Marburg virus disease: Difference between revisions
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==Background== | ==Background== | ||
*RNA | *Also known as Marburg [[Viral hemorrhagic fevers|hemorrhagic fever]] | ||
** | *RNA virus of the [[Filovirus|filovirus]] family | ||
*First outbreak, 1967, in Marburg and Frankfurt Germany- due to research on African green monkeys | **The 5 species of Ebola are the other 5 members of the family | ||
*First outbreak, 1967, in Marburg and Frankfurt Germany - due to research on African green monkeys | |||
*Reservoir: African fruit bat, Rousettus aegyptiacus | *Reservoir: African fruit bat, Rousettus aegyptiacus | ||
==Transmission== | ===Transmission=== | ||
*Host animal to human unknown. Likely; contact with infected bat feces or aerosols, handling infected primates or their tissues | *Host animal to human unknown. Likely; contact with infected bat feces or aerosols, handling infected primates or their tissues | ||
*Human to human: direct contact with droplets of body fluid or contaminated objects | *Human to human: direct contact with droplets of body fluid or contaminated objects | ||
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*[[Q fever]] | *[[Q fever]] | ||
== | ==Diagnostic Evaluation== | ||
*Difficult diagnosis and very rare/unlikely outside of Central Africa | *Difficult diagnosis and very rare/unlikely outside of Central Africa | ||
*Consider Marburg with typical symptoms and high risk exposure including: | *Consider Marburg with typical symptoms and high risk exposure including: | ||
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**Cave exploration in Africa | **Cave exploration in Africa | ||
=== | ===Work-up=== | ||
ELISA, PCR, and IgM ELISA for acute infection several days after symptom onset. | *ELISA, PCR, and IgM ELISA for acute infection several days after symptom onset. | ||
*IgG ELISA can be used later in the course of disease. | |||
==Management== | ==Management== | ||
*Supportive therapies are the hallmark of management | |||
*[[Isolation precautions]]: standard, contact and droplet<ref name="CAHealth">California Health Alert Network. Alert Id: 35317. 9/10/2014</ref> | *[[Isolation precautions]]: standard, contact and droplet<ref name="CAHealth">California Health Alert Network. Alert Id: 35317. 9/10/2014</ref> | ||
**Isolate in a single room with the door closed | **Isolate in a single room with the door closed | ||
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*Notify public health personnel | *Notify public health personnel | ||
*Continue to test and treat for other possible diseases | *Continue to test and treat for other possible diseases | ||
==Disposition== | ==Disposition== | ||
Admit | *Admit to ICU | ||
==See Also== | ==See Also== | ||
*[[Fever in | *[[Fever in travelers]] | ||
*[[Travel | *[[Travel medicine]] | ||
*[[Viral | *[[Viral hemorrhagic fevers]] | ||
*[[Ebola]] | *[[Ebola]] | ||
==External Links== | ==External Links== | ||
*[http://www.cdc.gov/vhf/marburg/index.html CDC Marburg Site] | |||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:TropMed]] | [[Category:TropMed]] | ||
Revision as of 06:37, 7 September 2015
Background
- Also known as Marburg hemorrhagic fever
- RNA virus of the filovirus family
- The 5 species of Ebola are the other 5 members of the family
- First outbreak, 1967, in Marburg and Frankfurt Germany - due to research on African green monkeys
- Reservoir: African fruit bat, Rousettus aegyptiacus
Transmission
- Host animal to human unknown. Likely; contact with infected bat feces or aerosols, handling infected primates or their tissues
- Human to human: direct contact with droplets of body fluid or contaminated objects
Clinical Features
- Incubation period: 5-10 days
- Initial symptoms are vague:
- Fever, headache, chills, myalgias, abdominal pain, diarrhea
- Maculopapular rash, typically on the trunk, around 5 days after symptom onset
- Massive hemorrhage, shock, and multiorgan system failure
- 23-90% fatal
Differential Diagnosis
Fever in Traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid Fever
- Typhus
- Viral Hemorrhagic Fevers
- Chikungunya
- Yellow fever
- Rift Valley Fever
- Q fever
Diagnostic Evaluation
- Difficult diagnosis and very rare/unlikely outside of Central Africa
- Consider Marburg with typical symptoms and high risk exposure including:
- Close contact with African fruit bats, infected humans, infected non-human primates
- Lab researcher using African primates
- Recent travel to Uganda or other Central African countries
- Cave exploration in Africa
Work-up
- ELISA, PCR, and IgM ELISA for acute infection several days after symptom onset.
- IgG ELISA can be used later in the course of disease.
Management
- Supportive therapies are the hallmark of management
- Isolation precautions: standard, contact and droplet[1]
- Isolate in a single room with the door closed
- Limit entry and maintain a log of people who enter the room
- Use standard, contact, and droplet precautions
- Notify public health personnel
- Continue to test and treat for other possible diseases
Disposition
- Admit to ICU
See Also
External Links
References
- ↑ California Health Alert Network. Alert Id: 35317. 9/10/2014