Marburg virus disease (MVD) is a severe hemorrhagic fever caused by the Marburg virus, which belongs to the same family as the Ebola virus. First identified in 1967, the virus can cause severe illness in humans, with a high case fatality rate recorded up to 90% in some outbreaks. The disease begins abruptly with symptoms like high fever, intense headache, and general malaise. Given its severity and potential to cause epidemics, understanding the available management strategies is necessary.
Supportive Care in Hospitals
With no approved vaccines or specific antiviral therapies for MVD, patient management relies on supportive care administered in a hospital, often in an intensive care unit (ICU). This approach does not target the virus directly but aims to manage symptoms and physiological stress, giving the immune system the opportunity to fight the infection. This care must be delivered under strict isolation protocols to prevent the virus from spreading.
A primary goal of supportive care is maintaining the patient’s fluid and electrolyte balance. Significant fluid loss is common due to symptoms like diarrhea and vomiting, requiring rehydration, often through intravenous (IV) fluids. Healthcare providers also work to maintain adequate oxygen levels and stable blood pressure.
In many cases, patients develop hemorrhagic symptoms, leading to significant blood loss. This requires the replacement of lost blood and clotting factors through transfusions. Additionally, patients are monitored and treated for any secondary bacterial infections that might develop while their immune system is compromised.
Experimental Antiviral Treatments
Researchers are investigating several experimental treatments not yet approved for MVD, which have been explored on a compassionate use basis during outbreaks. Among these are monoclonal antibodies, lab-made proteins designed to mimic the immune system’s ability to fight off pathogens. Treatments like MBP091 have been considered, drawing on similar strategies developed for Ebola.
Specific antiviral drugs have also been evaluated for effectiveness against the Marburg virus. Remdesivir, a broad-spectrum antiviral, has shown positive results in nonhuman primate models, with a majority of treated animals surviving infection. Favipiravir has also demonstrated a high survival rate in animal studies, but promising results in animal models do not guarantee effectiveness in humans.
Other compounds are in earlier stages of research, including small interfering RNA (siRNA), which can target the virus’s genetic material. These treatments remain investigational, and more clinical data is needed to establish their safety and efficacy in humans.
Vaccine Development Efforts
There is currently no licensed vaccine to protect against Marburg virus disease, but research efforts are underway. Several promising candidates are progressing through clinical trials. The goal is to provide a tool for preventing infection, which is a long-term strategy for managing the threat posed by the virus.
The most advanced vaccine candidates often use viral vector platforms. For example, a candidate based on a chimpanzee adenovirus (cAd3) has been in clinical studies. This type of vaccine uses a harmless, modified virus to deliver genetic instructions for a Marburg virus protein to the body’s cells, prompting an immune response. The recombinant vesicular stomatitis virus (rVSV) platform, successful for an Ebola vaccine, is also being explored for Marburg.
Other approaches, such as DNA vaccines, are also under investigation. These candidates are in various stages of development, from preclinical research to early-phase human trials. The deployment of a safe and effective vaccine would help prevent future outbreaks and control the spread of the virus.