Marburg virus: race against time for a vaccine for the world’s next major threat

Global health chiefs are in a race against time to develop a vaccine for a virus that is a deadlier version of Ebola and appears to be spreading in Central Africa.

Panic ensues over the Marburg virus, which may initially masquerade as a cold before causing an explosion of horrific symptoms, including organ failure and bleeding from multiple orifices.

An outbreak of the extremely deadly virus – which kills up to nine in 10 patients – was declared in Equatorial Guinea on Monday after nine deaths and 16 suspected cases.

Last night, neighboring Cameroon reported two suspected infections in a pair of teenagers with no travel links to Equatorial Guinea — indicating it’s more common than official numbers suggest.

The disease causes the body’s kidneys and spleen to fail to regulate fluids. It causes hemorrhagic fever similar to that of Ebola. It causes cells around the body to expand when inflamed, blood to clot around the body and ultimately – organ failure.

The Centers for Disease Control and Prevention (CDC) warns that while the disease is rare, it can spread quickly in areas with poor sanitation.

A person can become infected after coming into contact with a contaminated fluid, such as someone’s blood or feces, and then accidentally swallowing it.

Symptoms of the virus can progress quickly, from a simple cold to a devastating infection that causes organ failure and bleeding from the eyes within days.

Up to 90 percent of cases lead to death. Many patients die within eight days of the onset of symptoms.

It can take two days to three weeks from exposure to the first symptoms.

This is called the incubation period, which is the period during which the virus has entered the body but has not yet caused any symptoms.

In some cases, a person feels nothing more than the symptoms of a cold for the first week.

During this time, the virus binds to cells in the body and spreads as the infected cells multiply in the body.

Early symptoms include high fever, chills, severe headache, fatigue, difficulty breathing, muscle aches.

Sufferers will often experience a non-itchy rash that appears all over a person’s face, arms, legs, hands, and feet.

Other symptoms within the first few days include jaundice, severe nausea, abdominal pain, pink eye, throat irritation, spots in the mouth, and extremely watery diarrhea.

These are all signs of immune problems

Usually around day five, the disease will progress to what doctors describe as the “early organ phase.”

At this point, a patient may begin to suffer from bleeding from their eyes, inflammation around the body, and visible swelling around their body – usually on the legs, ankles, and feet.

The virus causes severe inflammation of the cells and organs around the body, causing these symptoms.

Internal bleeding can cause discoloration of the skin, vomiting of blood, dark and blood-colored stools, accumulation of blood in the lungs and stomach, and bleeding gums.

The fever remains high throughout the period. Some people have reported neurological symptoms such as brain swelling, delirium, confusion, irritability, and aggression.

According to the WHO, patients often die within eight or nine days of their first symptoms appearing.

This is because the kidney, liver, and pancreas begin to fail. A person can also die from severe blood loss.

If a person does survive, they can enter the late organ phase, where they suffer from dementia, go into a coma, and suffer permanent brain and organ damage.

Marburg is part of the Filoviridae family of viruses, making it a cousin of Ebola. However, it is more deadly and faster acting than its known relative.

It is believed to have been transmitted to humans from African fruit bats, with the first infected humans being exposed to the animals in mines and caves.

Unlike Covid, it does not spread through the air but through fluids such as blood, urine or saliva.

Like Ebola, even dead bodies can spread the virus to people exposed to the fluids.

Officials in Cameroon announced two suspected cases in the southern province of Olamze.

It borders the Kie Ntem province of Equatorial Guinea, where the original suspected cases were discovered.

The potential outbreak of 27 cases would be the largest since the Marburg virus outbreak in Angola in 2004-2005.

With 252 cases and 227 deaths, this is the worst infection outbreak on record. It is also the fourth largest outbreak on record.

This is the first time it has been detected in Equatorial Guinea or Cameroon, indicating that the virus is spreading further into Africa.

It was first discovered in 1967, when monkeys were imported from Uganda to Germany and Serbia for experimentation and carried the virus.

In the time since outbreaks of the virus have occurred sporadically in sub-Saharan Africa, making its appearance in Central Africa a worrying sign.

In the ten years before the outbreak in Equatorial Guinea, only nine cases have been recorded worldwide.

On Tuesday, WHO convened the Marburg virus vaccine consortium (MARVAC) to deal with the outbreak.

The group said it could be months before effective vaccines and therapies become available, as manufacturers must gather materials and conduct trials.

The MARVAC team identified 28 experimental vaccine candidates that could be effective against the virus – most of which have been developed to fight Ebola. Five were highlighted in particular as vaccines to be investigated.

The injections were developed by non-profit organizations such as the Sabin Vaccine Institute, the International AIDS Vaccine Initiative and Public Health Vaccines – along with pharmaceutical giants such as Emergent Biosolutions and Janssen.

However, testing these vaccines may be impossible.

Because viruses like Marburg rarely result in high case rates, it may take multiple outbreaks before there are enough cases to properly analyze the effectiveness of the virus.

The panel of experts said a trial must include at least 150 cases. For context, before this outbreak, there were 30 cases recorded worldwide from 2007 to 2022.

This makes it unlikely that a vaccine will become available to fight this outbreak – and it could be years before an injection is determined to be effective.