Marburg Virus Disease Outbreaks Research Articles

Marburg Virus Outbreak in Equatorial Guinea: Need for Speed.

The co-existence of deadly viral pandemics can be considered a nightmare for public health authorities. The surge of a Marburg virus disease (MVD) outbreak in Africa at a time when the coronavirus-19 (COVID-19) pandemic is partially controlled with its limited resources is an urgent call for concern. Over the past decades, several bouts of MVD outbreaks have occurred in Africa with an alarming case fatality rate. Despite this, little has been done to end its recurrence, and affected countries essentially depend on preventative rather than curative measures of management. The recent outbreak of MVD declared by the health officials of Equatorial Guinea, causing several deaths in the context of the COVID-19 pandemic, signals the need for speed in the establishment and the implementation of appropriate health policies and health system strategies to contain, destroy, and prevent the spread of this deadly virus to other neighboring countries.

A mathematical model of Marburg virus disease outbreaks and the potential role of vaccination in control

BackgroundMarburg virus disease is an acute haemorrhagic fever caused by Marburg virus. Marburg virus is zoonotic, maintained in nature in Egyptian fruit bats, with occasional spillover infections into humans and nonhuman primates. Although rare, sporadic cases and outbreaks occur in Africa, usually associated with exposure to bats in mines or caves, and sometimes with secondary human-to-human transmission. Outbreaks outside of Africa have also occurred due to importation of infected monkeys. Although all previous Marburg virus disease outbreaks have been brought under control without vaccination, there is nevertheless the potential for large outbreaks when implementation of public health measures is not possible or breaks down. Vaccines could thus be an important additional tool, and development of several candidate vaccines is under way.MethodsWe developed a branching process model of Marburg virus transmission and investigated the potential effects of several prophylactic and reactive vaccination strategies in settings driven primarily by multiple spillover events as well as human-to-human transmission. Linelist data from the 15 outbreaks up until 2022, as well as an Approximate Bayesian Computational framework, were used to inform the model parameters.ResultsOur results show a low basic reproduction number which varied across outbreaks, from 0.5 [95% CI 0.05–1.8] to 1.2 [95% CI 1.0–1.9] but a high case fatality ratio. Of six vaccination strategies explored, the two prophylactic strategies (mass and targeted vaccination of high-risk groups), as well as a combination of ring and targeted vaccination, were generally most effective, with a probability of potential outbreaks being terminated within 1 year of 0.90 (95% CI 0.90–0.91), 0.89 (95% CI 0.88–0.90), and 0.88 (95% CI 0.87–0.89) compared with 0.68 (0.67–0.69) for no vaccination, especially if the outbreak is driven by zoonotic spillovers and the vaccination campaign initiated as soon as possible after onset of the first case.ConclusionsOur study shows that various vaccination strategies can be effective in helping to control outbreaks of MVD, with the best approach varying with the particular epidemiologic circumstances of each outbreak.

Micro‒Global Positioning Systems for Identifying Nightly Opportunities for Marburg Virus Spillover to Humans by Egyptian Rousette Bats.

Marburg virus disease, caused by Marburg and Ravn orthomarburgviruses, emerges sporadically in sub-Saharan Africa and is often fatal in humans. The natural reservoir is the Egyptian rousette bat (ERB), which sheds virus in saliva, urine, and feces. Frugivorous ERBs discard test-bitten and partially eaten fruit, potentially leaving infectious virus behind that could be consumed by other susceptible animals or humans. Historically, 8 of 17 known Marburg virus disease outbreaks have been linked to human encroachment on ERB habitats, but no linkage exists for the other 9 outbreaks, raising the question of how bats and humans might intersect, leading to virus spillover. We used micro‒global positioning systems to identify nightly ERB foraging locations. ERBs from a known Marburg virus‒infected population traveled long distances to feed in cultivated fruit trees near homes. Our results show that ERB foraging behavior represents a Marburg virus spillover risk to humans and plausibly explains the origins of some past outbreaks.

Emergence of Marburg virus: a global perspective on fatal outbreaks and clinical challenges.

