NationMaster - Encyclopedia: Marburg hemorrhagic fever

The Marburg virus is the causative agent of Marburg hemorrhagic fever. Both the disease and virus are related to Ebola and originate in the same part of Africa (Uganda and Eastern Congo). The zoonosis is of unknown origin, but some scientists believe it may be hosted by bats. Negative stain electron micrograph of Marburg virus particles, showing structure typical of Filoviridae, as well as characteristic Sheperds Crook. Magnification is approximately 100,000x. ... Scientific classification or biological classification is how biologists group and categorize extinct and living species of organisms. ... Three types of viruses: a bacterial virus, otherwise called a bacteriophage (left center); an animal virus (top right); and a retrovirus (bottom right). ... Viruses can be classified in several ways, such as by their geometry, by whether they have envelopes, by the identity of the host organism they can infect, by mode of transmission, or by the type of disease they cause. ... Families Paramyxoviridae Rhabdoviridae Filoviridae Bornaviridae The Mononegavirales are an order of viruses comprising species that have a non-segmented, negative sense RNA genome. ... Genera Marburgvirus Ebolavirus Filoviruses are viruses belonging to the family Filoviridae, which is in the order Mononegavirales. ... A biological agent is an infectious disease that can be used in bioterrorism or biological warfare. ... Marburg is a city in Hesse, Germany, on the Lahn river. ... Viral hemorrhagic fevers are a group of illnesses that are caused by several distinct families of viruses: Arenavirus, Filoviridae, Bunyaviridae and Flavivirus. ... A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. ... Three types of viruses: a bacterial virus, otherwise called a bacteriophage (left center); an animal virus (top right); and a retrovirus (bottom right). ... Species Ivory Coast ebolavirus Reston ebolavirus Sudan ebolavirus Zaire virus Ebola hæmorrhagic fever (EHF — alternatively Ebola hemorrhagic fever; commonly referred to as simply Ebola) is a recently identified, severe, often fatal infectious disease occurring in humans and some primates caused by the Ebola virus. ... Africa is the largest of the three great southward projections from the main mass of the Earths surface. ... Zoonosis is any infectious disease that can be transmitted from animals, both wild and domestic, to humans. ... Families Pteropodidae Emballonuridae Rhinopomatidae Craseonycteridae Rhinolophidae Nycteridae Megadermatidae Vespertilionidae Molossidae Antrozoidae Natalidae Myzopodidae Thyropteridae Furipteridae Noctilionidae Mystacinidae Mormoopidae Phyllostomidae Bats are flying mammals in the order Chiroptera with forelimbs developed as wings. ...

The disease is spread through bodily fluids, including blood, excrement, saliva, and vomit. There is no cure or vaccine for this deadly and infectious virus. Victims suffer a high fever, diarrhea, vomiting, and severe bleeding from bodily orifices and usually die within a week. Fatality rates range from 25 to 100 percent. Bodily fluids are fluids, which are generally excreted or secreted from the human body. ... Red blood cells (erythrocytes) are present in the blood and help carry oxygen to the rest of the cells in the body Blood is a circulating tissue composed of fluid plasma and cells (red blood cells, white blood cells, platelets). ... Feces (also spelled faeces or fæces) are the waste products from the digestive tract expelled through the anus during defecation. ... For the band, see Saliva (band). ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... A bottle and a syringe containing the influenza vaccine. ... Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ... Fever, also known as pyrexia, is a medical symptom which describes an increase in temperature to levels which are above normal (37 degrees Celsius, 98. ... Diarrhea in American English, (spelled diarrhoea in other anglophone countries) is a condition in which the sufferer has frequent and watery or loose bowel movements (from the ancient Greek word διαρροή = leakage; lit. ...

As of May 2005, the virus is attracting widespread press attention for an outbreak in Angola. Beginning in October 2004 and continuing into 2005, the outbreak, which remains out of control, is the world's worst epidemic of any kind of hemorrhagic fever. 2005 is a common year starting on Saturday of the Gregorian calendar. ... October is the tenth month of the year in the Gregorian Calendar and one of seven Gregorian months with the length of 31 days. ... 2004 is a leap year starting on Thursday of the Gregorian calendar. ... 2005 is a common year starting on Saturday of the Gregorian calendar. ... An epidemic is generally a widespread disease that affects many individuals in a population. ...

