Marburg Virus Disease Outbreak in Ghana: What to Know About the Highly Fatal Illness

The West African nation of Ghana has confirmed an outbreak of Marburg virus disease, a highly-infectious, often fatal illness, similar to the more well-known Ebola virus disease.

Two people in the country, who were unrelated, died from the illness after experiencing symptoms ranging from diarrhea to fever, nausea, and vomiting, according to a press release issued by the World Health Organization (WHO).

Officials in Ghana and from the WHO are now working to contain the outbreak, including educating local communities about the disease and implementing various prevention measures. At the same time, officials in this country who are monitoring the outbreak have said it's highly unlikely the Marburg virus, which is not spread via airborne particles and droplets like COVID-19, would make its way to western countries.

"This is a case where we can be quite reassuring: This is not like monkeypox. This is not like Covid," William Schaffner, MD, a professor of preventive medicine for the Department of Health Policy and a professor of medicine for the Division of Infectious Diseases at Vanderbilt University Medical Center, told Health. "Both of those viruses spread in their own way and can be imported from abroad. But this one I think is very unlikely to spread, and if it does, it will just be a case here, a case there."

Here's a closer look at the origins of Marburg virus disease, how it's transmitted, and the type of treatment available.

What Is Marburg Virus Disease?

Marburg virus disease is caused by the Marburg virus, a genetically unique zoonotic (animal borne) virus. The disease is what's known as a viral hemorrhagic fever, and refers to a condition that affects many of the body's organ systems, damages the cardiovascular system, and reduces the body's ability to function on its own.

African fruit bats are the hosts of the Marburg, virus according to the Centers for Disease Control and Prevention (CDC). The bats, which are cave dwellers, are found throughout Africa. The disease has also been known to impact non-human primates.

Marburg virus was first recorded back in 1967, when outbreaks occurred in laboratories in Germany and Yugoslavia simultaneously. During that outbreak, 31 people became ill and seven died. The individuals infected at that time had been exposed to Ugandan-imported African green monkeys or their tissues while conducting research, according to the CDC.

Subsequent outbreaks have been very limited and sporadic. This is only the second time the disease has been reported in West Africa, according to the WHO. The first was in Guinea, a single case, and the outbreak was declared over in 2021.

Other outbreaks have taken place in Angola, the Democratic Republic of Congo, Kenya, South Africa, and Uganda.

How Does Marburg Virus Spread?

The current outbreak in Ghana is believed to have been transmitted to people from fruit bats.

"The virus can be transmitted if an individual comes in contact with bat feces, or body secretions, or urine," Thomas Russo, MD, chief of the Division of Infectious Diseases in the department of medicine at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, told Health.

Sometimes bats can get into houses, which may cause exposure, added Dr. Russo. Individuals may also be exposed through recreational or occupational related activities that result in inadvertently touching bat feces.

Once a human is infected with the virus, it can be transmitted through person-to-person contact via blood or body fluids, Dean Blumberg, MD, chief of the Division of Pediatric Infectious Diseases and a professor for the Division of Pediatric Infectious Diseases at UC Davis Health, told Health.

Measures to prevent person-to-person spread once the virus has been detected are similar to those used for other hemorrhagic fevers such as Ebola, added Dr. Blumberg.

"For instance, any patient suspected of having Marburg virus infection is strictly isolated and healthcare workers take precautions by wearing masks, gloves and protective gowns," said Dr. Blumberg.

Symptoms of Marburg Virus Disease

In humans, Marburg virus disease can trigger a very serious illness. Typically it begins abruptly, with high fever, severe headache and malaise, according to the WHO.

Additional symptoms, which may appear anywhere from two to 21 days after exposure include chills, headache, and muscle aches, said Dr. Blumberg.

"A rash often appears after about five days of symptoms," Dr. Blumberg said. "Gastrointestinal symptoms such as vomiting and diarrhea may also occur. Symptoms may progress to severe illness involving many organs, and shock may ensue involving massive bleeding episodes."

In many cases, patients develop severe hemorrhagic signs within seven days and case fatality rates range anywhere from 24% to 88%, depending on virus strain and case management, according to the WHO.

"It spreads throughout the body, making our organs progressively ill," explained Dr. Schaffner. "It can even get into the cells of our skin. That's why people die from Marburg. Different organ systems can become infected. It can affect your bleeding capacity and people can hemorrhage into their skin or bleed from the rectum or mouths."

Treatment for Marburg Virus Disease

There is no vaccine for Marburg virus disease, nor is there any specific cure. Instead, patients who have the virus receive what experts called "supportive care." This typically includes rehydration with oral or intravenous fluids.

Additional supportive treatment might include appropriate organ support, such as a ventilator and drugs to maintain blood pressure or other blood products if there are bleeding issues, explained Dr. Russo.

"It almost certainly has the potential to be a severe virus causing respiratory, cardiac, and renal dysfunction requiring hospitalization and appropriate organ support," said Dr. Russo.

Unfortunately, the level of medical treatment required is not available everywhere.

"In parts of the world where resources are limited, it is usually fatal," said Dr. Schaffner.

Does Marburg Virus Pose a Threat to the U.S.?

At this point, medical professionals are emphasizing that the virus is not cause for concern in the United States. This is due in large part to the fact that the virus spreads in a manner far different from COVID-19.

"It is spread through close, hands-on contact," said Dr. Schaffner. "It doesn't spread across the room or just if you are talking to someone."

On the rare occasions a person with Marburg has traveled from Africa into the United States or Canada—in those circumstances the people at greatest risk are healthcare workers who are putting their hands on a patient, added Dr. Schaffner.

"But even in those cases we have elaborate healthcare procedures to protect healthcare workers once the virus is diagnosed," Dr. Schaffner said.