The Marburg virus (MV), identified in 1967, has caused deadly outbreaks worldwide, the mortality rate of Marburg virus disease (MVD) varies depending on the outbreak and virus strain, but the average case fatality rate is around 50%. However, case fatality rates have varied from 24 to 88% in past outbreaks depending on virus strain and case management. Designated a priority pathogen by the National Institute of Allergy and Infectious Diseases (NIAID), MV induces hemorrhagic fever, organ failure, and coagulation issues in both humans and non-human primates. This review presents an extensive exploration of MVD outbreak evolution, virus structure, and genome, as well as the sources and transmission routes of MV, including human-to-human spread and involvement of natural hosts such as the Egyptian fruit bat (Rousettus aegyptiacus) and other Chiroptera species. The disease progression involves early viral replication impacting immune cells like monocytes, macrophages, and dendritic cells, followed by damage to the spleen, liver, and secondary lymphoid organs. Subsequent spread occurs to hepatocytes, endothelial cells, fibroblasts, and epithelial cells. MV can evade host immune response by inhibiting interferon type I (IFN-1) synthesis. This comprehensive investigation aims to enhance understanding of pathophysiology, cellular tropism, and injury sites in the host, aiding insights into MVD causes. Clinical data and treatments are discussed, albeit current methods to halt MVD outbreaks remain elusive. By elucidating MV infection's history and mechanisms, this review seeks to advance MV disease treatment, drug development, and vaccine creation. The World Health Organization (WHO) considers MV a high-concern filovirus causing severe and fatal hemorrhagic fever, with a death rate ranging from 24 to 88%. The virus often spreads through contact with infected individuals, originating from animals. Visitors to bat habitats like caves or mines face higher risk. We tailored this search strategy for four databases: Scopus, Web of Science, Google Scholar, and PubMed. we primarily utilized search terms such as "Marburg virus," "Epidemiology," "Vaccine," "Outbreak," and "Transmission." To enhance comprehension of the virus and associated disease, this summary offers a comprehensive overview of MV outbreaks, pathophysiology, and management strategies. Continued research and learning hold promise for preventing and controlling future MVD outbreaks. GRAPHICAL ABSTRACT.

The Outbreak of Marburg Virus in Tanzania: An Emerging Global Health Threat

This article explores the recent outbreak of Marburg virus disease in the United Republic of Tanzania, highlighting the significant global health threat posed by the virus. The article discusses the history of Marburg virus outbreaks in different parts of the world and emphasizes the high fatality rate of the Marburg virus, the lack of specific treatment and vaccine, and the zoonotic origin of the virus as contributing factors to the potential to become global health emergencies. The article suggests lessons learned from previous outbreaks, such as effective surveillance systems, infection prevention, and control measures, international cooperation and research, and community engagement; that can be applied to manage the current outbreak in Tanzania. Lastly, the article discusses the critical role of public health professionals in responding to the Marburg virus outbreak and preventing its spread beyond national borders.

First-ever Marburg virus disease outbreak in Equatorial Guinea and Tanzania: An imminent crisis in West and East Africa.

The Marburg virus, which is a member of the same virus family as the Ebola virus called Filoviridae, causes the severe infectious disease known as Marburg virus disease (MVD). Previously, different outbreaks of MVD have appeared in different African countries, including Ghana, Guinea, Uganda, Angola, the Democratic Republic of the Congo, Kenya, and South Africa. For the first time, Equatorial Guinea and Tanzania are experiencing MVD outbreaks. A total of 17 laboratory-confirmed cases of MVD and 23 probable cases have been reported in Equatorial Guinea since the confirmation of the outbreak on February 13, 2023. The first MVD outbreak in the United Republic of Tanzania was formally confirmed by the Ministry of Health on March 21, 2023. As of 22 March, there were eight cases and five fatalities (case fatality ratio [CFR]: 62.5%). Due to the facts that Ebebiyin and Nsock Nsomo districts, the affected regions of Equatorial Guinea, borders Cameroon and Gabon, and Kagera region, the affected region of Tanzania, borders Uganda, Rwanda, and Burundi, there is fear of cross-border spread of MVD due to cross-border migrations, and this can be a great crisis in West and East Africa. Although there are currently outbreaks of MVD in Equatorial Guinea and Tanzania, there is currently no proof of an epidemiological connection between the two outbreaks. The aim of this article is to describe MVD, describe its first outbreak in Equatorial Guinea and Tanzania, explain the efforts being used and the challenges being faced in MVD mitigation, and recommend different measures to be taken to cope with the outbreak of MVD in Equatorial Guinea and Tanzania.

Developing Vaccines to Improve Preparedness for Filovirus Outbreaks: The Perspective of the USA Biomedical Advanced Research and Development Authority (BARDA).

Outbreaks of viral hemorrhagic fever caused by filoviruses have become more prevalent in recent years, with outbreaks of Ebola virus (EBOV), Sudan virus (SUDV), and Marburg virus (MARV) all occurring in 2022 and 2023. While licensed vaccines are now available for EBOV, vaccine candidates for SUDV and MARV are all in preclinical or early clinical development phases. During the recent outbreak of SUDV virus disease, the Biomedical Advanced Research and Development Authority (BARDA), as part of the Administration for Strategic Preparedness and Response within the U.S. Department of Health and Human Services, implemented key actions with our existing partners to advance preparedness and enable rapid response to the outbreak, while also aligning with global partners involved in the implementation of clinical trials in an outbreak setting. Beyond pre-existing plans prior to the outbreak, BARDA worked with product sponsors to expedite manufacturing of vaccine doses that could be utilized in clinical trials. While the SUDV outbreak has since ended, a new outbreak of MARV disease has emerged. It remains critical that we continue to advance a portfolio of vaccines against SUDV and MARV while also expediting manufacturing activities ahead of, or in parallel if needed, outbreaks.

