West Africa’s first-ever case of Marburg virus disease that causes haemorrhagic fever
Brazzaville/Conakry: Health authorities in Guinea today confirmed a case of Marburg virus disease in the southern Gueckedou prefecture. This is the first time Marburg, a highly infectious disease that causes haemorrhagic fever, has been identified in the country, and in West Africa. Marburg, which is in the same family as the virus that causes Ebola, was detected less than two months after Guinea declared an end to an Ebola outbreak that erupted earlier this year.
The World Health Organization said on August 6, 2021, the Ministry of Health of Guinea informed WHO of a confirmed case of Marburg virus disease (MVD) in Guéckédou Prefecture, Nzérékoré Region, south-western Guinea. The village where the case resided is near both Sierra Leone and Liberian borders.
Samples taken from a now-deceased patient and tested by a field laboratory in Gueckedou as well as Guinea’s national haemorrhagic fever laboratory turned out positive for the Marburg virus. Further analysis by the Institut Pasteur in Senegal confirmed the result.
The case, a male, had onset of symptoms on 25 July. On August 1, he attended a small health facility near his village of residence with symptoms of fever, headache, fatigue, abdominal pain, and gingival hemorrhage. A rapid diagnostic test for malaria was performed which was negative. The patient received supportive care with rehydration, parenteral antibiotics and treatment to manage symptoms.
On August 2, 2021, he died in the community and an alert was raised by the sub-prefecture public health care facility to the prefectorial department of health in Guéckédou. Following the alert, an investigation team comprised of national authorities and WHO experts was deployed to conduct an in-depth investigation. The team collected a post-mortem oral swab sample, which was sent the same day to the viral haemorrhagic fever reference laboratory in Guéckédou.On 3 August a real-time PCR was conducted which confirmed the sample was positive for Marburg virus disease and negative for Ebola virus disease. On 5 August the National Reference Laboratory in Conakry provided confirmation by real-time PCR of the positive Marburg result and on 9 August Institut Pasteur Dakar in Senegal provided reconfirmation that the result was positive for Marburg virus disease and negative for Ebola virus disease.
The patient had sought treatment at a local clinic in Koundou area of Gueckedou, where a medical investigation team had been dispatched to probe his worsening symptoms.
“We applaud the alertness and the quick investigative action by Guinea’s health workers. The potential for the Marburg virus to spread far and wide means we need to stop it in its tracks,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “We are working with the health authorities to implement a swift response that builds on Guinea’s past experience and expertise in managing Ebola, which is transmitted in a similar way.”
Gueckedou, where Marburg has been confirmed, is also the same region where cases of the 2021 Ebola outbreak in Guinea as well as the 2014–2016 West Africa outbreak were initially detected. The most recent Ebola virus disease (EVD) outbreak in Guinea was declared over on 19 June 2021.
Also read: Ebola scare: Countries bordering Guinea on high alert
Efforts are underway to find the people who may have been in contact with the patient. As the disease is appearing for the first time in the country, health authorities are launching public education and community mobilization to raise awareness and galvanize support to help curb widespread infection.
An initial team of 10 WHO experts, including epidemiologists and socio-anthropologists is on the ground helping to investigate the case and supporting the national health authorities to swiftly step up emergency response, including risk assessment, disease surveillance, community mobilization, testing, clinical care, infection prevention as well as logistical support.
Cross-border surveillance is also being enhanced to quickly detect any cases, with neighbouring countries on alert. The Ebola control systems in place in Guinea and in neighbouring countries are proving crucial to the emergency response to the Marburg virus.
Marburg is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials.
Illness begins abruptly, with high fever, severe headache and malaise. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management.
Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated.
In Africa, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda.
– global bihari bureau
