When the Marburg Virus Attacks

Number 5 Michelle Barnes
On New Year’s Eve 2007 Michelle Barnes was travelling from Uganda to her home in Colorado,
after having spent an adventure holiday in Africa. Before she got home, Michelle had already
developed a rash, nausea and a headache. Nevertheless, she spent the next few days
in Colorado, with her family, friends and in public places. Unbeknownst to her, Barnes was carrying a
contagious virus, with a death rate of 25 to 90 percent. Her symptoms worsened as her body was slowly
shutting down and she began to suffer from multisystem organ failure. Barnes collapsed during a visit to her doctor
and was rushed to the emergency room. For the following twelve days, over two hundred
health care professionals treated her with antibiotics and fluids. Barnes started to recover but no one knew
what she’d suffered from. Then, about a year later, Barnes read about
a Dutch woman who’d died of Marburg virus disease after visiting the same cave in Uganda
where she’d been. Barnes’ delayed diagnosis confirmed her
suspicions – that she’d battled and survived the disease. Even though she was the first person to bring
the virus to the US, no other infections were confirmed. The same was true for the woman who’d taken
the disease to the Netherlands. Up next we go over the discovery of the Marburg
virus and the first outbreak associated with it but first let’s learn more about this
deadly viral agent. Today’s video was requested by Best Professor. If you have any other topics you’d like to
learn about subscribe and let us know in the comments section below. The Marburg virus, or MARV, belongs to the
Filoviridae virus family, of which Ebola is also a member. It measures about 80 nanometers in width but
has a variable length. When seen under a microscope, it can be coiled
or branched and may appear in the shape of a “U”, a “6” or that of a shepherd’s
crook. Like others in its family, the Marburg virus
causes a potentially deadly hemorrhagic fever, called Marburg virus disease. Humans and nonhuman primates that succumb
to it will have typically suffered multiple organ failure. The Marburg virus is considered to be extremely
dangerous and requires the highest level of precaution both in a laboratory setting and
in case of a potential outbreak. It has been described as the world’s deadliest
virus and even researched as a chemical weapon. Number 4 Discovery and Naming
In 1967, a number of people in Belgrade, Yugoslavia as well as in the German towns of Frankfurt
and Marburg became violently ill. There were 31 cases of viral infection which
resulted in 7 deaths. No one knew the source of the illness until
it was traced back to infected African green monkeys. They’d been brought from Uganda to a company
in Marburg called Behringwerke. The company had been founded by Emil von Behring,
who was the first person to be awarded the Nobel Prize in medicine. Behringwerke staff members were the first
to contract the disease. They got infected after working with tissue
samples from the infected monkeys without wearing proper protective equipment. Secondary infections involved a nurse, doctors,
a post-mortem attendant and a veterinarian’s wife. They’d all had direct contact with the fluids,
mainly blood, of a primary case. The virus and disease were subsequently named
after the town where they were first discovered. Our next listing takes a look at the deadliest
outbreak in recent history, but first let’s see where on the map is the virus most prevalent. Even though it carries the name of a German
town, MARV is actually endemic to the arid woodlands of equatorial Africa. It’s been reported in Uganda, Angola, Kenya,
South Africa and the Democratic Republic of the Congo. Although not endemic, it was also found in
the Soviet Union, but we’ll get to that later on. Most of the infections that have occurred
were associated with people working in mines or visiting natural caves. Old World fruit bats seem to play a major
role in the transmission and natural maintenance of the virus. Only in the original 1967 outbreak have other
animals been linked to MARV. It’s still unclear whether bats are the
hosts of the virus or if they serve as intermediates after being infected by other animals. Number 3 Angola Outbreak
So far the deadliest Marburg virus outbreak on record took place in Angola, from 2004
to 2005. Out of the 252 people who’d contracted Marburg
virus disease, 227 lost their lives. There was a combination of logistical and
social factors which contributed to the elevated fatality rate. One was a shortage of medical professionals. At the time of the outbreak, Angola had a
population of roughly 19 million people but only about 1,200 doctors. There were situations in which entire provinces
had as few as two. The country’s roads and other aspects of
infrastructure were left in shambles after decades of civil war. There was also a massive shortage of personal
