Germany 1967 To Ghana 2022: History Of Marburg Virus Disease Outbreaks Reported Across The World

Marburg virus disease was initially detected in 1967 following simultaneous outbreaks in Marburg and Frankfurt in Germany; and in Belgrade, Serbia. The virus was detected in laboratory workers.

Illustration of Marburg virus. The two large outbreaks that occurred simultaneously in Marburg and Frankfurt in Germany, and in Belgrade, Serbia, in 1967 were associated with laboratory work using African green monkeys imported from Uganda. As many as 31 people had become ill

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Ghana, a country in West Africa, has officially confirmed two cases of the Marburg virus, the Ghana Health Service said on July 18. The Marburg virus is a highly infectious disease similar to Ebola. 

The two persons, found to be positive for Marburg virus on July 10, have died.

According to the World Health Organization (WHO), more than 90 contacts, including health workers and community members, have been identified and are being monitored.

History Of Marburg Virus Disease

Marburg virus disease was initially detected in 1967 following simultaneous outbreaks in Marburg and Frankfurt in Germany; and in Belgrade, Serbia.

Both the Marburg and Ebola viruses are members of the Filoviridae family (filovirus), and cause diseases which are clinically similar. The Marburg virus is a genetically unique zoonotic RNA virus of the filovirus family. 

Both Marburg virus disease and Ebola virus disease are rare and have the capacity to cause outbreaks with high fatality rates. 

The two large outbreaks that occurred simultaneously in Marburg and Frankfurt in Germany, and in Belgrade, Serbia, in 1967 were associated with laboratory work using African green monkeys imported from Uganda. As many as 31 people had become ill, according to the Centers for Disease Control and Prevention (CDC). Initially, laboratory workers became ill. After this, several medical personnel and family members who had cared for them started showing symptoms. As many as seven deaths were reported. 

Other regions where subsequent outbreaks and sporadic cases were reported include Angola, the Democratic Republic of Congo, Kenya, South Africa, and Uganda. 

The first persons to be infected with Marburg virus had been exposed to the tissues of African green monkeys imported from Uganda while conducting research. 

Many of the sporadic outbreaks of Marburg virus disease throughout Africa started with male mine workers in bat-infested mines. 

During the 1967 outbreak, human cases of Marburg virus disease occurred in Belgrade, Siberia, which is outside Africa. 

Another instance of an outbreak of the Marburg virus disease occurring outside Africa was in 2008, when a Dutch tourist developed the disease after returning to the Netherlands from Uganda, and subsequently died. 

In the same year, an American tourist developed Marburg virus disease after returning to the US from Uganda and recovered. 

Both the Dutch and American tourists had visited a well-known cave inhabited by fruit bats in a national park, according to the CDC.

Known cases and outbreaks of Marburg virus disease in chronological order

Here is the complete list of known cases and outbreaks of Marburg virus disease, from the first outbreak in Germany and Siberia in 1967, to the recently confirmed cases in Ghana. 

1967

The first outbreaks of Marburg virus disease occurred in 1967, in Germany and Yugoslavia, now Serbia. Laboratory workers handling African green monkeys from Uganda were the first persons to be infected. Of 31 human cases of Marburg virus disease, seven deaths occurred.

1975

In 1975, three cases of the Marburg virus disease were reported in Johannesburg, South Africa. Of these, one person died.

According to the CDC, a man with a recent travel history to Zimbabwe was admitted to a hospital in South Africa. However, infection spread from the man to his travelling companion and a nurse at the hospital. While the man died, both women were given vigorous supportive treatment and eventually recovered.

1980

In 1980, two cases of Marburg virus disease were reported in Kenya. The case fatality rate was 50 per cent. 

One of the persons infected had visited the Kitum Cave in Kenya's Mount Elgon National Park. The other person infected was a doctor who attempted resuscitation. The male patient died, but the doctor, who developed symptoms nine days after attempting resuscitation, recovered.

1987

In 1987, a case of Marburg virus disease was reported in Kenya. A 15-year-old Danish boy, who was hospitalised with a three-day history of headache, malaise, fever, and vomiting, had visited Kitum Cave in Mount Elgon National Park nine days prior to symptom attempt.

