Overview of Marburg Disease and Outbreak in Angola, 2005

On March 17, 2005, the World Health Organization (WHO) reported 39 deaths from a suspected acute hemorrhagic (bleeding) fever syndrome in Uige Province of northern Angola . Four days later, the Special Pathogens Branch of the Centers for Disease Control and Prevention (CDC) confirmed the presence of Marburg virus in nine of 12 laboratory specimens submitted from patients who died during the outbreak. For more recent case numbers, see http://www.who.int/csr/don/en/.

As part of the public health response, CDC has sent personnel to join the WHO-coordinated international response team to assist with epidemiologic investigation, infection control, and laboratory diagnosis.

In addition, CDC in Atlanta will continue to provide laboratory and other scientific and logistical support to Angola's Ministry of Health. On March 25, CDC posted an outbreak notice on its website to inform travelers about the outbreak (available at http://www.cdc.gov/travel/other/marburg_vhf_angola_2005.htm). This website will be updated regularly as new information becomes available. No U.S. travel restrictions to the affected area are recommended at this time.

Marburg hemorrhagic fever is caused by a virus (family Filoviridae, which includes Ebola virus) that occurs primarily in countries in East and Central Africa. Although the disease is rare, it has the potential for person-to-person spread, especially among health-care staff and family members or others who care for the patient. Transmission to humans may occur through direct contact with blood or body fluids (e.g., saliva, and urine) of an infected person or animal or through contact with objects that have been contaminated with the blood or other body fluids of an infected person. Spread of the virus between humans has occurred in settings of close contact* with infected persons, such as in hospitals.

The likelihood of contracting any viral hemorrhagic fever (VHF), including Marburg, is considered extremely low unless there has been travel to the affected area and direct contact with the body fluids of symptomatic infected persons or animals or with objects that have been contaminated with body fluids. The cause of fever in persons who have traveled or live in areas where VHF is present is more likely to be a common infectious disease, but such persons would need to be evaluated by a health-care provider to be sure.

Early symptoms of Marburg hemorrhagic fever include sudden fever, chills, and muscle aches. Around the fifth day after the onset of symptoms, a skin rash may occur. Nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhea may follow. Symptoms become increasingly severe and may include jaundice (yellow skin and eyes), severe weight loss, mental confusion, shock, and multi-organ failure.

The prevention of Marburg virus infection includes measures to avoid contact with blood and body fluids of infected individuals and with objects contaminated with these fluids (e.g., syringes).