Today, Kenya has been rocked with the news that Trans Nzoia county is on alert over a suspected Marburg case. Ebola has been thrown around, and people have been asked not to panic. Already, a quarantine has been enforced in the affected area as we await results from the Kenya Medical Research Institute (KEMRI). But what really is Marburg and why should we be concerned? Here are 3 reasons why.
1. Marburg is Ebola's cousin.
We all remember the 2014-2016 Ebola crisis in West Africa. Who can forget the pictures of doom, of people wasting away from a strange disease with no cure at hand? Well, Marburg is Ebola's cousin and is just as dangerous. The Marburg virus, shortly referred to as Marburg, is one of the 8 deadliest viruses in the world. The virus was so named after the town in Germany by the same name where it was first described - in 1967. It belongs to the Filoviridae family of viruses, just like Ebola. In fact, Marburg and Ebola share a common ancestor, and their existence predates human existence. Viruses of the Filoviridae family cause severe diseases in humans and primates in the form of viral hemorrhagic fevers, which, in simple terms, means that the viruses cause high bodily temperature and leakage of blood from blood vessels. Additionally, this means that symptoms of infection by these viruses are similar. These viruses are so dangerous that they are designated the highest level of containment, Biosafety Level 4.
2. Marburg is highly transmissible.
Marburg easily spreads from person to person. In recorded cases of Marburg, patient zero is usually someone who contracted it from fruit bats or primates such as monkeys. Fruit bats are the host of the virus, and humans can get it directly from fruit bats or from infected primates. In our case, Marburg came to Kenya from neighbouring Uganda, where patient zero contracted it from laboratory work involving African green monkeys. Once it has infected a person, the virus catches on like wild fire. It spreads through bodily fluids i.e. blood, saliva, tears, semen, vaginal fluids, sweat, mucus, breast milk, urine, pus, and so many more. What this means is that if someone with Marburg sneezes around you, there's a very good chance that you will be infected from breathing in the bodily fluids of the infected person in their sneeze. Think of it like TB, but so much worse. Unprotected sex with someone with Marburg, you get Marburg too. Like AIDS, but so much worse. Touch someone with Marburg, be in the same vicinity as someone with Marburg, ding ding ding! Even touching clothing and bedding of an infected person may lead to infection. This is why the first step of action in a suspected Marburg case is quarantine. The entire area is cordoned off. No one leaves, and no one goes in except authorized essential health personnel. It is also why health personnel dealing with Marburg dress the way they do: respirators, face shields, full body suits, goggles, shoe coverings, two pairs of gloves, apron, and a hood. They're dressed like that to prevent infection, and anyone going into the affected area must to be dressed like that too. Even though the outbreak has not been confirmed to be Marburg as we are still awaiting results from KEMRI, containment steps at the highest level must be taken immediately the virus is suspected. It is important to note that the virus can be in incubation mode for up to 21 days, meaning that someone may be infected but not show signs of infection for those 21 days. This is why quarantine of ALL people in the affected area is important. Different areas should be designated for the diagnosed people, the suspected cases, the people who may have been infected, and the rest of the population in the area.
3. No cure and high mortality rate.
Marburg fever is a severe and highly fatal disease. Symptoms include hemorrhage, high fever, severe watery diarrhoea, vomiting, severe headaches, severe malaise, abdominal pain, cramping, and extreme lethargy. Patients may appear 'ghost-like' i.e. pale with deep-set eyes and expressionless faces. Death may occur 8-9 days after onset of disease, and it is preceded by severe blood loss and shock. Fatalities of recorded outbreak cases have gone as high as 88%. There is no known cure for the virus. People infected with Marburg remain infectious as long as the virus is in their body.However, a possible vaccine and possible cures for both Ebola and Marburg is being investigated.
How can we stay safe?
1. Do not panic. Remaining calm and level-headed is very important. The area affected has already been quarantined and border patrol is on high alert.
2. Read extensively about the virus and how to spot an infected person.
3. If you suspect that you and/or someone else is infected by the virus, seek medical attention IMMEDIATELY. Keep away from people as much as possible to not infect anyone else, and inform health officials of your suspicions from the start so that they can protect themselves too. If Marburg is confirmed, a special team - with a hotline, I suppose, will be put in place to handle the disease so as to lower transmission rates. Guidelines on handling a Marburg victim can be found here. DO NOT go to a herbal specialist or a traditional doctor. While herbal specialists and traditional doctors are very important people in the society, they are simply not equipped to deal with this class of viruses. In fact, the first suspected case of Marburg here in Kenya is that of a herbal specialist suspected to have been infected by a patient from Uganda who crossed the border seeking herbal treatment. I repeat. DO NOT go to a herbal specialist or a traditional doctor. While herbal specialists and traditional doctors are very important people in the society, they are simply not equipped to deal with this class of viruses.
4. Stay alert. Marburg is dangerous, but, with the proper surveillance and protection, the situation is far from hopeless.
5. Stay away from bats and primates. If your work involves these animals e.g. laboratory work involving African green monkeys like in this case, observe good laboratory practices and biosafety protocols. Do not eat these animals, that's how Ebola broke out in West Africa.
6. Examine your burial practices. Burial practices have a lot to do with disease. Before modern burial was embraced by Kenyan communities, the most common method of burial was feeding the corpse to dogs or wild animals and this led to a high prevalence of hydatid cysts (tapeworms) in humans because the human remains were somehow making their way back to food and water due to improper disposal. In New Guinea, an entire population was almost wiped out by a prion disease known as Kuru because they cannibalized the brains of the dead person as part of their burial rites. In Sierra Leone, Liberia, and Guinea, the spread of Ebola was especially fueled by their burial rites. Bodies of people with Marburg must be handled and buried by the personnel handling the containment of the virus. This is because the virus is still contagious in the dead person.
7. Raise awareness. Educate your friends and family. Do not forget about those in rural areas. Reach them too. Community engagement is key to successfully controlling outbreaks.