Marburg Hemorrhagic Fever
The causal agent of Marburg Hemorrhagic Fever is a virus of the Filoviridae family, which also includes the Ebola virus. The virus can be killed by disinfectants (bleach and glutaraldehyde), heat, and ultra-violet light. The Marburg virus, roughly 80 nm in across and 800 nm long, resembles Ebola and folds into a U or 6 shaped spiral. Despite superficial similarities, Marburg is antigenically different from the Ebola virus.
History of Marburg
Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (now Serbia). A total of 32 people became ill; they included laboratory workers as well as several medical personnel and family members who had cared for them. The first people infected had been exposed to African green monkeys or their tissues. In Marburg, the monkeys had been imported for research and to prepare polio vaccine. 7 of the cases resulted in fatalities.
No other case was recorded until 1975, when a traveler most likely exposed in Zimbabwe became ill in Johannesburg, South Africa - and passed the virus to his traveling companion and a nurse at the hospital. While the man died of the viral infection, both women survived.
In 1980 other cases were discovered, one in Western Kenya not far from the Ugandan source of the monkeys implicated in the 1967 outbreak. The patient had visited Kitum Cave in Kenya's Mount Elgon National Park. The patient's attending physician in Nairobi became the second case; he recovered. Mount Elgon is Kenya's 2nd highest mountain, and its famous caves were formed as lava tubes. Kitum Cave is the largest of the caves and reaches 200 meters into the mountain. The cave attracts elephants that lick salt deposits from its walls. Investigations of the cave and its ties to the Marburg virus have yielded negative results.
Another human Marburg infection was recognized in 1987 when a 15-year-old Danish boy who had traveled extensively in Kenya, including western Kenya, became ill and later died. Prior to the infection, he too, like the 1980 victim, had visited Kitum Cave.
In 1998, a severe outbreak occurred in Durba, Democratic Republic of the Congo. Cases were linked to individuals working in a gold mine and spread to the neighboring village of Watsa. Of the 154 cases, 83% resulted in fatalities (128 cases). After the outbreak subsided, there were still some sporadic cases that occurred in the region. Though the infection of family members of the victims suggested that person-to-person transmission did occur, there were different strains from a least seven separate sources. The environmental source of the Marburg virus remains unknown.
In October 2004, in the Uige Province of Angola, another outbreak of Marburg Hemorrhagic Fever began, proving to be the worst outbreak to date. Of the 252 cases, fatalities occurred in 90% of the cases (227 cases). The Angolan government, World Health Organization, and worldwide partner organizations worked together to provide surveillance and quarantine victims. Funeral practices, and home care and remedies, including home-based injections, helped spread the virus.
Marburg Virus as a Biological Weapons Agent
Marburg virus, like Ebola, is a Category A bio-warfare agent under the Center for Disease Control's classification system. Like Ebola, the fear remains that the Marburg virus could be isolated and cultivated for bioterrorism purposes.
In the 1980s, the Soviet Union experimented with the Marburg virus in aerosol form on monkeys and determined that infection required only a few virions. Ken Alibek (formerly Kanatjan Alikbekov) who secretly immigrated to the United States in 1992 revealed information about Soviet experimentation with the Marburg virus. The former First Deputy Director of Biopreparat, the Soviet biological weapons program, Dr. Alibek reported that Soviet scientists were researching whether Marburg could be loaded into a warhead or a MIRV delivery system. A colleague, Dr. Nikolai Ustinov, died from the virus after accidentally infecting himself while injecting guinea pigs with the Marburg virus for the Soviet biological weapons program. As described by Dr. Alibek, the disease that followed was horrifying and induced hemorrhages throughout Dr. Ustinov's body including from his nose, mouth, and sweat glands. After he died, Dr. Ustinov's journal was covered in his unclotted blood from star-shaped hemorrhages beneath his skin.
From Dr. Ustinov's corpse the Soviet scientists isolated a strain of Marburg that was especially deadly in airborne form; the strain was named Variant U in Dr. Ustinov's honor. According to Dr. Alibek, as of 1991, the Soviets were ready to manufacture Marburg Variant U in large amounts to be place into MIRVs (Multiple Independent Re-entry Vehicles) with 10 separate targeted warheads. Once completed, such weapons were designed to be part of the Soviet strategic/operational arsenal.
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