Marburg

Marburg virus disease (MVD) is a rare but severe disease caused by infection with Marburg virus. Marburg is in the same viral family (filovirus) as Ebola, and the two diseases are clinically similar.

Many of the signs and symptoms of MVD are similar to other infectious diseases (such as malaria or typhoid fever) or viral hemorrhagic fevers that may be endemic in the area (such as Lassa fever or Ebola). Signs and symptoms typically begin with severe fever, followed by chills, headache, myalgia, and severe malaise, with severe watery diarrhea, abdominal pain and cramping, nausea and vomiting potentially beginning on the third day. Around the fifth day after the onset of symptoms, a maculopapular rash, most prominent on the trunk (chest, back, stomach), may occur. In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock.

Marburg virus disease was initially detected in 1967 after simultaneous outbreaks in Marburg and Frankfurt, Germany, and Belgrade, Serbia. Outbreaks and sporadic cases have been reported in Uganda, the Democratic Republic of the Congo, and Angola.

Additional cases have been reported in travelers visiting endemic regions who have contact with fruit bats (Rousettus aegyptiacus) or who enter caves or mines inhabited by these bats. In 2008 cases were reported in the U.S. and the Netherlands, both with recent travel to Uganda. On August 9, 2021, health authorities in Guinea confirmed a case of Marburg virus disease (MVD); investigations into the source are ongoing. And on July 17, 2022, Ghana announced its first outbreak of Marburg, source unknown.

On February 13, 2023, Equatorial Guinea confirmed its first-ever outbreak of Marburg virus disease (WHO).

On September 27, 2024, the Rwanda Ministry of Health announced the confirmation of Marburg virus disease (WHO).

Person-to-person transmission of the virus spreads through direct contact (such as through broken skin or mucous membranes in the eyes, nose, or mouth) with:

blood or body fluids,
objects contaminated with body fluids from a person who is sick with or has died from Marburg virus disease, or
semen from a man who recovered from MVD (the virus can remain in certain body fluids of a patient who has recovered from MVD, even if they no longer have symptoms of severe illness)

Hospital and ambulatory staff members should screen all patients for exposure history, including travel to endemic areas, contact with sick persons or animals, and other risk factors for viral hemorrhagic fever. See UNMC's tool for screening patients.

If a person has symptoms of MVD and a possible exposure to Marburg virus, follow the identify, isolate, and inform strategy to reduce exposure in your health care facility. Watch NETEC’s webinar on The I’s Have It: Identify, Isolate, and Inform.

Follow guidance for personal protective equipment (PPE) and precautions necessary to use when managing a patient suspected or confirmed to be infected with a viral hemorrhagic fever. See NETEC’s PPE and precautions matrix.

Laboratory tests on patient samples present a high risk of transmission. See NETEC’s flyer with laboratory resources related to Marburg virus.

All hospitals should review their preparedness for high consequence infectious diseases and be ready to promptly identify, safely isolate and notify their key partners. NETEC is available to support hospitals assess and advance their operational readiness. The VHF Preparedness Checklist can be completed and submitted back to NETEC and the RESPTC with the opportunity to request our assistance. The tool is also available to be downloaded and completed independently at this link.

NETEC has collected some essential resources on this page. Additionally, health care and public health professionals can submit a question to one of NETEC’s many experts via the web portal or by emailing info@netec.org.