The neglected continuously emerging Marburg virus disease in Africa: A global public health threat

Behavioral risk assessment of exposure to wild and domestic animals in response to a Marburg virus disease outbreak, Ghana 2022

In July 2022, Ghana reported its first outbreak of Marburg virus disease (MVD). The source of the outbreak was unknown. In August 2022 we conducted a behavioral risk assessment, surveying 715 participants in three rural communities associated with the presumptive index case: Site 1 in Ashanti Region and Sites 2 and 3 in the Western Region of Ghana. Our primary aim was to characterize exposure to wild and domestic animals, specifically Egyptian rousette bats (ERBs), the natural reservoir for Marburg virus. We focused on two primary routes of potential exposure to ERBs: 1) eating fruit bearing bite marks and 2) entering caves or mines where bats were present. Eating fruit bearing bite marks was common across all sites, but highest at Site 2 in the Western Region. Higher levels of education were negatively correlated with eating fruit bearing bite marks, while having fruit trees present on the participant's home compound increased the odds of this exposure. Residents in Site 3 were significantly more likely to be exposed to bats in caves and mines. Participants across all sites also reported high levels of exposure to bats inside buildings; while ERBs do not typically roost in buildings, this presents a potential risk of exposure to other bat-associated pathogens. One participant at Site 3 reported symptoms consistent with MVD in the previous four months, suggesting the possibility of unrecognized cases that may have been associated with the outbreak. This study identified behaviors within the outbreak regions that could increase the risk of exposure to Marburg virus and other bat-borne pathogens. Serological surveys in these communities would provide important information about the extent of the Marburg outbreak by identifying unreported cases, as well as exposure to other filoviruses.

Marburg Virus Disease: Epidemiology, Immune Responses, and Innovations in Vaccination and Treatment for Enhanced Public Health Strategies

Marburg virus disease (MVD) remains an important global health concern, in part because of its particularly high mortality rate [...].

From protein to immunology: comprehensive insights into Marburg virus vaccines, mechanism, and application

The Marburg virus (MARV), a member of the Filoviridae family, is a highly lethal pathogen that causes Marburg virus disease (MVD), a severe hemorrhagic fever with high fatality rates.Despite recurrent outbreaks, no licensed vaccine is currently available. This review explores MARV's genomic architecture, structural proteins, and recent advancements in vaccine development. It highlights the crucial role of MARV's seven monocistronic genes in viral replication and pathogenesis, with a focus on structural proteins such as nucleoprotein (NP), glycoprotein (GP), and viral proteins VP35, VP40, and VP24. These proteins are essential for viral entry, immune evasion, and replication. The review further examines various vaccine platforms, including multi-epitope vaccines, DNA-based vaccines, viral vector vaccines, virus-like particles (VLPs), and mRNA vaccines. Cutting-edge immunoinformatics approaches are discussed for identifying conserved epitopes critical for broad-spectrum protection. The immunological responses induced by these vaccine candidates, particularly their efficacy in preclinical trials, are analyzed, showcasing promising results in generating both humoral and cellular immunity. Moreover, the review addresses challenges and future directions in MARV vaccine development, emphasizing the need for enhanced immunogenicity, safety, and global accessibility. The integration of omics technologies (genomics, transcriptomics, proteomics) with immunoinformatics is presented as a transformative approach for next-generation vaccine design. Innovative platforms such as mRNA and VLP-based vaccines offer rapid and effective development opportunities. In this study, underscores the urgent need for a licensed MARV vaccine to prevent future outbreaks and strengthen global preparedness. By synthesizing the latest research and technological advancements, it provides a strategic roadmap for developing safe, effective, and broadly protective vaccines. The fight against MARV is a global priority, requiring coordinated efforts from researchers, policymakers, and public health organizations.

Can Marburg virus be sexually transmitted?

Background and Aim

Marburg virus (MARV) is a highly virulent virus of animal origin and the cause of a lethal infection (known as Marburg virus disease [MVD]) with a case-fatality ratio ranging from 24% to 90%. While the potential nonzoonotic routes of virus spread are plausible, the risk is not yet fully determined. Here, we described the ways by which MARV spreads within the human population focusing mainly on the potential of sexual transmission. In addition, we addressed some measures that should be taken to minimize the risk of sexual spread of the virus and proposed a future research agenda on the risk of sexual transmission.

