Ebola & Marburg Outbreaks post COVID-19 – Where are we heading towards in 2022?

The world is witnessing many viral disease outbreaks apart from COVID-19, which too, has its share of variants.  Also, there are nearly 700+ new viruses and more than 75% of them are zoonotic species.  It is indeed a gruesome scene wherein we talk of life on mars while human health is not secured on earth yet! 

Currently, the world health scenario is plagued with widespread outbreaks of viral hemorrhagic fever across Africa, America, and even Europe to a great extent. There is hope that medicine and vaccination for effective treatment with ongoing research will bring a definite cure to these viral outbreaks.

The World Health Organization and national healthcare agencies are trying their level best to curb these outbreaks, but as witnessed earlier, travel curbs are not the only solution. 

Curbs on travel do create complications for the economies as well as citizens who need to travel for work, hobby or even for medical treatment. Currently, medical tourism is considered one of the most promising segments across the globe, wherein people travel across the globe seeking quality and affordable medical treatment in other countries.  There are several medical tourism agencies that provide guidance and assistance to such travelers.

However, viral fevers are infectious in nature, and the infected patients have to be quarantined for at least 21 days while the healthcare givers have to protect themselves with suitable protective gear to lower the chance of infection while looking after them. 

Viral hemorrhagic fevers (VHFs) are diseases that affect the patient’s multiple organ systems while damaging the cardiovascular system and reducing the body’s independent functioning. Depending upon the severity of the infection, the symptoms can be mild or severe.

The world has witnessed a spurt in zoonotic disease outbreaks in the last decade. As per WHO reports, there has been a nearly 63% increase in diseases originating in animals, switching species and infecting humans in Africa alone. 

As the world is still plagued and coping with the COVID pandemic along with Zika, Swine Flu, Ebola and Monkeypox, the reports of Marburg Virus and viral hemorrhagic fever have created more panic and anxiety.  

In the Democratic Republic of Congo, a total of 12 476 alerts were reported from eight health zones in Congo, including 11 519 from Mbandaka City for the Ebola virus from 23 April to 2 July, 2022. Nearly 1097 ( 9% of the alerts) of them were confirmed as suspected cases of the Ebola Virus Disease. 

Also, Ghana declared an outbreak of the Marburg virus in July 2022, its first Marburg outbreak. Two positive cases were declared, viz., 26 YO and 51 YO males infected with the Marburg virus have succumbed to the deadly Marburg virus. 

The WHO has called for a Public Health Emergency of International Concern (PHEIC) meeting to determine the extent of public health risk to other states through the spread of disease and the need to announce a coordinated international response to the virus outbreak.

Marburg Virus and Ebola Virus

The Marburg Virus and the Ebola virus belong to the same family, i.e., Filoviridae. It is an animal-borne virus discovered in laboratory workers in Marburg & Frankfurt, Germany, Belgrade, etc. These workers displayed hemorrhagic fever after being exposed to infected African monkeys. 

Infected people exhibit organ failure, severe bleeding, and death. Ebola and Marburg viruses survive in animals and, through them, reach humans. They spread to other humans through infected needles, unclean items, and body fluids.

Currently, treatment of the Ebola virus or Marburg virus involves managing the symptoms and treating the complications. Unfortunately, there is no approved drug or medicine to treat these viruses. While research is still underway to discover vaccines to combat other deadly viruses, only one or two vaccines for the Ebola virus have been approved. 

Marburg and Ebola are filoviruses that cause hemorrhage, multiple organ failure, and high mortality rates. Diagnosis involves enzyme-linked immunosorbent assay, polymerase chain reaction (PCR), or electron microscopy. Treatment is supportive. Strict isolation and quarantine measures are necessary to contain outbreaks.

Marburg and Ebola viruses are filamentous filoviruses that are distinct from each other but that cause clinically similar diseases characterized by hemorrhagic fevers and capillary leakage. Ebola virus infection is slightly more virulent than Marburg virus infection.

Symptoms of Marburg and Ebola Virus Infections

There is a great deal of similarity in the symptoms of Marburg and Ebola Virus infections, which include sudden flu-like illness, headache, weakness, fatigue, body and joint pain, sore throat From day three onwards, nausea, vomiting, loose motions with blood and/or mucus, loss of appetite, abdominal pain, and vomiting from day three onwards.

After five or seven days of infection, the patient complains of a red-coloured bumpy skin rash in the trunk area, bleeding, nosebleeds, bruising, and bleeding gums with impaired kidney and liver function.

In severe cases, the patient is in a delirium state, confused, irritated, and shows a low level of consciousness. In the final and fatal stage, the patient will have multi-organ failure and hypovolemic shock due to severe fluid loss. 

Distinct Differences in Marburg and Ebola Virus Infections

The Marburg virus in humans is less contagious than the Ebola virus. Marburg virus infection results from prolonged exposure to caves or mines inhabited by colonies of the Rousettus species of bat.

On the other hand, the Ebola virus is spread through close contact with bodily fluids, blood, secretions, and organs of infected animals, which include monkeys, forest antelope, porcupines, chimpanzees, gorillas, and fruit bats that are either ill or dead in the rainforest. 

The availability of vaccines to treat select strains of the Ebola virus and specifically approved treatment protocols for the Ebola virus does bring some relief, which is unfortunately not available for Marburg virus infections. 

How to stay safe?

Staying extra alert is a must, so people must remember that transmission of the virus occurs from animal or insect hosts to human beings.

Within human beings, these viruses spread through contact with bodily fluids or blood from person to person. Also, people should avoid venturing into affected areas to stay as safe as possible.

However, in the case of opportunities wherein there is close contact with the infected or suspected person or animal, wearing protective gear such as gloves, masks, eye protection, face shields, gowns, and so. is advised.

Also, adequate care for sterilizing medical equipment, proper disposal of patient excretions, and following hygiene protocols of washing hands frequently and disinfecting them with alcohol-based sanitisers are essential. It is advisable to avoid contact with primates and sick or dead animals. At all costs, avoid consumption of bushmeat, the meat of primates or rodents. 

International travelers should have their travel health kit handy, which contains a thermometer, alcohol-based hand sanitiser, surgical masks and disposable gloves, painkillers, and fever medication.

In the event of a likely infection or transmission, it is necessary to visit the nearest healthcare provider and brief them about the same so that they can take the necessary precautions to safeguard themselves and prevent further transmission.

Also, the patient should monitor their health for 21 days and brief the healthcare providers about the likelihood of being infected with viral hemorrhagic fever. 

Till now, dedicated efforts to create more awareness on how to prevent their spread, implementation of better hygiene and sanitation protocols are very much underway to curb their spread and prevent fatalities as much as possible across the globe.

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