Marburg – What it is, and what it is not

This article was last reviewed on 29.10.2024.

In late September 2024, reports of a deadly outbreak of Marburg virus began to emerge from Rwanda—the second outbreak of the disease to hit the African continent in as many years and the first in Rwanda. The Rwandan Ministry of Health and its Rwanda Biomedical Centre moved swiftly to trace contacts of known cases and to work with international organisations and vaccine developers to deploy an experimental vaccine against Marburg in a trial that could help contain the spread of the disease.

Using  ‘Answer the Public’, CEPI analysed some of the most frequently asked online questions about Marburg across Rwanda, Germany and Canada. These were among the countries with the highest numbers of people searching online for information about Marburg virus over the past 12 months, according to Google Trends at the time of publishing.

Those questions—and CEPI’s answers—are below:

What is Marburg virus? What are its symptoms, and can it kill you?

Marburg is similar to Ebola and comes from the same family of viruses—the Filovirus family.

Like Ebola, Marburg affects the body in several ways. It can cause haemorrhagic fever with very high temperatures, muscle pain and gastrointestinal symptoms, and often develops into severe and prolific internal and external bleeding.  

While some people can survive Marburg infection, it is one of the deadliest known human diseases. On average, half of all those who become infected with it die, and in some outbreaks, this case-fatality rate has been as high as 88 percent. 

When was Marburg virus discovered? And where is it found now?

Marburg virus is named after the German town of Marburg, where it was first detected in 1967. At that time, two large outbreaks occurred simultaneously in Hamburg and Marburg, which were associated with laboratory work involving monkeys from Uganda. 

Since then, outbreaks have been sporadically reported in Angola, the Democratic Republic of Congo, Kenya, South Africa and Uganda. In 2023, a Marburg outbreak infected at least 17 people in Equatorial Guinea, killing 12 of them, and a second unconnected outbreak in Tanzania at around the same time infected eight people and killed five of them. The swift introduction of containment measures brought these outbreaks to an end within a few months.

On September 27, 2024, Rwandan health authorities reported the first-ever outbreak of the disease in the East African nation. 

How does Marburg spread? How is it transmitted from person to person?

Marburg spreads between people through close contact with bodily fluids—for example, blood, vomit, faeces, urine—of an infected person. This means that healthcare workers are often at high risk of becoming infected if they are caring for someone with Marburg, particularly if they do not have access to full personal protective equipment (PPE). Marburg is not airborne, meaning it does not spread through the air. 

Will Marburg become a pandemic?

The potential for Marburg to develop into a global pandemic is much lower than for diseases caused by respiratory viruses such as COVID-19 or flu. 

This is mainly because it requires close bodily contact to spread between people, and hence infection control measures like handwashing, wearing PPE and physical distancing can help to swiftly control its transmission. 

But large outbreaks or cross-border epidemics of Marburg are possible if such public health interventions are not introduced quickly and/or the disease is misdiagnosed and therefore able to spread unchecked for long periods of time. 

Can Marburg be treated or cured? Are there any Marburg vaccines?

Marburg has no cure as yet, and there are currently no approved licenced vaccines to prevent it.  

There are, however, several potential drug treatments and candidate vaccines against Marburg in development. The experimental Marburg vaccines include three in early-stage, or so-called Phase I, trials and one being developed by the Sabin Vaccine Institute that has progressed to mid-stage Phase II clinical trials. A World Health Organization vaccine advisory group recommended in April 2023 that the Sabin Marburg vaccine candidate should be prioritised for inclusion in an emergency trial. Starting from October 6, 2024, the Sabin vaccine was deployed as part of a clinical trial to help control the Rwanda outbreak.