Last reviewed: 23 Feb 2023
Last updated: 14 Mar 2023
14 Mar 2023

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.

See Epidemiology

Original source of update



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



Lisa Bebell, MD

Infectious Diseases Division

Massachusetts General Hospital




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




MK declares that he has no competing interests.

Vanessa Raabe, MD, MSc

Adult and Pediatric Infectious Disease Fellow

Emory University




VR declares that she has no competing interests.

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