Marburg virus disease
What do health professionals need to know about Marburg virus disease?
Healthcare professionals in Canada are advised to be vigilant for the recognition, reporting and prompt investigation of patients with symptoms of Marburg and other similar diseases that can cause viral haemorrhagic fevers.
Person-to-person transmission of the Marburg virus is primarily associated with direct contact with blood and body fluids. Health care workers caring for patients with suspected or confirmed Marburg virus disease should apply strict infection control precautions.
All suspect or probable cases of Marburg virus disease must be immediately reported to the Public Health Agency of Canada through its 24-hour emergency line: 1-866-262-8433.
Do not undertake any laboratory testing on a patient suspected of a Marburg infection.
The Public Health Agency's National Microbiology Laboratory (NML) is the only facility in Canada that can work with live haemorrhagic fever viruses such as Marburg. The NML offers the world's highest level of containment and meets or exceeds all national and international guidelines for safety and security.
Health professionals should not undertake any laboratory testing on a patient suspected of Marburg virus disease or any other viral haemorrhagic fever infection.
Any testing related to a suspected Marburg infection must be carried out in a containment level 4 (CL4) laboratory. CL4 ensures maximum containment through:
- complete sealing of the laboratory
- isolation of personnel from the viruses through the use of positive pressure suits
- double HEPA (high-efficiency particulate absorption) filtration of exhausted air
- HEPA filtration of supply air
- decontamination of all waste
Shipping of samples
If a sample requires testing, immediately contact the Agency's 24-hour emergency line: 1-800-545-7661. An expert will assist you in developing an Emergency Response Assistance Plan for the safe shipping of the sample to the Agency's NML.
A confirmed Marburg virus disease case can only be done through laboratory testing at the Agency's NML.
A probable case is defined as one with clinical evidence of illness and a history within the three weeks before onset of fever of one of the following:
- travel in a specific area of a country where an outbreak of Marburg virus disease has recently occurred
- contact with a suspect, probable or confirmed case of Marburg virus disease
- direct contact with blood or other body fluid secretions or excretions of a person or animal with a confirmed or probable case of Marburg virus disease
- work in a laboratory or animal facility that handles haemorrhagic fever viruses
Clinical symptoms include severe acute viral illness consisting of sudden onset of fever, malaise, myalgia, headache, conjunctival injection, pharyngitis, vomiting and diarrhea that can be bloody.
It is often accompanied by a maculopapular or petechial rash that may progress to purpura. Bleeding from gums, nose, injection sites and gastrointestinal tract occurs in about 50% of patients. Dehydration and significant wasting occur as the disease progresses.
In severe cases, the haemorrhagic diathesis may be accompanied by leucopenia; thrombocytopenia; hepatic, renal and central nervous system involvement; or shock with multi-organ dysfunction.
There is no specific treatment or vaccine for Marburg virus disease.
Patients are treated for their symptoms. Treatment options include:
- supportive care in an intensive care unit
- maintenance of fluid levels and electrolytes
- maintenance of oxygen status and blood pressure
- replacement of lost blood and clotting factors
- strict isolation to prevent the infection from spreading
- Pathogen Safety Data Sheet – Marburg virus
- Centers for Disease Control and Prevention – Marburg Haemorrhagic Fever
- World Health Organization – Marburg virus disease
- Public Health England – Marburg virus disease
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