The Marburg virus

The viral structure is typical of filoviruses, with long threadlike particles which have a consistent diameter but vary greatly in length from an average of 800 nanometres up to 14,000 nm, with peak infectious activity at about 790 nm. Virions (viral particles) contain seven known structural proteins. While nearly identical to Ebola virus in structure, Marburg virus is antigenically distinct from Ebola virus — in other words, it triggers different antibodies in infected organisms. It was the first filovirus to be identified. Genera Marburgvirus Ebolavirus Filoviruses are viruses belonging to the family Filoviridae, which is in the order Mononegavirales. ... A nanometre (American spelling: nanometer) is 1. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... Species Ivory Coast ebolavirus Reston ebolavirus Sudan ebolavirus Zaire virus Ebola hæmorrhagic fever (EHF — alternatively Ebola hemorrhagic fever; commonly referred to as simply Ebola) is a recently identified, severe, often fatal infectious disease occurring in humans and some primates caused by the Ebola virus. ... An antigen is a molecule that stimulates the production of antibodies. ... Wikipedia does not yet have an article with this exact name. ... Genera Marburgvirus Ebolavirus Filoviruses are viruses belonging to the family Filoviridae, which is in the order Mononegavirales. ...

Infection details

Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases, such as malaria or typhoid, diagnosis of the disease can be difficult, especially if only a single case is involved. Red blood cell infected with Malaria (Italian: bad air; formerly called ague or marsh fever in English) is an infectious disease which in humans causes about 500 million infections and 2 million deaths annually, mainly in the tropics and sub-Saharan Africa. ... This is about the disease typhoid fever. ...

The disease is characterised by the sudden onset of fever, headache, and muscle pain after an incubation period of 3-9 days. Within a week, a maculopapular rash develops, followed by vomiting, chest and abdominal pain, and diarrhea. The disease can then become increasingly damaging, causing jaundice, delirium, organ failure, and extensive hemorrhage. Patients generally die from hypovolemic shock as fluid leaks out of the blood vessels, causing blood pressure to drop. Fever, also known as pyrexia, is a medical symptom which describes an increase in temperature to levels which are above normal (37 degrees Celsius, 98. ... A headache is a condition of mild to severe pain in the head; sometimes upper back or neck pain may also be interpreted as a headache. ... Myalgia means muscle pain and is a symptom of many diseases and disorders. ... A maculopapular rash (little spots or bumps) is a flat red rash which may include pimples or spots similar to those caused by measles. ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... This article is in need of attention. ... According to the International Society for the Study of Pain, there are two different terms: pain and nociception. ... Diarrhea in American English, (spelled diarrhoea in other anglophone countries) is a condition in which the sufferer has frequent and watery or loose bowel movements (from the ancient Greek word διαρροή = leakage; lit. ... Jaundice, technically known as icterus, is yellowing of the skin, sclera (eyes) and mucous membranes caused by increased levels of bilirubin in the system. ... Delirium is a medical term used to describe a mental state. ... In biology, an organ (Latin organum: instrument, tool) is a group of tissues, which perform a specific function or group of functions. ... Hemorrhage (alternate spelling is Haemorrhage) is the medical term meaning bleeding. ... In physiology and medicine, hypovolemia is a state of decreased blood volume. ... In medicine, shock is a life-threatening medical emergency characterized by inability of the body to supply enough oxygen to meet tissue requirements. ...

