Warning Signs Of Marburg Hemorrhagic Fever

September 5, 2024

Marburg hemorrhagic fever, also known as the Marburg virus, was first identified in 1967. Related to the Ebola virus, it affects both humans and non-human primates and is caused by an animal-borne RNA virus belonging to the filovirus family. The primary host of the Marburg virus is the African fruit bat. While the exact manner of transmission to humans remains unknown, scientists note in previous outbreaks of the virus, infected individuals had handled non-human primates, cell cultures, or fluids that were also infected. To diagnose Marburg hemorrhagic fever, antigen-capture enzyme-linked immunosorbent assay and polymerase chain reaction testing can be performed, and the results are normally available in a few days. Since the symptoms of Marburg hemorrhagic fever are very similar to malaria and other less serious illnesses, it can be very easy to misdiagnose this condition.

Outbreaks of Marburg hemorrhagic fever are very rare, and some of the most recent cases were documented in 2008 in two tourists who had recently visited African caves. A 2017 outbreak occurred in Uganda and was successfully contained. Thus, many healthcare providers have never encountered this virus. As with Ebola, Marburg hemorrhagic fever currently has no recognized treatments for humans. Although some patients have survived, the mortality rate associated with this virus can be as high as ninety percent. Hospital treatments focus on balancing electrolytes, maintaining blood pressure, replacing lost blood, and treating any secondary infections. Due to the highly contagious nature of this illness, patients must be treated in isolation units, and hospital staff are required to wear several types of protective equipment. Experimental treatments have worked in non-human primates, but they have not yet been tried in humans.

Myalgia

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Myalgia (muscle pain) is one of the first symptoms of Marburg hemorrhagic fever. It typically begins within five to ten days of infection, and it can result in muscle cramps, joint pain, and limited range of motion. Myalgia can impact tendons, ligaments, and the fascia, a layer of tissue that connects muscles with bones and organs. For patients with Marburg hemorrhagic fever, myalgia is often accompanied by generalized weakness throughout the body.

The muscle pain and weakness make it difficult for the patient to stand or sit, and most patients will become bedridden within a short period. Muscle pain may be treated in the hospital with intravenous pain relievers to keep the patient comfortable, and the patient will be turned every few hours in their hospital bed to help maintain their comfort and prevent the formation of bed sores.

Fever And Chills

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Both fever and chills are classic symptoms of Marburg hemorrhagic fever, and these generally begin within the first five days of the illness. The fever associated with this condition tends to be very high from even the earliest stages. In fact, many patients with Marburg hemorrhagic fever have had fevers of more than 104 degrees Fahrenheit. Patients with this symptom frequently feel a sense of general malaise throughout the body, and their health will often rapidly deteriorate. The fever may become increasingly high in patients with this condition, and it can be very difficult, if not impossible, for hospital staff to reduce the fever in patients with Marburg hemorrhagic fever.

Headaches

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The headaches that occur with Marburg hemorrhagic fever are severe, and they appear within the first five days of the illness. These headaches are largely unrelenting; rather than being intermittent, they tend to become progressively more intense. Patients with a severe headache may develop sensitivity to light, sound, and certain odors, and they may also experience blurry vision and other vision changes. For example, many patients with this illness develop red eyes.

The pain from a severe headache often affects the entire head, and it can also shift from one side of the head to the other. Patients generally describe the pain as throbbing or pounding. Some individuals with these headaches may develop dizziness, and sensations of feeling very hot or very cold have been reported. As the headache worsens, patients may see flashing lights or dots in their visual field; this is known as an aura. Hospital treatment with intravenous pain relievers may help to reduce some of the pain from severe headaches.

Maculopapular Rash

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Patients entering the second phase of Marburg hemorrhagic fever may develop a maculopapular rash. This type of rash normally presents between days five to ten of the infection. Maculopapular rashes are made up of both flat and raised bumps that are normally red, and itching is typically present. For patients with Marburg hemorrhagic fever, the rash is generally concentrated around the trunk, including the back, chest, and stomach areas.

At this stage, patients may develop chest pain, a cough, and a sore throat along with the rash, and they may begin to have signs of bruising on the skin. While maculopapular rashes are commonly treated with topical creams and oral medications, these treatments are unlikely to work for patients with Marburg hemorrhagic fever. However, hospital treatment may include the use of ointments that reduce itch to keep the patient comfortable.

Nausea And Vomiting

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Nausea and vomiting are likely to appear within the first ten days of this illness. These symptoms tend to cause a total loss of appetite for the patient, which can result in significant and severe weight loss. In addition, patients dealing with vomiting will likely be experiencing diarrhea at this stage of Marburg hemorrhagic fever too. These symptoms ultimately progress to the point where the pancreas becomes inflamed, and the liver fails, resulting in jaundice and triggering multi-organ dysfunction.

Patients begin to have internal bleeding, and they may become delirious or develop shock. To help patients with nausea and vomiting be more comfortable, doctors treating this virus may choose to administer intravenous medications that can reduce the amount of vomiting a patient experiences, and other medications can be given to alleviate nausea.

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