Marburg Hemorrhagic Fever in Durba and Watsa, Democratic Republic of the Congo: Clinical Documentation, Features of Illness, and Treatment

Colebunders, Robert; Tshomba, Antoine; Kerkhove, Maria D. Van; Bausch, Daniel G.; Campbell, Pat; Libande, Modeste L.; Pirard, Patricia; Tshioko, Florimond; Mardel, S; Mulangu, Sabue; Sleurs, Hilde; Rollin, Pierre E.; Muyembe‐Tamfum, Jean‐Jacques; Jeffs, Benjamin; Borchert, Matthias

doi:10.1086/520543

Cited by 66 publications

(62 citation statements)

References 9 publications

(17 reference statements)

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“…Although hamsters were used following the original 1967 outbreak of MARV to characterize general features of MARV pathogenesis24, our work here expands upon this initial work and offers a more rigorous analysis along with important and novel insights that have not been described until now. Indeed, our hamster model accurately recapitulated all the critical clinical hallmarks observed in humans and NHPs infected with MARV68102223252627282930, making it one of the most accurate small animal disease models developed for MHF to date.…”

Section: Discussionmentioning

confidence: 92%

A hamster model for Marburg virus infection accurately recapitulates Marburg hemorrhagic fever

Marzi

Banadyga

Haddock

et al. 2016

Sci Rep

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Marburg virus (MARV), a close relative of Ebola virus, is the causative agent of a severe human disease known as Marburg hemorrhagic fever (MHF). No licensed vaccine or therapeutic exists to treat MHF, and MARV is therefore classified as a Tier 1 select agent and a category A bioterrorism agent. In order to develop countermeasures against this severe disease, animal models that accurately recapitulate human disease are required. Here we describe the development of a novel, uniformly lethal Syrian golden hamster model of MHF using a hamster-adapted MARV variant Angola. Remarkably, this model displayed almost all of the clinical features of MHF seen in humans and non-human primates, including coagulation abnormalities, hemorrhagic manifestations, petechial rash, and a severely dysregulated immune response. This MHF hamster model represents a powerful tool for further dissecting MARV pathogenesis and accelerating the development of effective medical countermeasures against human MHF.

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Section: Discussionmentioning

confidence: 92%

A hamster model for Marburg virus infection accurately recapitulates Marburg hemorrhagic fever

Marzi

Banadyga

Haddock

et al. 2016

Sci Rep

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“…The dearth of clinical data has reached a stage where the failure to contribute to our understanding of best clinical practice should be considered as unethical. We urgently need a consensus on which clinical data ought to be documented, and how [22]. …”

Section: Discussionmentioning

confidence: 99%

Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned

Mutyaba²,

et al. 2011

Self Cite

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BackgroundEbola haemorrhagic fever (EHF) is infamous for its high case-fatality proportion (CFP) and the ease with which it spreads among contacts of the diseased. We describe the course of the EHF outbreak in Masindi, Uganda, in the year 2000, and report on response activities.MethodsWe analysed surveillance records, hospital statistics, and our own observations during response activities. We used Fisher's exact tests for differences in proportions, t-tests for differences in means, and logistic regression for multivariable analysis.ResultsThe response to the outbreak consisted of surveillance, case management, logistics and public mobilisation. Twenty-six EHF cases (24 laboratory confirmed, two probable) occurred between October 21st and December 22nd, 2000. CFP was 69% (18/26). Nosocomial transmission to the index case occurred in Lacor hospital in Gulu, outside the Ebola ward. After returning home to Masindi district the index case became the origin of a transmission chain within her own extended family (18 further cases), from index family members to health care workers (HCWs, 6 cases), and from HCWs to their household contacts (1 case). Five out of six occupational cases of EHF in HCWs occurred after the introduction of barrier nursing, probably due to breaches of barrier nursing principles. CFP was initially very high (76%) but decreased (20%) due to better case management after reinforcing the response team. The mobilisation of the community for the response efforts was challenging at the beginning, when fear, panic and mistrust had to be countered by the response team.ConclusionsLarge scale transmission in the community beyond the index family was prevented by early case identification and isolation as well as quarantine imposed by the community. The high number of occupational EHF after implementing barrier nursing points at the need to strengthen training and supervision of local HCWs. The difference in CFP before and after reinforcing the response team together with observations on the ward suggest a critical role for intensive supportive treatment. Collecting high quality clinical data is a priority for future outbreaks in order to identify the best possible FHF treatment regime under field conditions.

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“…Several management strategies have been attempted in outbreak settings, as summarized in this review, but none of the strategies have been implemented or documented to permit evaluation of the treatment efficacy. As noted by Colebunders et al, improvements in clinical documentation are required for basic evaluation of supportive treatment [50]. In the absence of a clinical trial, accurate collection and timely publication of observational data on patient demographics, clinical signs and symptoms, treatment, and clinical outcome are crucial.…”

Section: Recommendations and Conclusionmentioning

confidence: 99%

Clinical Management of Filovirus-Infected Patients

Clark¹,

Jahrling²,

Lawler

2012

Viruses

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Filovirus infection presents many unique challenges to patient management. Currently no approved treatments are available, and the recommendations for supportive care are not evidence based. The austere clinical settings in which patients often present and the sporadic and at times explosive nature of filovirus outbreaks have effectively limited the information available to evaluate potential management strategies. This review will summarize the management approaches used in filovirus outbreaks and provide recommendations for collecting the information necessary for evaluating and potentially improving patient outcomes in the future.

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Marburg Hemorrhagic Fever in Durba and Watsa, Democratic Republic of the Congo: Clinical Documentation, Features of Illness, and Treatment

Cited by 66 publications

References 9 publications

A hamster model for Marburg virus infection accurately recapitulates Marburg hemorrhagic fever

A hamster model for Marburg virus infection accurately recapitulates Marburg hemorrhagic fever

Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned

Clinical Management of Filovirus-Infected Patients

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