Marburg hemorrhagic fever primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief:

Primary Prevention

• No specific treatment or vaccine is yet available for MHF. Several vaccine candidates are being tested but it could be several years before any are available. New drug therapies have shown promising results in laboratory studies and are currently being evaluated.
• One way to protect against infection is avoiding fruit bats, and sick non-human primates in central Africa.

Precautionary measures for pig farms in endemic zones

Avoid pigs becoming infected through preventing contact with fruit bats in pig farms in Africa. There may be potential amplification of the virus which may cause or contribute to outbreak of Marburg hemorrhagic fever.

Reducing the risk of infection in people

In the absence of effective treatment and human vaccine, raising awareness of the risk factors for Marburg infection and the protective measures individuals can take to reduce human exposure to the virus, are the only ways to reduce human infections and deaths.

During MHF outbreaks in Africa, public health educational messages for risk reduction should focus on:

• Reducing the risk of bat-to-human transmission:
  • Bat-to-human transmissiomn arises from prolonged exposure to mines or caves inhabited by fruit bat colonies.
  • People should wear gloves and other appropriate protective clothing (including masks) during work or research activities or tourist visits in mines or caves inhabited by fruit bat colonies.
  • All animal products (blood and meat) should be thoroughly cooked before consumption during the outbreaks.
• Reducing the risk of human-to-human transmission:
  • Human-to-human transmission arises through direct or close contact with infected patients (particularly with their body fluids).
  • Close physical contact should be avoided with patients suffering from Marburg hemorrhagic fever.
  • When taking care of ill patients at home, gloves and appropriate personal protective equipment should be worn.
  • Regular hand washing should be performed after visiting sick relatives in hospital, as well as after taking care of ill patients at home.
• Communities affected by Marburg
  • Efforts should be made to ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures.
• Outbreak containment measures
  • Prompt and safe burial of the dead
  • Identifying people who may have been in contact with someone infected with Marburg and monitoring their health for 21 days
  • Separating the healthy from the sick to prevent further spread
  • Maintaining good hygiene and a clean environment
• Reducing the risk of possible sexual transmission.
  • WHO recommends that male survivors of Marburg virus disease practice safe sex and hygiene for 12 months from onset of symptoms or until their semen twice tests negative for Marburg virus.
• Contact with body fluids should be avoided and washing with soap and water is recommended.
• WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for Marburg virus.

Controlling infection in health-care settings

• Health-care workers caring for patients with suspected or confirmed Marburg virus should apply infection control precautions to avoid any exposure to blood and body fluids and to direct unprotected contact with possibly contaminated environment. Therefore, provision of health care for suspected or confirmed Marburg patients requires specific control measures and reinforcement of standard precautions, particularly hand hygiene, use of personal protective equipment (PPE), safe injection practices, and safe burial practices.

Laboratory workers are also at risk. Samples taken from suspected human and animal Marburg cases for diagnosis should be handled by trained staff and processed in suitably equipped laboratories.