A rare Marburg outbreak sparks a race against time to test vaccines and drugs
Original article from STAT by Helen Branswell. February 14, 2023
A Marburg fever outbreak in Equatorial Guinea is galvanizing efforts to test drugs and vaccines for a virus that currently has none. But every day counts, warned experts who gathered virtually on Tuesday to try to chart a course for the work.
The outbreak is believed to have begun in early January, but the confirmation that the Marburg virus was responsible for the growing cluster of people sick with hemorrhagic-fever-like illness was only confirmed on Monday. To date, nine people have died; all were epidemiologically linked. Another 16 people with some symptoms are in quarantine.
There are a number of experimental vaccines and drugs that have been shown in animals to prevent or treat Marburg, a deadly cousin of the deadly Ebola virus family. But finding out if they actually work in people requires an outbreak, and Marburg outbreaks are blessedly rare. This is the first one Equatorial Guinea has recorded. While there have been four in the past decade in Ghana, Guinea, and Uganda (which had two), the last Marburg outbreak with cases that numbered in the double digits was in 2012. And even that one only recorded 15 cases.
“I cannot emphasize enough the requirement for speed for doing any trials,” John Edmunds, an epidemiologist from the London School of Hygiene and Tropical Medicine, said during the meeting, which was organized by the World Health Organization.
Edmunds noted that of the 16 known Marburg outbreaks, most have stopped quickly after normal containment measures have been put in place — isolating people who are sick, using protective equipment to safeguard the medical staff looking after them, and performing safe burials on those who die. “All but two have been curtailed almost immediately,” Edmunds noted of the outbreaks.
Nancy Sullivan, director of Boston University’s National Emerging Infectious Diseases Laboratories, agreed, but noted there are factors in this instance that could increase the risk of a larger outbreak.
“The difficulty with predicting where the outbreak will go is that there is more movement in and out of Equatorial Guinea than we have in some of the more remote locations,” said Sullivan, who led the team that designed one of the Marburg vaccines that could be tested if authorities in Equatorial Guinea agree to conduct a clinical trial. “And while the [ministry of health] has done a great job tracking cases, I think we would be foolish to assume that no cases have gone undetected.”
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