Marburg virus outbreak in Equatorial Guinea: Asian countries to act or not?

Sahjid Mukhida, Sameena Khan, NikunjaKumar Das, Sabha Khan
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Abstract

The Marburg virus is a filovirus that causes a severe, often fatal viral hemorrhagic fever known as Marburg virus disease (MVD).[1] It was first identified in 1967 in Germany among people who had come in contact with imported Ugandan green monkeys, and it is thought to have originated in bats. The disease initially spread to humans through contact with infected fruit bats and then continued to spread through interpersonal contact between humans.[2] The World Health Organization (WHO) warns that living conditions in mines or caves where bat colonies are located can be a risk of infection. This zoonotic disease is manifested by high fever, malaise, nausea, vomiting, diarrhea, rash, and bleeding. Not contagious through the air, this disease is instead transmitted through personal contact with an infected person’s blood or other bodily fluids or with contaminated objects such as towels or clothing.[3] Recently, an epidemic broke out on February 13, 2023, in the northern Equatorial Guinean province and 12 deaths out of a total of 25 probable cases have been linked to the virus.[4] This is the third outbreak of MVD in the Guinean region in the last 3 years although outbreaks have been recorded every year and declared as being over in a few months.[5] In most cases, epidemics may be contained and brought to a rapid stop after the necessary actions have been taken.[6] In this regard, the WHO convened an urgent meeting to discuss the feasibility of testing Marburg vaccines that are in various stages of development throughout the world to see if any experimental vaccines offered any protection. However, scientists warn that the trial’s chances of success are low because the epidemic can be contained through measures like quarantine even before a single dose of vaccine is provided.[7] Considerations for conducting clinical trials of vaccinations against the Marburg virus in Equatorial Guinea can be troublesome or equally beneficial. This may provide valuable data on the safety of vaccines and the immune responses they generate in populations at risk of future outbreaks and can be evidence pointing toward the efficacy of vaccines. Despite the fact that MVD has a poor spread characteristic and their point of origin is far from Asia, we still need to be vigilant. To prevent MVD from spreading to Asian countries, we should take certain steps to ensure that travelers and visitors who came from the epicenter be thoroughly vetted. In addition, as outbreaks of MVD have been traced to humans who recently visited or worked in caves minimum of 21 days, community engagement with the preparation of proper control measures that include quarantine of suspected cases and rapid detection can help. Vaccines may not provide 100% protection from the disease but will surely give some assurance to the population after a successful trial. Furthermore, all international airports of outbreak region can use rapid diagnostic tests for MVD at the time of departure during the ongoing outbreak time and after words of 3 months from declaration of outbreak over. Establishing mobile laboratories and medical centers along with counseling and isolation facilities which can help for screening, treatment and follow up of positive cases of MVD. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
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赤道几内亚马尔堡病毒爆发:亚洲国家是否采取行动?
马尔堡病毒是一种线状病毒,可引起严重的,通常是致命的病毒性出血热,称为马尔堡病毒病(MVD)。[1]该病毒于1967年在德国首次在接触过进口乌干达绿猴的人群中被发现,并被认为起源于蝙蝠。这种疾病最初通过与受感染的果蝠接触传播给人类,然后通过人与人之间的人际接触继续传播。[2]世界卫生组织(WHO)警告说,蝙蝠聚集地所在的矿井或洞穴的生活条件可能存在感染风险。这种人畜共患疾病的表现是高烧、不适、恶心、呕吐、腹泻、皮疹和出血。这种疾病不是通过空气传播的,而是通过与感染者的血液或其他体液或被污染的物体(如毛巾或衣服)的个人接触传播的。[3]最近,2023年2月13日在赤道几内亚省北部爆发了一场流行病,在总共25例可能病例中,有12例死亡与该病毒有关。[4]这是过去三年中几内亚地区第三次暴发暴发,尽管每年都有暴发记录,并在几个月内宣布结束。[5]在大多数情况下,采取必要的行动后,流行病可以得到控制并迅速停止。[6]在这方面,世卫组织召开了一次紧急会议,讨论在世界各地测试处于不同开发阶段的马尔堡疫苗的可行性,以确定是否有任何实验性疫苗提供任何保护。然而,科学家们警告说,试验成功的机会很低,因为即使在提供一剂疫苗之前,这种流行病也可以通过隔离等措施得到控制。[7]在赤道几内亚进行马尔堡病毒疫苗接种临床试验的考虑可能是麻烦的,也可能是同样有益的。这可能为疫苗的安全性及其在未来有爆发风险的人群中产生的免疫反应提供宝贵的数据,并可能成为指向疫苗有效性的证据。尽管MVD具有较差的传播特征,其起源点远离亚洲,但我们仍然需要保持警惕。为了防止MVD扩散到亚洲国家,我们应该采取一些措施,确保对来自震中的旅行者和游客进行彻底的审查。此外,由于MVD的暴发可追溯到最近至少21天访问过洞穴或在洞穴中工作过的人,社区参与制定适当的控制措施,包括隔离疑似病例和快速发现,可能会有所帮助。疫苗可能不能提供100%的预防疾病的保护,但在成功的试验后,肯定会给人口提供一些保证。此外,疫情地区的所有国际机场均可在持续疫情期间和宣布疫情结束后3个月离境时使用MVD快速诊断检测。建立流动实验室和医疗中心以及咨询和隔离设施,以帮助筛查、治疗和跟踪MVD阳性病例。财政支持及赞助无。利益冲突没有利益冲突。
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