Marburg hemorrhagic fever history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]

Overview

Marburg hemorrhagic fever initially appears as a nonspecific febrile illness, which then rapidly progresses and leads to hemorrhagic complications and in severe cases may lead to a septic shock-like syndrome.

History and Symptoms

• Marburg hemorrhagic fever initially appears as a nonspecific febrile illness, which then rapidly progresses and leads to hemorrhagic complications and in severe cases may lead to a septic shock-like syndrome.
• Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases, such as malaria or typhoid, diagnosis of the disease can be difficult, especially if only a single case is involved.
• The incubation period (interval from infection to onset of symptoms) varies from 5 to 10 days. The disease is spread through bodily fluids, including blood, excrement, saliva, and vomit and a history of such contact should be solicited.
• Many patients develop severe hemorrhagic manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding, often from multiple areas. Fresh blood in vomitus and feces is often accompanied by bleeding from the nose, gums, and vagina. Spontaneous bleeding at venipuncture sites can also occur.
• The time course varies but the disease lasts betweeen one and three weeks.
• The fatality rate ranges from 23 to 90%.
• Death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock. If a patient survives, recovery is usually prompt and complete, though it may be prolonged in some cases. Persistent symptoms may include inflammation or secondary infection of various organs, including: orchitis, hepatitis, transverse myelitis, uveitis, or parotitis. Involvement of the central nervous system can result in confusion, irritability, and aggression. Orchitis has been reported occasionally in the late phase of disease (15 days).
• The major cause of death is attributed to multiorgan failure and shock.
• Survivors experience delayed recovery with a variety of complications.

Marburg Hemorrhagic Fever: Symptoms and Disease Progression
Generalisation Phase (Day 1 to Day 5)	Fever Headache Chills Myalgia Malaise Fatigue Nausea Vomiting Diarrhoea Abdominal Pain Conjunctivitis Rash Pharyngitis
Early Organ Phase (Day 6 to Day 13)	Fever Bloody diarrhea (Melena) Hematemesis Exanthema Petechiae/ecchymoses Mucosal hemorrhage Visceral hemorrhage Dyspnea Conjunctival injection Edema Apathy/depression Irritability/aggression
Late Organ or Convalescence Phase (Day 14 to Day 21)	Fever Obtundation Dementia Coma Convulsions Diffuse coagulopathy Metabolic disturbances Shock Myalgia Arthralgia Hepatitis Asthenia Ocular disease Psychosis Social separation Orchitis (inflammation of one or both testicles)