History

In 1967, a disease outbreak occurred in a laboratory in Marburg, Germany, where the kidneys of cercopithecoid (Green African; vervet) monkeys were being taken out for preparation of cell cultures. Twenty-seven laboratory workers (including a worker in Yugoslavia) fell ill with a grave illness, and seven died. There were four secondary cases in total (including the wife of an infected laboratory worker in Yugoslavia secondarily infected by sexual intercourse), but none fatal. Early suspicions focused on yellow fever, but this was soon ruled out (Casals 1971). In due course, a virus was isolated and found to be quite distinct from any other known viruses. Electron micrographs revealed a virus with bizarre morphology of a type never seen before (Peters, Muller, and Slenckza 1971). Pictures taken resembled photographs of a bowl of spaghetti. The agent was named Marburg virus and the disease Marburg disease. Strict monkey quarantines were initiated. No further cases were seen in laboratory workers.

An intensive and extensive series of field studies were initiated in East Africa, which had been the monkeys' homeland (Henderson et al. 1971; Hennes-sen 1971; Kalter 1971). No virus recoveries were made from any of the monkeys examined. In later years, serologic studies involving humans and primates, and also rodents, have been carried out in many regions, as can be seen in Table VIII.86.1.

The first Marburg cases seen in Africa occurred in February of 1975. A young Australian couple touring in Rhodesia (Zimbabwe) became ill by the time they got to South Africa. They were admitted to a major hospital in Johannesburg where the young man died and the young lady recovered. A nurse tending them also sickened and recovered. After the disease was determined to be Marburg, a thorough epidemiological inquest was carried out all along the

Table VIH.86.1. Serologic studies of Marburg virus in humans and other primates

No.

No.

Percent

Study area

Date

examined

positive

positive

Remarks

Humans

Senegal: northern provinces

1977

159

0

0

Central African Republic

1980

499

7

1.4

several regions

Liberia

1982

400+

4

1

several regions

Gabon

1982

253

0

0

Kenya

1982

58

0

0

Cameroons

1982

1517

15

1

several regions

Sudan: northern provinces

1979-82

231

0

0

very desert region

Sudan: central provinces

1979-82

240

0

0

savannah regions

Sudan: southern provinces

1979-82

176

1

0.6

agri and forest

Kenya

1983

741

0

0

several regions

Kenya

1983

1899

8

4.2

several regions

Liberia

1986

215

2

2

Nigeria

1988

1677

29

1.1

several regions

Primates

Kenya

1981

136

4

3

vervet monkeys

Kenya

1981

184

1

0.6

baboons

Gabon

1982

48

0

0

chimpanzees

route of passage of the victims, concentrating particular attention on every locale where they spent a night. Animal, insect, and human populations were sampled. No evidence of endemic disease was found (Gear et al. 1975).

On January 14,1980, a 58-year-old man from western Kenya was seen in a Nairobi hospital. He died 6 hours after admission, and a physician who attended him also became ill but recovered. A Marburg virus was isolated from his blood (Centers for Disease Control 1980). Subsequent epidemiological investigations carried on in western Kenya produced a positive finding: Antibodies against the Marburg virus were found in two vervet monkeys from among many primates examined.

The latest episode involved a boy in Kenya in 1987 who became infected in a visit to a park in the western part of Kenya. The boy died. There were no secondary cases reported.

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