Marburg hemorrhagic fever
Overview
Marburg hemorrhagic fever is a rare, severe type 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.
Symptoms
The signs and symptoms of Marburg hemorrhagic fever strike suddenly 5 to 10 days after infection with the virus and usually include fever, chills, headache, and myalgia (muscle aches). Nausea, vomiting, and chest or abdominal pain may also occur. A maculopapular rash (with both of flat and raised lesions) appears about 5 days after symptoms have begun. The disease can worsen to include pancreatitis, jaundice, delirium, and ultimately shock and multi-organ failure.
Causes
The virus is believed to be transmitted from an unknown animal host to humans. Humans may spread the virus to others through extremely close contact with a patient and body fluid (blood, faeces, vomitus, urine, saliva, sweat, respiratory secretions). Close contact with a severely ill patient, during care at home or in hospital, and certain burial practices are common routes of infection. Transmission through needle-stick injuries is associated with more severe disease, rapid deterioration, and possibly higher fatality. Humans may also be infected after close contact with infected primates or their body fluids.
Prevention
There is no vaccine for the disease. The best way to prevent the disease is to: * Observe good personal hygiene. Frequent handwashing with soap can remove infectious materials from the hands and prevent disease transmission. * Close contact with feverish or infected persons must be avoided. * Avoid contact with sick or dead animals especially primates. * Do not eat bushmeat of primates. * After returning from the affected area, travellers should monitor their health for 10 days and seek medical advice promptly if symptoms of fever, watery diarrhoea, malaise, muscle ache or nausea develop, and inform recent travel history.
Diagnosis
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.
Prognosis
Prognosis is generally poor. If a patient survives, recovery may be prompt and complete, or protracted with sequelae, such as orchitis, hepatitis, uveitis, parotitis, desquamation or alopecia.
Treatment
Recovery from Marburg hemorrhagic fever may be prolonged and accompanied by orchititis, recurrent hepatitis, transverse myelitis or uvetis. Other possible complications include inflammation of the testis, spinal cord, eye, parotid gland, or by prolonged hepatitis. The case-fatality rate for Marburg hemorrhagic fever is between 23-25%. A specific treatment for this disease is unknown. However, supportive hospital therapy should be utilized. This 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. One controversial treatment is the use of heparin (which blocks clotting) to prevent the consumption of clotting factors. Some researchers believe the consumption of clotting factors is part of the disease process.