The neglected continuously emerging Marburg virus disease in Africa: A global public health threat

Abstract

Background and AimSevere viral hemorrhagic fever (VHF) is caused by Marburg virus which is a member of the Filoviridae (filovirus) family. Many Marburg virus disease (MVD) outbreaks are reported in five decades. A major notable outbreak with substantial reported cases of infections and deaths was in 2022 in Uganda. The World Health Organisation (WHO) reported MVD outbreak in Ghana in July 2022 following the detection of two probable VHF patients there. Further, the virus was reported from two other African countries, the Equatorial Guinea (February 2023) and Tanzania (March 2023). There have been 35 deaths out of 40 reported cases in Equatorial Guinea, and six of the nine confirmed cases in Tanzania so far.MethodsData particularly on the several MVD outbreaks as reported from the African countries were searched on various databases including the Pubmed, Scopus, and Web‐of‐science. Also, the primary data and reports from health agencies like the WHO and the Centers for Disease Control and Prevention CDC) were evaluated and the efficacy reviewed.ResultsChiroptera in general and bat species like Rousettus aegyptiacus and Hipposideros caffer in particular are natural reservoirs of the Marburg virus. MVD‐infected nonhuman primate African fruit‐bat and the MVD‐infected humans pose significant risk in human infections. Cross‐border viral transmission and its potential further international ramification concerns raise the risk of its rapid spread and a potential outbreak. Occurrence of MVD is becoming more frequent in Africa with higher case fatality rates. Effective prophylactic and therapeutic interventions to counter this deadly virus are suggested.ConclusionIn the face of the lack of effective therapeutics and preventives against MVD, supportive care is the only available option which contributes to the growing concern and disease severity. In view of the preventive approaches involving effective surveillance and monitoring system following the “One Health” model is extremely beneficial to ensure a healthy world for all, this article aims at emphasizing several MVD outbreaks, epidemiology, zoonosis of the virus, current treatment strategies, risk assessments, and the mitigation strategies against MVD.

The urgency of Marburg therapeutics: preventing local outbreaks from the potential global spread

“…Egyptian fruit-bat ( Rousettus aegyptiacus ) is the natural hosts and primary reservoirs of MARV, which infects both animals and humans. After its first reports from Germany and Serbia in 1967, many outbreaks were recorded majorly in Africa (Srivastava D. et al, 2023 ). As the mechanism of bat-bat transmission of MARV as also to other animals is yet unclear, a prudent approach to avoid bat-human contracting of MVD is by reduce anthropogenic activities on the mining areas or caves that are the primary habitat of fruit-bat (Mohapatra et al, 2022 ).…”

“…in the endemic regions is suggested ( Figure 1 ). Challenges posed by the lack of knowledge on the pathogenicity and transmission dynamics of MARV necessitate global collaborative research and innovative therapeutic interventions especially in the face of dearth of approved therapeutics (Srivastava D. et al, 2023 ). Collective research efforts from diverse expertise to develop broad-spectrum vaccines and antiviral agents could contribute to effectively address the MARV public health threat.…”

Can Marburg virus be sexually transmitted?

“… 11 It is believed that humans are most likely to become infected when they come into direct contact (injured skin [wound and scrape] or ruptured mucous membranes [eyes, nose, or mouth]) with the virus‐laden biofluids (i.e., urine, saliva, breast milk, amniotic fluid, and semen) of an infected individual usually during the care of patients (by family members and health workers) or via close contact with those who have died of the disease through handling of corpses during burial proceeding. 10 , 12 , 13 Given the risk of virus spread through contaminated material (with stability for 4–5 days on surfaces), the disease may appear in humans through indirect contact. 1 , 14 Considering the similarities between MARV and EBOV in terms of many anecdotal routes of transmission, that is, infection through biofluids, the question arises as to whether MARV could also be sexually transmissible through genital fluids during sexual intercourse.…”

Bioinformatic, Biochemical, and Immunological Mining of MHC Class I Restricted T Cell Epitopes for a Marburg Nucleoprotein Microparticle Vaccine

“…Over 25 viruses from four viral families are known to cause VHFs, including Lassa, Junín, Crimean–Congo hemorrhagic fever, Rift Valley fever, yellow fever, Ebola (EBoV), and MARV. These viruses pose a significant threat because of their high rates of illness and mortality [ 10 ], coupled with a limited understanding of hemorrhagic fever syndrome [ 11 ].…”

“…Following exposure, MARV enters the body, replicates intracellularly (preferentially in monocytes, dendritic cells, and endothelial cells [ 15 ]), disseminates, and leads to a clinical syndrome comprising an Ebola-like cytokine storm [ 16 , 17 , 18 ], fever, malaise, myalgia, and blood coagulation disorders [ 2 ]. These symptoms progress to shock, multiorgan failure, and death, with a case fatality rate ranging from 20–100% [ 10 ].…”