Assessing the feasibility of Phase 3 vaccine trials against Marburg Virus Disease: A modelling study

BackgroundOutbreaks of Marburg virus disease (MVD) are rare and small in size, with only 18 recorded outbreaks since 1967, only two of which involved more than 100 cases. It has been proposed, therefore, that Phase 3 trials for MVD vaccines should be held open over multiple outbreaks until sufficient end points accrue to enable vaccine efficacy (VE) to be calculated. Here we estimate how many outbreaks might be needed for VE to be estimated. MethodsWe adapt a mathematical model of MVD transmission to simulate a Phase 3 individually randomised placebo controlled vaccine trial. We assume in the base case that vaccine efficacy is 70% and that 50% of individuals in affected areas are enrolled into the trial (1:1 randomisation). We further assume that the vaccine trial starts two weeks after public health interventions are put in place and that cases occurring within 10 days of vaccination are not included in VE calculations. ResultsThe median size of simulated outbreaks was 2 cases. Only 0.3% of simulated outbreaks were predicted to have more than 100 MVD cases. 95% of simulated outbreaks terminated before cases accrued in the placebo and vaccine arms. Therefore the number of outbreaks required to estimate VE was large: after 100 outbreaks, the estimated VE was 69% but with considerable uncertainty (95% CIs: 0%−100%) while the estimated VE after 200 outbreaks was 67% (95% CIs: 42%−85%). Altering base-case assumptions made little difference to the findings. In a sensitivity analysis, increasing R0 by 25% and 50% led to an estimated VE after 200 outbreaks of 69% (95% CIs: 53–85%) and 70% (95% CIs: 59–82%), respectively. ConclusionsIt is unlikely that the efficacy of any candidate vaccine can be calculated before more MVD outbreaks have occurred than have been recorded to date. This is because MVD outbreaks tend to be small, public health interventions have been historically effective at reducing transmission, and vaccine trials are only likely to start after these interventions are already in place. Hence, it is expected that outbreaks will terminate before, or shortly after, cases start to accrue in the vaccine and placebo arms.

Recent outbreaks of Marburg virus in Africa: an urgent call for public concern

Recent outbreaks of Marburg virus in Africa: an urgent call for public concern

Marburg virus disease outbreak amid COVID-19 pandemic: an emerging concern in Ghana, West Africa.

Marburg virus disease outbreak amid COVID-19 pandemic: an emerging concern in Ghana, West Africa.

Deadly Marburg virus in Ghana, 2022 amidst monkeypox and COVID-19 pandemic: A distressing concern for public health.

Deadly Marburg virus in Ghana, 2022 amidst monkeypox and COVID-19 pandemic: A distressing concern for public health.

The SPIN framework to control and prevent the Marburg virus disease outbreak in Equatorial Guinea.

A full grasp of the epidemiological factors promoting transmission is necessary for responding to highly infectious diseases, which involves their control and prevention. With the recent outbreak of Marburg Virus Disease (MVD) in Equatorial Guinea, we saw the need to re-shed some technical light based on our field experiences and published literature. We reviewed 15 previous MVD outbreaks globally. Coupled with core One-Health approaches, we highlighted the SPIN (socio-environmental context, possible transmission routes, informing and guiding public health action, needs in terms of control measures) framework as a guiding tool for response teams to appropriately approach this highly contagious infectious disease outbreak for collective and stronger global health security. The Central African Regional Collaborating Centre (RCC) of the Africa Centres for Disease Control and Prevention (Africa CDC) has a big lead role to play, most especially in coordinating the community engagement and risk communication packages of the response, which is highly needed at this point. We reiterate that this framework remains relevant, if not timely, in rethinking pandemic preparedness and response in resource-limited settings.

