An outbreak of Marburg virus has been identified in Equatorial Guinea. This prompts an urgent meeting with the World Health Organisation (WHO), amid concerns that it could spread.

Marburg can cause death up to 88% in some cases.

This is everything you need about the deadly virus.

Where is the virus located so far?

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As of 16 February, nine deaths were reported in Equatorial Guinée from people suffering from symptoms similar to the virus.

Another 16 cases of suspected diarrhoea, fever, fatigue, blood-stained vomit or diarrhoea were reported.

This is the first Marburg virus epidemic in Central Africa.

Two 16-year-olds from Cameroon were reported to have been infected with the virus by a neighbor. However, these cases have not yet been confirmed by WHO.

What are the symptoms of ?

According to WHO, Marburg virus illness can be sudden and include high fever, severe headaches, and severe malaise.

On the third day, severe watery diarrhoea and abdominal pain, cramping, nausea, and vomiting may occur.

Many patients experience severe haemorrhagic symptoms within a week. This could include bleeding under the skin or in internal organs or orifices like the eyes, ears, mouth or eyes.

Death in fatal cases usually occurs on the eighth or ninth day.

How dangerous is it?

Very.

The WHO estimates that the average death rate for infected patients is 50%, but depending on how the infection is managed, it could be as high as 88%.

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Two men who died from the Marburg virus in Ghana have been confirmed to have had Marburg viruses.

How is it spread?

Fruit bats transmit the virus to humans.

It can spread to humans by direct contact with bodily fluids or surfaces contaminated with these fluids (e.g. bedding).

Injection equipment that has been contaminated can also spread the virus, which can lead to more severe complications.

As long as the virus remains in the blood, people can remain infected. Burial ceremonies that are close to the body may also cause infection.

How concerned should I be?

The WHO has praised Equatorial Guinea’s “rapid, decisive action” in confirming the illness. This means that an emergency response could be launched quickly.

Between 1967 and 2022, there were 15 Marburg outbreaks. Some were small outbreaks with only one or two cases. The largest outbreak was in Angola in 2004-2005, where 252 people became infected.

Although the current epidemic has just hit double digits in severity, the fact that the Cameroon cases have not traveled recently could indicate an undetected spread.

How does it get treated?

Marburg is not a place where there are approved drugs or vaccines. However, rehydration can be used to relieve symptoms and increase survival chances.

Five vaccine candidates are currently being tested by researchers to find experimental vaccines. These vaccine candidates have been proven promising in animal studies.

What is the WHO response?

On 14 February, the WHO called for an urgent meeting to discuss Marburg virus. Efforts are being made to quickly mount an emergency response.

To stop the spread of Marburg, surveillance has been intensified. Teams that used to be involved in contact tracing for have been re-deployed.

WHO has sent health emergency specialists to assist with epidemiology, case management and infection prevention.

It also sends laboratory glove tents to be tested, as well as a kit with personal protective equipment (PPE), that can be used for 500 health workers.

At the meeting, the main topic was the intention to test Marburg vaccines. Three vaccine developers indicated that they would likely be able to make the necessary doses for testing in this outbreak.

Independent experts will now assess which candidate should be prioritized. The WHO will also work with Equatorial Guinean health officials to determine the best way to conduct a trial.