Marburg virus disease , formerly known as Marburg haemorrhagic fever, is a severe and often fatal illness in both humans and non-human primates. It is caused by the Marburg virus and Ravn virus, both of which are part of the Filoviridae family. It is closely linked to Ebola virus disease although it is a different virus. It is transmitted to humans from fruit bats and can spread from person to person.
The incubation period for Marburg virus disease is typically between two to 21 days. The onset of the illness is abrupt and symptoms include.
Marburg virus disease is a serious and deadly illness. In fatal cases, death often occurs between eight and nine days after the onset of symptoms.
As the disease advances, symptoms can become more severe. These can include liver failure, delirium, shock, bleeding (haemorrhaging), and multi-organ dysfunction. Some patients may develop fresh blood in vomit and faeces, as well as bleeding from the nose, gums, and vagina. Those affected can also be confused, irritable and aggressive.
It can be difficult to distinguish the disease from other infectious diseases such as malaria, typhoid and other haemorrhagic fevers such as Ebola.
Marburg virus infection occurs via contact with the saliva, urine and faeces of the infected fruit bat, Rousettus aegyptiacus. Once the disease has spilled over from wildlife to people, the virus can spread through direct contact with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials contaminated with these fluids. This includes clothing, bedding, needles, and equipment.
Healthcare workers have frequently been infected while treating patients, particularly when infection control precautions are not strictly practiced. Burial ceremonies involving direct contact with the body of the deceased can also contribute to the transmission. The virus can also be sexually transmitted.
People cannot transmit the virus before they have symptoms but remain infectious as long as their blood contains the virus.
Currently, there are no licenced treatments for Marburg, although some are in development. There has also been research showing potential with two antivirals. However, currently treatment is mainly limited to supportive care. This includes rest, hydration, managing oxygen status and blood pressure, and treatment of secondary infections.
Scientists in Oxford are in the early stages of testing a vaccine against the disease. However, current prevention methods include:
Marburg virus disease was first recognised in 1967 after two simultaneous outbreaks in Marburg and Frankfurt in Germany, and in Belgrade, Serbia. These outbreaks were linked to laboratory work involving African green monkeys imported from Uganda. Since then, outbreaks and sporadic cases have been reported in several African countries, including Rwanda, the Democratic Republic of the Congo, Kenya, South Africa, Tanzania and Uganda.
The largest outbreak on record occurred in 2005 in Angola and involved 252 cases, of which 227 people died.
In 2008, two cases were reported in travellers – one from the US and the other from the Netherlands – who had visited a cave inhabited by Rousettus aegyptiacus bat colonies in Uganda.
In 2024 and 2025 Tanzania experienced an outbreak of the disease – although it was controlled all 10 people who were affected died.
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