The Valencian Community has activated the action protocol in the event of a suspected case of suffering from the disease caused by the highly lethal Marburg virus. The patient, a 34-year-old man, presents symptoms compatible with the disease and was in Equatorial Guinea for a period of time “that could correspond to the incubation and development of the disease,” as reported late Friday by the Ministry of Health. The man is isolated at Hospital La Fe in Valencia, a reference center in the autonomous community. It is the first case detected in Spain suspected of having contracted this virus similar to Ebola, which also causes hemorrhagic fever, at least with official proof of its existence.
The government of the African country declared a health alert on February 13 in the face of an outbreak of the Marburg virus that had caused the death of nine people in the province of Kie Ntem, on the mainland and near the border with Cameroon. In addition, there were 16 people who were in contact with the deceased who are isolated in various hospitals. To prevent the spread of the outbreak, the Government decreed that 4,325 people remain in quarantine at home, according to information provided by the Guinean administration at the time.
The biological samples of the patient, admitted to Valencia, have been sent to the reference laboratory of the Carlos III Health Institute in Madrid for possible confirmation of the case. The Ministry transferred the man from a private hospital to the High-Level Isolation Unit of the La Fe de València University and Polytechnic Hospital, “which guarantees the safety of both his care and the protection of the health professionals who treat him”, affirms the Ministry of Health.
This virus, which has an incubation period of between 5 and 10 days during which it is not transmitted, causes a febrile hemorrhagic illness that begins abruptly with fever, muscle pain, weakness, headache, and sore throat. In fact, between 50 and 80% of the patients, a rapid weakening occurs accompanied by gastrointestinal symptoms, abdominal discomfort, intense nausea, vomiting and diarrhea within a period of 2 to 5 days, according to the report of the Ministry of Health.
The intensity of the disease increases after 5-7 days with a maculopapular rash and hemorrhagic symptoms such as petechiae, mucosal and gastrointestinal bleeding. In addition, and as reflected in the report, neurological symptoms (disorientation, seizure and coma) can occur in later stages of the disease. Transmissibility begins when symptoms develop and persists as long as there is virus in the blood.
Currently, there is no specific treatment, although supportive therapy (intravenous fluids, supplemental oxygen, electrolytes, etc.) can significantly improve clinical outcome. However, some pharmaceutical products such as immunotherapeutics, interferons or antivirals are being developed to combat the disease. Specifically, antivirals such as faviparavir and remdesivir seem to be advantageous in non-human primates, but there is still no clear evidence of their benefit in humans, according to the ministry report. There is also no licensed vaccine, although the European Medicines Agency (EMA) has licensed vaccines Zabdeno and mvabea for post-exposure prophylaxis of Ebola virus disease.
Given this situation, Health indicates in the report that cases under investigation and confirmed cases will be urgently notified to the public health services of the autonomous communities and from there to the Center for Coordination of Health Alerts and Emergencies (CCAES) of the Ministry of Health and the National Epidemiology Center of the Carlos III Health Institute.
This disease, caused by a virus from the same family as Ebola, was first detected in 1967 in the German cities of Marburg, hence its name, and Frankfurt, as well as in Belgrade (Serbia). These outbreaks were caused by laboratory work with African green monkeys imported from Uganda.
Until now, outbreaks of Marburg fever have occurred in Angola, Kenya, the Democratic Republic of the Congo, Uganda and South Africa, although in the latter country through a person who had traveled to Zimbabwe. It is the first time that Equatorial Guinea has experienced an outbreak of this disease. After the jump of the virus from the infected animal to the human being or zoonosis, transmission between people occurs through direct contact with fluids from the sick, as well as with surfaces contaminated by said fluids. As with Ebola, the unprotected handling of the corpses of deceased people is usually a source of contagion.
