Marburg Virus Disease

What is Marburg virus disease?

Marburg virus disease (MVD) is a serious illness that sometimes causes outbreaks in African countries. Symptoms start out flu-like but can progress to severe vomiting, bleeding and neurological (brain and nerve) issues. Outbreaks usually start by spreading from bats or primates (like monkeys) to humans. From there, it can spread from human to human and cause outbreaks.

Marburg is a viral hemorrhagic fever, or a virus that damages blood vessels and causes bleeding. It’s part of the same family of viruses as Ebola.

How common is Marburg virus disease?

Marburg virus disease is rare, but there are sometimes outbreaks in certain areas of Africa. During these outbreaks, anywhere from a few people to hundreds are infected around the same time.

Marburg virus outbreaks

The most recent Marburg outbreaks were in 2023. The first was in February 2023 in Equatorial Guinea with 16 confirmed cases and 12 deaths. Another, unrelated outbreak in Tanzania in March had eight confirmed cases and five deaths.

Other large outbreaks include:

• Uganda in 2012. There were 15 people infected and four people died.
• Angola from 2004 to 2005. There were 252 people infected and 227 died.
• Democratic Republic of Congo (DRC) from 1998 to 2000. Most cases during this outbreak were in mine workers and their families. There were 154 people infected and 128 died.
• Germany and Yugoslavia in 1967. There were two outbreaks at the same time in Europe in 1967. They were both among workers that handled African green monkeys from Uganda. There were 31 people infected and seven people died.

Is Marburg virus in the U.S.?

No, there’ve been no known cases of Marburg virus infections starting or spreading in the U.S. In 2008, someone who had traveled to Uganda developed symptoms of Marburg after they returned to the U.S. They made a full recovery and didn’t spread the disease to anyone else.

What are the symptoms of Marburg virus disease?

Symptoms of Marburg happen in two phases. The first phase of symptoms lasts five to seven days and includes:

• Fever.
• Chills.
• Severe headache.
• Cough.
• Muscle or joint pain.
• Sore throat.
• Rash. This might have raised and flat areas (maculopapular).

You might get a little better for a day or two, then additional symptoms start. The second phase of symptoms can include:

• Abdominal or chest pain.
• Vomiting.
• Diarrhea.
• Dizziness.
• Unintended weight loss.
• Bloody poop or vomit.
• Bleeding from your nose, mouth, eyes or vagina.
• Confusion.

Seek immediate medical attention if you have these symptoms.

What causes Marburg virus disease?

Two related viruses, Marburg virus (MARV) and Ravn virus (RAVV) cause MVD. They’re also related to the virus that causes Ebola. Marburg virus disease is a viral hemorrhagic fever, which can damage your blood vessels and cause severe bleeding.

How does Marburg virus disease spread?

Marburg virus spreads through contact with body fluids of infected humans or animals.

Body fluids include:

• Blood.
• Pee (urine).
• Poop (stool).
• Spit (saliva).
• Human milk.
• Semen.
• Vaginal fluids.

You can also get it from surfaces, objects or medical devices that are contaminated with the virus.

How do humans get Marburg virus?

Experts think Egyptian rousettes (fruit bats) typically carry MARV and RAVV. People usually get infected through contact with body fluids or tissues from infected bats or nonhuman primates, like monkeys. Then, it can spread to other humans, usually close family members or healthcare providers caring for them.

What are the risk factors for Marburg virus disease?

You’re at risk for MVD if you:

• Work with animals that can carry it.
• Work in mines, caves or other environments where fruit bats live.
• Are in close contact with or caring for someone who’s infected with it.

How is Marburg virus disease diagnosed?

Healthcare providers diagnose Marburg with a blood test. It can be difficult to diagnose since it can have symptoms similar to other illnesses, like yellow fever, malaria and typhoid fever. Let your provider know about any recent travel or other ways you could’ve been exposed to Marburg.

How is Marburg virus disease treated?

There’s no specific treatment or cure for Marburg virus. Providers can try to manage your symptoms, treat any complications and keep your condition stable. They might give you:

• Oxygen.
• Intravenous (IV) fluids.
• Treatments for specific symptoms, like pain medications.

Can Marburg be prevented?

Public health organizations work to contain outbreaks of Marburg by monitoring for new cases and taking precautions to keep healthcare workers safe while caring for people with MVD. Steps you can take include:

• Use protective equipment (such as a mask, goggles, apron and gloves) when caring for someone with MVD. Avoid touching any of their body fluids and wash your hands after contact, even if you wear gloves.
• Use condoms or don’t have sex until tests confirm that the virus isn’t present in your semen (or your sex partner’s, if they had MVD). Even if you feel better, the virus can live in semen for a long time. There isn’t evidence that it’s contagious in vaginal fluids for as long.
• Avoid contact with anything that may have touched infected body fluids. Don’t touch semen unless tests have confirmed it no longer carries the virus.
• Avoid touching the body of someone who died from MVD, or use protective equipment if you have to. This includes funeral customs.
• Avoid contact with fruit bats and nonhuman primates and the places they live. This includes caves and mines.
• Don’t eat bush meat (the meat of wild animals).
• If you’ve recently returned from travel to a place where there’s a Marburg virus outbreak, monitor yourself for symptoms for 21 days. Get medical care right away if you develop symptoms.
• Isolate yourself from others if you could have Marburg.

What should I expect if I have Marburg virus disease?

If you have MVD, you should avoid being around other people. Healthcare providers and others caring for you will need to take special precautions. This includes wearing protective gear and clothing (like masks, gloves, goggles and aprons) and isolating you from other people. You’ll need to be monitored closely for life-threatening complications.

Even after you’ve recovered, you may have long-lasting effects. These include:

• Memory and thinking issues.
• Skin peeling.
• Tiredness.
• Muscle pain.
• Hair loss.

The virus can also live in semen for a long time after you’re better. Use a condom when having sex to protect your partner from infection. Ask your provider about testing so you can know when you’re no longer contagious.

Is it possible to survive Marburg virus?

Marburg is usually fatal, but people have survived. The average mortality (death) rate is around 80%. There’s a large difference in mortality rates during outbreaks, ranging from 23% to 90%.

When should I see my healthcare provider?

If you could’ve been exposed to Marburg virus — for instance, you live in an area with animals that carry it or you’ve traveled to an area with an outbreak — and you develop symptoms, see a healthcare provider right away. Monitor yourself for symptoms for 21 days after exposure or returning from an area with an outbreak. Tell your provider that you could have Marburg and how you were exposed.

When should I go to the ER?

Go to the emergency room right away if you have symptoms of serious illness, including:

• High fever (over 103 degrees Fahrenheit or 40 degrees Celsius).
• Unusual bleeding.
• Severe headache.
• Chest or abdominal pain.
• Confusion or mental changes.

What questions should I ask my doctor?

It might be helpful to ask your healthcare provider:

• How can I prevent spreading the virus to others?
• What are my treatment options?
• For how long am I contagious?

A note from Cleveland Clinic

Marburg is a rare but deadly illness. It can be alarming to hear stories about outbreaks and wonder if it could affect you. If there’s a chance you could encounter Marburg, there are steps you can take to protect yourself and prevent spreading the virus. If you think you’ve been exposed, keep an eye on your health and get medical attention right away if you notice symptoms.