Marburg hemorrhagic fever natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief:
Overview
Case fatality rates in Marburg hemorrhagic fever outbreaks have ranged from 23% to 90%.
Natural History
- Humans and nonhuman primates are susceptible to filovirus infection and are considered to be end hosts.[1]
- Surveys to identify animal reservoirs and arthropod vectors have been aggressively undertaken in endemic areas, particularly after most large filovirus outbreaks.
- If left untreated symptoms of marburg hemorrhagic fever become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhage, and multi-organ dysfunction.
- Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases such as malaria or typhoid fever, clinical diagnosis of the disease can be difficult, especially if only a single case is involved.
Complications
Common complications of marburg hemorrhagic fever include:[2][3]
- Orchitis
- Transverse myelitis
- Parotitis
- Pancreatic hemorrhage
- Chronic hepatitis
Prognosis
- Prognosis of marburg hemorrhagic fever is generally poor.[4][5]
- Case fatality rates in marburg hemorrhagic fever outbreaks have ranged from 23% to 90%.
- Both acute kidney injury and higher viral load are associated with adverse outcome and increased mortality.
- Younger children (<5 years) and adults(> 40 years) have a higher mortality rate compared with adolescents and younger adults.
- Patients who live through the second week of infection have a >75% chance of surviving.
- Viral shedding in seminal fluid may continue for more than a year and a half after recovery.
- Patients who survive commonly exhibit a protracted recovery characterized by arthralgias, fatigue, ocular symptoms, headache, abdominal pain, anemia, and deafness.
References
- ↑ Grolla A, Lucht A, Dick D, Strong JE, Feldmann H (2005). "Laboratory diagnosis of Ebola and Marburg hemorrhagic fever". Bull Soc Pathol Exot. 98 (3): 205–9. PMID 16267962.
- ↑ Bausch DG, Borchert M, Grein T, Roth C, Swanepoel R, Libande ML, Talarmin A, Bertherat E, Muyembe-Tamfum JJ, Tugume B, Colebunders R, Kondé KM, Pirad P, Olinda LL, Rodier GR, Campbell P, Tomori O, Ksiazek TG, Rollin PE (2003). "Risk factors for Marburg hemorrhagic fever, Democratic Republic of the Congo". Emerging Infect. Dis. 9 (12): 1531–7. doi:10.3201/eid0912.030355. PMC 3034318. PMID 14720391.
- ↑ Roddy P, Thomas SL, Jeffs B, Nascimento Folo P, Pablo Palma P, Moco Henrique B, Villa L, Damiao Machado FP, Bernal O, Jones SM, Strong JE, Feldmann H, Borchert M (2010). "Factors associated with Marburg hemorrhagic fever: analysis of patient data from Uige, Angola". J. Infect. Dis. 201 (12): 1909–18. doi:10.1086/652748. PMC 3407405. PMID 20441515.
- ↑ Smith CE, Simpson DI, Bowen ET, Zlotnik I (1967). "Fatal human disease from vervet monkeys". Lancet. 2 (7526): 1119–21. PMID 4168558.
- ↑ Kissling RE, Robinson RQ, Murphy FA, Whitfield SG (1968). "Agent of disease contracted from green monkeys". Science. 160 (3830): 888–90. PMID 4296724.