The patient died on the 11th day of illness, despite aggressive supportive therapy.

1990

A case of Marburg virus disease was reported in Russia in 1990, due to laboratory contamination. The person infected with the virus died. 

1998 to 2000

An outbreak of the Marburg virus disease occurred in the Democratic Republic of Congo from 1998 to 2000. As many as 154 cases were reported. The case fatality rate was 83 per cent, which means that 128 people infected with Marburg virus died.

Most cases occurred in young male workers at a gold mine in Durba, in the north eastern part of the Democratic Republic of Congo. Durba proved to be the epicentre of the outbreak. Subsequently, cases were detected in the neighbouring village of Watsa.

2004 to 2005

An outbreak of the Marburg virus disease occurred in Angola from 2004 to 2005. The outbreak is believed to have begun in Uige Province in October 2004, and most cases detected in other provinces were linked directly to the outbreak in Uige. 

2007

In 2007, four cases of Marburg virus disease were reported in Uganda. Of these, one person died.

It was a small outbreak, with four cases of young males working in a mine. It was the Leaf and Gold mine in Kamwenge District, Uganda.

2008: US

In 2008, a case of Marburg virus disease was reported in the United States. 

A US traveller had returned from Uganda in January 2008. The patient, who developed illness four days after returning, was hospitalised, discharged and fully recovered. According to the CDC, the patient, who had visited a cave in Maramagambo forest in Uganda, at the southern edge of Queen Elizabeth National Park, was retrospectively diagnosed with Marburg virus infection.

 

2008: Netherlands

In 2008, a case of Marburg virus disease was reported in the Netherlands. A 40-year-old Dutch woman had visited a cave in Maramagambo forest in Uganda, at the southern edge of Queen Elizabeth National Park. She was admitted to a hospital in the Netherlands. 

She developed the first symptoms — fever, chills — three days prior to hospitalisation. After developing the symptoms, she experienced rapid clinical deterioration. The Dutch woman died on the 10th day of the illness.

2012

An outbreak of Marburg virus disease was reported in Uganda in 2012. Testing at the Uganda Virus Research Institute (UVRI) identified a Marburg virus disease outbreak in the districts of Kabale, Ibanda, Mbarara, and Kampala over a three-week time period. 

As many as 15 cases were reported. Of these, four persons died.

2014

A case of Marburg virus disease was reported in Uganda in 2014. The case was fatal.

As many as 197 contacts of the person infected with Marburg virus were followed for three weeks. Of the 197 contacts, eight developed symptoms similar to Marburg. However, all the contacts tested negative at the UVRI.

2017

As many as four cases of Marburg virus disease were reported in Uganda in 2017. The case fatality rate was 75 per cent. 

A blood sample from Kween District in Eastern Uganda had tested positive for the Marburg virus, and within 24 hours of confirmation, a rapid outbreak response was begun. The outbreak occurred as a family cluster with no additional transmission outside of the four related cases.

2021

A case of Marburg virus disease was reported in Guinea in 2021. The case was reported and confirmed by the Guinean Ministry of Health in a patient who was diagnosed after death.

After more than 170 high-risk contacts were monitored for 21 days, no additional cases were confirmed.

2022

Ghana has officially confirmed two cases of the Marburg virus, the Ghana Health Service said on July 18. 

The Ghana Health Service confirmed the two cases after two persons who later died tested positive for the Marburg virus earlier in July. This is Ghana's first outbreak of Marburg virus disease.

The two people were found to be positive for the Marburg virus on July 10. However, in order for the cases to be considered confirmed, the results had to be verified by a laboratory in Senegal, another west African country, according to the WHO. 

Samples from each of the two patients were sent to the Institut Pasteur in Dakar. The two patients, who were unrelated, showed symptoms including diarrhoea, fever, nausea and vomiting.

According to the WHO, the laboratory in Senegal corroborated the results from the Noguchi Memorial Institute for Medical Research, Accra, Ghana, which suggested the illness of the two patients was due to the Marburg virus. 

One of the patients was a 26-year-old male who checked into a hospital on June 26 and died on June 27. The other person was a 51-year-old man who reported to the hospital on June 28 and died the same day.