Equatorial Guinea on a very high alert as Marburg virus spreads: an urgent rising concern

Abstract

The filoviridae family of viruses, which comprises the more well-known Ebola virus, also includes the Marburg virus (MARV). An African fruit bat is thought to harbor the virus, where following laboratory workers in Frankfurt, Germany, Marburg, Germany, and Belgrade, Yugoslavia (now Serbia), contracted the MARV leading to its initial identification in 1967. Humans may contract the virus and exhibit the syndrome, as can other primates1. Notwithstanding disagreements on the origin, the majority of the evidence refers to Uganda2. In addition to the Democratic Republic of the Congo, Angola, Uganda, the United States, Guinea, Uganda, and Ghana, outbreaks have also been documented in South Africa, Kenya, and Angola since 1967. Equatorial Guinea only recently confirmed its first MARV epidemic outbreak on February 13, 20231. Humans may contract the virus through direct contact with infected individuals alongside bat saliva, urine, or excrement. Contact with said infected animals, such as primates, may also cause human infection3. Hy viral transmission with blood, saliva, or other bodily fluids of the infected individual, the virus may disseminate within populations. Possessing a mortality rate of ~90%, the MARV infection has symptoms that are comparable to those of other viral hemorrhagic fevers, resulting in major bleeding, shock, organ failure, and death3. There are presently no clinically authorized treatments or vaccines to prevent or treat MARV disease, respectively. Palliation is occasionally considered when conservative measures have failed3. The current Marburg virus outbreak in Equatorial Guinea and efforts to curb the virus The deaths are said to have occurred between January 7 and February 7. Moreover, as of 13 February 2023, there are 16 suspected cases of Marburg virus disease (MVD) in Equatorial Guinea4. Meanwhile, 2 potential Marburg disease cases were discovered on Monday in Olamze, a commune near the Equatorial Guinea border, by Cameroonian authorities5. In response, WHO convened the MARV vaccine consortium to evaluate several potential vaccine candidates. Also, the WHO is collaborating with the government of Equatorial Guinea to provide rapid emergency response services and has deployed experts to assist with MARV epidemiology, case management, infection prevention, laboratory, and risk communication4. Recommendations Equatorial Guinea took more than a month to announce an outbreak after the reported date of the first mortality caused by the MARV. This highlights a need for rapid diagnosis and a capacity limitation in public health. The western part of Equatorial Guinea needs immediate action to bolster its monitoring system and limit additional virus transmission through contact tracing. In addition, as there are 2 probable cases in Cameroon, immediate action must be enforced to halt the local dissemination of the virus. Further, providing guidance to medical personnel concerning case management alongside access to appropriate diagnostic testing will further dissipate viral transmission. We must reinforce the paramount importance of Personal Protective equipment in health care professionals as is essential for limiting viral spread. The MARV vaccine needs to be developed, and antivirals specific to the virus need to be produced as quickly as possible. To conclude, the government’s efforts towards making sure the public has access to timely, reliable information about the virus should be strengthened, at the same time it would also be beneficial for the global community to launch campaigns to raise public knowledge about the MARV globally through the mass and social medias. Ethical approval None. Sources of funding None. Author contribution None. Conflict of interest disclosures The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) None. Guarantor None.