Recovery from the disease is prolonged and can be marked by orchitis, recurrent hepatitis, transverse myelitis or uveitis, or inflammation of the spinal cord, eyes, or parotid gland. Depending upon health care and hospitalization support, the disease can have very high fatality rates, with estimates ranging from 25 percent up to 100 percent. [1] (http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg.htm) [2] (http://www.recombinomics.com/News/03270504/Marburg_Luanda_Transmission.html) Orchitis is the swelling of the testicles. ... In medicine (gastroenterology), hepatitis is any disease featuring inflammation of the liver. ... Myelitis is a human disease involving swelling of the spinal cord, which disrupts central nervous system functions linking brain and limbs. ... Uveitis specifically refers to inflammation of the middle layer of the eye, termed the uvea but in common usage may refer to any inflammatory process involving the interior of the eye. ... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... The spinal cord is a part of the vertebrate nervous system that is enclosed in and protected by the vertebral column (it passes through the spinal canal). ... An eye is an organ that detects light. ... The parotid gland is the largest of the salivary glands. ... Health care or healthcare is the delivery of medical services by specialist providers, such as midwives, doctors, nurses, home health aides, vaccination technicians and physicians assistants. ... A hospital today is an institution for professional health care provided by physicians and nurses. ...

Infection is believed to be spread by close contact with body fluids of those infected, and the virus is unlikely to spread through casual contact. Patients are most contagious during the acute phase of the illness when fluids such as vomit and blood are present. Unsafe burial practices such as embracing, kissing or ritual bathing of the corpse present another infection vector. [3] (http://www.swissinfo.org/sen/swissinfo.html?siteSect=143&sid=5687036&cKey=1113528035000) By other animals Humans are not the only species to bury their dead. ...

According to a report in the New York Times, the virus moves very quickly. "On Day 3 of the infection, fewer than 200 viruses are in a drop of blood. By Day 8, there are five million."

Treatment and prevention

As with other hemorrhagic fever viruses, the treatment options for Marburg are limited. Hypotension and shock may require early administration of vasopressors and hemodynamic monitoring with attention to fluid and electrolyte balance, circulatory volume, and blood pressure. Viral hemorrhagic fever (VHF) patients tend to respond poorly to fluid infusions and rapidly develop pulmonary edema. Viral hemorrhagic fevers are a group of illnesses that are caused by several distinct families of viruses: Arenavirus, Filoviridae, Bunyaviridae and Flavivirus. ... Pulmonary Edema is swelling and/or fluid accumulation in the lungs. ...

Patient caregivers require barrier infection control measures including double gloves, impermeable gowns, face shields, eye protection, and leg and shoe coverings.

A few research groups are working on drugs and vaccines to fight the virus. In 2002, Genphar, a company doing research for the United States Army's biodefense program, announced that an experimental vaccine protected animals from a high dose of Marburg virus. The tests were conducted by the United States Army Medical Research Institute of Infectious Diseases (USAMRIID). According to the company, all animals in the control group died within days whereas all animals that received the regular dosage of the vaccine were fully protected. The company has moved on to non-human primate trials. [4] (http://www.genphar.com/news/100702.html) Late in 2003, the US government awarded the company a contract worth $8.4 million for what was described as "a multivalent Ebola, Marburg filovirus vaccine program". Research is an active, diligent and systematic process of inquiry in order to discover, interpret or revise facts, events, behaviours, or theories, or to make practical applications with the help of such facts, laws or theories. ... Many drugs are provided in tablet form. ... 2002 is a common year starting on Tuesday of the Gregorian calendar. ... The Army is the branch of the United States armed forces which has primary responsibility for land-based military operations. ... Biodefense refers to short term, local, usually military measures to restore biosecurity to a given group of persons in a given area — in the civilian terminology, it is a very robust biohazard response. ... The U.S. Army Medical Research Institute of Infectious Diseases is based at Fort Detrick, Frederick, Maryland. ... 2003 is a common year starting on Wednesday of the Gregorian calendar. ...

