Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News
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The Centers for Disease Control and Prevention (CDC) issued travel warnings last week for two African countries that have declared outbreaks of Marburg virus disease (MVD).
Equatorial Guinea declared an outbreak of the deadly disease in February after cases were confirmed in several provinces. The CDC elevated travel warnings to the country to a “level 2”, which encourages travelers to increase preventative measures and avoid all non-essential travel.
The agency has deployed an initial team of six scientists with expertise in epidemiology and laboratory testing to assist local health officials. The team will help with case investigation, contact tracing, and laboratory training.
According to the World Health Organization (WHO), there have been nine confirmed cases and 20 probable cases in Equatorial Guinea. Seven of the people with confirmed cases and all of those listed as probable cases have died.
In the second country, the United Republic of Tanzania, eight confirmed cases, including five deaths, have been reported in two villages in the Bukoba district, Kagera region. Three patients are currently receiving treatment and there have been no cases reported from outside of the area.
The CDC has issued a “level 1” travel alert to this area, which recommends following usual precautions such as avoiding sick individuals, avoiding contact with blood and body fluids, avoiding contact with dead bodies or items that have been in contact with dead bodies, and recommending avoiding healthcare facilities in outbreak areas. The agency also recommends against contact with fruit bats and primates like chimpanzees or gorillas.
The CDC and WHO advise that individuals who have traveled to outbreak areas monitor for symptoms of Marburg while in the area and for 21 days after leaving. People can become infected without showing symptoms for two days up to three weeks.
WHAT IS MARBURG?
Marburg is a hemorrhagic fever virus that is in the same family as the Ebola virus disease and has similar symptoms. Once an individual is infected it can easily be spread from person to person and symptoms start suddenly and patients can rapidly decline. Symptoms are severe and include headache, fever, watery diarrhea, abdominal pain and cramping, nausea, and vomiting can begin around the third day. Symptoms of hemorrhage usually appear between days five and seven after symptom onset. Bleeding usually occurs from multiple areas and death is usually a result of severe blood loss, multi-organ failure, and shock.
The WHO estimates that fatality rates are about 50% and can be as high as 88% fatal, but can be lower with appropriate care. There are no antiviral treatment options or vaccines, but survival rates are improved when patients are adequately rehydrated.
WHO LINKS OUTBREAKS TO ‘CLIMATE CHANGE’
Tedros Adhanom Ghebreyesus, WHO’s Director General, spoke at a press conference, claiming the effects of climate change made disease outbreaks more likely and worse. Ghebreyesus said “The outbreaks of Marburg virus disease are another reminder that we can only truly protect human health if we also protect the health of animals and our planet, which sustains all life,” adding that the WHO is working with numerous global environmental programs to address this issue.