Emerging Threat of Marburg Virus Disease: Epidemiology, Clinical Management, and the One Health Strategy for Prevention and Control

Objectives: Marburg virus disease (MVD), caused by the Marburg virus, is a severe zoonotic viral hemorrhagic fever with high mortality that threats the Global Health Security. Marburg virus is on the WHO list for the next pandemic-prone pathogens it always emerges in outbreaks. Considering it is current involvement in outbreak in Rwanda, there is an urgent need for up to date information to inform policymaking, resources mobilization, strategic planning and guide the implementation of cost-effective response strategies. Methods: Through technical and scientific consultancies with experts and reviewing publicly existed knowledge, we collected and synthesized available information about the disease and summarized it into a brief evidence to inform policymakers, public health leaders, and frontline responders in developing and implementing cost-effective prevention and control measures. Results: We have identified the historical outbreaks and geographical distribution of MVD, main clinical signs and diagnostic tools, primary reservoir, transmission dynamics and case management protocol. More importantly, we summarized the best practices for multisectoral One Health strategy for the prevention and control of MVD outbreaks including strict implementation of WASH and infection prevention measures, isolation of infected humans and animals, contact tracking for confirmed cases, and International Health Regulations (IHRs 2005). High risk populations such as frontline responders including healthcare providers and community health worker should be prioritized for the experimental vaccination. Conclusions: In lack of licensed treatment or vaccine, cost-effective preparedness and response strategy to MVD should focus on preventive measures including community engagement, reduced contact between humans and reservoirs, supportive care and isolation of patients, and proper waste management.