Risk Factors for Marburg Hemorrhagic Fever, Democratic Republic of the Congo

Abstract

We conducted two antibody surveys to assess risk factors for Marburg hemorrhagic fever in an area of confirmed Marburg virus transmission in the Democratic Republic of the Congo. Questionnaires were administered and serum samples tested for Marburg-specific antibodies by enzyme-linked immunosorbent assay. Fifteen (2%) of 912 participants in a general village cross-sectional antibody survey were positive for Marburg immunoglobulin G antibody. Thirteen (87%) of these 15 were men who worked in the local gold mines. Working as a miner (odds ratio [OR] 13.9, 95% confidence interval [CI] 3.1 to 62.1) and receiving injections (OR 7.4, 95% CI 1.6 to 33.2) were associated with a positive antibody result. All 103 participants in a targeted antibody survey of healthcare workers were antibody negative. Primary transmission of Marburg virus to humans likely occurred via exposure to a still unidentified reservoir in the local mines. Secondary transmission appears to be less common with Marburg virus than with Ebola virus, the other known filovirus.

Geographic Potential for Outbreaks of Marburg Hemorrhagic Fever

“…Note, however, that seroprevalence studies do not necessarily support this prediction, pointing to an issue for future research. 10,11 Visualization and exploratory analyses of modeled Marburg virus distribution with respect to climatic parameters showed several interesting features ( Figure 5). For example, whereas Marburg is modeled as distributed throughout precipitation regimens in Africa (except the very wettest regions), it is limited to areas of relatively low annual mean temperatures.…”

“…8 One important commonality among known Marburg virus outbreaks is that at least three have involved caves or mines in the infection of the apparent index case. 1,2,[9][10][11][12][13] Few efforts have been made to map these outbreak occurrences and understand the ecologic regimen under which they occur. 6,14 The only existing spatially explicit study 6 presented maps of potential distribution of Marburg virus based on ecologic niche models derived from the four localities available at the time.…”

Serosurvey on Household Contacts of Marburg Hemorrhagic Fever Patients

“…The outbreak probably started in October 1998, had several peaks alternating with latent periods, and ended in August 2000, when the last confirmed MHF cases occurred ( 6 ). Primary cases were predominantly in orpailleurs (unofficial gold miners), while secondary cases were predominantly in household contacts and healthcare workers.…”

Molecular Evolution of Viruses of the Family Filoviridae Based on 97 Whole-Genome Sequences

“…Finally, Taï Forest virus has been described only in a single nonfatal human case (13). Marburg and Ravn virus infections can result in case fatalities ranging from approximately 20% to 90% (3,14,15).…”