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Tanzania-The New Habitat of Marburg Virus

Article  in  New Microbes and New Infections · April 2023

DOI: 10.1016/j.nmni.2023.101145

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President Abdul Hamid Medical College Hospital & NSTU
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Tanzania - The new habitat of Marburg virus

Fatema Hasan Kaifa, Prosun Bhattacharya, Abdullah Al Marzan, Md Aminul Islam

PII: S2052-2975(23)00064-1
DOI: https://doi.org/10.1016/j.nmni.2023.101145
Reference: NMNI 101145

To appear in: New Microbes and New Infections

Received Date: 2 April 2023

Accepted Date: 26 April 2023

Please cite this article as: Kaifa FH, Bhattacharya P, Marzan AA, Islam MA, Tanzania - The new
habitat of Marburg virus, New Microbes and New Infections (2023), doi: https://doi.org/10.1016/
j.nmni.2023.101145.

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© 2023 Published by Elsevier Ltd.

MANUSCRIPT TYPE: Letter to the Editor
TITLE: Tanzania- The New Habitat of Marburg Virus

Authors and their Affiliations:

1) Fatema Hasan Kaifa

COVID-19 Diagnostic lab, Department of Microbiology, Noakhali Science and
Technology University, Noakhali-3814, Bangladesh
E-mail ID – kaifafatema@gmail.com
2) Prosun Bhattacharya
COVID-19 Research @KTH, Department of Sustainable Development, Environmental
Science and Engineering, KTH Royal Institute of Technology, Teknikringen 10B, SE-

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100 44 Stockholm, Sweden
E-mail ID: prosun@kth.se

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3) Abdullah Al Marzan
MS Student
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Biochemistry and Molecular Biology
Shahjalal University of Science and Technology
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Sylhet-3114, Bangladesh\
E-mail ID: marzansust16@gmail.com
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4) Md. Aminul Islam

Advanced Molecular Lab, Department of Microbiology, President Abdul Hamid Medical
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College, Karimganj, Kishoreganj, Bangladesh

COVID-19 Diagnostic lab, Department of Microbiology, Noakhali Science and
Technology University, Noakhali-3814, Bangladesh
E-mail ID: aminul@pahmc.edu.bd/aminulmbg@gmail.com

Corresponding Author:
Md. Aminul Islam
Advanced Molecular Lab, Department of Microbiology, President Abdul Hamid Medical
College, Karimganj, Kishoreganj, Bangladesh
COVID-19 Diagnostic lab, Department of Microbiology, Noakhali Science and
Technology University, Noakhali-3814, Bangladesh
E-mail ID: aminul@pahmc.edu.bd/aminulmbg@gmail.com

Prosun Bhattacharya
COVID-19 Research @KTH, Department of Sustainable Development, Environmental
Science and Engineering, KTH Royal Institute of Technology, Teknikringen 10B, SE-
100 44 Stockholm, Sweden
E-mail ID: prosun@kth.se

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 1 Letter to the Editor

2 Tanzania- The New Habitat of Marburg Virus

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4 Keywords: Marburg Virus; Hemorrhagic Fever; MARV Outbreak; Tanzania

6 Dear Editor,

7 Marburg virus (MARV) is a rare, virulent, and zoonotic virus causing hemorrhagic fever with

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8 a mortality rate of about 88%. Enveloped and pleomorphic morphological appearance the virus
9 contains a negative-sense single-stranded RNA (–ssRNA). After Ebola, one of the prominent
10 members of the family, Filoviridae is this virus under the genus Marburgvirus and

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11 species Marburg marburgvirus, which causes illness in both humans and primates other than
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human [1]. The virus is comprised of seven Open Reading Fragments (ORFs) including four
virion proteins (VP35, VP40, VP30, and VP24). The remaining three fragments are
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14 nucleoprotein (NP), glycoprotein (GP), and large-viral polymerase (L) [1] and each having
15 distinct functions (Figure 1). The Marburg virus was formerly identified in 1967 when
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16 hemorrhagic fever outbreaks concurrently emerged in labs in Belgrade, Yugoslavia (now

17 Serbia), Marburg, Frankfurt, Germany [1]. Rousettus aegyptiacus, an African fruit bat, is the
18 reservoir animal of the Marburg virus . Direct contact (such as through crushed epidermis or
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19 mucous membranes of the mouth, nose or eyes) with infected patients body fluids (urine,
20 sputum, perspiration, stool, maternal milk, amniotic liquid, vomit and semen) or blood also
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21 responsible for the dissemination of MARV [2].

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23 Figure 1: MARV genomic structure, transmission, pathogenesis, symptoms, and prevention strategies.

