Fever Marburg

Marburg fever (Maridi haemorrhagic fever, Ebola fever) is an acute viral disease characterized by severe course, high lethality, hemorrhagic syndrome, liver, gastrointestinal and CNS lesions.

Etiology, pathogenesis. For the first time, the disease was observed in 1967 in Marburg and Frankfurt am Main (Marburg fever), later such diseases were observed in the Sudan, Maridi village (Maridi fever) and in Zaire near the Ebola river (Ebola fever). The viruses of Marburg, Ebola, Maridi are similar in their morphology and properties, only small antigenic differences are established. The source of infection in Europe (West Germany, Yugoslavia) was the tissue of African green monkeys, there were secondary diseases. Infection of people can occur by airborne and by contact. For medical workers, contact with the blood of patients is especially dangerous. The ingestion of it on the skin with microtrauma leads to infection. Gateway infection can serve and mucous membranes (mouth, eyes). Characterized by hematogenous dissemination of the virus. Reproduction of it can occur in various organs and tissues. The virus is found in the blood, sperm (up to 12 weeks). There are morphological changes in the liver / kidneys, spleen, myocardium, and lungs.

Symptoms, course. The incubation period is 2-16 days. Clinical symptoms, severity of the course and outcomes in diseases described as Marburg fever and Maridi fever do not differ. The prodromal period is absent. The disease begins acutely, with a rapid increase in body temperature to 39-40 C, expressed by a general intoxication (headache, weakness, muscle and joint pain), a few days later, hemorrhagic syndrome and gastrointestinal tract damage join; Dehydration develops, consciousness is disturbed. In the initial period, patients complain of a headache, stitching in the chest, coughing, dryness in the throat. There is hyperemia of the pharyngeal mucosa, the tip and edges of the tongue are red; On the hard and soft sky, the tongue appears vesicles, at the opening of which surface erosions are formed; In contrast to the Lassa fever, severe necrosis is not observed. Muscle tone, especially the muscles of the back, neck, chewing muscles, is elevated, their palpation is painful. From the 3rd-4th day, pain in the abdomen of a cramping character joins. The stool is liquid, watery, half of patients have an admixture of blood in the stool (sometimes with clots) or signs of gastrointestinal bleeding (melena). Diarrhea appears in almost all patients and lasts about a week, vomiting is less frequent (68%), lasts for 4-5 days.

Half of patients on the 4th-5th day of the disease develop a rash, more often crustacean, which seizes the trunk and limbs, and can be pruritus. At the end of the 1st week, sometimes at the 2nd week the signs of toxicosis reach maximum severity. There are symptoms of dehydration, infectious-toxic shock. In this period, patients often die.

The diagnosis is justified by epidemiological data (stay in the areas with natural foci of the Marburg fever, work with the tissues of African monkeys) and characteristic clinical symptoms. Specific methods of laboratory research can identify a virus or antibodies to it.

Treatment. Etiotropic therapy has not been developed. Pathogenetic therapy is of primary importance. A set of measures is being taken to combat dehydration, infectious-toxic shock and hemorrhagic syndrome (see Cholera, Lassa Fever). When the secondary bacterial infection stratifies, antibiotics, mainly anti-staphylococcal action (oxacillin, methicillin, erythromycin) are prescribed.

The prognosis is always serious, the lethality is 30-90%.

Prevention. Patients with Marburg fever are subject to mandatory hospitalization and strict isolation in a separate box. When treating a patient and carrying out laboratory tests, observe all the precautions recommended for working with especially dangerous infections (see Pass Fever). Control is carried out on persons arriving from endemic areas. Specific prophylaxis is not developed.