infectious diseases
Marburg and Ebola Virus Infections
Introduction
Marburg and Ebola are Overview of Arbovirus, Arenavirus, and Filovirus Infections that cause hemorrhage, multiple organ failure, and high mortality rates. Diagnosis is with enzyme-linked immunosorbent assay, polymerase chain reaction (PCR), or electron microscopy. Treatment is supportive. Strict isolation and quarantine measures are necessary to contain outbreaks. Marburg and Ebola viruses are filamentous filoviruses that are distinct from each other but that cause clinically similar diseases characterized by hemorrhagic fevers and capillary leakage. Ebola virus infection is slightly more virulent than Marburg virus infection. Ebola virus isolateshave been differentiated into 5 species: Zaire Ebola virus Sudan Ebola virus Tai Forest Ebola virus (formerly, Côte d'Ivoire Ebola virus [the Tai forest is located in Côte D'Ivoire]) Bundibugyo Ebola virus Reston Ebola virus (which is present in Asia but does not cause disease in humans) Most outbreaks of Marburg and Ebola virus infections have originated in sub-Saharan Central and West Africa. Outbreaks have been rare and sporadic; they have been contained partly because they have occurred in isolated areas. When spread to other areas occurs, it has usually resulted from travelers from Africa. However, in 1967, a small Marburg hemorrhagic fever outbreak occurred in Germany and Yugoslavia among laboratory workers who had been exposed to tissues from imported green monkeys. In December 2013, a large Zaire Ebola virus outbreak began in rural Guinea (West Africa), then spread to densely populated urban regions in Guinea and to neighboring Liberia and Sierra Leone. It was first recognized in March 2014. It involved thousands of people and had a case fatality rate of about 59%. Infected travelers spread Ebola virus to Nigeria, Europe, and North America. Cases of Ebola continued to occur in the first few months of 2016; Sierra Leone was finally declared Ebola-free in March 2016, Guinea in May 2016, and Liberia in June 2016. In 2017, a small outbreak due to Zaire Ebola virus was reported in a remote region of the Democratic Republic of the Congo (DRC); the World Health Organization (WHO) declared an end to this outbreak in July 2017 ( General references ). In May 2018, another outbreak occurred in the DRC ( In September 2022, Uganda reported a case of Ebola disease caused by the Sudan ebolavirus, the first in a decade. This outbreak was declared over in January 2023, after 142 confirmed cases and 77 deaths ( General references ). There was a small outbreak starting in February 2021 in Guinea that is speculated to have started with the wife of a man who had recovered from an Ebola virus infection 5 years earlier and was thought to have transmitted the virus to his wife. This persistent infection and delayed transmission was suggested by the fact that the genetically sequenced virus was remarkably similar to that of the West Africa outbreak 5 to 7 years earlier. 