Marburg fever is a serious and dangerous disease that is accompanied by damage to the liver and central nervous system, as well as hemorrhagic syndrome. This is an infectious disease, the outcome of which is often fatal.
It is worth noting that the disease is not widespread - over the past 50 years, only isolated cases have been reported. However, many people are interested in more information about the infection. So what is Marburg hemorrhagic fever? How does the infection spread? What are the symptoms to look out for? Can modern medicine offer an effective therapy? The answers to these questions are of interest to many people.
Marburg fever: disease description and brief historical background
To begin with, it is worth noting that this is a rather rare disease that is not so well known to the general public. Marburg fever is an infectious, viral disease, which is accompanied by severe intoxication, the appearance of skin hemorrhages and internal bleeding. It is worth noting that the disease often ends in death.
First time small outbreaksdiseases were registered in 1967 simultaneously in the cities of Marburg and Frankfurt. In addition, there is evidence of a case of illness in the territory of the former Yugoslavia. Later it was proved that African green monkeys were the reservoir of infection. During the outbreak, experts also noted that pathogenic viruses can be transmitted from person to person.
Marburg fever has also been reported in Africa - cases of illness have been recorded in Kenya and South Africa.
Features of the structure and activity of the pathogen
What is Marburg fever? Causes, ways of spreading infection, features of vital activity of pathogenic microorganisms are, of course, important points.
The causative agent of this disease is an RNA genomic virus that belongs to the genus Filovirus (family Filoviridae). By the way, today four serotypes of this pathogen are known. It is also worth mentioning that the infections that lead to diseases such as Marburg and Ebola have some similar properties. For example, both pathogens are thermostable, sensitive to chloroform and ethyl alcohol.
The virus that provokes hemorrhagic fever is characterized by polymorphism - virions can have a round, worm-like or spiral shape. The length of the viral particle is 665-1200 nm, and the diameter is 70-80 nm.
There is evidence that these pathogens can be spread by exoparasites. In the body of mosquitoes belonging to the species AnophelesMaculipennis, viral particles survive for eight days, and in the cells of the tick Ixodes ricinus - up to 15 days.
How is the infection transmitted?
Despite the fact that the first cases of the disease among humans were due to contact with green monkeys, the features of the circulation of infection between representatives of this group of animals have not yet been fully studied.
Marburg hemorrhagic fever is a highly contagious disease, in most cases the source of infection is an infected person. The virus enters the body through mucous membranes (eg, oral tissues, eye conjunctiva) and damaged skin tissues. Casual contact with a sick patient, kissing, contact of microparticles of saliva on the mucous membrane of the eyes are the main ways of transmitting the pathogen.
It is worth noting that the disease can also spread sexually, as viral particles are present in the seminal fluid. A contact-household transmission route is also possible, since the pathogen is contained in the patient's feces, blood, saliva and other internal fluids.
Man is a reservoir of infection for many months. There are known cases of infection from humans 2-3 months after the complete disappearance of symptoms. That is why it is so important to isolate a sick patient and adhere to safety rules.
Pathogenesis of disease
As already mentioned, Marburg fever is a viral disease, and the infection enters the body through mucous membranes and skinfabrics.
Infection spreads rapidly throughout the body. The virus can multiply in almost any tissue - its traces are found in the spleen, liver, bone marrow, lungs, testicles of men. By the way, viral particles are present in the blood and semen for a long time - sometimes they are detected 2-3 months after the illness.
Already at the initial stages, one can observe rapid cell death and the formation of small foci of necrosis in various organs. There are no pronounced inflammatory reactions in this case.
The situation is getting worse as the infection contributes to various microcirculation disorders. There is also a change in the rheological properties of blood. That is why the disease is accompanied by spasm and thrombosis of small vessels, increased permeability of arterial and venous walls.
The lack of an adequate response from the immune system is another factor that complicates the disease. Marburg fever often ends in shock, swelling of the brain or lungs, which in turn leads to the death of the patient.
Initial stage symptoms
What disorders accompany Marburg fever? The symptoms of the disease are varied. The incubation period lasts up to 12 days.
The patient's condition tends to worsen suddenly. Body temperature rises sharply. The patient complains of chills, body aches, weakness. The person has difficulty breathing. There is a sore throat and an annoying dry cough. When examining the oral cavity, you can notice the appearance of reddish rashes on the tongue and palate. The patient also notesthe appearance of pain in the jaw while chewing or talking.
