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Marburg haemorrhagic fever.

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VOL: 102, ISSUE: 11, PAGE NO: 25

What is it?

 

What is it?
- Marburg haemorrhagic fever, also known as green monkey disease, is an often fatal infection caused by a zoonotic RNA virus of the filovirus family. Fatality rates often exceed 80% (Hensley et al, 2005).

 

 

- The virus is indigenous to central Africa and was identified in 1967 when human outbreaks occurred simultaneously in laboratories in Germany and the former Yugoslavia, which were conducting research on green monkeys.

 

 

- It affects humans and non-human primates.

 

 

- The only other identified members of the filovirus family are the four Ebola species.

 

 

- Humans are not in the natural transmission cycle of the virus but become infected incidentally (World Health Organization, 2005).

 

 

Causes
- It is not known exactly how the Marburg virus is transmitted to humans from the animal host. Despite exhaustive research no animal reservoir or environmental source of the virus has been isolated. However, people who have come into close contact with the bodily fluids of infected monkeys have contracted the disease.

 

 

- It can be spread from human to human through extremely close contact with bodily fluids, including blood.

 

 

Symptoms
- There is an incubation period of 5-10 days. Onset of symptoms is sudden and initially includes:

 

 

- Fever;

 

 

- Headache;

 

 

- Muscle pain;

 

 

- Chills.

 

 

- After the initial symptoms, a maculopapular rash often appears on the chest and back. Other symptoms follow, including:

 

 

- Nausea;

 

 

- Stomach pain;

 

 

- Vomiting;

 

 

- Chest pain;

 

 

- Diarrhoea.

 

 

- The condition worsens until the patient experiences complications including:

 

 

- Jaundice;

 

 

- Pancreatitis;

 

 

- Liver failure;

 

 

- Weight loss,

 

 

- Confusion;

 

 

- Shock.

 

 

- Eventually the patient will suffer multi-organ failure. Fatal cases usually involve bleeding from the nose, gums and vagina, and blood is found in faeces and vomit. Death usually results approximately 10 days after the initial onset of symptoms and is immediately preceded by severe blood loss and shock (WHO, 2005).

 

 

Diagnosis
- The symptoms of Marburg haemorrhagic fever are similar to those of other infectious diseases, especially malaria and typhoid fever. Diagnosis is difficult because of this, especially in isolated cases.

 

 

- Immunohistochemistry, isolation of the virus, or polymerase chain reaction of blood or tissue specimens from deceased patients can identify the disease.

 

 

Treatment
- There is no specific treatment or vaccine (Hensley et al, 2005).

 

 

- It is important that patients are supported in hospital through maintaining fluid and electrolyte balance, maintaining oxygen levels and blood pressure, stabilising blood loss with clotting factors, and treating any secondary infections.

 

 

- Treatment can also involve fresh-frozen plasma transfusion to replace the blood-clotting proteins.

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