Risk of Marburg outbreak in Equatorial Guinea reaching Portugal is low | Virus

Infectious disease specialist Jaime Nina considers that Portugal may be “relatively” rested in relation to the Marburg outbreak in Equatorial Guinea, despite the risk of imported cases.

In an interview with the Lusa agency regarding the outbreak of the disease in Equatorial Guinea, which has already caused nine deaths in this country and has spread to Cameroon, Jaime Nina recalled that Portugal has a response prepared and that it will be activated in suspected cases.

The system was tested several times during the threat of Ebola (a “cousin” virus of Marburg) in 2013 and 2014, in the face of an outbreak in Guinea-Conakry (which borders Guinea-Bissau), Sierra Leone and Liberia, electing as reference hospitals, São João, in Porto, and the Curry Cabral and Dona Estefânia hospitals, in Lisbon.

Relatively rare, but with a high lethality, Marburg disease represents a greater risk for Portugal when it reaches countries with greater connections, as happened in 2004 and 2005 in Angola, stage of the biggest outbreak in Marburg, with the epicenter in Uige.

According to Jaime Nina, who was present at the outbreak site at the time, of the 374 confirmed cases, 329 were fatal, which represents a lethality rate of 81%.

“The greatest risk is Angola, which probably has infected bats”, which at any moment can transmit the disease to a human, and it is a country with which Portugal has strong links, he said, adding: “If the person wants to worry , think of Angola”.

Regarding the current outbreak in Equatorial Guinea, a member of the Community of Portuguese Speaking Countries (CPLP), the infectiologist at Hospital Egas Moniz and professor of Infectious Diseases and Tropical Medicine at Universidade Nova de Lisboa says that there will be few travelers to and from Portugal, which then reduces the risk.

Even so, he noted, there is always the risk of imported cases. But he recalled that contagion is “relatively difficult”, unlike viruses like the one that causes covid-19, requiring contact with the person, their blood, vomit or feces.

It is known that this hemorrhagic fever is caused by the Marburg virus, so named because it was identified in the German city of the same name in 1967, in a research center working with imported monkeys.

The reservoir of the virus is the bat, an animal that spends the night in the thin and high branches of trees, above the monkeys, to which it transmitted the virus, through the feces it manages to produce during sleep.

Jaime Nina mentions that there have been outbreaks throughout intertropical Africa: “Angola, the Democratic Republic of Congo, Uganda, Kenya, Guinea-Conakry and Cameroon. It was a matter of time before it was diagnosed in Equatorial Guinea”.

But he emphasizes that “you only find what you are looking for”. “For a case to be notified, there needs to be a case, someone to diagnose it and the diagnosed case to be notified. That is, doctors are needed to make the diagnosis and a public health network to notify cases, but in most countries Africans it doesn’t work,” he said.

For this reason, he concludes: “Most likely there were outbreaks without anyone noticing”, to which the isolation of infected people may have contributed.

A virus as lethal as that of Marburg requires rapid and timely screening, isolation of patients and their close contacts and adequate protection of health professionals, along with disinfection, measures that must be known to the population, so that this understand them at the time of their application.

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