Definition of Marburg disease
Marburg disease definition - medical term A severe form of hemorrhagic fever which affects both
humans and non-human primates. Caused by a genetically unique zoonotic (that is,
animal-borne) RNA virus of the filovirus family, its recognition led to the creation
of this virus family. The four species of Ebola virus are the only other known members
of the filovirus family.
Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever
occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in
Belgrade, Yugoslavia (now Serbia). A total of 37 people became ill; they included
laboratory workers as well as several medical personnel and family members who had
cared for them. The first people infected had been exposed to African green monkeys
or their tissues. In Marburg, the monkeys had been imported for research and to
prepare polio vaccine.
Recorded cases of the disease have appeared in only a few locations. While the
1967 outbreak occurred in Europe, the disease agent had arrived with imported monkeys
from Uganda. No other case was recorded until 1975, when a traveler most likely
exposed in Zimbabwe became ill in Johannesburg, South Africa - and passed the virus
to his travelling companion and a nurse. 1980 saw two other cases, one in Western
Kenya not far from the Ugandan source of the monkeys implicated in the 1967 outbreak.
This patient's attending physician in Nairobi became the second case. Another human
Marburg infection was recognized in 1987 when a young man who had traveled extensively
in Kenya, including western Kenya, became ill and later died.
Marburg virus is indigenous to Africa. While the geographic area to which it
is native is unknown, this area appears to include at least parts of Uganda and
Western Kenya, and perhaps Zimbabwe. As with Ebola virus, the actual animal host
for Marburg virus also remains a mystery. Both of the men infected in 1980 in western
Kenya had traveled extensively, including making a visit to a cave, in that region.
The cave was investigated by placing sentinels animals inside to see if they would
become infected, and by taking samples from numerous animals and arthropods trapped
during the investigation. The investigation yielded no virus: The sentinel animals
remained healthy and no virus isolations from the samples obtained have been reported.
Just how the animal host first transmits Marburg virus to humans is unknown.
However, as with some other viruses which cause viral hemorrhagic fever, humans
who become ill with Marburg hemorrhagic fever may spread the virus to other people.
This may happen in several ways. Persons handling infected monkeys who come into
direct contact with them or their fluids or cell cultures, have become infected.
Spread of the virus between humans has occurred in a setting of close contact, often
in a hospital. Droplets of body fluids, or direct contact with persons, equipment,
or other objects contaminated with infectious blood or tissues are all highly suspect
as sources of disease.
After an incubation period of 5-10 days, the onset of the disease is sudden and
is marked by fever, chills, headache, and myalgia. Around the fifth day after the
onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back,
stomach), may occur. Nausea, vomiting, chest pain, a sore throat, abdominal pain,
and diarrhea then may appear. Symptoms become increasingly severe and may include
jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver
failure, massive hemorrhaging, and multi-organ dysfunction.
Because many of the signs and symptoms of Marburg hemorrhagic fever are similar
to those of other infectious diseases, such as malaria or typhoid fever, diagnosis
of the disease can be difficult, especially if only a single case is involved. Laboratory
tests including antigen-capture enzyme-linked immunosorbent assay (ELISA) testing,
IgM-capture ELISA, polymerase chain reaction (PCR), and virus isolation, can be
used to confirm a case of Marburg hemorrhagic fever within a few days of the onset
of symptoms. The disease is also readily diagnosed by immunohistochemistry, virus
isolation, or PCR of blood or tissue specimens from deceased patients.
Recovery from Marburg hemorrhagic fever may be prolonged and accompanied by prolonged
hepatitis and transverse myelitis. Other possible complications include inflammation
of the testis, spinal cord, eye, and parotid gland. The case-fatality rate for Marburg
hemorrhagic fever is between 23-25%.
Specific treatment for this disease is unknown. However, supportive hospital
therapy includes balancing the patient's fluids and electrolytes, maintaining their
oxygen status and blood pressure, replacing lost blood and clotting factors and
treating them for any complicating infections. Sometimes treatment also has used
transfusion of fresh-frozen plasma and other preparations to replace the blood proteins
important in clotting.
Common Misspellings: marburg diease, marburg desease
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