In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock. Orchitis has been reported occasionally in the late phase of disease (15 days). Involvement of the central nervous system can result in confusion, irritability, and aggression.
During the severe phase of illness, patients have sustained high fever. Spontaneous bleeding at venepuncture sites (where intravenous access is obtained to give fluids or obtain blood samples) can be particularly troublesome. Fresh blood in vomitus and faeces is often accompanied by bleeding from the nose, gums, and vagina. Many patients develop severe haemorrhagic manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding, often from multiple areas. In the 1967 European outbreak, non-itchy rash was a feature noted in most patients between 2 and 7 days after onset of symptoms. The appearance of patients at this phase has been described as showing “ghost-like” drawn features, deep-set eyes, expressionless faces, and extreme lethargy. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Muscle aches and pains are a common feature. Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. The incubation period (interval from infection to onset of symptoms) varies from 2 to 21 days. Both diseases are rare and have the capacity to cause dramatic outbreaks with high fatality rates. Though caused by different viruses, the two diseases are clinically similar. Marburg and Ebola viruses are the two members of the Filoviridae family (filovirus). Marburg haemorrhagic fever was initially detected in 1967 after simultaneous outbreaks in Marburg, from which the disease takes its name, and Frankfurt in Germany and in Belgrade, Serbia. Marburg virus is the causative agent of Marburg haemorrhagic fever (MHF), a disease with a case fatality ratio of up to 88%. No specific antiviral treatment or vaccine is available.The Marburg virus is transmitted to people from fruit bats and spreads among humans through human-to-human transmission. Rousettus aegypti, fruit bats of the Pteropodidae family, are considered to be natural hosts of Marburg virus.Case fatality rates in Marburg haemorrhagic fever outbreaks have ranged from 24% to 88%.The Marburg virus causes severe viral haemorrhagic fever in humans.Severe cases require intensive supportive care, as patients are frequently dehydrated and in need of intravenous fluids or oral rehydration with solutions containing electrolytes.Ĭase fatality rates have varied greatly, from 25% in the initial laboratory-associated outbreak in 1967, to more than 80% in the Democratic Republic of Congo from 1998 to 2000, to even higher in the outbreak that began in Angola in late 2004. The disease has no vaccine and the predominant treatment is general supportive therapy. Transmission of the virus can also occur by handling ill or dead infected wild animals (monkeys and fruit bats). Close contact with severely ill patients, during care at home or in hospital, and certain burial practices are common routes of infection. The Marburg virus is transmitted via direct contact with the blood, bodily fluids and tissues of infected persons. Many patients develop severe haemorrhagic manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding, often from multiple sites. Illness caused by Marburg virus begins abruptly, with severe headache and severe malaise. Both diseases are rare, but have a capacity to cause dramatic outbreaks with high fatality rates. These viruses are among the most virulent pathogens known to infect humans. Marburg haemorrhagic fever (MHF) is a viral haemorrhagic fever and a virus from the same family as the one that causes Ebola haemorrhagic fever.
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