First-ever Marburg virus infection outbreak in Equatorial Guinea
Equatorial Guinea has confirmed its first-ever outbreak of Marburg virus infection. Nine cases have been reported including one confirmed case, four probable cases, and four suspected cases (as of 21 February 2023). Further investigations are ongoing. So far, all cases have been detected in the Kie-Ntem province.
Marburg virus infection is often fatal, with death occurring in approximately 70% of cases, although case fatality rates of 23% to 100% (in smaller outbreaks) have been reported. There are no vaccines or antivirals approved to treat the infection, but supportive care improves the chances of survival. Various vaccines and therapeutics are currently in development.
Summary
Definition
History and exam
Key diagnostic factors
- exposure to Marburg virus in previous 21 days
- fever
- myalgia
- malaise
Other diagnostic factors
- fatigue
- diarrhoea
- nausea/vomiting
- severe headache
- abdominal pain
- sore throat
- prostration
- maculopapular rash
- conjunctivitis
- hiccups
- difficulty breathing
- anorexia
- bleeding
- tachycardia
- hypotension
- neurological signs
- petechiae
Risk factors
- living or working in, or arrival from, endemic area in previous 21 days
- contact with infected body fluids
- occupational exposure
- bioterrorism
Diagnostic investigations
1st investigations to order
- reverse transcriptase polymerase chain reaction (RT-PCR)
- malaria investigations
Investigations to consider
- serum electrolyte levels
- serum creatinine and urea
- blood lactate
- ABG
- FBC
- coagulation studies
- urinalysis
- LFTs
- serum amylase level
- blood cultures
- antigen-capture enzyme-linked immunosorbent assay (ELISA)
- IgG antibodies
Treatment algorithm
Contributors
Authors
Lisa Bebell, MD
Infectious Diseases Division
Massachusetts General Hospital
Boston
MA
Disclosures
LB is the author of a reference cited in this topic.
Peer reviewers
Mark Kortepeter, MD, MPH
Professor of Epidemiology
University of Nebraska Medical Center
Omaha
NE
Disclosures
MK declares that he has no competing interests.
Vanessa Raabe, MD, MSc
Adult and Pediatric Infectious Disease Fellow
Emory University
Atlanta
GA
Disclosures
VR declares that she has no competing interests.
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