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Vol 2 | Issue 4 | Oct – Dec 2023                                                                          Indian J Pharm Drug Studies | 127  

Review Article 

Marburg Virus Disease: Latest Outbreak and Current Research Review 

Ramdas Bhat1, Preeti Shanbhag2 

From, 1Assistant Professor, 2PG Scholar, Department of Pharmacology, Srinivas College of Pharmacy, Valachil, Mangalore, 

Karnataka, India. 

ABSTRACT 

The Marburg virus disease (MVD) is a severe and deadly viral hemorrhagic fever caused by the Marburg virus. Recent 

outbreaks have raised global concerns due to the severity of the disease, high mortality rate, and limited treatment options. This 

review provides an overview of the latest outbreak and current research on MVD, including efforts to understand the virus's 

epidemiology, transmission, pathogenesis, and diagnosis, as well as the development of antiviral therapies and vaccines. 

Advances in diagnostic techniques and experimental antiviral drugs show promising results. However, controlling outbreaks 

remains challenging due to various factors such as limited access to affected areas, inadequate healthcare infrastructure, and 

community resistance to interventions. Therefore, a multidisciplinary approach involving public health measures, clinical care, 

and research efforts is crucial in mitigating the impact of MVD outbreaks and improving patient outcomes. Further research 

and collaborative efforts are needed to develop effective strategies for preventing and managing MVD and protecting public 

health. 

Key words: Marburg virus disease (MVD), viral hemorrhagic fever, Outbreaks, Antiviral therapies, Vaccines. 

arburg virus disease (MVD) is a severe and 

often fatal viral illness caused by the Marburg 

virus (MARV), a member of the Filovirus 

family [1]. In August 1967, an epidemic in Frankfurt am 

Main and Marburg a der Lahn, West Germany (Germany), 

led to the discovery of MVD for the first time. Since then, 

several outbreaks of MVD have been reported in Africa, 

with the most recent outbreak occurring in 2022. MVD 

shares similarities with Ebola virus disease (EVD) in terms 

of its clinical presentation, transmission, and high 

mortality rate [2].  

 

The Marburg virus is an enveloped, negative-sense 

RNA virus that has a close resemblance to the Ebola virus 

[1]. It is transmitted to humans from infected animals, 

particularly fruit bats, through contact with bodily fluids or 

contaminated surfaces. Once the virus enters the human 

body, it can cause severe systemic disease with a wide 

range of clinical manifestations [3]. MVD is characterized 

by a sudden onset of fever, headache, myalgia, and 

malaise, which may progress to more severe symptoms 

such as hemorrhagic manifestations, including petechiae,  
 

Access this article online 

Received – 22nd June 2023 

Initial review – 27th June 2023 

Accepted – 12th July 2023  

Quick Response Code 

ecchymoses, and mucosal bleeding. Gastrointestinal 

symptoms such as nausea, vomiting, and diarrhea are also 

common. Severe cases of MVD can lead to multiorgan 

failure, shock, and death, with mortality rates ranging from 

24-88% depending on the outbreak and population 

affected [4,5].  

 

Diagnosing MVD can be challenging, as the early 

symptoms are nonspecific and can resemble other febrile 

illnesses. Laboratory testing, including PCR-based 

methods, antigen detection, and serological assays, are 

used for confirmation [6]. However, access to these 

diagnostic tools may be limited in resource-limited settings 

where MVD outbreaks often occur. There is no specific 

antiviral treatment for MVD, and supportive care remains 

the cornerstone of management. This includes strict 

infection control measures, fluid and electrolyte 

management, and organ support as needed. Experimental 

treatments, including antiviral drugs and immunotherapies, 

have been used in some cases, but their efficacy and safety 

are still being evaluated through ongoing research efforts 

[7].  

_______________________________________________ 

 

Correspondence to: Ramdas Bhat, Associate Professor, 

Department of Pharmacology, Karavali College of 

Pharmacy, Vamanjoor (post), Mangalore, Karnataka, 

India- 575028, Email: ramdas21@gmail.com, Tel.: +91 

7795772463 

M 

mailto:ramdas21@gmail.com


Bhat R & Shanbhag P                                                  Marburg Virus: Outbreak Updates and Research Review 

Vol 2 | Issue 4 | Oct – Dec 2023                                                                          Indian J Pharm Drug Studies | 128  

Since the identification of MARV, significant research 

efforts have been directed toward understanding the virus 

and developing strategies for its prevention, diagnosis, and 

treatment. Advances in our understanding of MARV 

epidemiology, viral pathogenesis, and host immune 

response have shed light on the complex interplay between 

the virus and the host, and have informed public health 

measures to control outbreaks [8]. In recent years, the 

emergence of new outbreaks of MVD, including the most 

recent one in 2022, has renewed the focus on this deadly 

disease. Ongoing research efforts are aimed at improving 

diagnostics, understanding the factors driving the 

emergence and spread of MVD, developing effective 

treatments, and advancing vaccine development [9].  

