Marburg virus: Race against time for a vaccine for world’s next big threat

Global health chiefs are in a race against time to develop a vaccine for a virus that is a deadlier version of Ebola and appears to be spreading in Central Africa.

Panic is setting in about Marburg virus, which can initially masquerade as a cold before causing an explosion of horrifying symptoms, including organ failure and bleeding from multiple orifices.

An outbreak of the extremely deadly virus – which kills up to nine in 10 sufferers – was declared in Equatorial Guinea Monday after nine deaths and 16 suspected cases. 

Last night neighboring Cameroon declared two suspected infections in a pair of teenagers with no travel links to Equatorial Guinea – indicating it is more widespread than official case counts suggest.

The disease causes the body’s kidneys and spleen to fail to regulate fluids. It causes a hemorrhagic fever similar to that of Ebola. It causes cells around the body to expand as they are inflamed, blood clotting around the body, and eventually – organ failure.

The Marburg virus has an incubation period of up to 21 days. The virus attacks the kidney and spleen and causes clotting and inflammation around the body. Symptoms can be pretty severe, such as rashes, bleeding from the eyes and delirium. A large portion of cases result in death, and even survivors suffer permanent damage

A total on nine deaths and 18 suspected cases of Marburg virus have been detected across Cameroon and Equatorial Guinea in Central Africa

A total on nine deaths and 18 suspected cases of Marburg virus have been detected across Cameroon and Equatorial Guinea in Central Africa

The Centers for Disease Control and Prevention (CDC) warns that while the disease is rare, it can quickly spread in areas with low sanitation. 

A person can be infected after coming into contact with a contaminated fluid, like a person’s blood or feces, and then accidentally swallowing it.

Symptoms of the virus can quickly ramp up, moving from a simple cold to a devastating infection that causes organ failure and bleeding out of the eyes within days. 

Up to 90 percent of cases result in death. Many patients die within eight days of symptom onset. 

It can take from two days to three weeks from exposure to the first appearance of symptoms. 

Called the incubation period, this is the period where the virus has entered the body but has not yet caused symptoms.

In some cases, a person will feel nothing more than the symptoms of a common cold for the first week.

During this time, the virus binds to cells in the body, and spreads as the infected cells replicate in the body. 

Early symptoms include a high fever, chills, severe headaches, fatigue, trouble breathing, muscle pains.

Sufferers will often suffer a non-itchy rash that appears all over a person’s face, arms, legs, hands and feet. 

Other symptoms within the first few days include jaundice, severe nausea, abdominal pain, pink eye, throat irritation, spots appearing within the mouth and extremely watery diarrhea. 

These are all signs of immune issues  

Usually, around the fifth day, the disease will progress to what doctors describe as the ‘early organ phase’. 

At this point, a patient may start suffering hemorrhaging out of their eyes, inflammation around the body, and visible swelling around their body – usually on the legs, ankles and feet.

The virus causes severe inflammation of the cells and organs around the body, causing these symptoms.

Internal bleeding can cause discoloration of the skin, vomiting blood, dark and blood-colored feces, blood collection in the lungs and stomach and bleeding gums.

The fever remains high during the period. Some people have reported neurological symptoms such as brain swelling, delirium, confusion, irritability and aggression.

Patients will often die within eight or nine days of their first symptoms appearing, according to the WHO. 

This is because the kidney, liver and pancreas will start failing. A person may also die from a severe loss of blood.

If a person does remain alive, they could enter the late organ phase, where they suffer dementia, could fall into a coma, and have permanent brain and organ damage. 

Marburg is part of the Filoviridae family of viruses, making it a cousin of Ebola. It is more deadly and acts faster than its well-known relative, though.

It is believed to have been transmitted to humans from African fruit bats, with the first infected people exposed to the animals in mines and caves.

Unlike Covid, it does not spread through the air but through fluids such as blood, urine or saliva.

Like Ebola, even dead bodies can spread the virus to people exposed to its fluids. 

Officials in Cameroon announced two suspected cases in the southern province of Olamze.

Q+A: What is MVD?  

What do we know about the outbreak? 

Health officials yesterday confirmed 16 cases and nine deaths have been identified so far, in the country’s western Kie Ntem Province. 

What is the disease?

Marburg virus disease (MVD) is a lethal virus that has a case fatality ratio that can be as high as 88 percent.

It was initially detected in 1967 after an outbreak in Marburg, Germany, among workers exposed to African green monkeys.

Marburg and Ebola viruses are both members of the Filoviridae family. Though caused by different viruses, the two diseases are clinically similar.

How does it spread? 

Initially, human MVD infection results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies (fruit bats).

People remain infectious as long as their blood contains the virus.

Is it spreading? 

A team of ‘health emergency experts’ have been deployed by the WHO to help prevent the spread of infection further.  

At a press conference last week, health minister Mitoha Ondo’o Ayekaba said a ‘containment plan has been put in place’ after consulting with the WHO and United Nations, to help contain the spread of infection. 

It borders the Kie Ntem province of Equatorial Guinea, where the original suspected cases were detected.

The potential 27 cases outbreak would be the largest since the 2004-2005 Marburg Virus outbreak in Angola. 

The 252 cases and 227 deaths make it the worst infection outbreak ever recorded. It is also the fourth-largest outbreak ever.

This is the first time it has been detected in either Equatorial Guinea or Cameroon, signaling that the virus is spreading further into Africa.

It was first detected in 1967, when monkeys were imported from Uganda to Germany and Serbia for experimentation were carrying the virus.

In the time since outbreaks of the virus have occurred sporadically throughout sub-Saharan Africa, making its appearance in Central Africa a worrying sign.

Only nine cases have been recorded globally in the ten years before the Equatorial Guinea outbreak. 

On Tuesday, the WHO convened the Marburg virus vaccine consortium (MARVAC) to handle the outbreak.

The group said it could take months for effective vaccines and therapeutics to become available, as manufacturers would need to gather materials and perform trials.

The MARVAC team identified 28 experimental vaccine candidates that could be effective against the virus – most of which were developed to combat Ebola. Five were highlighted in particular as vaccines to be explored.

The shots were developed by non-profits such as the Sabin Vaccine Institute, the International Aids Vaccine Initiative, and Public Health Vaccines – along with pharma giants like Emergent Biosolutions and Janssen.

Trialing these vaccines may be impossible, though. 

Because viruses such as Marburg rarely result in high case figures, it may take multiple outbreaks for enough cases to properly analyze the virus’s effectiveness.

The panel of experts said a trial should include at least 150 cases. For context, before this outbreak, there had been 30 cases recorded globally from 2007 to 2022.

This makes it unlikely a vaccine will be made available to combat this outbreak – and it could be years until a shot is determined to be effective against it.