The Ugandan Ministry of Health is reporting today that a 30-year-old male health care worker died of Marburg hemorrhagic fever on September 30.
The gentleman had been a radiographer, or X-ray technician, at the Mpigi Health Centre IV, but was recruited two months ago for a similar position at Mengo Hospital, about 20 miles (33 km) away. When he felt ill on September 17, he traveled back to Mpigi for treatment since “he felt more confortable with a facility that he had worked with for a long time.”Today’s statement from Elioda Tumwesigye, Minister of State for General Duties & Holding the Portfolio of Minister for Health, describes a total of 80 people who were in contact with the man have been identified and isolated to follow for signs and symptoms during the 21-day incubation period, the same incubation period for Ebola.
Most concerning is that 38 of the contacts are health care workers from Mengo Hospital, including the man’s brother, and 22 health care workers from Mpigi Health Center IV. The remaining 20 contacts are residents of the Kasese districtThe official reports that the man’s brother has already developed signs consistent with Marburg infection. He has been quarantined and isolated for further monitoring while his blood samples are being analyzed at the Uganda Virus Research Institute.
Marburg is one of the five members of the family of filoviruses, to which Ebola belongs. Like Ebola, a person infected with Marburg will experience a sudden onset of fever. The most common additional signs are headache, joint and muscle pains, vomiting blood, and bleeding through body openings. The disease has a two to 21-day incubation period and, like Ebola, has no cure other than supportive treatment.
Sarepta Therapeutics of Cambridge, Massachusetts, has been developing an RNA-interfering drug against Marburg virus as part of a collaboration with the U.S. Department of Defense. The drug, called AVI-7288, is targeted against the nucelocapsid protein of Marburg virus. In March, the company reported infection protection rates of up to 83% to 100% in non-human primates when given at up to four days post-infection. As a result, Sarepta initiated a multiple, ascending dose Phase I safety trial in humans in May.
Tekmira Pharmaceuticals of Burnaby, British Columbia, has a lipid nanoparticle, RNA interfering drug that also protects non-human primates from Marburg infection. This work, done with Thomas Geisbert at the University of Texas Medical Branch at Galveston, appeared in Science Translational Medicine in August. There, the drug is called NP-718m-LNP, but Tekmira’s website currently calls it TKM-Marburg
Colorized electron micrograph of Marburg virus from the laboratory of Dr. Thomas W. Geisbert, UTMB-Galveston. Credit: NIAID
Kent State University infectious disease specialist, Tara C. Smith, PhD, wrote an excellent history of Marburg virus in 2007. The 1967 discovery of the virus precedes that of Ebola (1976), but occurred outside of Africa, in Marburg, Germany.
Dr. Smith writes,
“The year was 1967. Several laboratory workers, all from the same lab in Marburg, Germany, were hospitalized with a severe and strange disease. The physicians on staff realized the workers were all suffering from the same ailment, with symptoms that included fever, diarrhea, vomiting, massive bleeding from many different organs, shock, and eventually circulatory system collapse. An investigation began in an attempt to uncover the source of the outbreak. This led to the identification of the source of the virus in Germany: a species of African green monkeys, imported from Uganda, which were being used by the scientists for polio vaccine research. The virus was isolated, and found to exhibit a unique morphology, leading to the designation of a new group: the Filoviridae In that outbreak, a total of 31 human cases were observed, and the disease presented with a 23% mortality rate (7 deaths occurred out of 31 total infections).”
