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Equatorial Guinea confirms Marburg outbreak – nine dead, 4,000 in quarantine

Equatorial Guinea has confirmed its first outbreak of Marburg disease, a virus which is closely related to Ebola and can kill up to 88 per cent of people it infects. 

 

Electron Micrograph Of The Marburg Virus© Provided by The Telegraph

Although only one case has been confirmed, 16 people are suspected of having caught the virus, nine of whom have died. More than 4,000 people have been quarantined at home.

Neighbouring Cameroon has restricted movement across the border. 

"Marburg is always very serious and we’re very concerned. The fact it's close to international borders is a concern," said Prof Jimmy Whitworth, a specialist in infectious diseases at the London School of Hygiene and Tropical Medicine. 

Another expert on haemorrhagic fevers told the Telegraph that there was added concern considering the country has no experience fighting viruses from the filovirus family, which includes both Marburg and Ebola. It is thought healthcare workers are among those who have been infected, they added.

At an emergency meeting held by the World Health Organization (WHO) on Tuesday, it was announced that the index case occurred a month ago, on January 7, and the ministry of health was alerted four weeks later. 

"Surveillance in the field has been intensified," said George Ameh, WHO's country representative in Equatorial Guinea.

"Contact tracing, as you know, is a cornerstone of the response. We have...redeployed the Covid-19 teams that were there for contact tracing and quickly retrofitted them to really help us out." 

 

The Egyptian rousette or Egyptian fruit bat - Alamy Stock Photo© Provided by The Telegraph

The small Central African country tested for the virus following the unexplained deaths of at least nine people in the country’s western Kie Ntem Province over the last week. It is understood that these people are thought to have been infected during funerals of other positive cases.

Marburg is a severe, often fatal illness. It begins abruptly, with high fever, severe headache and severe malaise. Many patients develop severe haemorrhagic symptoms within seven days. 

It is transmitted from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials.

Health experts are now racing to trace contacts of those affected and increase epidemiological surveillance.

Efforts are also under way to mount an emergency response, with the WHO deploying epidemiologists and infection prevention measures.

"One thing that is a little bit worrying is that it borders on to both Gabon and Cameroon," said Prof Whitworth. "We're going to need an international response."

"The positive signs are that the WHO is acting very quickly, they deployed a team very quickly and are meeting today to discuss vaccine and therapeutic options," he said.

He added that the current outbreak is in a sparsely populated and isolated area, which could help control its spread.

Marburg virus was first recognised in 1967, when outbreaks of haemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (now Serbia). The infections were traced back to three laboratories which received a shared shipment of infected African green monkeys.

Thirty-one people became ill, initially laboratory workers followed by several medical personnel and family members who had cared for them. Seven deaths were reported. The first people infected had been exposed to Ugandan imported African green monkeys or their tissues while conducting research.

Subsequently, outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda. These are naturally occurring, caused by bats.

“Marburg is highly infectious. Thanks to the rapid and decisive action by the Equatorial Guinean authorities in confirming the disease, emergency response can get to full steam quickly so that we save lives and halt the virus as soon as possible,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa.

There are no vaccines or antiviral treatments approved to treat the virus. However, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms improves survival rates. 

A range of potential treatments, including blood products, immune therapies and drug therapies, as well as vaccine candidates with early trial data, are being evaluated.