Diferencia entre revisiones de «Marburg virus disease»
m (Mholtz moved page Marburg to Marburg virus disease) |
Sin resumen de edición |
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| Línea 4: | Línea 4: | ||
**The 5 species of Ebola are the other 5 members of the family | **The 5 species of Ebola are the other 5 members of the family | ||
*First outbreak, 1967, in Marburg and Frankfurt Germany - due to research on African green monkeys | *First outbreak, 1967, in Marburg and Frankfurt Germany - due to research on African green monkeys | ||
*Reservoir: African fruit bat | *Reservoir: African fruit bat (''Rousettus aegyptiacus'') | ||
===Transmission=== | ===Transmission=== | ||
*Host animal to human | *Host animal to human - most outbreaks have implicated contact with bats<ref name="Pigott">Pigott DM, Golding N, Mylne A, et al. Mapping the zoonotic niche of Marburg virus disease in Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2015;109(6):366-378. doi:10.1093/trstmh/trv024.</ref> | ||
**No documented cases of primate-human transmission outside laboratory setting | |||
*Human to human: direct contact with droplets of body fluid or contaminated objects | *Human to human: direct contact with droplets of body fluid or contaminated objects | ||
Revisión del 06:53 7 sep 2015
Background
- Also known as Marburg hemorrhagic fever
- RNA virus of the filovirus family
- The 5 species of Ebola are the other 5 members of the family
- First outbreak, 1967, in Marburg and Frankfurt Germany - due to research on African green monkeys
- Reservoir: African fruit bat (Rousettus aegyptiacus)
Transmission
- Host animal to human - most outbreaks have implicated contact with bats[1]
- No documented cases of primate-human transmission outside laboratory setting
- Human to human: direct contact with droplets of body fluid or contaminated objects
Clinical Features
- Incubation period: 5-10 days
- Initial symptoms are vague:
- Fever, headache, chills, myalgias, abdominal pain, diarrhea
- Maculopapular rash, typically on the trunk, around 5 days after symptom onset
- Massive hemorrhage, shock, and multiorgan system failure
- 23-90% fatal
Differential Diagnosis
Fever in Traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid Fever
- Typhus
- Viral Hemorrhagic Fevers
- Chikungunya
- Yellow fever
- Rift Valley Fever
- Q fever
Diagnostic Evaluation
- Difficult diagnosis and very rare/unlikely outside of Central Africa
- Consider Marburg with typical symptoms and high risk exposure including:
- Close contact with African fruit bats, infected humans, infected non-human primates
- Lab researcher using African primates
- Recent travel to Uganda or other Central African countries
- Cave exploration in Africa
Work-up
- ELISA, PCR, and IgM ELISA for acute infection several days after symptom onset.
- IgG ELISA can be used later in the course of disease.
Management
- Supportive therapies are the hallmark of management
- Isolation precautions: standard, contact and droplet[2]
- Isolate in a single room with the door closed
- Limit entry and maintain a log of people who enter the room
- Use standard, contact, and droplet precautions
- Notify public health personnel
- Continue to test and treat for other possible diseases
Disposition
- Admit to ICU