|




|  By: Chris Macko
  

 
 


 

‡154 cases total (48 confirmed and 106 suspected)
Marburg Hemmorrhagic Fever (MHF) was first discovered in
Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia ‡83% mortality rate
(nowSerbia). The 31 individuals were infected by contact with
‡52% of the cases were in young male miners. 94% of
monkeys. MHF is caused by the Marburg virus (MARV) , part of the  |
 

RNA filovirus family which includes the Ebola virus. Symptoms these miners came from an underground mine called the
include: fever, generalized body pains, nausea and vomiting, Goroumbwa mine.
headache, anorexia, malaise, abdominal pain, diarrhea, hiccups,
conjunctivitis, rash, and abnormal bleeding from the nose, mouth, or ‡Only 27% of the infected miners reported having contact
gastrointestinal tract. The average mortality rate is 23-25% although with infected persons before becoming sick.
in some outbreaks the mortality has been as high as 83%. In 1998
Durba, a mining village in the Democratic Republic of the Congo had
‡67% of the patients who were not miners reported contact
an outbreak of MHF. Due to the ongoing civil war, researchers were with infected individuals.
unable to access the region until after the main wave of the virus
‡When the mine flooded and became unusable, the
had passed. They used hospital records to reconstruct the history of
the outbreak and blood samples to confirm the current cases. outbreak stopped.
Results showed that the majority of the cases came from miners
‡Genomic analysis shows at least 9 distinct Marburg VP35
working in the Goroumbwa mine. The researchers also gathered
samples of the fauna of the Goroumbwa mine during the 1998-2000
lineages in circulation during the outbreak
outbreak. The fauna included bats, rodents, shrews, frogs, snakes,
cockroaches, crickets, spiders, wasps, and moth flies. By using PCR
and ELISA assays, they were able to identify Marburg virus in 3
species of bats. ‡Out of all of the organisms tested, only the Egyptian fruit bat
(Rhinolophus eloquens), the eloquent horseshoe bat
(Rousettus aegyptiacus) and greater long fingered bat
(Miniopterus inflatus) contained Marburg virus
‡The bats appeared to be healthy and asymptomatic when
caught.
|
During the 1998-2000 outbreak, aid was prevented from reaching Durba,
Democratic Republic of the Congo until after the main wave of disease had
passed because of an ongoing civil war. When researchers finally arrived, they
took blood samples from those currently infected by the disease and punch-
biospys from those recently diseased. Hospital records were used to reconstruct
the history of the outbreak. Patients were suspected to be infected if they had
the characteristic clinical syndrome. Laboratory confirmation involved using
enzyme-linked immunosorbent assay(ELISA). The ELISA tested for IgG, IgM
antibodies for MARV, and MARV antigen. Reverse Transcriptase PCR was also
used for laboratory confirmation. The primers used targeted a filovirus-specific
segment of the polymerase (L) gene and nested primers targeting the Marburg
virus VP35 gene. Virus isolation was also attempted by using were cultureing
cells in Vero 76 or Vero E6 cells in an effort to isolate the virus. Ecological
samples were taken of the fauna of the Goroumbwa Mine using nets and traps.
These samples were frozen and later examined for presence of the virus using
ELISA and RT-PCR. Sequencing was done on Viral protein 35 (VP35) in both
humans and bats.

 

‡The outbreak of MARV appears to initially have infected
the miners who then transmitted the disease to their
caretakers.
‡The multiple lineages of virus in the population are thought
to be a result of multiple introductions of the virus into the

|
 
  
 population, and thus short independent chains of
‡The mine was two vertical shafts descending 400m into the ground.
From there horizontal tunnels took off.
‡Due to drainage pump problems, the mine had flooding problems
and was completely flooded by September 2000.
‡The miners stayed in the mine for up to a week at a time.
‡The mine had poor sanitary conditions and was covered with human
and bat excrement.
transmission.
‡The presence of the virus in the bat species of the mine
indicates that they may be a reservoir for the virus. More
tests would need to be done to determine if the bats are the
reservoir of if they are a secondary transmitter.
‡Six of the lineages found in the bats were identical to the
lineages found in the human population. This suggests that
humans may have acquired the virus from the bats.
‡15 distinct VP35 lineages were found in
‡6 of the genetically distinct Marburg VP35 lineages found in
infected humans were identical to the sequences found in
infected bats.
Reference
Bausch, Daniel G. "Marburg Hemorrhagic Fever Associated with Multiple Genetic
Lineages of Virus." new england journal of medicine. 355.9 (2006): 909-919.
Swanepoel, Robert. "Studies of Reservoir Hosts for Marburg Virus." Emerging
Infectious Diseases. 13.12 (2007): 1847-1851.