Madrid/València (EFE) and that it is transmitted through direct contact with the infected person.
The Ministry of Health has just published an action protocol for the “early detection and management” of patients with the Marburg virus, coinciding with the investigation of this suspected case in Valencia of a disease similar to Ebola and whose outbreak was detected on 13 February in Equatorial Guinea.
The protocol contains information on aspects of the disease, such as its origin, symptoms, transmission or treatment.
Origin of Marburg virus disease
Marburg virus disease was first identified in two large outbreaks that occurred simultaneously in 1976 in Marburg and Frankfurt, Germany, and in Belgrade, Serbia, specifically among laboratory workers investigating tissues from African green monkeys imported from Uganda. .
Since then, in Africa there have been various sporadic outbreaks of this disease, whose virus is from the same family as Ebola and usually inhabits species of bats on that continent that feed on fruits.
The World Health Organization (WHO) has recently reported the first outbreak in Equatorial Guinea, in the Kié-Ntem province located in the northeastern part of the country, in the border area with Cameroon and Gabon.
Cases in Spain
At the moment there is no confirmed case of Marburg virus in Spain and only one under study in Valencia: a 34-year-old man with symptoms compatible with the disease and who was in Equatorial Guinea.
The most likely route of introduction of the virus into Spain is through infected travelers coming by ship or plane.
main symptoms
Marburg virus disease begins “abruptly” with fever, muscle pain, weakness, headache, and sore throat when swallowing.
Rapid wasting accompanied by gastrointestinal symptoms, abdominal discomfort, severe nausea, vomiting, and diarrhea occurs in 50-80% of patients within two to five days. The intensity of the disease increases between five and seven days with dermatological eruptions and hemorrhagic symptoms such as mucosal bleeding.
Mortality and treatment
It is considered a disease with a high lethality, with an average rate of around 50%.
There is currently no specific treatment, although supportive therapy with intravenous fluids and supplemental oxygen can significantly improve clinical outcome. Also, some pharmaceuticals are being developed to combat this ailment.
There is also no specific vaccine at the moment, but it is possible that one of the vaccines used against the Ebola virus could serve to protect against the Marburg virus, although its efficacy has not yet been demonstrated in clinical trials.
transmission mechanisms
In most of the reported outbreaks, human infection with this disease is due to prolonged stay in mines or caves inhabited by colonies of virus-carrying bats.
Other relevant transmission mechanisms are direct person-to-person contact through non-intact skin or mucous membranes with blood, secretions, organs, or other bodily fluids of infected people, as well as surfaces and materials contaminated with such fluids, such as personal clothing or of bed.
It can also be spread by direct contact with dead or live infected animals.
The incubation period is five to ten days, a time during which disease transmission does not usually take place.
Marburg virus case reporting procedure
Cases under investigation and confirmed cases will be urgently notified to the public health services of the autonomous communities and from there to the Coordination Center for Health Alerts and Emergencies (CCAES) of the Ministry of Health and to the National Epidemiology Center of the Institute of Health Carlos III.
Information on confirmed cases will be sent through the SiViEs surveillance tool managed by the National Epidemiology Center.
From the CCAES the information will be transmitted to the established national and international organizations.
Action steps for contacts
Depending on the level of exposure to the infected person, contacts are considered high or low risk.
In the case of high-risk contacts, quarantine is generally not indicated, although it is advisable to limit social relationships.
The person under surveillance must be locatable and will have to check and record their temperature twice a day (in the morning and in the late afternoon) for 21 days after the last exposure with the case.
For their part, low-risk contacts must also have their temperature checked twice a day and be locatable, although they may generally lead a normal life.
In all cases, those contacts who present symptoms compatible with the disease must isolate themselves at home and contact the health services.
