Marburg Virus: NCDC issues guidelines

The Nigeria Centre for Disease Control (NCDC) says it is on a high alert following the first outbreak of the Marburg virus in the country’s neighbouring Ghana.

The NCDC director-general, Ifedayo Adetifa stated this in a statement Tuesday, noting that no case of Marburg virus has been reported in Nigeria but several measures are being put in place to prevent its outbreak

On Monday, the World Health Organisation (WHO) confirmed the outbreak of the virus in Ghana after blood samples from two patients in the southern Ashanti region, both of whom later died, tested positive.

The current outbreak in Ghana is the second time the virus will be detected in West Africa, after the 2021 experience in Guinea.

Mr Adetifa revealed in the statement that given the proximity of Ghana to Nigeria as well as the WHO alert, the NCDC-led multisectoral National Emerging Viral Haemorrhagic Diseases Working Group (EVHDWG) has conducted a rapid risk assessment to guide in-country preparedness activities.

Based on available data, the NCDC DG said, the overall risk of both importations of the disease and its potential impact on the Nigerian population is said to be moderate.

He noted that this was assessed by NCDC experts and partners considering the proximity and high traffic from Ghana and countries that share borders, the incubation period of 21 days of the virus, and heightened surveillance at the point of entry.

It added that they also considered “Nigeria’s capacity to respond to the outbreak in the country and the fact that persons with MVD transmit the virus when they become symptomatic unlike for SARS-CoV-2 that causes COVID-19 that can also be transmitted by infected persons without symptoms.”

Testing

The NCDC boss also noted that Nigeria has the capacity to test for the virus presently at the National Reference Laboratory in Abuja and the University of Lagos Teaching Hospital Laboratory Centre for Human and Zoonotic Virology.

“Diagnostic capacity can be scaled up to other laboratories if required. Nigeria has the resources (human, technical and laboratory) for prompt identification and management in the event of a single imported case,” he added.

Mr Adetifa assured that the risk of importation may be further reduced as the current situation in Ghana is under control and active case finding is ongoing while there is heightened surveillance in Togo and Benin.

He also disclosed that “many of the contacts under follow-up in Ghana will soon exit the 21-day quarantine period and so far, there have been no secondary cases reported.”

Preventive measures

To prevent the outbreak of the Marburg virus in Nigeria, the NCDC highlighted measures that Nigerians should strictly adhere to.

It urged Nigerians to avoid: non-essential travel to locations where the outbreak is reported, for now, direct contact with blood, saliva, vomit, urine, and other bodily fluids of people suspected or confirmed to have the virus, and reservoir for fruit bats and other sick animals.

ALSO READ: Ghana quarantines 98 contacts over Marburg virus disease

It further said: “Ensure all persons with the symptoms described above are promptly taken to healthcare facilities for diagnosis and initiation of supportive treatment.

“In suspected and/or confirmed MVD cases, direct physical contact should be avoided by ensuring strict isolation, the use of protective gowns, masks, gloves and safe disposal of needles, bedding, and other contaminated materials.

“Strict practice of infection prevention control in the healthcare setting for all suspected patients.”

NCDC added that male survivors of Marburg virus disease should practise safer sexual practices and hygiene for 12 months from onset of symptoms or until their semen tests negative twice, for the virus.

About Marburg Virus Disease (MVD)

The Marburg virus causes a rare, highly infectious viral hemorrhagic fever and is in the same family as Ebola, both members of the Filoviridae family (filovirus).

It is another example of zoonoses such as Lassa fever, etc. Marburg is transmitted to people from fruit bats as a result of prolonged exposure to mines and caves that have Rousettus bat colonies. It is not an airborne disease.

The virus spreads through human-to-human transmission via direct contact with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials contaminated with these fluids.

NCDC said; “The initial symptoms of the disease include sudden onset of high fever, chills, headache, body aches which may be accompanied by a rash, most prominent on the chest, back and stomach, nausea/vomiting, chest pain, sore throat, abdominal pain by the fifth day of illness.

“Increase in severity of the illness can be heralded by the appearance of severe watery diarrhoea, jaundice, inflammation of the pancreas, severe weight loss, bleeding from multiple areas, delirium, shock, liver failure, massive haemorrhaging, and multi-organ dysfunction and/or failure.

“In fatal cases, death occurs often between 8 and 9 days after symptom onset. The case fatality rate for MVD is estimated to be 24 to 88 per cent.”

It added that the Marburg virus is known to persist in the body – placenta, amniotic fluid, the fetus of infected pregnant women, breast milk of women who were infected while breastfeeding and semen – of persons who have recovered from MVD.