Early outbreaks

This virus was first documented in 1967, when 31 people became ill in the German town of Marburg, after which it is named, as well as in Frankfurt am Main and the then Yugoslavian city of Belgrade. The outbreak involved 25 primary infections, with 7 deaths, and 6 secondary cases, with no deaths. The primary infections were in laboratory staff exposed to the Marburg virus while working with monkeys or their tissues. The secondary cases involved two doctors, a nurse, a post-mortem attendant, and the wife of a veterinarian. All secondary cases had direct contact, usually involving blood, with a primary case. Both doctors became infected through accidental skin pricks when drawing blood from patients. 1967 was a common year starting on Sunday of the Gregorian calendar. ... Marburg is a city in Hesse, Germany, on the Lahn river. ... Frankfurt am Main [ˈfraŋkfʊrt] is the largest city in the German state of Hessen and the fifth largest city of Germany. ... Yugoslavia (Jugoslavija in all south Slavic languages) is a term used for three separate but successive political entities that existed during most of the 20th century on the Balkan Peninsula in Europe. ... Belgrade (Serbian, Београд, Beograd listen), is the capital (2003–) of Serbia and Montenegro and Yugoslavia (1918–2003). ... Biochemistry laboratory at the University of Cologne. ... Cynomolgus Monkey at Batu Caves, Malaysia A monkey is any member of two of the three groupings of simian primates. ... A nurse comforting a patient A nurse is a health care professional, who is engaged in the practice of nursing. ... In American and Canadian English, a veterinarian (from Latin veterinae, draught animals) is an animal doctor, a practitioner of veterinary medicine. ...

The outbreak was traced to infected African grivets of the species Cercopithecus aethiops taken from Uganda and used in developing polio vaccines. The monkeys were imported by Behringwerke, a Marburg company founded by the first winner of the Nobel Prize in Medicine, Emil von Behring. The company, which at the time was owned by Hoechst and is now part of Aventis, was originally set up to develop serums against tetanus and diphtheria. A grivet is an African monkey with long white tufts of hair along the sides of the face. ... In biology, a species is a kind of organism. ... Poliomyelitis (polio), or infantile paralysis, is a viral paralytic disease. ... A bottle and a syringe containing the influenza vaccine. ... A company in the broadest sense is an aggregation of people who stay together for a common purpose. ... List of Nobel Prize laureates in Physiology or Medicine from 1901 to the present day. ... Emil Adolf von Behring (March 15, 1854 - March 31, 1917) was born at Hansdorf, Germany. ... Hoechst AG was a company focusing on life sciences, specifically pharmaceuticals, agriculture, and animal health. ... Aventis was formed in 1999 when Rhône-Poulenc S.A. merged with Hoechst AG. The merged company was based in France. ... Blood plasma is a component of blood. ... Tetanus is a serious and often fatal disease caused by the exotoxin tetanospasmin which is produced by the Gram-positive, anaerobic bacterium Clostridium tetani. ...

In 1975, three people in South Africa were infected by the Marburg virus by a man returning from Zimbabwe, resulting in one death. Two similar cases in 1980 and 1987 occurred in Kenya after European visitors went to Kitum Cave. Both later died. The next major outbreak occurred in the Democratic Republic of Congo from 1998 to 2000, where 123 of 149 cases were fatal. This outbreak originated with miners in Durba and Watsa in Orientale, Congo. 1975 was a common year starting on Wednesday (the link is to a full 1975 calendar). ... 1980 is a leap year starting on Tuesday. ... 1987 is a common year starting on Thursday of the Gregorian calendar. ... Kitum Cave is a lava tube cave in Mount Elgon National Park in Kenya. ... 1998 is a common year starting on Thursday of the Gregorian calendar, and was designated the International Year of the Ocean. ... 2000 is a leap year starting on Saturday of the Gregorian calendar. ... Orientale (also Oriental) (formerly Haute-Zaire) is a province of the Democratic Republic of Congo. ...

