Marburg virus disease

Revision as of 23:58, 14 October 2014 by Cchoff (talk | contribs) (references)

Background

  • RNA based 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
  • Viral hemorrhagic fever

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

Workup

  • 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

Diagnostics

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

  • 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
  • Supportive management
    • Experimental treatment has never been used in humans

Disposition

Admit, isolation, possible ICU for serologic results and clinical observation/supportive care.

See Also

External Links

Sources

  1. Marburg Hemorrhagic Fever http://www.cdc.gov/vhf/marburg/index.html
  1. Cite error: Invalid <ref> tag; no text was provided for refs named CAHealth