Prognosis

Historically, Marburg virus disease is often fatal, with death occurring in 80% of historical cases, although case fatality rates of 24% to 88% have been reported. The average case fatality rate is 50%, and case fatality rates of 100% have been reported in small outbreaks (1 to 3 cases).[2] High case fatality rates in Marburg and Ebola virus disease patients in sub-Saharan Africa may be related to the lack of full supportive care available in resource-poor, rural settings where outbreaks have occurred.[46] Among survivors, complications such as myalgia, arthralgia, asthenia, hepatitis, ocular disease, psychosis and ostracisation are thought common.[9] Survivors develop long-lasting antibody response and are considered immune to reinfection by the same filovirus strain.

Pregnant women

Historically, survival among pregnant women with filovirus disease was very low and a poor prognosis was associated with pregnancy.[4][9] However, data from the 2014 to 2016 West Africa Ebola virus disease outbreak suggest that survival rates among pregnant women may equal those of other reproductive-aged women.[58] With appropriate and aggressive supportive care, it is likely that pregnant women with Ebola or Marburg virus disease have a similar prognosis to other reproductive-aged women.

Fetuses and neonates

Marburg virus infection during pregnancy is associated with nearly 100% incidence of spontaneous abortion and stillbirth.[9] Only one child born to an Ebola virus-infected mother is known to have survived longer than 19 days postpartum.[4][59] Thus, prognosis among congenitally infected fetuses and neonates is extremely poor.

Children

Data are limited for paediatric survival in Marburg virus infection. However, the first confirmed paediatric Marburg virus disease case survived, an 8-month old infant breastfed and cared for by her mother.[60]

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