The UK Government has issued warnings about an untreatable Ebola-like virus — which kills up to nine in 10 people it infects — that is currently spreading in Africa.
Marburg, one of the deadliest pathogens ever discovered, has already killed 10 people in Rwanda, with around 300 people being monitored for suspected infection.
In a statement, UK health chiefs demanded that businesses provide extra monitoring of employees visiting the African nation.
The World Health Organization (WHO) has previously described the situation as of ‘great concern’, adding there is high risk of the outbreak spreading to other African countries.
Last year, an outbreak of the virus — which causes sufferers to bleed from the eyes — tool hold in nearby Tanzania.
But what is Marburg? How does it spread? And are there any treatments to stop the spread of infection? Here, we answer all your questions.
Marburg virus, a relative of Ebola, causes people to bleed from their orifices and kills up to 9 in 10 of those infected.
MVD has a mortality rate of up to 88 percent. There are currently no vaccines or treatments approved to treat the virus
How deadly is Marburg?
Marburg is one of the deadliest pathogens known to man.
The WHO says it has a case-fatality ratio (CFR) of up to 88 percent, meaning it can kill nearly 9 in 10 people it infects.
However, the CFR of any outbreak varies depending on strain and the health resources available.
Experts estimate the average overall CFR sits about 50 per cent, closer to Ebola to which Marburg is related, meaning about half of those infected are expected to die.
That means that out of every 100 people confirmed to be infected with Marburg, at least half would be expected to die.
Scientists don’t, however, know the infection-fatality rate, which measures everyone who gets infected — not just cases that test positive.
For comparison, Covid had a CFR of around 3 percent when it initially burst onto the scene.
Marburg virus (MVD) is initially transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials.
Is there a vaccine?
No vaccines are currently approved to treat the virus.
However, several are in development and there have been talks about testing some of the most promising candidates in the Rwandan outbreak.
If enacted this is expected to follow a model called ‘ring vaccination’, which has been deployed in previous Ebola outbreaks for vaccine trials.
This involves offering close contacts of a Marburg patient, who are at risk of potential infection, the vaccine in a bid to help them fend off the virus before they become severely ill.
One vaccine candidate is even currently being trialled in Britain and using the same technology as the now maligned Oxford/AstraZeneca Covid vaccine.
Called ChAdOx1 Marburg, and made by Oxford University, 46 Brits received the experimental jab earlier this year though results have not yet been announced.
What about drugs, have any been proven to work?
As well as there being no vaccines, there are also no treatments approved to treat the virus.
However, the WHO is currently evaluating a range of potential treatments, including blood products, immune therapies and drug therapies.
The UN agency also advises that supportive care such as rehydration and drugs to ease certain symptoms can improve survival chances.
Supportive hospital therapy includes balancing the patient’s fluids and electrolytes, maintaining oxygen levels and blood pressure, replacing lost blood and clotting factors, and treatment for any complicating infections.
According to the Centers for Disease Control and Prevention (CDC), experimental treatments have never been tested on humans.
Outbreaks typically occur in areas where people have been exposed to fruit bats, which naturally harbour the virus, via entering mines or caves where the animals live
How far away are therapeutics realistically?
Experts have previously said it may take multiple outbreaks for enough cases to properly analyse the effectiveness of potential drugs and ‘years’ before an effective therapeutic becomes routinely available.
Professor Jimmy Whitworth, an expert in international public health at the London School of Hygiene & Tropical Medicine, said during a 2023 outbreak: ‘Usually Marburg virus outbreaks develop very quickly, only a few cases are infected, and the outbreak dies down rapidly once control measures are in place.
He added: ‘It is likely that any vaccine will need to be tested over several outbreaks before we have a definite answer on whether it works.’
Instead, health officials hope the virus — which spreads via prolonged physical contact — will be contained and controlled before it causes a larger outbreak.
Dr Michael Head, senior research fellow in global health at the University of Southampton, added: ‘There’s no immediate timescale of when we might see a Marburg vaccine.
‘There are many promising candidates, but my best guess is we’re probably some years off seeing a finished product being widely available in high-risk settings.’
How is this outbreak being contained?
At least 19 people are currently being quarantined in Rwanda having tested positive for Marburg.
A further 290 people, deemed close contacts of the infected, have also been traced by Rwandan health officials to ensure that if they fall ill help is available.
When both the quarantined and known fatalities are taken into account this means there are currently 30 cases in the current outbreak which officially started last Friday.
