I am The two boys who returned from Rwanda tested “negative” for the Marburg virus who had experienced flu symptoms on a high-speed train arriving at Hamburg station. This was reported first by the European Commission’s Health spokesperson Stefan de Keersmaecker. But what do we know about this virus? What are the symptoms?
The two suspected cases in Hamburg
Then came the confirmation from the ECDC, the European Center for Disease Control and Prevention. Yesterday, we read, “Germany reported that 2 travelers returning from Rwanda were isolated in Hamburg due to history of exposure in a medical facility in Rwanda, where patients suffering from Marburg virus disease were being treated. The ECDC has been in close contact with German public health authorities. The negative test results were reported today.”
Marburg disease, what it is and symptoms
Marburg disease, or Marburg hemorrhagic fever, explains the Swiss Federal Office of Public Health, is a zoonosis, that is, a virus that has passed from animals to humans. The natural vector of the virus is a frugivorous bat of the Pteropodidae family, the Egyptian Scarlet Bat (Rousettus aegyptiacus) which lives mainly in Africa. Monkeys and some antelopes can serve as intermediate vectors. For humans, contagion can occur indirectly by ingesting contaminated fruit, or directly through contact with bats and their excrement. The virus is also transmitted directly through the body fluids (especially blood, vomit and excrement) of infected and sick humans or animals, living or dead. Contagion via contaminated objects cannot be ruled out, but there are no indications that it can be transmitted via aerosols. The virus is so called because it was imported into Europe via laboratory animals (vervet monkeys) in Marburg, Germany, where some researchers developed the disease.
Marburg, the virus that resembles Ebola: the alarm of experts
The Marburg outbreak “in various areas of Africa is worrying because it is a virus that resembles Ebola, with haemorrhagic fever and very high mortality”, said infectious disease specialist Matteo Bassetti, director of infectious diseases at the San Martino polyclinic hospital in Genoa, who said he was very worried after the news of the Hamburg cases.
The virologist Fabrizio Pregliasco thinks that it is necessary to strengthen surveillance also on this pathogen, which “can cause a serious haemorrhagic disease like Ebola”, and is convinced “that at the moment there is no cause for alarm in our country” and that in any case case “Italy has all the capabilities to intercept any cases to isolate and monitor”.
Advice for travellers
Advice for those heading to Rwanda, which reported the first outbreak of Marburg virus disease (MVD) on 27 September, is provided by the ECDC (European Center for Disease Prevention and Control).
The ECDC specifies that “person-to-person transmission” of the Marburg virus “requires contact with the body fluids of a symptomatic case”, therefore “the probability of exposure and infection with the Marburg virus for citizens of the European Union/Economic Area Europeans traveling to or residing in the affected areas in Rwanda is currently considered low”. To date, however, the probability of exposure in a healthcare environment is considered “moderate”. While “in case of importation of a case of MVD into the EU/EEA, the probability of further transmission is considered very low, if appropriate measures are applied”.
So here is some advice for travellers. Those headed to Rwanda “must be informed of the ongoing outbreak and follow the recommendations of local health authorities.” In particular, they should be advised to: “Avoid contact with anyone showing symptoms of Marburg virus disease (fever, vomiting, diarrhoea, bleeding) or contact with materials and surfaces contaminated by body fluids of infected people, which also means avoiding contact with bodies of people who have died from MVD and the burial process; avoid visiting healthcare facilities in MVD-affected areas for non-urgent medical care or for non-medical reasons; avoid habitats that may be populated by bats, such as caves or mines, as well as any form of close contact with wild animals whether alive or dead, and the handling or consumption of any type of bushmeat.”
Finally, “travellers returning from Rwanda to the EU/EEA should be advised to promptly seek medical attention if they develop symptoms compatible with Marburg virus disease and to report their travel history, as well as any exposure history and close contacts.” .
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