 

In this review, we will provide an overview of the latest 

outbreak of MVD, and summarize the current 

understanding of the virus, including its epidemiology, 

clinical features, diagnostics, treatment, and ongoing 

research efforts. We will review the existing literature and 

highlight key findings, discuss challenges and future  

directions in MVD research, and emphasize the need for 

 

continued efforts in understanding and controlling this 

menacing virus. 

 

Epidemiology of Marburg Virus Disease 

 

The epidemiology of Marburg virus disease (MVD) 

involves studying its distribution, patterns, and 

determinants within populations. MVD is primarily 

endemic to Africa, with sporadic outbreaks occurring in 

countries like Uganda, Angola, Kenya, and the Democratic 

Republic of Congo. Fruit bats are believed to be the 

natural reservoir of the virus, transmitting it to humans 

through direct contact or exposure to infected animals' 

bodily fluids or tissues. Understanding MVD 

epidemiology is challenging due to sporadic outbreaks 

linked to activities such as cave exploration, mining, or 

handling infected animals. International collaboration, led 

by organizations like the WHO, plays a crucial role in 

responding to MVD outbreaks. Ongoing research aims to 

improve our understanding of the virus's transmission 

dynamics, and host reservoirs, and develop effective 

prevention and control strategies [2,10,11]. 

Figure 1:  Marburg virus outbreaks in the past [10]. 

PATHOGENESIS 

Marburg virus disease (MVD) is a severe and often fatal 

illness caused by the Marburg virus. The pathophysiology 

involves the virus entering the body and infecting immune 

cells, leading to their destruction and facilitating viral 

spread. The virus causes dysfunction of endothelial cells, 

increasing vascular permeability and causing leakage of 

fluid and clotting factors. This results in disseminated 

intravascular coagulation (DIC), abnormal blood clotting, 



Bhat R & Shanbhag P                                                  Marburg Virus: Outbreak Updates and Research Review 

Vol 2 | Issue 4 | Oct – Dec 2023                                                                          Indian J Pharm Drug Studies | 129  

and bleeding. Multiple organ systems, including the liver, 

spleen, lymph nodes, and adrenal glands, are affected, 

leading to organ failure. Immune dysregulation and a 

cytokine storm contribute to systemic symptoms.  

The precise mechanisms are still being studied, but these 

processes collectively contribute to the severe illness and 

organ damage seen in MVD [12]. 

Figure 2:   Pathogenesis of Marburg virus disease [13] 

Clinical Features of Marburg Virus Disease (MVD) 

Marburg virus disease (MVD) is a severe and often fatal 

viral hemorrhagic fever, shares similarities with Ebola 

virus disease. The incubation period ranges from 2 to 21 

days, with an average of 5-10 days, during which 

individuals may remain asymptomatic. The disease 

typically begins with a prodromal phase characterized by 

sudden onset fever, chills, headache, muscle aches, fatigue, 

and gastrointestinal symptoms. As MVD progresses, 

hemorrhagic manifestations occur, including bleeding 

from gums, nose, gastrointestinal tract, and injection sites, 

along with petechiae and ecchymosis. Multi-organ 

dysfunction follows, leading to liver damage, kidney 

failure, and DIC, which causes simultaneous clotting and 

bleeding. Severe cases involve central nervous system 

involvement with confusion, irritability, aggression, 

delirium, seizures, coma, and neurological deficits. The 

disease progression can lead to shock, with low blood 

pressure, rapid heart rate, and poor organ perfusion. 

Despite supportive care, MVD has a high mortality rate 

ranging from 24% to 88% depending on the outbreak and 

healthcare resources available [1]. 

Prognosis of Marburg Virus Disease (MVD) 

The prognosis of Marburg virus disease (MVD) remains 

poor as there is currently no approved treatment available, 

and only supportive care can be provided. Optimal 

management requires specialized biocontainment units to 

ensure the safety of healthcare personnel. Strict adherence 

to proper personal protective equipment (PPE), hand 

hygiene practices, and safe handling of needles and sharps 

is essential to minimize the risk of occupational exposure. 

Controlling future outbreaks is crucial in preventing 

primary infections and secondary transmission. The 

variability in disease severity observed in different 

outbreaks is believed to be influenced by factors such as 

the availability of medical care, infectious dose, route of 

infection, the virulence of the virus strain, and overall 

population health [1,5]. 

Treatment & Management of Marburg Virus Disease 

The Marburg virus has no currently approved therapies. 

During outbreaks, supportive treatment is the primary 

strategy, and it's essential to take infection control 

precautions to stop the virus from spreading. Many 

pharmacological substances are being researched as 

potential treatments. An evaluation of the safety and 

pharmacokinetics of the antiviral nucleoside analog 



Bhat R & Shanbhag P                                                  Marburg Virus: Outbreak Updates and Research Review 

Vol 2 | Issue 4 | Oct – Dec 2023                                                                          Indian J Pharm Drug Studies | 130  

Galidesivir (BCX4430), which has shown promise in 

animal models, was completed. Interferon-beta and other 

antivirals such as favipiravir and remdesivir have also 

been researched, but neither has shown any appreciable 

survival advantages [14].  

