As a centre in Senegal confirmed that Ghana is experiencing its first outbreak of Marburg disease, questions circulate about prevention and protection for Ghana and the rest of the world. The two unrelated patients, in the Ashanti region, had been admitted to the same hospital within days of each other with symptoms including diarrhoea, fever, and vomiting. Both were reported to have died because of their infection.
Marburg is from the same family as Ebola and has a fatality ratio of up to 88%. Infection occurs through contact with bodily fluids and can spread through human-to-human transmission. Over 90 contacts are being monitored as part of Ghana’s response. Dr Matshidiso Moeti, the WHO Regional Director for Africa, praised the health authorities who have been “getting a head start”, and assured us that the WHO is “marshalling more resources for the response”. What kind of response can we expect, as we are getting more familiar with disease preparedness, or lack thereof?
There is no approved vaccine to date, yet several candidates are in Phase 1 studies. Although DNA vaccines have the potential to produce humoral and cellular immunity, these have demonstrated low immunogenicity in clinical trials. In October 2021 a vaccine was based on vesicular stomatitis virus expressing the MARV glycoprotein as the viral antigen. When administered 28 days prior to challenge in nonhuman primates, this vaccine was found protective, like the approved Ebola vaccine.
Investment by the UK Vaccine Network to tackle diseases in lower income countries includes a £498,000 grant to DIOSynVax to produce a vaccine against Marburg. It also contributes to Lassa and Ebola viruses after the death of a child from Lassa virus earlier in 2022.
Although there is currently no approved vaccine or treatment, these outbreaks have historically been short and concentrated. Does this mean that our attention should turn elsewhere? Or should we pursue protective measures to reduce the likelihood of further outbreaks?