An outbreak of Marburg virus disease: World Health Organization

In this review, we discussed in brief about the recent emergency update released by the World Health Organization (WHO) (July 22, 2022) on Marburg virus disease (MVD). This virus was first identified in some African countries in 1976 as hemorrhagic fever. This was noticed that year during a series of Marburg virus (MARV) infections in German cities as well as in the Yugoslav capital of Belgrade. The epidemic was linked to research involving African apes transported from Uganda. To complete this review, we used previously published studies related to this disease and a regular visit to the WHO’s official website to know the current status of MVD. Information was collected from Google scholar, PubMed, Research gate, and national library of medicine from September 2022 to December 2022. The main objective of this study is to provide current information on MVD to researchers, practicians, health-care professionals, and academicians due to awareness. If people know about that disease, only then can they handle and prevent it themselves. For this, we include the pathogenesis of the disease, epidemiology status, symptoms of the disease, how to diagnose according to the WHO guidelines, possible treatments according to the WHO, and a brief comparison of COVID-19 and MARV. This is a needful study for future perspective because if no one takes it seriously, then maybe in the future, it will become a severe pandemic like COVID-19.

Marburg Virus and Monkeypox Virus: The Concurrent Outbreaks in Ghana and the lesson learned from the Marburg Virus Containment

Ghana, a country in the African continent experienced its first ever outbreak of Marburg Virus disease on July 2022. Prior to this, Democratic Republic of Congo and Angola were the two most severely affected countries to be affected by the same disease. Marburg Virus disease is a lethal and serious disease with an average mortality of 50% and has been seen to go as high as 90% in some cases. But despite the propensity to cause fast epidemics, the Ghana government acted swiftly and controlled its spread saving many lives. Simultaneously the country was also facing the Monkeypox outbreak and was doing its best to control the outbreak. This brief article is about the containment measures taken by the country to effectively prevent both the diseases to spread.

Recent outbreak of Marburg virus disease: Could it be a threat for global public health?

Recent outbreak of Marburg virus disease: Could it be a threat for global public health?

Emergence of Marburg Virus Disease in West Africa amid COVID-19 and Ebola: Efforts, Challenges, and Recommendations to Prevent the Next Public Health Crisis

Marburg virus disease (MVD) is a type of hemorrhagic fever caused by a genetically unique animal-borne RNA virus of the filovirus family-like Ebola virus. The African fruit bat is the known reservoir of this virus, and due to its animal-to-animal, animal-to-human, and human-to-human transmission patterns, it is capable of rapid spread. The history of previous MVD outbreaks shows that this can be highly fatal, and the fatality rate can reach up to 90%.

2022 outbreak of Marburg virus disease in Ghana: Public health alert

Marburg virus disease is a severe viral disease that is often associated with high mortality. The outbreak of the fatal hemorrhagic disease has been reported for the first time in Ghana in 2022, wherein two cases of the disease were reported in hospitals. The World Health Organization has strengthened its ongoing activities by alerting the neighboring nations, deployment of experts in the nation, and increasing the availability of personal protective equipment. The success of sustainable control of the infection lies in the engagement of the community and this essentially requires measures to create awareness about the infection. It is of paramount importance to safeguard the well-being of healthcare professionals and thus each and every one of them should be sensitized and trained about the safety measures. To conclude, Marburg virus disease results in hemorrhagic manifestations, which makes the infected persons highly prone to adverse clinical outcomes. The first outbreak of the infection reported in Ghana is a reminder for international health agencies and public health authorities that we cannot let our guard down and there is an indispensable need to strengthen infection prevention and control measures.

Recurrent Marburg virus disease outbreaks from 1967 to 2022: A perspective on challenges imposed and future implications

Recurrent Marburg virus disease outbreaks from 1967 to 2022: A perspective on challenges imposed and future implications

Marburg virus disease outbreak in Guinea: a SPIN framework of its transmission and control measures for an exemplary response pattern in West Africa.

Responding to highly infectious diseases relies on a thorough understanding of transmission epidemiology. With the recent outbreak of Marburg Virus Disease (MVD) in Guinea, we saw the need to shed some technical light based on published literature and our field experiences. We reviewed 14 previous MVD outbreaks globally. Coupled with core one - health approaches, we propose a Socio-environmental context, Possible transmission routes, Informing and guiding public health action, Needs in terms of control measures (SPIN) framework as a guiding tool for response teams to appropriately approach future infectious disease outbreaks.

Comparing small world network and traditional models of Marburg virus disease

Like Ebola, Marburg Virus Disease (MVD), formerly known as Marburg hemorrhagic fever, belongs to the deadly Filovirus family of viruses. It is transmitted among humans when an individual comes into contact with the bodily fluids of an infected person. We model the spread of the Marburg virus disease u Susceptible-Exposed-Infectious-Recovered (SEIR) epidemic model and a small-world network model. The World Health Organization (WHO) recommends “community engagement as key to successfully controlling MVD outbreaks. Good outbreak control relies on applying a package of interventions, including infection prevention and control practices, surveillance and contact tracing and social mobilization. This paper highlights the need for a network based model over the traditional models to control the spread of MVD.