The Chairman, BIOVACCINE Nigeria Ltd. (BVNL), Prof. Oyewale Tomori, has urged the Federal Government to enhance surveillance in the country now that Marburg disease has arrived in Equatorial Guinea and possibly Cameroon.
Tomori, a professor of virology and former vice-chancellor of the Redeemer’s University, Ede, told the News Agency of Nigeria (NAN), on Friday in Abuja, that there was need for enhanced disease surveillance activities in the country.
NAN reports that like Ebola, the Marburg virus originated in bats and spreads via close contact with the bodily fluids of infected people, or surfaces, like contaminated bed sheets.
Tomori said while Marburg disease was not as frequently reported as Ebola, it could cause an outbreak with high death rate.
He said African fruit bats were the reservoirs of the Marburg virus and could be transmitted to people from infected bats through their urine and/or excretions.
“There have been reports of infection of workers in mines inhabited by these bats or tourists visiting caves housing hundreds and thousands of these bats,” he explained.
Marburg disease spread
He said given the proximity of Equatorial Guinea to Nigeria (the distance from Malabo to Calabar is 144 km), and the porous borders at the likely port of entry, it was urgent for the country to intensify disease surveillance activities.
“In addition to heightened surveillance, Nigeria needs to fine-tune her laboratory services to more effectively, accurately, and timely confirm the agents of the thousands of suspected hemorrhagic fevers we report annually.
“For example, in the past five years, our laboratory system has been able to provide a definitive diagnosis for about 10 per cent of all reported suspected Lassa fever hemorrhagic fever cases.
“One is left in confusion about the pathogens responsible for the remaining thousands of suspected hemorrhagic fever cases that are discarded undiagnosed annually,” he explained.
According to him, another reason for the intensification of surveillance is that serological studies have revealed evidence of past infections in Nigeria with Marburg or a Marburg-related virus.
He cited instances such as: TOMORI, O. Fabiyi, a., Sorungbe, A., Smith, A. (1988). Viral haemorrhagic fever antibodies in Nigeria. Am. J. Trop. Med. Hyg. 38(3): 407-410.
The professor of virology said the Marburg virus disease was a form of hemorrhagic fever that could affect the body’s organs and cause bleeding.
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He noted that it was a highly infectious disease with a case fatality rate ranging from 23 per cent to 90 per cent.
“In the 2004 Angola outbreak, Marburg disease killed 227 (90 per cent) of 252 people infected.
“In 2008, an American returning from Uganda was retroactively diagnosed with the illness after recovery.
“In 2022, there were two Marburg disease deaths of the three reported cases in Ghana,” he said.
He said the Marburg virus was a zoonotic virus that along with the six species of Ebola virus, comprised the filovirus family.
“The rare virus was first identified in 1967 after it caused simultaneous outbreaks of disease in laboratories in Marburg, Germany, and Belgrade, (now Serbia).
“Thirty-one people who were exposed to the virus while working with tissues of infected monkeys became ill, and seven died,” he explained.
He said the monkeys were imported from Uganda, and that of the 16 Marburg disease outbreaks of varying magnitude reported between 1967 and 2023, eight episodes originated or were associated with Uganda.
“Other countries reporting Marburg disease outbreaks include Zimbabwe/ South Africa, Kenya, DR Congo, Guinea, and Ghana. There was a case of Marburg infection in a laboratory accident in Russia in 1990.
“Expatriate travellers visiting Uganda were responsible for Marburg importations into the USA and Netherlands in 2008,” he narrated.
Tomori said the incubation period for the Marburg disease was from two days to three weeks. “Symptoms begin abruptly, with an intense fever and headache.
“A few days after the onset, many patients experience vomiting, diarrhoea, and stomach pain for up to a week.
“Severe cases are accompanied by bleeding within the first week. Some patients vomit blood or pass it in their stool. Patients also bleed from their gums, nose, and genitalia.
“The disease can spread to the nervous system, causing patients to become confused, irritable and aggressive,” he said.
He said most fatal cases lasted just over a week, noting that deaths were typically accompanied by severe blood loss and shock.
He explained that there was currently no cure or specific treatment for Marburg disease, while adding that survival improved when patients were provided early with supportive care with rehydration and symptomatic treatment.
He said there was a range of drug and blood therapies to treat the disease under development.
Meanwhile, The World Health Organisation (WHO) said earlier on Tuesday that it was increasing its epidemiological surveillance in Equatorial Guinea.
The country has so far reported nine deaths as well as 16 suspected cases of Marburg virus disease, with symptoms including fever, fatigue, and blood-stained vomit and diarrhoea, according to the WHO.
Equatorial Guinea has also quarantined more than 200 people and restricted movement last week in its Kie-Ntem province, where the hemorrhagic fever was first detected.
There was an initial report that Cameroonian authorities detected two suspected cases of Marburg disease on Monday in Olamze, a town on the border with Equatorial Guinea.
According to the Cameroonian authorities, “On Feb. 13, we had two suspected cases of Marburg disease. These are two 16-year-old children, a boy and a girl, who have no previous travel history to the affected areas in Equatorial Guinea.
“Forty-two people who came into contact with the two children have been identified and contact tracing is ongoing.”
Although the report has since been dismissed by the Cameroon authorities, the country continues to restrict movement along the porous border with Equatorial Guinea. (NAN)
