Marburg Virus Disease: What to Know

Medically Reviewed by Melinda Ratini, MS, DO on July 28, 2022
Written by Alexandra Benisek
4 min read

This virus, formally known as Marburg hemorrhagic fever (MHF), is similar to the Ebola virus. It causes you to quickly develop severe illness and fever, which could lead to shock or death. Experts first found Marburg virus disease (MVD) after two large outbreaks in Germany and Serbia in 1967.

Cases in these countries resulted from laboratory work done with infected monkeys imported from Uganda. Later reports of outbreaks and other lone cases emerged throughout Africa.

Humans usually get infected with this disease after lengthy exposure to mines or caves where Rousettus bat colonies live. These bats are natural hosts of the Marburg virus.

Marburg virus spreads from person to person through direct contact with an infected person’s blood, organs, secretions, or other bodily fluids. Materials and surfaces (like clothing or bedding) can contain infected fluids, and touching them can also spread the virus.

Health care workers often become infected after they treat people with confirmed or suspected cases of MVD. This happens when facilities don’t follow infection control safety measures after a staffer comes into close contact with an infected person.

Transmission can also result from contaminated injection tools or needle-stick injuries. These cases usually cause more intense disease, a quick decline in health, and perhaps a higher death rate.

In addition, burial ceremonies that involve direct contact with the body of someone who had MVD could also lead to transmission. Experts still consider you infectious if your blood contains the virus.

The incubation period, which refers to the length of time from infection to when you first notice symptoms, can be anywhere from 2 to 21 days.

These symptoms usually begin abruptly:

  • High fever
  • Severe headaches
  • Intense malaise, or general feeling of illness
  • Muscle aches and pains
  • Severe, watery diarrhea (usually on the third day, lasting until a week after symptoms occur)
  • Abdominal pain and cramping (usually on the third day after symptoms occur)
  • Nausea and vomiting (usually on the third day after symptoms occur)
  • Ghost-like features (deep-set eyes, expressionless face)
  • Severe fatigue

In the 1967 outbreaks, a non-itchy rash appeared between 2 to 7 days after the first symptoms.

You’ll likely develop severe bleeding between 5 to 7 days from the onset of symptoms. Blood may appear in your vomit or stool, or you might bleed from your nose, gums, or vagina. You could also bleed from an IV, or intravenous, port. During this intense period, you might have a high fever that results in confusion, aggression, and irritability.

Orchitis, which is inflammation of one or both testicles, often happens late in the disease (around 15 days after the first symptoms).

In fatal cases, great blood loss and shock usually lead to death around 8 to 9 days after the first symptoms appear.

About half the people who get MVD die, but this has varied in past outbreaks based on the virus strain and how well experts manage the illness.

It’s easy to confuse MVD with other diseases like typhoid fever, malaria, shigellosis, meningitis, and other viral fevers that cause bleeding. Doctors confirm MVD by testing your body fluids. They may use:

  • Antibody-capture enzyme-linked immunosorbent assay (ELISA)
  • Antigen-capture detection tests
  • Serum neutralization test
  • Reverse transcriptase polymerase chain reaction (RT-PCR) assay
  • Electron microscopy
  • Virus isolation by a cell culture

No, but it’s possible to recover if you get hospital care as soon as possible.

There are no vaccines or antiviral treatments approved for MVD. Even though it’s similar to Ebola, the Ebola vaccine won’t work against MVD. But supportive care often boosts survival. This includes rehydration with oral or IV fluids and treatment of specific symptoms.

There are treatments under study. Experts continue to develop monoclonal antibodies -- human-made proteins that help your immune system work better. They’re also researching antiviral medications like favipiravir and remdesivir, which doctors used in clinical studies for Ebola, to see if they might help with MVD treatment.

In 2020, the European Medicines Agency (EMA) approved the vaccines Mvabea and Zabdeno for use against the Ebola. These vaccines could possibly protect people against MVD, but experts need to conduct further clinical trials to know for sure.

They’re different viruses, but they belong to the same family, called Filoviridae. The diseases they cause have a lot in common, too. MVD and Ebola:

  • Develop in your body in a similar way
  • Can cause similar symptoms and complications
  • Spread from person to person in the same ways  
  • Can cause outbreaks with high death rates

People who have either one of them can benefit from similar supportive care at the hospital. Hospitals are supposed to use the same safety measures to help prevent or control the spread of infection while giving someone supportive care.

Some key differences between Marburg and Ebola are:

  • Marburg has caused fewer outbreaks than Ebola as of late 2020.
  • Doctors have rapid tests to diagnose Ebola. Researchers are still working on creating rapid tests for Marburg.
  • There isn’t an FDA-approved treatment or vaccine for Marburg yet. You can get those for Ebola, though.