Most of the fatalities are among health care workers working in intensive care units with the sickest patients according to the country’s health minister Sabin Nsanzimana. Pictured here speaking in new York earlier this month
This leaves the Rwandan outbreak approaching the scale of the 2023 Equatorial Guinea one in which saw 40 cases, of which 35 were fatal.
Most of the Rwandan fatalities are among health care workers working in intensive care units, according to the country’s health minister Sabin Nsanzimana.
Mr Nsanzimana has urged people with early signs of the disease, which includes severe headaches, muscle aches, fever, diarrhoea, fatigue stomach pain and vomiting, to cease their usual activities like work and school and seek medical aid.
Most of the cases are understood to be in the country’s capital of Kigali, which has direct flights to Britain.
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This has prompted the the UK Government to issue a warning to British travellers to Rwanda
This states: ‘We understand it is present in hospitals in Kigali. Investigations are being carried out to determine the origin of the infection.’
In a statement the WHO said there was a ‘high’ risk of the virus spreading outside or Rwanda to nearby countries.
‘There is a risk of this outbreak spreading to neighbouring countries since cases have been reported in districts located at the borders with the Democratic Republic of the Congo, the United Republic of Tanzania, and Uganda.’
Some of these countries are already in the midst of battling an ongoing mpox outbreak.
The WHO also said there was a theoretical risk of the virus spreading more widely through international air travel.
Despite these risks, WHO officials said they advised against any travel and trade restrictions with Rwanda.
The body also said it has provided guidance to the Rwandan Ministry of Health on how to manage cases.
The World Health Organization (WHO) convened an urgent meeting over the rising cases, calling in experts from around the world to help prevent mass outbreaks of the untreatable infection
How bad were previous Marburg clusters and where were they?
Before this outbreak, only 78 cases had been recorded globally from 2007 to 2023.
Rwanda’s outbreak is already the second biggest in that time frame only being eclipsed by Equatorial Guinea’s 2023 one which saw 40 cases.
It is still far behind the 2004-2005 outbreak in Angola, where among 252 infected people as many as 227 died (90 percent).
Could it reach Britain or the US?
Most outbreaks of Marburg fizzle out after infecting a few people.
For this reason, experts say the chances of it sparking a pandemic or spreading onto another continent are tiny. Yet, it is not impossible.
Marburg virus has only reached the US once before in 2008, when it was diagnosed in a 44-year-old woman who had returned to Colorado from a two-week safari in Uganda. She was hospitalized but later made a full recovery.
There are no known cases of Marburg viruses reaching the UK.
What are the tell-tale symptoms of Marburg?
Symptoms appear abruptly and include severe headaches, fever, diarrhoea, stomach pain and vomiting. They become increasingly severe.
In the early stages of MVD — the disease it causes — it is very difficult to distinguish from other tropical illnesses, such as Ebola, and malaria.
Infected patients become ‘ghost-like’, often developing deep-set eyes and expressionless faces.
This is usually accompanied by bleeding from multiple orifices — including the nose, gums, eyes and vagina.
Like Ebola, even dead bodies can spread the virus to people exposed to its fluids.
How does the virus spread?
Human infections typically start in areas where people have prolonged exposure to mines or caves inhabited by infected fruit bat colonies.
Fruit bats naturally harbour the virus.
It can, however, then spread between humans, through direct contact with the bodily fluids of infected people, surfaces and materials.
Contaminated clothing and bedding are a risk, as are burial ceremonies that involve direct contact with the deceased.
Is Marburg as contagious as Covid?
Covid took off so quickly because of how it spread — through infectious respiratory particles when they are inhaled, or come into contact with the eyes, nose or mouth.
Marburg, although contagious, is nowhere near as infectious.
As it outbreaks are so sporadic, scientists have never been able to pinpoint its R rate a measure which epidemiologists use to measure a disease’s ability to spread.
R is, in essence, the number of people that one infected person will pass on a virus to, on average.
Ebola, when it swept through West Africa between 2014 and 2016, had an R rate of around 1.5, studies suggest.
Covid, for comparison, has mutated to have a basic R rate even higher than measles (around 15).
Why is it called Marburg and how long have scientists known about it?
Marburg was first recognized in 1967 when outbreaks of haemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (now Serbia).
The infections were traced back to three laboratories that received a shared shipment of infected African green monkeys.
There have been eight subsequent outbreaks involving multiple infections, including the current outbreak in Equatorial Guinea and Cameroon.
MVD is normally associated with outbreaks in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda.
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