Marburg virus disease is dangerous but difficult to spread

Characteristics of the disease

Marburg virus disease is a dangerous infectious disease of group A (According to the Law on Prevention and Control of Infectious Diseases of Vietnam), with a mortality rate of 25% to 90%. The disease was first recorded in 1967 in Germany and Serbia, and then sporadic cases appeared in some African countries. According to information from the World Health Organization , there is currently an outbreak of Marburg virus in Equatorial Guinea with dozens of cases and 9 deaths (data as of February 13, 2023).

The disease is caused by the Marburg virus. The virus can survive for several days in patient waste or neutral surfaces at room temperature, but is killed by temperatures above 56 ⁰ C for 60 minutes. Chlorine chemicals, oxidizing agents, heavy metal salts, detergents and soaps, as well as ultraviolet light and gamma radiation can all kill the virus at normal doses.

Marburg disease is mainly transmitted through direct contact with blood and secretions of infected people or animals (bats are identified as the source of infection); or through contaminated tools and objects when slaughtering animals, treatment tools in hospitals, and in daily life. The virus can also be transmitted through saliva and respiratory secretions from infected people; it can be transmitted through sexual intercourse and in laboratories due to lack of biosafety.

The incubation period is from 2 to 21 days. The disease is transmitted from person to person at the end of the incubation period, peaking at the full-blown stage with high fever and lasting as long as the virus is present in the blood and secretions of the surviving patient. Anyone, of any age, who is not immune, can be infected with the virus and get sick with Marburg virus. There is currently no vaccine to prevent the disease.

Symptom

The disease has the general clinical picture of acute viral infection, with sudden onset of symptoms such as prolonged high fever, headache, abdominal and chest muscle pain, sore throat, vomiting or nausea, acute diarrhea, mucosal bleeding, nosebleeds, visceral bleeding (vomiting, bloody stools...). The typical severe form often has liver damage, kidney failure, encephalitis, multiple organ failure, pleural effusion and shock.

Treatment

There is currently no specific medicine, so treatment follows the principles: Early detection and treatment; focusing mainly on symptomatic treatment such as fever reduction, pain relief, anti-hemorrhage; anti-liver and kidney failure; cardiovascular support, anti-allergy, anti-shock; minimizing complications. Some antiviral chemicals such as Ribavirin can be used. Antibiotics should only be used when there are signs of secondary infection.

Possibility of spreading to Vietnam

Based on the epidemiological characteristics, transmission routes and information about the disease caused by the Marburg virus, the disease is unlikely to spread globally as well as to Vietnam. However, this is a dangerous infectious disease of group A, so we must not be subjective, always monitor, evaluate, analyze, forecast and proactively have measures, solutions and plans to prevent and control the disease effectively.

How to prevent and control epidemics?

According to the Military Medical Department , it is necessary to educate the community to have the most basic understanding and ways to prevent and fight when there is a risk of warning about the possibility of virus penetration.

Strict border quarantine to promptly detect suspected cases of the disease that may enter from areas where the disease is circulating in the world. Provide guidance and organization for medical staff, especially those working at border gates, on regulations for monitoring, controlling, handling and preventing diseases caused by the Marburg virus.

Laboratory personnel must be periodically trained in biosafety practices for viruses in this group of diseases. Medical personnel must be fully equipped with biosafety level 3 personal protective equipment when working with suspected Marburg virus agents.

At the hospital, when treating patients, strictly isolate the patient in the hospital for 21 days after the onset of the disease. It is mandatory to wear proper personal protective equipment when in contact with patients, specimens or suspected cases. Thoroughly disinfect according to regulations the patient's body fluids (blood, cerebrospinal fluid, semen, other secretions), sickrooms, clothes, contaminated items... Closely monitor the health for 3 weeks from the time of exposure of those who have direct contact or lived with the patient 5 days before the onset of the disease or laboratory staff during the time of working with specimens containing Marburg virus.

The Military Medical Sector currently has 5 facilities capable of diagnosing and detecting pathogens: Military Central Hospital 108 , Military Hospital 175, Military Hospital 103 , Military Preventive Medicine Institute and Southern Military Preventive Medicine Institute. Military medical facilities at all levels are capable of implementing disease prevention and control measures. Military hospitals at strategic and final levels of military regions are capable of treating Marburg virus disease at different levels.

MILITARY MEDICAL DEPARTMENT

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