Ghana has reported two suspected cases of the rare and deadly Marburg virus disease – the first to ever be recorded within its borders. Marburg is a highly infectious viral haemorrhagic fever in the same family as the more well-known Ebola virus disease, said WHO’s Ghana Country Office in making the announcement. It has a fatality rate of up to 88%. 

Preliminary analysis of samples taken from two patients by the country’s Noguchi Memorial Institute for Medical Research indicated the cases were positive for Marburg. The samples have been sent to the Institut Pasteur in Senegal, a World Health Organization (WHO) Collaborating Centre, for confirmation. The two patients from the southern Ashanti region – both  unrelated – showed symptoms including diarrhoea, fever, nausea and vomiting. They died after having been taken to a district hospital in Ashanti region. 

Preparations for a possible outbreak response are being set up swiftly as further investigations are underway, WHO said.

“The health authorities are on the ground investigating the situation and preparing for a possible outbreak response. We are working closely with the country to ramp up detection, track contacts, be ready to control the spread of the virus,” said Dr Francis Kasolo, World Health Organization (WHO) Representative in Ghana.

WHO is deploying experts to support Ghana’s health authorities by bolstering disease surveillance, testing, tracing contacts, preparing to treat patients and working with communities to alert and educate them about the risks and dangers of the disease and to collaborate with the emergency response teams.

Ghana cases outside of endemic zone

The outbreak in Ghana is a source of concern not only because the virus is particularly deadly, but also because it has occurred outside of the central and southern African zone where most  cases have been previously reported. Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda, according to WHO.

Marburg has been detected in just one other West African country, Guinea.  The country confirmed a single case in an outbreak that was declared over on 16 September 2021, five weeks after that case was detected.

The deadly virus was first identified in 1967 after two outbreaks of cases simultaneously in Marburg and Frankfurt Germany and in Belgrade, Serbia – thus the naming of the disease. The outbreak was later raved to laboratory work with African green monkeys (Cercopithecus aethiops) that had been imported from Uganda.

Marburg is transmitted to people from fruit bats and following that, it can spread person-to-person through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise, said WHO. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24% to 88% in past outbreaks depending on virus strain and case management.

Although there are no vaccines or antiviral treatments approved to treat the virus, 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, are being evaluated.

Image Credits: Chris Black/WHO, World Health Organization .