Context: 

Rwanda has been facing an alarming outbreak of the Marburg virus, which has infected at least 46 individuals and has resulted in 12 deaths. 

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• Around 80% of the infections have affected healthcare workers, posing a severe threat to Rwanda’s healthcare system, which has only 1,500 doctors for a population of over 13 million.
• Last year, the disease was reported in Tanzania’s north-west Kagera region, Ghana and Equatorial Guinea. 

About Marburg virus disease (MVD)

• Marburg virus disease (MVD), earlier known as Marburg haemorrhagic fever, is a severe and often fatal haemorrhagic fever caused by the Marburg virus (MARV). 
• It belongs to the filovirus family, which also includes the Ebola virus. Both diseases are clinically similar with high fatality rates. 
• The virus was first identified in 1967 during simultaneous outbreaks in Marburg and Frankfurt, Germany, and Belgrade, Serbia.
• The fatality rate ranges from 24% to 88%, depending on the virus strain and the level of care provided. 

Transmission:

• The Rousettus fruit bat (specifically, the Egyptian fruit bat) is believed to be the natural host of the Marburg virus.
• However, African green monkeys imported from Uganda were the source of the first human infection. 

According to the World Health Organization (WHO), the virus can also spread through – 

• Direct contact with the blood or bodily fluids (such as vomit, urine, or saliva) of an infected person.
• Indirect contact through contaminated surfaces and materials, such as bedding or clothing.

Symptoms:

• The symptoms of Marburg virus disease appear after an incubation period of 2 to 21 days.
• Initial symptoms include high fever, severe headache, muscle ache, severe watery diarrhoea, abdominal pain and cramping, and vomiting.
• Soon many patients develop haemorrhagic symptoms (bleeding from various parts of the body, including gums, digestive system, and vagina).
• Severe blood loss leads to death, often between 8 to 9 days after symptoms begin.

Diagnosis & Treatment:

• Diagnosing MVD is challenging as its symptoms are similar to other diseases like malaria or typhoid. 
• However, it can be confirmed through laboratory testing of blood and other samples, which is risky due to the extreme biohazard posed by the virus.
• Currently, there are no approved vaccines or specific treatments for MVD.
• However, according to WHO, supportive care (rehydration with oral or intravenous fluids) and treatment of specific symptoms, improve survival. 
• Experimental vaccines and treatments are being developed currently, with US-based Sabin Vaccine Institute providing Rwanda with 700 doses of its experimental Marburg vaccine.