What is Marburg virus disease?

Marburg virus disease (MVD) is a rare but highly lethal haemorrhagic fever caused by Marburg virus — a filovirus closely related to Ebola. First identified in 1967 when laboratory workers in Marburg (Germany) and Belgrade (Yugoslavia) were exposed to infected African green monkeys, it causes acute fever, haemorrhage, multi-organ failure and death in approximately 50% of cases (range 20-90%). The primary reservoir is Rousettus aegyptiacus (the Egyptian fruit bat).

How does Marburg differ from Ebola?

Both are filoviruses causing haemorrhagic fever with high mortality — but: Marburg was discovered first (1967 vs 1976); Marburg is transmitted from bats directly (Rousettus aegyptiacus) while Ebola's bat reservoir (Pteropus) is less clearly linked to human cases; Marburg outbreaks have historically been smaller than Ebola outbreaks (exception: Angola 2005 — 374 cases); both are WHO R&D Blueprint priority pathogens; both require identical infection control measures (strict PPE); both have no approved vaccines (though Ervebo is approved for Ebola, not Marburg); both have similar clinical courses.

How is Marburg transmitted?

Bat-to-human: direct contact with Rousettus aegyptiacus bats or their excreta during cave/mine visits. Animal-to-human: from primates or other animals infected from bats. Human-to-human: direct contact with blood, secretions, organs or other body fluids of infected people; contaminated hospital equipment (needles, syringes — the primary amplifier in Angola 2005); sexual contact (MVD RNA found in semen for weeks after recovery). Burial practices handling the body are high-risk. No airborne transmission in natural settings.

Why are there more Marburg outbreaks recently?

Three factors may explain increased Marburg emergence: better surveillance and laboratory capacity (previously silent outbreaks may now be detected); increasing human encroachment into bat habitats (deforestation, mining, cave tourism); and possibly changes in bat populations or geographic range. The 2022-2023 pattern (Ghana, Equatorial Guinea, Tanzania — all new countries, never having had Marburg before) suggests either expanded bat range or expanded human-bat interface. WHO has created pre-positioned response plans.

What vaccines are in development?

Multiple Marburg vaccine candidates are in clinical trials: rVSV-MARV (Saiba Group/CEPI — VSV vector with Marburg glycoprotein, most advanced); cAd3-MARV (Oxford/GSK — chimpanzee adenovirus vector); mRNA vaccines (Moderna/CEPI, Saiba mRNA — leveraging COVID-19 mRNA platform); VLP vaccine (Novavax-BARDA collaboration). CEPI has committed funding to accelerate Marburg vaccine development to have a stockpile ready for ring vaccination in future outbreaks.

How is Marburg treated?

No specific approved antiviral. Treatment is entirely supportive: IV fluid replacement; electrolyte management; blood products (platelet transfusion, fresh frozen plasma for coagulopathy); treatment of comorbid infections; vasopressors for shock. Experimental treatments: remdesivir; favipiravir; MR-186-YTE (human monoclonal antibody — showed survival benefit in macaques). The experience from Ebola treatments is being applied: early IV fluid therapy significantly improves survival.

How does GMJ News cover Marburg?

GMJ News covers WHO Marburg outbreak alerts (Ghana, Equatorial Guinea, Tanzania 2022-2023), bat reservoir ecology, CEPI vaccine development, ring vaccination strategy and infection control essentials. Marburg preparedness — including IPC protocols and diagnostic capacity — is a WHO health security priority relevant to PHIG.

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Marburg Virus Disease

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Marburg virus disease (MVD) — caused by Marburg virus (a filovirus closely related to Ebola) with average case fatality rates of 50% (ranging 20-90%) — has caused multiple outbreaks across Africa since its 1967 discovery and is on the WHO R&D Blueprint priority pathogen list as a disease with serious outbreak potential and insufficient countermeasures (WHO). Three significant outbreaks occurred in 2022-2023 alone (Ghana, Equatorial Guinea, Tanzania) — reflecting either increased detection or genuine emergence. The Egyptian fruit bat (Rousettus aegyptiacus) is the natural reservoir. No vaccine is approved, though multiple candidates including mRNA vaccines are in clinical trials under CEPI funding.

