Marburg hemorrhagic fever overview
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Differentiating Marburg hemorrhagic fever from other Diseases |
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Diagnosis |
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Treatment |
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Overview
The Marburg virus causes severe viral hemorrhagic fever in humans with case fatality rates ranging from 24% to 88%. [1] Rousettus aegypti, fruit bats of the Pteropodidae family, are considered to be natural hosts of Marburg virus. The Marburg virus is transmitted to people from fruit bats and spreads through human-to-human transmission. No specific antiviral treatment or vaccine is available.
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Marburg hemorrhagic fever from Other Diseases
Epidemiology and Demographics
Risk Factors
Common risk factors in the development of Marburg hemorrhagic fever include close contact with African fruit bats, human patients, or non-human primates infected with Marburg virus. Less common risk factors in the development of Marburg hemorrhagic fever include occupations (people who handle non-human primates from Africa) and travellers to endemic areas.
Screening
There is insufficient evidence to recommend routine screening for Marburg hemorrhagic fever.
Natural History, Complications, and Prognosis
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. Common complications of marburg hemorrhagic fever include orchitis, Transverse myelitis and Parotitis. Prognosis of marburg hemorrhagic fever is generally poor. Case fatality rates in marburg hemorrhagic fever outbreaks have ranged from 23% to 90%.
Diagnosis
Diagnostic Criteria
The diagnosis of Marburg hemorrhagic fever relies primarily on the laboratory techniques such as reverse transcriptase PCR and ELISA-based antigen and antibody detection.
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.
Physical Examination
Laboratory Findings
Marburg virus infection may be confirmed by the laboratory techniques such as antibody-capture enzyme-linked immunosorbent assay, antigen-capture detection tests, serum neutralization test, reverse-transcriptase polymerase chain reaction (RT-PCR), Antigen detection tests and virus isolation by cell culture.
Electrocardiogram
X-ray
Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
There has been no approved treatment regimen yet for Marburg virus disease. However, few of the treatment modalities such as blood component therapy, immune therapy, and drug therapy are currently being evaluated. Supportive care such as rehydration with oral or intravenous fluids and maintenance of electrolyte balance, analgesics and symptomatic treatment may be beneficial.
Surgery
Surgical intervention is not recommended for the management of Marburg hemorrhagic fever.
Primary Prevention
No specific treatment or vaccine is yet available for Marburg hemorrhagic fever. 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. Reducing the risk of infection to people include reducing the risk of bat-to-human transmission as well as human-to-human transmission, health education and, outbreak containment measures.
Secondary Prevention
Effective measures for the secondary prevention of transmission Marburg hemorrhagic fever from person-to-person include barrier nursing techniques (wearing of protective gowns, gloves, and masks, placing the infected individual in strict isolation, sterilization or proper disposal of needles, equipment, and patient excretions).