The death toll from an outbreak of Marburg virus in Equatorial Guinea has reached nine, the health ministry said on Thursday amid World Health Organization estimates the real toll is double that.

The outbreak of the hemorrhagic fever has spread beyond the province of Kie-Ntem, where it caused the first known deaths in January and reached Bata, the economic capital of the west African nation.

The ministry raised the confirmed death toll from seven just a day after the WHO urged the country to report all cases over fears transmission may be more widespread.

The reported cases are in three provinces 150 kilometres apart, "suggesting wider transmission of the virus", said WHO chief Tedros Adhanom Ghebreyesus on Wednesday.

On March 22, WHO Africa regional headquarters said it knew of 20 further probable cases, all of whom were dead and the organisation's alert and response director Abdi Mahamud noted "signs of the wide spread of transmission that are making us (worried)".

Citing nine "laboratory confirmed deaths", the ministry tweeted there were a further 13 positive cases, two of whom had been hospitalised and another who had recovered while "a total of 825 contacts have been followed up".

WHO warns over spread of virus

The WHO has warned of a potential large scale epidemic which could spread to neighbouring Gabon and Cameroon.

Tanzania also announced last week five deaths from Marburg, but insisted it has the spread under control after sending a rapid response team to the northwestern region of Kagera which borders Uganda.

The WHO also added there were currently nine deaths and 16 suspected cases with symptoms including fever, fatigue, diarrhea and vomiting. Let's have a look at the causes, symptoms, diagnosis and treatment options of Marburg disease.

What is Marburg disease?

Marburg virus disease is a highly virulent disease that causes haemorrhagic fever, with a fatality ratio of up to 88%. It is in the same family as the virus that causes Ebola virus disease. There have been a dozen major Marburg outbreaks since 1967, mostly in southern and eastern Africa.

How does the disease spread?

Like Ebola, the Marburg virus originates in bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials. The rare virus was first identified in 1967.

Symptoms of Marburg disease

Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Many patients develop severe haemorrhagic symptoms within seven days. The virus is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials.

Diagnosis of the virus

Clinically, Marburg virus can be difficult to distinguish from other infectious diseases like malaria, typhoid fever, shigellosis, meningitis, and other viral hemorrhagic fevers. The following diagnostic methods are used to confirm that symptoms are caused by Marburg virus infection:

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 cell culture

Patient samples pose an extreme biohazard risk; laboratory testing on non-inactivated samples should be performed under the strictest biological containment conditions. When transported nationally and internationally, all biological specimens should be packaged using the triple packaging system.

Treatments

There are no vaccines or antiviral treatments approved to treat the virus. However, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, as well as candidate vaccines with phase 1 data are being evaluated.

Incubation period:  Within an incubation period of 2-21 days, infected individuals get fever, chills, headache, and myalgia (muscle pain).

Travel AdvisoriesMarburg virus, which causes infection as deadly as Ebola, has been spreading like a wildfire in Africa. Now the US Centers for Disease Control and Prevention (CDC) has urged all travellers going to Guinea and Tanzania to take prevention to avoid catching the fatal virus. Furthermore, the health body is also sending personnel to help halt the spread of the virus.

UAE

The UAE has advised Emiratis not to travel to Tanzania and Guinea due to the recent outbreak of the Marburg virus. To ensure the safety of Emirati citizens, the Ministry of Foreign Affairs and International Cooperation has recommended postponing all travel plans to these destinations until further notice. In case of an emergency, Emiratis are advised to contact the ministry through the hotline number 0097180024.

The Ministry's warning comes as a precautionary measure to prevent the spread of the virus and to ensure the safety of UAE citizens.

The Ministry of Health has affirmed its continued close follow-up on regional and global developments regarding the health conditions related to monitoring a number of cases infected with the Marburg Virus Disease (MVD) in Tanzania and Equatorial Guinea.

Oman

Oman has issued a similar warning with the health ministry calling on its citizens not to travel to both countries unless“extremely necessary.” The death toll from the outbreak of Marburg virus in Equatorial Guinea has reached nine, the health ministry said on Thursday amid World Health Organization estimates the real toll is double that.

Kuwait

The Ministry of Foreign Affairs has urged Kuwaitis to avoid traveling to the United Republic of Tanzania and Equatorial Guinea until further notice. The ministry has also advised citizens in these countries to adhere to the preventive health measures and guidelines issued by local health authorities.

The decision was made following reports of Marburg virus disease outbreaks in these two countries and based on the recommendations of the Gulf Center for Disease Prevention and Control and the Ministry of Health in Kuwait.

Bahrain

The health authorities of Bahrain have allayed concerns over the Marburg virus that has claimed several lives in Equatorial Guinea and Tanzania. The Health Ministry said the virus was unlikely to affect Bahrain as the kingdom had no direct flights to the two African countries .

Thailand 

Owing to the increasing number of visitors to Thailand, the department would closely monitor the situation through the WHO, the Department of Disease Control said. Thailand has tightened restrictions and urged health centres throughout the country to be on alert, as the two possible cases of the virus on the Cameroon – Equatorial Guinea boundary have just been reported.

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