Comment After the coronavirus pandemic and the rise of monkeypox cases, news of another virus may set off nerves worldwide. The highly contagious Marburg virus was reported in the West African country of Ghana this week, according to the World Health Organization. Two unrelated people died after testing positive in Marburg in the country’s southern Ashanti region, the WHO said on Sunday, confirming laboratory results from Ghana’s health service. The highly contagious disease is similar to Ebola and has no vaccine. Health officials in the country say they are working to isolate close contacts and mitigate the spread of the virus, and the WHO is pooling resources and sending experts to the country. “Health authorities responded quickly, beginning to prepare for a potential outbreak. This is good because without immediate and decisive action, Marburg can easily get out of control,” said WHO Regional Director for Africa, Matshidiso Moeti. Mortality rates from the disease can reach nearly 90 percent, according to the WHO. Here’s what we know about the virus:

What is Marburg virus? Marburg is a rare but highly contagious viral hemorrhagic fever and belongs to the same family as Ebola, a better-known virus that has plagued West Africa for years. Marburg virus is a “genetically unique zoonotic … RNA virus of the filovirus family,” according to the Centers for Disease Control and Prevention. “The six species of Ebola virus are the only other known members of the filovirus family.” Case fatality rates range from 24 percent to 88 percent, according to the WHO, depending on the strain of the virus and the quality of case management. Marburg has probably been transmitted to humans by African fruit bats as a result of prolonged exposure by people working in mines and caves that have colonies of Rousettus bats. It is not an airborne disease. Once infected, the virus can spread easily between people through direct contact with the body fluids of infected people such as blood, saliva or urine, as well as on surfaces and materials. Relatives and health workers remain more vulnerable along with patients, and bodies may remain contagious during burial. The first cases of the virus were identified in Europe in 1967. Two large outbreaks in Marburg and Frankfurt, Germany and Belgrade, Serbia led to the initial recognition of the disease. At least seven deaths have been reported in this outbreak, with the first people infected having been exposed to imported African monkeys from Uganda or their tissue during laboratory research, the CDC said. Nearly 800,000 doses of monkeypox vaccine could be available in US by end of July

Where was Marburg detected? The Ghanaian cases are only the second time Marburg has been detected in West Africa. The first case reported in the region was in Guinea last year. The virus can spread quickly. More than 90 contacts, including health workers and community members, are being followed in Ghana. The WHO said it has also contacted neighboring high-risk countries to put them on alert. Cases of Marburg have previously been reported elsewhere in Africa, including Uganda, the Democratic Republic of Congo, Kenya, South Africa and Zimbabwe. The largest outbreak killed more than 200 people in Angola in 2005. The virus is not known to be native to other continents, such as North America, and the CDC says cases outside of Africa are “rare.” In 2008, however, a Dutch woman died of Marburg disease after visiting Uganda. An American tourist also contracted the disease after a trip to Uganda in 2008, but recovered. Both travelers had visited a known cave inhabited by fruit bats in a national park. The disease begins “abruptly”, according to the WHO, with high fever, severe headache and malaise. Muscle aches and cramps are also common features. In Ghana, the two unrelated people who died had symptoms including diarrhea, fever, nausea and vomiting. One case was a 26-year-old man who was admitted to hospital on June 26 and died a day later. The second was a 51-year-old man who went to hospital on June 28 and died the same day, the WHO said. In fatal cases, death usually occurs between eight and nine days after the onset of the disease and is preceded by severe blood loss and hemorrhage, as well as multiorgan dysfunction. The CDC has also noted that around the fifth day, a non-pruritic rash may appear on the chest, back, or stomach. Clinical diagnosis of Marburg “can be difficult,” he says, with many of the symptoms similar to other infectious diseases such as malaria or typhoid fever. There are no approved vaccines or antiviral treatments to treat Marburg virus. However, supportive care can improve survival rates, such as rehydration with oral or intravenous fluids, maintaining oxygen levels, using drug therapies, and treating specific symptoms as they occur. Some health experts say drugs similar to those used for Ebola could be effective. Some “experimental treatments” for Marburg have been tested on animals, but have never been tested on humans, the CDC said. Virus samples collected from patients for study pose an “extreme biohazard risk,” the WHO says, and laboratory tests should be conducted under “maximum biocontainment conditions.” WHO warns of ‘never-ending’ coronavirus as variants rise in US, Europe The WHO said this week it was supporting a “joint national investigation team” in Ghana and sending its own experts to the country. It is also sending personal protective equipment, strengthening disease surveillance, and contact tracing in response to rare cases. More details are likely to be shared at a WHO Africa online briefing scheduled for Thursday. “Worryingly, the geographic range of this viral infection appears to have spread. This is a very serious infection with a high mortality rate,” international public health expert and professor Jimmy Whitworth of the London School of Hygiene and Tropical Medicine told The Washington Post on Monday. “It is important that we try to understand how the virus entered the human population to cause this outbreak and stop any further outbreaks. Currently, the risk of the outbreak spreading outside the Ashanti region of Ghana is very low,” he added.