Marburg Virus

Introduction

Marburg Virus is a highly infectious pathogen that causes a rapidly progressive febrile illness, leading to death in approximately 70% of cases. Although described as type of viral haemorrhagic fever, only a few patients develop significant bleeding. Instead, most people just suffer from a systemic inflammatory response causing shock.

Virology

In terms of its virology, the Marburg virus has an RNA structure and is a part of the Filoviridae family just like Ebola. Filo refers to its filamentous thread-like structure.

It has a natural reservoir in Egyptian Fruit Bats found in several African countries like Uganda and Guinea.

Transmission occurs through close contact with the body fluids of infected patients like sweat.

Pathophysiology

Its pathophysiology is really interesting, but I only want you to remember 3 things.

Firstly, it causes systemic inflammation. Infected dendritic cells and macrophages produce large quantities of cytokines and chemokines.

Secondly, you get a severely impaired adaptive immune response. Dysfunctional macrophages and dendritic cells are unable to initiate the second line of defence including B cells.

Finally, it induces the production of tissue factor. This initiates coagulation cascades, causing disseminated intravascular coagulation.

The virus has an incubation period of around one week. During this time, patients are not considered infectious because they are asymptomatic.

After this, there are three main phases: A generalization phase, an early organ phase and a late organ phase. Each one lasts approximately one week. Use my acronym: THE BAD COP to remember the features in each.

Phase one kicks off with typical viral features including a high temperature, severe headache, a maculopapular exanthem.

Phase two, represents the initial manifestations of organ dysfunction. Think bleeding, anuria, and diarrhoea. This highlights its haematological signs like bleeding mucous membranes and gastrointestinal issues in the form of bloody diarrhoea.

Lastly, it causes severe complications due to complete organ failure, including coagulopathy like DIC, obtundation, and preagonal signs like gasping.

This disease is the scam of a lifetime because it’s going to kill you.

Its incubation period is seven days, and so are each of the other stages. The first phase causes constitutional symptoms like a fever, this progresses into abdominal issues like bloody diarrhoea and finally, it causes multiorgan failure.