Antibody therapy has been researched in animal 

models and is slated for human use. The monoclonal 

antibody MR 191-N has demonstrated effectiveness in 

preventing Marburg virus infection in rhesus macaques. 

Due to the similarities between the Marburg virus sickness 

and the Ebola virus disease, antibodies have been utilized 

successfully in the treatment of both diseases [15]. 

Additionally, work is being done to create a vaccine that is 

effective against filoviruses like the Marburg virus. 

Clinical trials are looking into several vaccine modalities, 

including inactivated viruses, replication-incompetent 

vaccines, viral vectors, DNA-based vaccines, and virus-

like particles. After the 2013 Ebola virus pandemic, the 

need for effective immunization grew, but it will take time 

and more research to assess the value and efficacy of these 

vaccine candidates [16-18]. 

Future Directions 

Future directions for Marburg virus disease (MVD) 

involve key areas of focus, including the development of 

specific antiviral treatments and vaccines, enhanced 

surveillance and early detection systems, and investment 

in public health infrastructure. Continued research is 

needed to develop targeted therapies and safe, effective 

vaccines against MVD. Improving surveillance 

capabilities and diagnostic methods will enable early 

detection and timely response to MVD outbreaks. This 

includes strengthening laboratory capacity for prompt 

identification of cases and implementing robust 

surveillance networks to monitor disease trends [19]. In 

addition, research efforts should prioritize the development 

of specific antiviral treatments that target the Marburg 

virus. Identifying novel drug targets and conducting 

clinical trials to assess their safety and efficacy are crucial 

steps in improving treatment options for MVD. This 

involves collaboration between scientists, pharmaceutical 

companies, and regulatory agencies to accelerate the 

development and approval of potential therapies [19,20]. 

Furthermore, the development of safe and effective 

vaccines is paramount in preventing and controlling MVD. 

Ongoing research should explore different vaccine 

platforms, such as viral vectors and protein subunits, to 

elicit robust immune responses and provide long-term 

protection against the Marburg virus. Conducting rigorous 

preclinical and clinical studies, and ensuring regulatory 

compliance, are essential for advancing vaccine candidates 

toward licensure and deployment [20,21]. Enhanced 

surveillance and early detection systems are critical in 

managing MVD outbreaks. Strengthening surveillance 

capabilities involves establishing efficient reporting 

mechanisms, improving laboratory diagnostics, and 

enhancing data sharing between countries and 

international organizations. Early detection enables timely 

implementation of public health measures, such as case 

isolation, contact tracing, and infection control protocols, 

to prevent further transmission and contain outbreaks 

[20,22]. 

Investment in public health infrastructure is vital for 

effective prevention and management of MVD. This 

includes establishing specialized treatment centers 

equipped with isolation units and trained healthcare 

professionals experienced in handling viral hemorrhagic 

fevers. Adequate resources, including personal protective 

equipment, laboratory facilities, and medical supplies, 

must be available to support the response to MVD 

outbreaks [23]. Furthermore, the development of safe and 

effective vaccines is paramount in preventing and 

controlling MVD. Ongoing research should explore 

different vaccine platforms, such as viral vectors and 

protein subunits, to elicit robust immune responses and 

provide long-term protection against the Marburg virus. 

Conducting rigorous preclinical and clinical studies, and 

ensuring regulatory compliance, are essential for 

advancing vaccine candidates toward licensure and 

deployment [18]. 

Thus, the future directions for MVD encompass the 

development of specific antiviral treatments and vaccines, 

enhanced surveillance and early detection systems, and 

investment in public health infrastructure. Continued 

research, collaboration, and investment in these areas are 

essential for improving the prevention, diagnosis, and 

management of MVD, ultimately reducing its impact on 

global public health. 

CONCLUSION  

MVD is a highly virulent viral hemorrhagic fever caused 

by the Marburg virus. Its diagnosis, treatment, and 

prevention pose significant challenges. Current 

management primarily involves supportive care, while 

research focuses on developing specific antiviral 

treatments and vaccines. Early detection, rapid response, 

and improved healthcare infrastructure are crucial to 

curtail outbreaks. International collaboration, surveillance 

strengthening, and public health investment are vital for 

addressing MVD globally. Despite the grim prognosis, 



Bhat R & Shanbhag P                                                  Marburg Virus: Outbreak Updates and Research Review 

Vol 2 | Issue 4 | Oct – Dec 2023                                                                          Indian J Pharm Drug Studies | 131  

ongoing research, collaboration, and public health efforts 

offer hope for improving outcomes and minimizing the 

impact of MVD. Advancing knowledge, developing 

treatments, and implementing possible prevention 

strategies are very important to lower the threat of MVD 

and to safeguard the affected individuals/group. 

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How to cite this article: Ramdas Bhat, Preeti 

Shanbhag. Marburg Virus Disease: Latest Outbreak and 

Current Research Review. Indian J Pharm Drug 

Studies. 2023; 2(4):127-131. 

Funding: None         Conflict of Interest: None Stated 

 

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