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Marburg in Equatorial Guinea: Symptoms of a deadly virus

February 16, 2023

While outbreaks of Marburg virus are rare, the viral hemorrhagic fever can be fatal. Here's what you need to know.

Marburg-Virus electronmicrograph
The Marburg pathogen is one of the most dangerous known pathogensImage: CDC/dpa/picture alliance

The West African country Equatorial Guinea is experiencing its first-ever outbreak of Marburg fever. At least nine people had died from the highly contagious viral disease, said the World Health Organisation (WHO) in a statement on February 13. There were a further 16 suspected cases, involving symtoms such as fever, fatigue, diarrhea and vomiting.

Marburg virus belongs to the same "family" as the Ebola virus.

Here's what else we know about the pathogen.

The symptoms of Marburg virus

Marburg virus is one of the most dangerous pathogens currently known. It can spread very quickly in the body, infecting and destroying cells in the blood, liver and skin.

Once someone is infected, the virus incubates for five to ten days. It then presents itself with sudden onset of fever, headache and muscle pain, as well as bleeding in the skin and mucous membranes. The mouth, eyes, gastrointestinal tract and internal organs are often affected, too.

In severe cases, people can experience neurological paralysis. Coagulation disorders associated with the virus can cause what is known as hemorrhagic shock. That can lead to organ and circulatory failure and death. Without intensive medical care, most infected people die.

How is Marburg virus transmitted?

The virus is transmitted through bodily fluids such as blood, urine or saliva.

Outside the body, however, the viruses do not last long and droplet infections through the air are extremely rare.

Marburg virus under a micropscope
The Marburg pathogen can infect and destroy blood, liver and skin cellsImage: Bernhard-Nocht-Institut

How is Marburg virus treated?

Patients usually need intensive medical care and have to be isolated because of the high risk of infection. So far, however, it's only possible to treat the symptoms of the virus.

The most common treatments include infusions to prevent fluid loss, with electrolytes to replace blood salts and glucose to regulate sugar balance.

Drugs are also used to stabilize blood pressure, reduce fever or stop diarrhoea and vomiting. Patient may also receive a blood transfusion and clotting agents to slow and stop any extreme loss of blood.

These measures increase the infected person's chances of survival, but the disease is still fatal in about half of all cases. Death usually occurs eight to nine days after the onset of the disease and is often the result of severe blood loss.

Antiviral drugs such as remdesivir have been used in clinical trials to treat Ebola and could also be tested against Marburg fever. But there is neither a specific treatment nor an approved vaccine — vaccines are being developed, however.

How common is Marburg fever?

The first recognized outbreak of Marburg fever was detected in Marburg, Germany and Belgrade, then of Yugoslavia and now Serbia, in 1967.

Since then, Marburg virus has broken out in isolated cases or in smaller epidemics — often in sub-Saharan African countries.

Angola, the Democratic Republic of Congo, South Sudan, Gabon and Uganda have been particularly affected by Marburg and Ebola viruses.

There have been outbreaks of the disease in Guinea and Ghana in recent years.

Where does the Marburg virus come from?

The virus was named after Marburg, a small, German town on the river Lahn, where it was first detected. In 1967, several laboratory workers in Marburg and Belgrade were infected with the virus via a monkey imported from Uganda.

It is likely that various bat species serve as a natural reservoir for the Marburg virus, as well as for the Ebola virus. The virus is transmitted to monkeys and humans through contact with the animals or their bodily fluids. The consumption of infected wild animals can also lead to an infection.

This article was translated from German.

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