Methods

For this perspective, we searched four electronic databases (i.e., PubMed, Scopus, Web of Science, and Google Scholar) and included the most relevant studies published since the first identification of the virus in 1967. We used "Marburg virus," "Marburg virus disease," "Seminal fluid," "Sexually-transmitted virus," "Sexual transmission," and "Emerging infectious disease" as keywords.

Results

MARV is transmitted to humans via both direct and indirect contact with infected animals (most importantly bats) and individuals who have recently been diagnosed with or died of the disease. The virus transmission through sexual contact has been previously suspected (exclusively from men to their sexual partners). Studies suggest that this virus persists predominantly in testicular Sertoli cells within seminiferous tubules over a relatively long period and is released through seminal fluid (in some reports >200 days post onset of infection) both could potentially threaten sexual health. In addition to men, women could theoretically, although less probably contribute to the sexual transmission of the disease.

Conclusion

MVD, however, rarely, could be passed through sex, and men appear to be the main carriers in this regard. Taking preventive countermeasures and practicing safe sex are recommended to reduce the risk of interhuman transmission.

Infection prevention and control: Qualitative study of the preparedness and response of Christian health Association of Ghana to Marburg virus disease in Ghana

Objective

Recent disease outbreaks underscore the importance of robust disease surveillance and infection prevention and control (IPC) programmes to bolster Africa's public health response system. Yet, available evidence shows extensive gaps in the emergency response capacity of faith-based healthcare providers on the continent. Accordingly, this study examines the IPC and surveillance strategies adopted by a faith-based healthcare provider and the challenges encountered during Marburg Virus Disease outbreak (MVD) in Ghana.

Method

We collected data from 15 clinical and nonclinical health workers from the Christian Health Association of Ghana (CHAG) and the Ghana Health Service (GHS). Data was collected through online interviews to examine two pillars of the WHO COVID-19 SPRP-AFR (2021) framework. We analyzed the data using Braun and Clarke's thematic analysis.

Findings

The facility performed creditably well with contact tracing and other quarantine protocols during MVD outbreak in Ghana. However, it also encountered several challenges in the enforcement of IPC protocols, including human resource constraints, the lack of decontamination equipment, and limited infrastructure, among others. Given these limitations, we assessed that the facility cannot handle major outbreaks.

Conclusion

Due to numerous infectious disease outbreaks in Sub-Saharan Africa in recent years, the government of Ghana and faith-based healthcare providers must resource their facilities with the relevant equipment and qualified human resources against future disease outbreaks.

Bioinformatic, Biochemical, and Immunological Mining of MHC Class I Restricted T Cell Epitopes for a Marburg Nucleoprotein Microparticle Vaccine

The Marburg virus (MARV), the virus responsible for Marburg hemorrhagic fever (MHF), is considered a top-priority pathogen for vaccine development. Recent outbreaks in Equatorial Africa have highlighted the urgency of MARV because of its high fatality rate and historical concerns about potential weaponization. Currently, there are no licensed vaccines for MARV. Existing vaccine candidates rely on attenuated recombinant vesicular stomatitis virus carrying MARV glycoprotein (VSVΔG) or the chimpanzee replication-defective adenovirus 3 vector ChAd3-MARV. Although these platforms provide significant protection in animal models, they face challenges because of their limited thermal stability and the need for cold storage during deployment in resource-poor areas. An alternative approach involves using adjuvanted poly (lactic-co-glycolic acid) (PLGA) microparticles loaded with synthetic peptides representing MHC class I-restricted T cell epitopes. This vaccine platform has demonstrated effectiveness in protecting against SARS-CoV-2 and EBoV disease in animal models and has the advantage of not requiring cold storage and remaining stable at room temperature for over six months. This report outlines the design, manufacturing, and in vivo immunogenicity testing of PLGA microparticle human vaccines designed to prevent Marburg hemorrhagic fever.