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24 The medical features of a MARV-infected patient might change based on several variables,
25 such as virulent strain, physical condition, host vulnerability, and ongoing hospital care. With
26 three phages as the early organ phase, the late organ phase, or convalescence phase, the reported
27 incubation period in humans has ranged between 2 and 21 days, with an average duration of 5
28 to 9 days. Within 24–48 hours after infection, MARV can inhibit interferon (IFN) reactions,
29 enhance inflammatory cytokine response, and demonstrate rapid replication by altering the host
30 gene expression profile in a manner linked to interferon-stimulated gene (ISG) production in
31 hepatocytes and genes involved in immunoregulation, coagulation, and apoptotic pathways.
32 However, after the appearance of the Marburg virus outbreaks consecutively in Uganda from
33 2012 to 2017, the virus reappeared in Guinea (2021) and Ghana (2022). Tanzania, which has
34 previously not encountered any Marburg virus cases, has recently faced various health crises
35 such as COVID-19, cholera, and dengue in the last three years. Based on a strategic risk
36 assessment conducted by the WHO in September 2022, the country is at a high risk of
37 infectious disease outbreaks. In light of this, it is concerning that the WHO confirmed the first
38 cases of MARV on 21st March 2023 in the Bukoba district of the Kagera region in northwestern

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39 Tanzania [3]. There have been eight positive cases with five death cases, including a healthcare

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40 worker (case fatality rate 63%). Currently, 161 contacts are being monitored for possible
41 infection. With nine confirmed and twenty probable cases, Equatorial Guinea has experienced

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42 its first-ever Marburg virus disease outbreak since the epidemic began in 2023. With nine
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confirmed and twenty probable cases, Equatorial Guinea has experienced its first-ever Marburg
virus disease outbreak, since the epidemic started in 2023 as of March 21 [2]. A WHO team of
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45 epidemiologists, case managers, infection prevention experts, and laboratory experts has thus
46 been dispatched to enhance the country's response. The worst outbreak on Marburg virus was
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47 in 2004-2005 in Angola.

48 Enzyme-linked immunosorbent assay (ELISA) testing to capture antigen, IgM, and polymerase
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49 chain reaction (PCR), are available to diagnose this virus. Though there is no definite treatment,
50 supportive care along with oxygen supply, controlling blood pressure, supplanting damaged
51 blood, and clotting factors can be utilized as much as possible [4]. The Food and Drug
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52 Administration has not yet approved vaccines to quell MVD. Many potential vaccinations have
53 been created and evaluated in numerous animal models [4]. Avoiding straightforward (skin-to-
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54 skin) contact with sick individuals, their body fluids, and potentially infected objects like
55 utensils is the easiest way to prevent MVD epidemics. Although patients should be kept apart,
56 family members can approach them without risk. Medical personnel must be taught and use
57 stringent barrier nursing practices (disposable gloves, goggles, face masks, and a gown at all
58 times). It is best to avoid or alter traditional funeral practices, especially those that ask for the
59 preservation of corpses, with the assistance of local traditional healers [5]. The recent outbreaks
60 of this virus surround Africa, which gives a prediction of the plausible occurrence of its
61 endemic. So, it’s high time people took all preventive measures and established public concerns
62 regarding this.

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64 Conflicts of Interest – All the authors have no conflict of interest

65 Funding – Nil

66 Ethical Approval – Not Required

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67 Informed Consent - Not Applicable

68 Data Availability - Not Applicable

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70

71 References:

72 1. Islam, M. A., Adeiza, S. S., Amin, M. R., Kaifa, F. H., Lorenzo, J. M., Bhattacharya,
73 P., & Dhama, K. (2023). A bibliometric study on Marburg virus research with
74 prevention and control strategies. Front. Trop. Dis, 3(1068364), 10-3389.
75 2. Daddario-DiCaprio, K. M., Geisbert, T. W., Geisbert, J. B., Ströher, U., Hensley, L.
76 E., Grolla, A., ... & Jones, S. M. (2006). Cross-protection against Marburg virus

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77 strains by using a live, attenuated recombinant vaccine. Journal of virology, 80(19),
78 9659-9666.
79 3. WHO 2023, Marburg virus disease; Accessed from:

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80 https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON451;
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Accessed on: 24 March
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4. Becker, S., Rinne, C., Hofsäss, U., Klenk, H. D., & Mühlberger, E. (1998).
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83 Interactions of Marburg virus nucleocapsid proteins. Virology, 249(2), 406-417.
84 5. Bamberg, S., Kolesnikova, L., Möller, P., Klenk, H. D., & Becker, S. (2005). VP24 of
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85 Marburg virus influences formation of infectious particles. Journal of virology, 79(21),

86 13421-13433.
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 Declaration of interests

☒The authors declare that they have no known competing financial interestsor personal
relationships that could have appeared to influence the work reported in this paper.

☐The authors declare the following financial interests/personal relationships which may be
considered as potential competing interests:

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