What are the symptoms? How is it transmitted? Can you reach Europe? Everything we know about the Marburg virus

CNN Portugal sought to answer the most frequently asked questions about a virus that could meet new developments this Thursday, at the WHO briefing

The World Health Organization (WHO) is on alert, after two confirmed cases of Marburg virus infection in Ghana, from the same family as Ebola, highly contagious, and which caused as many deaths in the country.

The two victims were two unrelated men, aged 26 and 51, in the Ashanti region, in the south of the country. As dozens of risk contacts were identified and reported to the WHO, the Ghanaian Ministry of Health decided to isolate the region.

At this time, the objective is to isolate risk contacts as much as possible, mitigate the spread of the virus and prevent outbreaks. WHO also already has experts in place to help with monitoring.

CNN Portugal gathered the available information about this virus and spoke with a public health expert to try to answer the most frequently asked questions about a virus that could meet new developments this Thursday, at the World Health Organization briefing.

What virus is this?

Based on the WHO and European Center for Disease Prevention and Control (ECDC) definition, Marburg is a rare viral hemorrhagic fever that is highly contagious when symptoms appear and has an incubation period of five to 10 days, which can vary between three and 21 days.

The mortality rate varies between 24% and 80%, depending on the strain of the virus and how cases are managed. According to the WHO, death usually occurs eight to nine days after the patient has contracted the virus.

What are the symptoms?

Symptoms start “abruptly” and can include severe headache, high fever (39ºC/40ºC), muscle pain, chills, diarrhea, nausea, vomiting with blood and bleeding, many of them severe. Gastrointestinal symptoms appear within the first two to five days.

There have also been cases with a rash, without itching, on the chest, belly and back.

The two men who died in Ghana had symptoms of diarrhea, fever, nausea and vomiting. One of them died the day he was admitted to the hospital and the other died the next day.

The intensity or strength of symptoms increases from the fifth or seventh day of infection.

How is it transmitted?

They are known to be fruit bats – Rousettus aegyptiacus – those responsible for transmitting the virus to humans, more specifically those who work in mines or caves where this species lives.

Among humans, the virus is transmitted through bodily fluids – blood, saliva or urine -, infected surfaces and materials, such as clothing, sheets or medical equipment. It is not an airborne disease.

Fruit bats (GettyImages)

When was it identified?

Despite being now the order of the day, the Marburg virus is not new. The first cases appeared in Europe in 1967. Perhaps it has now gained more notoriety because of the covid-19 pandemic and also with the rise in the number of Monkeypox cases.

At that time there were two major outbreaks in Marburg and Frankfurt, Germany, and in Belgrade, Serbia. At least seven people died. It is also known that the first cases of infected people emerged after they had been in contact with African green monkeys imported from Uganda.

There was also a major outbreak in Angola in 2005 that killed more than 200 people.

Where was it detected?

With the cases now detected in Ghana, this is the second time that Marburg has appeared in West Africa. The first case was identified in Guinea last year.

This time, they emerged in the Ashanti region. More than 90 risk contacts between health professionals and community members have already been identified. All have been reported to WHO and are being monitored. Neighboring countries have also been contacted by the WHO to be on alert.

Over time, cases have been reported in other African countries such as Uganda, Democratic Republic of Congo, Kenya, South Africa, Zimbabwe and Angola.

Despite not being native to other continents, tourists visiting any of these African countries should be aware, especially if they go to caves and caves. In 2008, for example, a Dutch tourist died after visiting Uganda. Another American tourist contracted the virus on a trip to Uganda that same year, but managed to recover.

Bat Grotto in Queen Elizabeth National Park, Uganda (GettyImages)

Is there a danger of returning to Europe? And to Portugal?

In the view of the president of the National Association of Public Health Physicians (ANMSP), Gustavo Tato Borges, this possibility exists through tourists who can visit these countries.

“This virus, like so many others, can circulate from one place to another with the mobility that people have. The fact that we have a disease in Africa does not mean that it cannot reach the rest of the world”, he explained to CNN Portugal.

In the specific case of Portugal, the Public Health doctor believes that the Directorate-General for Health (DGS) already has “a contingency plan ready to act with measures for these cases and for patients with the virus”. Tato Borges also said that it could be, for example, the same contingency plan that was applied with Ebola, since these are similar diseases.

CNN Portugal questioned the DGS about whether it has, in fact, this contingency plan prepared, but until the publication of this article it has not received a response.

What precautions can tourists have?

The answer to this question depends on how each tourist travels. For the specialist in Public Health, the first thing to do before visiting, in this case, African countries is to carry out the Traveler’s Consultation “which helps us to take measures and be careful with the risks”. But not only.

“You should look at your trip and realize if you were exposed to the local community, if you took walks in forests and caves, or if you were simply in your hotel and in more touristy environments and, therefore, possibly more protected.”

Having done this analysis, if your trip is part of the first scenario, “you should be aware of symptoms and if you feel any, you should immediately start monitoring the situation”. When contacting the SNS 24 or 122, you must “communicate this situation” so that a different treatment is applied, that is, so that professionals know, for example, that they have to use a specific ambulance and, upon arrival at the hospital, know that he has to be hospitalized with strong safety rules, as “this is a highly contagious disease with a high fatality rate”.

If your trip falls under the second scenario, you should still be aware of any signs of the body. Remember that although the virus has an incubation period that can be long, the symptoms appear abruptly and very intensely.

Do you have treatment?

Not. To date, there are no vaccines or antiviral treatments approved to treat this virus. However, experts guarantee that the Oral or intravenous rehydration, maintenance of oxygen levels, and use of medications for specific symptoms greatly increase the survival rate.

There are also experts who advocate the use of the same drugs that are used to fight Ebola.

The ECDC also confirmed that some “experimental treatments” have already been tested on animals, but never on humans.

Lab (GettyImages)