Marburg Virus Disease: Pathophysiology, Diagnostic Challenges, and Global Health Preparedness Strategies

Background: Marburg virus disease (MVD) is a highly virulent viral hemorrhagic fever with reported case fatality rates of up to 90%. It is part of the same family as the Ebola virus (Filoviridae). MVD, originally identified in 1967 in the context of outbreaks associated with African green monkeys, has been reported sporadically in Africa. Recent outbreaks, including those in Equatorial Guinea and Rwanda, underscore the need for robust preparedness systems and global response. Objectives: This narrative review focuses on the pathogenesis, clinical manifestations, diagnostic challenges and treatment strategies regarding MVD. It also stresses the need for better surveillance, diagnostic capabilities and vaccines to help prepare for future outbreaks. Methods: A comprehensive review of clinical data, epidemiological trends, and diagnostic developments was performed by searching relevant literature in PubMed, Medline and Scopus. The relevant data were extracted from studies on MVD and presented as a narrative review. Findings: MVD primarily affects immune and endothelial cells, resulting in a consequent cytokine storm, coagulopathy, and multi‑organ failure. Early symptoms such as fever, headache and myalgia are nonspecific and can delay diagnosis, as they mimic other infections. Monoclonal antibodies and newer antiviral agents are presently being evaluated for the management of MVD. Conclusions: MVD leads to significant morbidity and mortality, and the high fatality rate, along with the absence of targeted therapies, represents a serious global health threat. Collectively, the establishment of infrastructure for diagnostics, global collaboration, and advanced vaccine development will help bolster the response to MVD outbreaks and thus shorten periods of spiking mortality.