New Marburg outbreaks in Africa raise alarm over spread of deadly virus

Spread of Ebola-like virus has claimed lives but could be a crucial chance to test a vaccine – if supplies and researchers are mobilized in time .< /p>

Two simultaneous outbreaks of Marburg virus, a close cousin of Ebola that can kill up to 90% of those it infects, raise critical questions about the behavior of this mysterious bat-borne pathogen and global efforts to prepare for possible pandemics.

Marburg, a hemorrhagic fever, is rare: only a few outbreaks have been reported since the virus was identified in 1967. But a steady increase in occurrences in Africa in recent years is alarming.

Marburg causes high fever, vomiting, diarrhea and, in more severe cases, bleeding from the orifices. It spreads between people through direct contact with the blood or other bodily fluids of infected people and with surfaces and materials such as clothing contaminated with these fluids.

One ​​of the two outbreaks, in Tanzania in East Africa, appears to have been brought under control, with only two people in quarantine. But in the other, in Equatorial Guinea on the west coast, the spread of the virus continues and the World Health Organization said last week that the country was not transparent in reporting cases.

There is no treatment or vaccine for Marburg, but some candidates have shown promise in phase 1 clinical trials. However, these candidates need to be tested in active outbreaks to prove they work, and so far no vaccines have been delivered for testing in current outbreaks.

"The moment an outbreak is detected, there should be a rapid response mechanism,” said Dr John Amuasi, head of the global health department at Kwame Nkrumah University of Science and Technology in Ghana, who investigated a Marburg outbreak in this country last year.

The W.H.O. and others are good at rapid response to control the spread of a virus, he said, but lack an equally fast response for research. This requires ready-to-ship stocks of candidate vaccines and researchers equipped to operate without putting additional strain on an already struggling health system; neither currently exists.

The W.H.O. says he's written a research protocol that can be applied to these outbreaks and any other filoviruses — the family that includes Marburg and Ebola — and has been scrambling for more than a month to get trials started, working against a clock. /p>

If the epidemic response works well (isolation of cases and contact tracing), the epidemic will be brought under control quickly, which seems to be the case in Tanzania. If the response is not as good (as in Equatorial Guinea), there are fears of a generalized epidemic and an increased need for vaccination.

When an Ebola epidemic has started in Uganda in September 2022, the strain that quickly claimed lives was a strain for which there was no vaccine, but, likewise, there was a strong candidate waiting for a chance to be tested. Researchers have announced their intention to try it in Uganda. But the outbreak was over by the time the vaccine doses arrived.

The outbreaks in Equatorial Guinea and Tanzania are the first ever reported in either country. 'other country. The outbreak in Equatorial Guinea began in January. The government has reported the deaths of nine people with confirmed Marburg virus disease and the deaths of another 20 people linked to the confirmed cases who have not been tested but are considered probable cases.

The government of Equatorial Guinea has released limited information about the outbreak, and the WHO. said there are likely undetected chains of transmission and not all known cases have a clear link to each other, suggesting a wi...