protective equipment for healthcare workers. When a Doctors Without Borders team arrived
at a hospital, which was at the center of the outbreak, they found that it operated
without water and electricity. Because of the disease’s association with
death, locals treated healthcare workers with hostility and refused getting treatment. Coming up, we’re going to take a look at
how Marburg virus disease can kill you and later on we’ll learn how one government
tried to weaponize it. As MARV or its lesser-known relative the Ravn
virus, or RAVV, enter the body they cause Marburg virus disease also known as Marburg
hemorrhaging fever. The incubation period is, on average, between
five to nine days. First symptoms include a high fever, a severe
headache, rashes, vomiting, diarrhea and abdominal pain. Within a few days the disease progresses to
include shortness of breath, edema, encephalitis and conjunctivitis. The combination of symptoms may cause sufferers
to become confused, delirious and aggressive. After the onset of bleeding symptoms, the
sufferer will either recover or die. Blood may leak from the gums, nose or appear
in the form of ecchymosis, a subcutaneous bleeding spot similar to bruises. The sufferer may experience bloody stools
or vomiting blood. A state of convalescence follows as multiple
organs begin to shut down. Death, on average, occurs within two weeks
after the onset of the first symptoms. Even if it doesn’t kill a patient initially,
MARV is known to persist in the body and may reactivate or be transmitted through sperm
and even breastmilk or amniotic fluid. Number 2 Research as a Biological Weapon
We’ve previously mentioned that Marburg virus disease has also been detected in the
Soviet Union. It didn’t occur naturally, however, as it
was part of a biological weapons research program. At least three separate institutions were
researching warfare applications of the deadly virus during the Cold War. There was also one accident at a facility
in Koltsovo, in 1988, which resulted in the death of a researcher named Nikolai Ustinov. The research was highly classified so it’s
still unclear how far the Soviets got towards a weaponized version of the virus. According to biological warfare expert and
Soviet Union defector Ken Alibek, the progress was indeed substantial. He claimed that a MARV-containing weapon was
tested at a base in the Kazakh Soviet Socialist Republic, on the territory of present-day
Kazakhstan. Before we move on to the country with the
most MARV outbreaks, let’s see what can be done to survive Marburg virus disease. As of the making of this video there is no
cure or proper vaccine available for Marburg virus disease. An early diagnosis is the best chance of survival
if you’re infected. Immediate supportive treatment includes antibiotics
to combat secondary infections and balancing fluids to prevent dehydration. It’s also important to maintain oxygen levels
and control blood coagulation. In the first stage of the disease drugs should
be administered to prevent the formation of blood clots. Later in the infection pro-coagulants should
be administered to control excessive bleeding. Since the disease has a high fatality rate,
prevention is the best course of action. This means avoiding the places where the virus
exists in nature as well as avoiding skin-to-skin contact with people you believe may be infected. MARV doesn’t get transmitted by aerosol
during MVD outbreaks. Its primary means of transmission among humans
is through excretions, body fluids and possibly contaminated materials and utensils. The virus requires biosafety level 4-equivalent
containment, the highest safety level available. Those working with viral samples in a laboratory
setting should receive proper training in multi-layered safety protocols. Number 1 2017 Outbreak in Uganda
Uganda seems to be ground zero for the Marburg virus as the country with the most recorded
outbreaks. Nearly every instance of MVD travelling across
intercontinental lines has been traced back to the African country. Five separate outbreaks from 2007 to 2017
have involved roughly two dozen cases of human infection and 14 confirmed deaths. Hundreds of individuals were under surveillance
for the virus through contact tracing. In the most recent outbreaks the index case,
meaning the first person known to have contracted the disease, was a game hunter. The man lived near the mountain caves where
the bats harboring Marburg viruses dwelled. He transmitted the disease to another family
member and she died as well. They were, however, the only two confirmed
fatalities in the 2017 outbreak. In recent years, the Ugandan Ministry of Health
has collaborated with international organizations, like UNICEF, the WHO and Doctors Without Borders,
to improve the way the country deals with viral outbreaks. Thanks for watching! Be sure to click on one of the links on your
screen for more videos!

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