Marburg Hemorrhagic Fever In Equatorial Guinea And Cameroon: Equatorial Guinea has reported 16 deaths and nine suspected cases of Marburg disease. Cameroon reports two more suspected cases. The outbreak began on February 7, 2023. Although the suspected cases in Cameroon were located in the same area as Equatorial Guia, it is alarming that neither of the cases had a travel history. This suggests that local transmission may still be ongoing in both countries.
Marburg is an infectious disease similar to Ebola that can cause death. Only four of the fifteen cases reached double digits in the CDC’s reports. Two of those cases were large, with 154 cases in the Democratic Republic of the Congo and 252 cases from Angola in 1998-2000.
Marburg is also a Filovirus, much like Ebola. Outbreaks are thought to begin with the spread of the virus from fruit bats into the human population. The subsequent transmission of the virus from person to the patient is via contaminated body fluids. Marburg isn’t geographically isolated as spillovers have already occurred in Angola (Democratic Republic of Congo), Ghana, Guinea, and Kenya. We don’t know why there haven’t more outbreaks.
Marburg is most dangerous because of its lethality. Only 379 out of 474 known cases between 1967 and 2022 were fatal. The raw case fatality ratio is approximately 80%.
Contrary to media reports and lethal, Marburg is not especially contagious. For the 2005 Angola epidemic, the basic reproduction value (R0), was approximately 1.6. This is comparable to seasonal influenza. Marburg’s generation time is nine days. It has an estimated doubling time of approximately 12.4 days. This is more flowers than Covid-19. Marburg infections, like Ebola, can be very long-lasting. It is believed that peak infectiousness occurs around 10 days after infection.
Central Africa’s fight against Marburg
Equatorial Guinea, in response to the current outbreak of the disease, quarantined more than 200 people and restrained movement in its Kie-Ntem Province last week. This is where the first cases were detected.
Authorities in both countries are using a combination of contact tracing and border closures to combat the outbreak. These have been successful in controlling the spread of Marburg as well as Ebola in other outbreaks. They also use simulated interventions to help with the disease.
Marburg does not have a licensed vaccine, but there are experimental forms. According to Helen Braswell, who reported on an emergency meeting held by the World Health Organization (WHO), supplies are limited to a few hundred available doses. Marburg outbreaks have been rare. This outbreak allows for the testing of vaccines in the field. However, deployment would need to be immediate. With such a small outbreak, it is difficult to predict how distribution would work best.
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However, international experts and local authorities seem to be doing the right thing. They are responding with a measured response that aims at quick containment. It is possible that additional cases may be discovered. However, the virus is unlikely to spread outside of the affected countries if there has been enough attention.