An outbreak of Marburg virus has experts concerned. Here’s what ophthalmologists need to know.
The Marburg virus disease (MVD), colloquially referred to as the “bleeding eye virus,” has resurfaced in Africa, prompting global concern over its potential to become a widespread health crisis. Characterized by a high fatality rate and devastating symptoms, the virus has gained renewed attention following Rwanda’s first-ever outbreak earlier this year.
In September 2024, Rwanda reported its inaugural outbreak of MVD. As of November 8, 2024, the virus had led to 66 confirmed cases and 15 deaths. With an average fatality rate of 50%, and some past outbreaks recording mortality rates as high as 88%, MVD is a significant threat, according to the World Health Organization (WHO).1
To curb further spread, the WHO has issued travel advisories against visiting affected regions. Neighboring countries are closely monitoring the situation and planning strategies to prevent the virus from crossing their borders.
Epidemiology
MVD is caused by the Marburg virus, a highly contagious pathogen in the Filoviridae family, which also includes Ebola.2 The virus, first identified in 1967, can persist in immune-protected areas of the body, such as the testicles and the eye, even in recovered patients. The initial outbreaks were traced to African green monkeys imported from Uganda for laboratory research.
Since then, sporadic outbreaks have been reported in multiple African nations, including Tanzania, Equatorial Guinea, Angola, Congo, Kenya, South Africa, Uganda and Ghana.
Symptoms and progression
The incubation period for MVD ranges from 2 to 21 days. Early symptoms include high fever, severe headaches, muscle pain, and extreme fatigue. These progress to gastrointestinal issues such as diarrhea, abdominal cramping, nausea, and vomiting. Some patients may experience a non-itchy rash during the first week of illness.3
By the fifth day, hemorrhagic symptoms—such as bleeding from the gums, nose, and vagina, as well as blood in vomit and feces—may occur. Neurological symptoms like confusion, irritability, and aggression can also emerge. In rare cases, orchitis (swelling of the testicles) has been observed in later stages. Severe cases result in death within eight to nine days, often due to significant blood loss and shock. These fatal outcomes highlight the urgency of early intervention and strict infection control measures to save lives.4
Is there a cure?
Currently, there is no cure for Marburg virus disease. Supportive care, such as rehydration and symptom management, has been shown to improve survival rates. However, the absence of targeted therapies has left healthcare workers with limited tools to fight the virus.
For now, healthcare workers and public health agencies are focusing on containment strategies to limit the spread of the disease. Meanwhile, scientists are working to develop vaccines and antiviral drugs that could help turn the tide against this deadly pathogen.
Public health agencies, including the WHO, the Rwanda Biomedical Centre and the Centers for Disease Control and Prevention (CDC) are also taking precautions to combat the spread of the virus. Their efforts focus on containment, education, and providing protective equipment to healthcare workers.
Prevention measures
According to the WHO, preventing Marburg Virus Disease requires a multi-pronged approach, with community engagement at its core. Those working in caves or mines are encouraged to wear protective clothing, such as gloves and masks, to reduce bat-to-human transmission. During outbreaks, communities are urged to thoroughly cook animal products like meat and blood before consumption.
To prevent human-to-human transmission, it is crucial to avoid close physical contact with infected individuals and to isolate suspected or confirmed cases in designated treatment centers. Those exposed should be monitored for 21 days to curb further spread, and safe burial practices are critical.
Find more resources about the Marburg virus disease from the CDC Resources page.
References
- Marburg virus disease – Rwanda. WHO Website. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON544 Accessed on 9 December 2024.
- Slenczka W, Klenk HD. Forty years of marburg virus. J Infect Dis. 2007; 196 Suppl 2:S131-135.
- Zhao F, He Y, Lu H. Marburg virus disease: A deadly rare virus is coming. Biosci Trends. 2022;16(4):312-316.
- Marburg virus disease. WHO Website. Available at: https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease Accessed on 9 December 2024.
