Environmental Disease

SHORT COMMUNICATION
Year
: 2022  |  Volume : 7  |  Issue : 3  |  Page : 80--82

2022 outbreak of Marburg virus disease in Ghana: Public health alert


Saurabh RamBihariLal Shrivastava1, Prateek Saurabh Shrivastava2,  
1 Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Correspondence Address:
Prateek Saurabh Shrivastava
MD, FAIMER, PGDHHM, DHRM, FCS, ACME, M.Phil. (HPE). Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India

Abstract

Marburg virus disease is a severe viral disease that is often associated with high mortality. The outbreak of the fatal hemorrhagic disease has been reported for the first time in Ghana in 2022, wherein two cases of the disease were reported in hospitals. The World Health Organization has strengthened its ongoing activities by alerting the neighboring nations, deployment of experts in the nation, and increasing the availability of personal protective equipment. The success of sustainable control of the infection lies in the engagement of the community and this essentially requires measures to create awareness about the infection. It is of paramount importance to safeguard the well-being of healthcare professionals and thus each and every one of them should be sensitized and trained about the safety measures. To conclude, Marburg virus disease results in hemorrhagic manifestations, which makes the infected persons highly prone to adverse clinical outcomes. The first outbreak of the infection reported in Ghana is a reminder for international health agencies and public health authorities that we cannot let our guard down and there is an indispensable need to strengthen infection prevention and control measures.



How to cite this article:
Shrivastava SR, Shrivastava PS. 2022 outbreak of Marburg virus disease in Ghana: Public health alert.Environ Dis 2022;7:80-82


How to cite this URL:
Shrivastava SR, Shrivastava PS. 2022 outbreak of Marburg virus disease in Ghana: Public health alert. Environ Dis [serial online] 2022 [cited 2022 Dec 7 ];7:80-82
Available from: http://www.environmentmed.org/text.asp?2022/7/3/80/357451


Full Text



 Introduction



Marburg virus disease is a severe viral disease that is often associated with high mortality. The causative virus belongs to the Filoviridae family and accounts for severe hemorrhagic fever among patients.[1] The available estimates from the previous outbreaks suggest that the average case-fatality rate is 50%, nevertheless, depending on the strain of the virus and management of the affected people, the case-fatality rate can vary.[1] The infection has been earlier reported in nations such as Angola, Kenya, South Africa, and Uganda.[1] Although initial human infections were acquired by exposure to bats, in the present era, human-to-human transmission has been reported by means of direct contact with the blood, secretions, etc., through broken skin or mucous membranes, or by coming in contact with the fomites contaminated with these fluids of an infected person.[1],[2]

 Clinical Presentation



Healthcare professionals who are involved in the care of these patients or people involved in the burial are at high risk to acquire the infection. The incubation period of the infection ranges between 2 and 21 days, and the patients are generally infectious with the presence of the virus in the blood.[2],[3] The patients generally present with high fever, severe headache, bodyache, and malaise initially, which is followed by the occurrence of watery diarrhea, abdominal pain, nausea, and vomiting. In fact, a significant proportion of patients develop hemorrhagic manifestations involving different body parts. The involvement of the nervous system accounts for confusion and irritability among the patients. Finally, people succumb to the infection because of severe blood loss and shock.[1]

 2022 Outbreak in Ghana



The outbreak of the fatal hemorrhagic disease has been reported for the first time in Ghana in 2022, wherein two cases of the disease were reported in hospitals.[4] Unfortunately, both these patients lost their lives due to disease-associated complications, and subsequently, all the potential contacts (family members and healthcare professionals) are being tracked and monitored for the development of symptoms suggestive of Marburg infection.[4],[5],[6] The World Health Organization has strengthened its ongoing activities by alerting the neighboring nations, deployment of experts in the nation, and increasing the availability of personal protective equipment. In addition, steps have been taken to strengthen surveillance, expedite laboratory testing, contact tracing, and involvement of community members through intensification of awareness activities.[4],[6]

 Prevention and Control



The success of sustainable control of the infection lies in the engagement of the community and this essentially requires measures to create awareness about the infection: mode of transmission, clinical features, do's and don'ts.[1] The general population should be made aware of the necessity to use gloves and other measures while taking care of sick patients at home. Similar sort of precautions should be taken while burying the patients who have succumbed to the infection.[1],[2] Caregivers and people who have visited sick patients should practice regular handwashing to prevent the acquisition of infection. The contacts of the patients should be monitored for a minimum period of 3 weeks.[1],[4] It has even been envisaged that male survivors of the infection should practice safe sex for a period of 1 year or till their semen sample tests negative on two occasions. In the absence of availability of an effective vaccine or drug, there is an immense need to strengthen appropriate and adequate management of cases by providing early supportive care and ensuring rehydration.[4],[5],[6]

 Measures in Healthcare Establishments



It is of paramount importance to safeguard the well-being of healthcare professionals and thus each and every one of them should be sensitized and trained about the safety measures. This calls for the need to take standard precautions while caring for the patients, irrespective of their diagnosis.[1] The preventive measures include hand hygiene, adhering to safe injection practices, promoting the use of personal protective equipment, maintaining respiratory hygiene, and strictly encouraging safe and dignified burials of patients who have lost their lives due to disease-associated complications.[1],[2],[4] Further, healthcare professionals should be extra cautious to prevent exposure to blood and body fluids of patients, and this also applies to the articles (viz. clothes, bed sheets, etc.) that might be contaminated with these fluids. These safety measures should also be practiced by laboratory personnel who are dealing with the samples obtained from the potential suspects of the highly infectious disease.[1]

 Conclusion



To conclude, Marburg virus disease results in hemorrhagic manifestations, which makes the infected persons highly prone to adverse clinical outcomes. The first outbreak of the infection reported in Ghana is a reminder for international health agencies and public health authorities that we cannot let our guard down and there is an indispensable need to strengthen infection prevention and control measures.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1World Health Organization. Marburg Virus Disease – Key Facts; 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease. [Last accessed on 2022 Aug 05].
2Abir MH, Rahman T, Das A, Etu SN, Nafiz IH, Rakib A, et al. Pathogenicity and virulence of Marburg virus. Virulence 2022;13:609-33.
3Aborode AT, Wireko AA, Bel-Nono KN, Quarshie LS, Allison M, Bello MA. Marburg virus amidst COVID-19 pandemic in Guinea: Fighting within the looming cases. Int J Health Plann Manage 2022;37:553-5.
4World Health Organization. Ghana Declares First-Ever Outbreak of Marburg Virus Disease; 2022. Available from: https://www.afro.who.int/countries/ghana/news/ghana-declares-first-ever-outbreak-marburg-virus-disease-0. [Last accessed on 2022 Aug 05].
5BBC News. Ghana Confirms First Cases of Deadly Marburg Virus; 2022. Available from: https://www.bbc.com/news/world-africa-62202240. [Last accessed on 2022 Aug 05].
6Hussain Z. Ghana declares its first outbreak of Marburg virus disease after two deaths. BMJ 2022;378:o1797.