Key messages

50% average CFR — 2022-2023 multiple outbreaks

Marburg virus disease has an average case fatality rate of approximately 50% (range 20-90%) and caused multiple outbreaks in 2022-2023: Ghana (3 cases), Equatorial Guinea (9 deaths), Tanzania (5 deaths/8 cases) — demonstrating increasing emergence.

Filovirus — Ebola's cousin

Marburg virus is a filovirus — the same family as Ebola. Both cause haemorrhagic fever with high mortality, require strict isolation and PPE, and have Egyptian fruit bat reservoirs. Marburg was discovered before Ebola (1967).

Egyptian fruit bat — the reservoir

Rousettus aegyptiacus (the Egyptian fruit bat) is the natural reservoir of Marburg virus — shedding it without apparent disease. Human exposure occurs through visiting bat-inhabited caves and mines. Animals infected from bats (primates, pigs) can amplify transmission.

No approved vaccine or treatment

No vaccine or specific antiviral is approved for Marburg as of 2024. Multiple vaccine candidates are in Phase 1-2 clinical trials — including rVSV-MARV, mRNA vaccines (Saiba, Moderna) funded by CEPI.

First outbreak in Germany and Yugoslavia — 1967

Marburg virus was first identified in 1967 in Marburg (Germany) and Belgrade (Yugoslavia) when laboratory workers handling imported African green monkeys from Uganda became severely ill — 31 cases, 7 deaths.

Strict IPC essential — hospital amplification

Like Ebola, Marburg spreads through direct contact with blood and body fluids. Nosocomial transmission in healthcare settings (without PPE) can dramatically amplify outbreaks. Strict contact, droplet and airborne precautions are required.

Key statistics

~50%

average case fatality rate (range 20-90%)

WHO

outbreaks in 2022-2023 (Ghana, Eq. Guinea, Tanzania)

WHO 2023

1967

year of first identified outbreak (Germany/Yugoslavia)

WHO/History

approved vaccines or specific antivirals

WHO 2024

WHO R&D Blueprint

priority pathogen with insufficient countermeasures

WHO

Caves/mines

primary exposure site — bat habitat

WHO

Marburg virus disease outbreaks — confirmed cases and deaths by year/country

Source: WHO. Sporadic outbreaks with high CFR; increasing frequency 2022-2023.

Glossary of key terms

Marburg virus
WHOA negative-sense RNA filovirus — one of only two members of the genus Marburgvirus (along with Ravn virus). Identical family to Ebola virus (Filoviridae). First identified 1967 in Marburg, Germany. Causes Marburg virus disease (MVD) — haemorrhagic fever with average 50% CFR.

Rousettus aegyptiacus (Egyptian fruit bat)
WHOThe natural reservoir of Marburg virus — a cave-dwelling bat found across Sub-Saharan Africa and extending into North Africa and the Mediterranean. Marburg-infected bats shed virus in their secretions without apparent disease. Bat-rich caves in Uganda (Python Cave, Kitum Cave in Kenya) are known risk sites.

Filoviral haemorrhagic fever
WHO/ClinicalMarburg disease progresses: incubation 2-21 days → sudden fever, headache, myalgia → nausea, vomiting, profuse watery diarrhoea → haemorrhagic phase (day 5-7): petechiae, bleeding from multiple sites, DIC → shock/multi-organ failure → death (day 8-9 in severe cases) or recovery.

rVSV-MARV vaccine
CEPI/SaibaA recombinant vesicular stomatitis virus vaccine expressing the Marburg virus glycoprotein — the most advanced candidate. Phase 1 safety data available; Phase 2 trials in progress. Similar platform to rVSV-ZEBOV (Ervebo), which was approved for Ebola. WHO is working with CEPI to maintain stockpiles for rapid outbreak deployment.

Ring vaccination
WHO/Ebola modelThe strategy used successfully in Ebola outbreaks — vaccinating all contacts of confirmed cases and contacts of contacts (a "ring") — planned for Marburg outbreak response once vaccine is available. WHO has developed ring vaccination protocols for rapid deployment if Marburg vaccine advances to approval.

Angola 2005 outbreak
WHOThe largest Marburg outbreak ever — 374 cases, 329 deaths (88% CFR) in Uige, Angola. Amplified in a paediatric ward through reuse of syringes. Primarily affected children. The scale demonstrated Marburg's potential for large-scale nosocomial outbreak given inadequate infection control.