2004-2005 outbreak in Angola

In early 2005, the World Health Organization began investigating an outbreak of a then-undiagnosed hemorrhagic fever in Angola, which was centered around the northeastern Uige Province. The disease may have surfaced as early as March 2004 in a crowded children's ward. A doctor noted that a child, who subsequently died, was displaying signs of hemorrhagic fever. By October, the death rate on the ward went from three to five children a week to three to five a day. On March 22, 2005, as the death toll neared 100, the cause of the illness was identified as the Marburg virus. By May 16, 2005, Angola's health department reported that 292 of 336 known cases had been fatal. There have been cases in 7 of 18 provinces but the outbreak seems mostly confined to Uige province. 2005 is a common year starting on Saturday of the Gregorian calendar. ... For other meanings of the acronym WHO, see WHO (disambiguation) WHO flag Headquartered in Geneva, Switzerland, the World Health Organization (WHO) is an agency of the United Nations, acting as a coordinating authority on international public health. ... Uige is a province of Angola. ... March 22 is the 81st day of the year in the Gregorian Calendar (82nd in Leap years). ... 2005 is a common year starting on Saturday of the Gregorian calendar. ... May 16 is the 136th day of the year in the Gregorian Calendar (137th in leap years). ... 2005 is a common year starting on Saturday of the Gregorian calendar. ...

According to the World Health Organization, 80 percent of the deaths in the early stages of the Angola outbreak were children under the age of 15, but that has dropped to 30 to 40 percent. [5] (http://www.kentucky.com/mld/kentucky/news/world/11489787.htm) The virus has also taken a toll on health care workers, including 14 nurses and two doctors.

There has been speculation that the high death rate among children in the early stages of this outbreak may simply be due to the initial appearance of the disease in the children's ward at the Uige hospital. Early death rates (prior to effective monitoring) are meaningless as only the dead are adequately counted.

Deaths by Month

Deaths by Week

Control efforts

Countries with direct airline links, such as Portugal, have begun screening passengers arriving from Angola. The Angolan government has asked for international assistance, pointing out that there are only about 1,200 doctors in the entire country, with some provinces having as few as two. Health care workers have also complained about a shortage of personal protection equipment such as gloves, gowns and masks. Médecins Sans Frontières (MSF) reported that when their team arrived at the provincial hospital at the centre of the outbreak, they found it operating without water and electricity. Contact tracing is complicated by the fact that the country's roads and other infrastructure have been devastated after nearly three decades of civil war and the countryside remains littered with land mines. Médecins Sans Frontières (abbreviated MSF; known as Doctors Without Borders in the English language, as Médicos Sin Fronteras in the Spanish language and as Médicos Sem Fronteiras in Portuguese language) is a nonprofit private organisation created in 1971 by a small group of French doctors led... Water (from the Anglo-Saxon and Low German wæter) is a colourless, tasteless, and odourless substance that is essential to all known forms of life and is the most universal solvent. ... The article on electrical energy is located elsewhere. ... In epidemiology, contact tracing is the identification and diagnosis of persons who may have come into contact with an infected person. ... The Angolan War of Independence (1961–1989) was a multi-faction struggle for control of Angola. ... A landmine is a type of mine which is placed onto or into the ground and explodes when triggered by a vehicle or person. ...

One innovation in the Angola outbreak has been the use of a portable laboratory operated by a team of Canadian doctors and technicians. The lab, which can operate on a car battery, has eliminated the need to send blood samples outside the country for testing. This has reduced the turnaround time from days or weeks to about four hours.

Meanwhile, at Americo Boa Vida Hospital in the capital, Luanda, a team of international experts has prepared a special isolation ward to handle cases from the countryside. The ward can accommodate up to 40 patients, but there has been growing resistance to medical treatment. Because the disease has almost invariably resulted in death, some people have come to view hospitals and medical workers with suspicion and there was a brief period when medical teams were attacked in the countryside. [6] (http://www.iol.co.za/index.php?set_id=1&click_id=84&art_id=qw1113046741868B243) A specially-equipped isolation ward at the provincial hospital in Uige is reported to be empty, even though the facility is at the center of the outbreak. [7] (http://www.reuters.com/newsArticle.jhtml?type=healthNews&storyID=8193079) WHO has been forced to implement what they describe as a "harm reduction strategy" which entails distributing disinfectants to affected families who refuse hospital care. An education effort and an increase in the number of Angolan health practitioners in the outbreak area, has resulted in improved relations with the community. In politics a capital (also called capital city or political capital — although the latter phrase has an alternative meaning based on an alternative meaning of capital) is the principal city or town associated with its government. ... Luanda (formerly called Loanda) is the largest city and capital of Angola. ...