THE DOCTOR IS IN
OP-ED BY DR. ADIL MANZOOR
After 2020, there’s panic in society when the news of a potentially deadly disease breaks. This panic is even more exaggerated if the disease has viral roots. Yes, such is the damage the coronavirus and, recently, the monkeypox virus has done to us over the last two years. Considering all of that, you’re not going to like what you read today.
On July 1, two cases previously suspected as viral hemorrhagic fever (VHF) were confirmed as positive Marburg Virus Disease (MVD) cases. The two individuals in question – a 26-year-old man and a 51-year-old man – did not survive. In fact, they both died within a day of going to the hospital for treatment for the condition. This happened in the Ashanti region, the most populated region in Ghana.
There have been understandable concerns from a few people closely monitoring the news about the virus. But should we really be worried about the Marburg Virus? To answer that, we need first to examine exactly what the virus is.
The Marburg virus disease (MVD), formerly known as Marburg hemorrhagic fever, is a rare but severe hemorrhagic fever that affects humans and other primates. As you would imagine, MVD is caused by the Marburg virus. It is a genetically unique animal-borne RNA virus of the filovirus family.
Does the name filovirus ring a bell? If that doesn’t, the Ebola virus will certainly ring bells. Who could forget the carnage this virus wreaked in such a short period in 2014?
Well, all of the six other known members of the filovirus family have been Ebola virus species. That alone is enough to incite fear in many people, especially those who felt the effects of the Ebola virus disease (EVD) eight years ago.
Like the Ebola virus, the Marburg virus has fruit bats as its reservoir hosts. For context, those are primary hosts that harbor a pathogen and serve as a source of potential infection in humans. However, the reservoir hosts do not show symptoms of the disease the pathogen they harbor causes. The African fruit bat, Rousettus aegyptiacus,has been identified as the reservoir host of the Marburg virus.
Despite the seemingly close ties of the virus with Africa, the virus was first detected in Europe in 1967. To be specific, Marburg and Frankfurt in Germany and Belgrade in Serbia. This is, of course, where the naming originates. However, since the initial discovery, recorded outbreaks have occurred in African countries, including Uganda, Angola, the Democratic Republic of the Congo, Kenya, South Africa, and just last year, Guinea.
While we don’t fully understand how the virus passes from animals to humans, the most likely routes of infection are contact with the feces and aerosols of these fruit bats. This also means people who frequent bat caves or eat bats, especially without proper cooking, are at a higher risk of getting the virus.
After initial human infection by animals, the virus spreads through direct contact with body fluids of infected or dead MVD patients. Infection is not airborne, which is a relief considering how dangerous the virus is.
The symptoms of the condition usually surface after 2 to 21 days of contracting the virus. They often present suddenly as high fever, severe headache and severe malaise. Muscle pains may accompany this. On the third day after the illness starts, the patient may experience watery diarrhea that lasts up to a week, abdominal pain and cramping, and nausea and vomiting.
After about a week of the illness’ onset, the patient may experience hemorrhagic episodes, with bleeding from various orifices, feces, and vomitus. Patients that die of the virus often do so within eight to nine days of the onset of symptoms.
Now that we have that out of the way, I know the lingering question in your mind is if you should be concerned? Fortunately, health authorities have responded swiftly to the infections, preparing themselves for a possible outbreak. Soon after the positive cases were confirmed, 98 people were placed under quarantine. As such, there is no immediate concern about the virus getting out of hand.
Also, the WHO has previously said cases outside of Africa are infrequent. There is no strong concern about the virus making its way into the United States. Even if you visit the African regions where the virus is native, you will be fine as long as you avoid bat caves and only eat properly cooked meat.
Right now, there is no cure for MVD. The treatments available now are experimental and haven’t been tested on humans. Nonetheless, doctors believe treatment options for the Ebola virus could be useful, as well as various supportive care practices.
This article was written by Dr. Adil Manzoor DO, a Board Certified Internist & Board Eligible Pediatrician, who works as a Hospitalist, and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice Mobile Medicine NJ.
References
- https://www.washingtonpost.com/world/2022/07/18/marburg-virus-disease-ghana-africa-who/
- https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON402
- https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease
- https://www.cdc.gov/vhf/marburg/transmission/index.html
- https://www.theguardian.com/science/2022/jul/18/ghana-reports-first-cases-of-deadly-ebola-like-marburg-virus
