Marburg Virus Disease: Virology, Pathogenesis, Diagnosis, Treatment, and Preventive Strategies

Marburg virus disease (MVD) is a severe and often fatal hemorrhagic fever caused by the Marburg virus, a member of the Filoviridae family. First identified in 1967 during simultaneous outbreaks in Germany and Serbia, the virus is a zoonotic pathogen whose natural reservoir is the African fruit bat, Rousettus aegyptiacus. Human infection typically occurs through contact with bat excreta in mines or caves, or via secondary transmission from infected individuals through direct contact with bodily fluids. The clinical course of MVD is characterized by an abrupt onset of non-specific symptoms including high fever, severe headache, and myalgia after a 5-10 day incubation period. This progresses to gastrointestinal symptoms and, in severe cases, hemorrhagic manifestations, jaundice, and multi-organ failure, with a high case fatality rate ranging from 23% to 90%. Diagnosis is challenging due to symptom overlap with other tropical diseases but is confirmed through RT-PCR, antigen-capture ELISA, or virus isolation in high-containment (BSL-4) laboratories. There are currently no approved vaccines or specific antiviral treatments for MVD. Management is primarily supportive, focusing on fluid balance, electrolyte correction, and treating complications. Prevention relies on public health measures, including avoiding contact with bats, implementing strict barrier nursing techniques in healthcare settings, and safe burial practices during outbreaks. Ongoing research into post-exposure prophylactics, such as experimental vaccines and antisense therapies, shows promise for future outbreak control.