After repeat testing, the US Centers for Disease Control and Prevention (CDC) confirmed at the end of last month that a man treated last year in a Colorado hospital had contracted Marburg hemorrhagic fever, the first known case in the United States.
According to a report in the online version of Colorado’s daily newspaper Rocky Mountain News late on Friday, the man contracted the virus during a visit to Uganda and was treated at Lutheran Medical Center in Wheat Ridge in January 2008. The man recovered and came back for a follow up in June 2008 when he was re-tested.
The man, who has not been identified, had visited a python cave in Maramagambo Forest in Queen Elizabeth Park in Uganda. The cave is populated by fruit bats, known to carry the Marburg virus.
According to the CDC, Marburg hemorrhagic fever is a rare, severe type of animal-borne hemorrhagic fever that affects both humans and non-human primates.
It is caused by a unique member of the filovirus family, of which the five species of Ebola are the only other known members.
While the virus is indigenous to Africa, it carries the name Marburg because it was first recognized in 1967 when outbreaks of the fever simultaneously broke out in laboratories in Marburg and Frankfurt in Germany and in Belgrade, in what was then Yugoslavia (now Serbia). The outbreaks killed 37 people in all, some were lab workers and some were family members who had nursed them. The lab workers had caught the virus from African green monkeys that had been imported for research on polio vaccine.
Lutheran Medical Center is working with state and local health authorities and the CDC to establish the risk doctors and staff have been exposed to as a result of coming into contact with the patient.
A spokeswoman for Exempla Healthcare, of which the Lutheran Medical Centre is a part, told Rocky Mountain News that so far investigations have concluded that none of the doctors and staff who cared for the patient have developed symptoms of the fever. However, any member of staff who is still concerned can still get a blood test, said the paper.
Exactly how the virus is transmitted is not known, says the CDC, but the incubation period is about 5 to 10 days and the onset of the disease is quite sudden, with fever, chills, headache, and myalgia (muscle pain). It is most likely passed via bodily fluids, such as blood drops, and doctors and care staff should wear protective gowns, gloves and masks around the patient.
About 5 days after the symptoms start, the patient may get a maculopapular rash of spots and bumps, most noticeable on the chest, back and stomach. This may then be followed by nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhea. Symptoms then become more and more severe, and may include jaundice, inflammation of the pancreas, delirium, shock, severe weight loss, liver failure, and multiple organ dysfunction. The disease can be fatal.
Diagnosis of Marburg fever is made difficult by the fact the symptoms are similar to those of other infectious diseases, such as malaria or typhoid fever, says the CDC, which may explain why it wasn’t diagnosed at the time, but there was no explanation as to why the first lab test didn’t identify it.
Officials from the hospital told Rocky Mountain News that they followed the protocols for dealing with an unknown infection. This included:
“Contact isolation (gown and glove) and testing for a number of infectious [agents], with some of the tests being performed at the CDC.”
Sources: Rocky Mountain News, CDC.
Written by: Catharine Paddock, PhD