Marburg virus disease: Emerging threat, pathogenesis, and global public health strategies

Abstract

The Marburg virus (MARV) is a dangerous infection that causes a deadly sickness known as MARV disease. This severe hemorrhagic fever is a major concern for people all over the world. Since the initial identification in 1967 during simultaneous outbreaks in Germany and Serbia, MARV has caused recurrent epidemics predominantly in sub-Saharan Africa with fatality rates ranging from 24% to 90% as a result of differences in virus strains, healthcare infrastructure, and the quality of patient treatment. Like Ebola virus, MARV causes a viral hemorrhagic fever identified in some of the same principles of clinical and epidemiological concern. However, MARV has unique biologic characteristics that require specialized research and response by public health and among researchers. Diagnosis relies on molecular tools such as real-time reverse transcriptase-polymerase chain reaction and enzyme-linked immunosorbent assay, as well as clinical and epidemiological assessments. Despite advancements in understanding MARV biology, no vaccines or antiviral therapies have been approved, with treatment limited to supportive care. Experimental therapeutics, monoclonal antibodies, RNA-based drugs, and adenovirus-based vaccines, show promise but require further validation. Current efforts in outbreak containment include surveillance, rapid diagnostics, case isolation, and safe burial practices. However, gaps in understanding MARV pathogenesis, limited diagnostic tools, and the absence of regulatory-approved vaccines underscore the urgent need for global collaboration and investment in research. Bridging these gaps is critical to mitigating the public health impact of MARV, ensuring effective response strategies for future outbreaks.

Keywords: Enzyme-linked immunosorbent assay; Hemorrhagic fever; Marburg virus; Outbreak control; Real-time reverse transcriptase-polymerase chain reaction; Zoonotic transmission.

Figure 1

Structure of Marburg virus. NP: Nucleoprotein; VP: Viral matrix protein.

Figure 2

Marburg virus transmission and dissemination. Marburg virus reservoirs, like African fruit bat, may transmit the virus to other members of their own species via biting, sexual transmission, or direct contamination.

Figure 3

Rousettus aegyptiacus bat and Cercopithecus aethiops.

Figure 4

Human model of Marburg virus hemorrhagic fever pathogenesis.