong antigenicity. The full-length NP of EBO was strongly expressed in insect cells upon infection with the recombinant baculovirus, while expression of the full-length NP of MBG was weak. We developed an immunoglobulin G (IgG) ELISA using His-EBO-NP and the C-terminal halves of the NPs of EBO and MBG as antigens. We evaluated the IgG ELISA for the ability to detect IgG antibodies to EBO and MBG, using human sera collected from EBO and MBG patients. The IgG ELISA with the recombinant NPs showed high sensitivity and specificity in detecting EBO and MBG antibodies. The results indicate that ELISA systems prepared with the recombinant NPs of EBO and MBG are valuable tools for the diagnosis of EBO and MBG infections and for seroepidemiological field studies.
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Affiliation(s)
- M Saijo
- Special Pathogens Laboratory, Department of Virology 1, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashimurayama, Tokyo 208-0011, Japan
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Schou S, Hansen AK. Marburg and Ebola virus infections in laboratory non-human primates: a literature review. Comp Med 2000; 50:108-23. [PMID: 10857001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND AND PURPOSE Several non-human primate species are used as laboratory animals for various types of studies. Although importation of monkeys may introduce different diseases, special attention has recently been drawn to Marburg and Ebola viruses. This review presented here discusses the potential risk of these viruses for persons working with non-human primates as laboratory animals by focusing on epidemiology, virology, symptoms, pathogenesis, natural reservoir, transmission, quarantine of non-human primates, therapy, and prevention. CONCLUSION A total of 23 Marburg and Ebola virus outbreaks causing viral hemorrhagic fever has been reported among humans and monkeys since the first outbreak in Marburg, Germany in 1967. Most of the 1,100 human cases, with nearly 800 deaths, developed in Africa due mainly to direct and intimate contact with infected patients. Few human cases have developed after contact with non-human primates used for various scientific purposes. However, adequate quarantine should be applied to prevent human infections not only due to Marburg and Ebola viruses, but also to other infective agents. By following proper guidelines, the filovirus infection risk for people working with non-human primates during quarantine exists, but is minimal. There seems to be little risk for filovirus infections after an adequate quarantine period. Therefore, non-human primates can be used as laboratory animals, with little risk of filovirus infections, provided adequate precautions are taken.
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Affiliation(s)
- S Schou
- Department of Oral Surgery, School of Dentistry, Faculty of Health Sciences, University of Copenhagen and University Hospital (Rigshospitalet), Denmark
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