Marburg virus disease: transmission, symptoms and outbreaks
Marburg virus disease (MVD), formerly Marburg haemorrhagic fever, is a severe illness caused by Marburg virus, a filovirus closely related to Ebola virus. The average case fatality is around 50%. There is currently no licensed vaccine or specific antiviral treatment.
The virus
Marburg viruses are filamentous, single-stranded RNA viruses of the family Filoviridae, genus Marburgvirus. The single species Marburg marburgvirus includes two viruses, Marburg virus and Ravn virus, which differ genetically by about 20% but cause clinically indistinguishable disease. The disease is named after the German city of Marburg, where it was first recognised in 1967.
How Marburg virus spreads
The natural reservoir is the Egyptian rousette bat (Rousettus aegyptiacus), a fruit bat found across sub-Saharan Africa and the Nile Valley. People are typically infected after prolonged exposure in caves or mines inhabited by these bats. Between people, the virus spreads through direct contact with blood and body fluids and with contaminated objects such as bedding or syringes. Marburg virus disease is not airborne and is considered not contagious before symptoms appear.
Symptoms and course
Symptoms appear between about 4 and 21 days after exposure, with an average incubation of 5 to 9 days. Illness begins abruptly with high fever, severe headache and severe malaise. Around the fifth day, a rash and spontaneous bleeding from the nose or gums can occur. Severe disease may lead to shock and multiple organ failure; neurological symptoms can appear in later stages. Survivors often face a prolonged convalescence, and the virus can persist in immune-privileged sites.
Recent outbreaks
All recorded MVD outbreaks have originated in Africa. Outbreaks since the Berlin workshop include Uganda (2017), Guinea (2021), Ghana (2022), Equatorial Guinea and Tanzania (2023) and Rwanda (2024). MVD is a notifiable disease in the EU/EEA.
Diagnosis and treatment
RT-PCR detects viral genetic material in the acute phase. There is currently no licensed vaccine or specific antiviral treatment; early supportive care improves survival. Male survivors are advised to practise safer sex until their semen has twice tested negative for the virus, or for 12 months after onset.
Medical note: this page summarises public-health sources for general information. It is not medical advice. If you develop fever after travel to an affected area or after contact with a patient or with animal blood or ticks, contact a doctor or your local health authority by phone before attending in person, and mention the exposure.
Frequently asked questions
Is Marburg virus the same as Ebola?
No. Both are filoviruses and cause similar illness, but they are different viruses. Ebola vaccines and antibody treatments do not protect against Marburg.
How deadly is Marburg virus disease?
The average case fatality rate is around 50%, varying by outbreak and access to care.
Is Marburg virus airborne?
No. It spreads through direct contact with blood, body fluids and contaminated objects, and people are not considered contagious before symptoms appear.
Where does Marburg virus come from?
Its natural host is the Egyptian rousette bat. Human infections often follow prolonged exposure in caves or mines where these bats live.
Is there a Marburg vaccine?
No licensed vaccine is currently available.