The initial symptoms of the disease include severe migraines, chest pains, muscle weakness. Often, the virus causes conjunctivitis, which is accompanied by scant discharge, severe itching, and redness of the mucous membrane of the eyes.
Features of the clinical picture in the first week
It is worth noting that each stage of the disease is accompanied by the appearance of new symptoms. If during the first few days patients complain only of general weakness and symptoms of intoxication, then on the 4th-5th day the signs become more characteristic.
Patients complain of sharp, cutting pains in the abdomen. There are other disorders of the digestive tract, including severe nausea and vomiting, loose stools. Sometimes impurities, even blood clots, can be seen in the vomit.
Around the same period, hemorrhagic syndrome develops - patients complain of blood from the nose. More massive gastrointestinal and uterine bleeding is possible.
The virus continues to spread throughout the body, which affects the functioning of the nervous system - patients often lose consciousness. Seizures are also possible. Other symptoms include skin rashes, which are localized mainly in the neck, face, upper limbs.
Second week of illness and possible complications
The second week is considered the most dangerous, since it is during this period that complications develop,incompatible with life.
It becomes very difficult for patients to breathe. The body is severely dehydrated. Severe toxicosis can lead to the development of shock conditions. The infection affects the work of the nervous and endocrine systems, which leads to the appearance of various disorders, including psychoses.
The list of possible symptoms include heart rhythm disturbances, pulmonary edema, acute renal failure. Possible development of myocardial infarction.
How is the recovery going?
Even if the patient managed to endure the most difficult period of the disease, it should be understood that the recovery process will be long. As a rule, the human body recovers within 3-4 weeks. At this time, many patients complain of constant weakness, nausea and loss of appetite. That is why they are recommended rest and good nutrition - high-calorie, but easily digestible foods should be included in the menu.
Sometimes hair loss can be observed throughout the patient's body. It is worth noting that fever often flows into pneumonia, encephalitis and other inflammatory diseases.
Diagnostic measures
Diagnosis in this case is difficult because there are no characteristic symptoms. Moreover, the disease must be differentiated from other similar infections, including the Ebola virus.
An important step is the collection of anamnesis, because it is important to know not only about the symptoms, but also about the place, conditions in which the patient could catch the infection. Of course, blood tests are carried out. Processdiagnostics includes various serological and virological studies, including PCR, RN, ELISA and virus culture isolation. Such procedures allow you to determine the nature of the pathogen and take appropriate measures.
In the future, instrumental studies are also carried out, including electrocardiography and ultrasound of internal organs - this is the only way to assess the degree of damage to the body and the presence of complications.
How is fever treated?
What to do if a patient is diagnosed with Marburg fever? Treatment, unfortunately, is only symptomatic. The therapy is aimed at eliminating dehydration, combating toxic shock, hemorrhagic syndrome and their consequences.
Patients are given intravenous platelet mass, rehydration and detoxification therapy. In some cases, doctors decide to introduce interferons into the treatment regimen. Sometimes patients are prescribed plasmaphoresis. Patients are also injected with convalescent plasma.
It is worth noting that all infected people must be urgently hospitalized and placed in special boxes of the infectious diseases department. In the process of treatment, it is very important to adhere to safety rules, to monitor disinfection and sterilization more closely. Self-medication or home therapy is not acceptable.
Possible Complications
Marburg fever is a disease that should never be ignored. Even with adequate treatment, there is a high risk of developing certain complications.
Infectionaffects the liver and often ends with severe forms of hepatitis. Other complications include pneumonia, transverse myelitis, myocarditis, orchitis with further testicular atrophy. Fever negatively affects the functioning of the nervous system - some patients suffer from various psychoses. The most severe consequences include swelling of the brain and lungs, shock conditions that can result in the death of the patient.
Prognosis for patients
Marburg fever is an extremely dangerous disease. According to various sources, the mortality rate among patients with this diagnosis varies widely - 25-70%.
Even if we are talking about a favorable outcome, you should understand that recovery is slow. Quite often, the disease is accompanied by a mass of complications that significantly worsen a person's standard of living.
Marburg Fever: Prevention
Unfortunately, there are no special means that can completely protect against infection. To date, only a drug containing specific serum immunoglobulin has been developed. This medicine is sometimes used for immunoprophylaxis, although it is not 100% effective.
All patients with this infection must be hospitalized. Patient care is provided only by specially trained staff. It is important to use protective equipment and appropriate gear. It should be understood that the virus spreads quickly and the human immune system practically does notis able to cope with the infection on its own - it is extremely important to prevent the development of the epidemic.
