A mysterious and deadly virus has captured global attention, prompting urgent travel warnings and widespread alarm. What is this untreatable illness that has everyone on edge? How did it originate, and why is it spreading so quickly?
What Is the Bleeding Eye Virus?
Known as the Marburg virus, the “bleeding eye” virus is a highly infectious pathogen that causes Marburg virus disease (MVD), a severe hemorrhagic fever in humans. It was first identified in 1967 during simultaneous outbreaks in Marburg and Frankfurt, Germany, and Belgrade, Serbia. These outbreaks were traced to African green monkeys imported from Uganda for research, resulting in several fatalities among laboratory workers and marking the virus’s alarming introduction to the human population.
Closely related to the Ebola virus, Marburg shares similar structural and symptomatic characteristics. Both viruses are filamentous, with single-stranded RNA genomes, and cause severe hemorrhagic fevers with high mortality rates. The virus’s natural host is the Egyptian fruit bat (Rousettus aegyptiacus), with human infections typically arising from prolonged exposure to caves or mines where these bats reside.
Transmission to humans occurs through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals or animals. Human-to-human transmission is facilitated by contact with broken skin, mucous membranes, or contaminated surfaces and materials, such as clothing or bedding.
The World Health Organization (WHO) reports an average case fatality rate for MVD of around 50%, varying between 24% and 88% in past outbreaks depending on the virus strain and treatment. Currently, there are no approved vaccines or antiviral treatments for Marburg virus disease.
Recent Outbreak and Current Status of the Marburg Virus
Since the first recorded outbreak in 1967, MVD has primarily affected African nations. Recent outbreaks have been reported in Ghana (2022), Tanzania (2023), and, most recently, Rwanda.
In September 2024, Rwanda confirmed its first case of the Marburg virus, with 66 cases and 15 deaths reported as of November 29, 2024. The outbreak prompted the U.S. State Department to issue a travel advisory on November 22, urging travelers to exercise increased caution when visiting Rwanda. The advisory also highlighted the potential for additional health screenings for travelers entering and leaving the country.
Encouragingly, approximately 75% of reported cases in Rwanda have recovered, with the last known patient discharged on November 8, 2024, after testing negative for the virus. Following this, the WHO initiated a 42-day countdown on November 9, 2024, to declare the outbreak over if no new cases arise. If successful, this declaration is expected by December 22, 2024. Meanwhile, the Centers for Disease Control and Prevention (CDC) maintains a Level 2 travel advisory (Practice Enhanced Precautions) for Rwanda and continues to monitor the situation closely.
This latest outbreak underscores the ongoing threat posed by hemorrhagic fevers like Marburg. Vigilance, rapid response, and international collaboration are essential to managing such crises effectively.
How Does the Bleeding Eye Virus Spread?
Marburg virus disease is a fast-moving, often fatal illness. Understanding its progression can aid in early detection and improve survival rates:
- Incubation Period: Symptoms typically appear abruptly, 2 to 21 days after infection.
- Early Symptoms: The disease begins with high fever, severe headache, and malaise. Muscle pain is also common.
- Gastrointestinal Phase: By day three, severe watery diarrhea, abdominal pain, cramping, nausea, and vomiting often occur. Patients in this stage are described as having “ghost-like” features, including sunken eyes, drawn expressions, and extreme lethargy.
- Hemorrhagic Symptoms: Between days five and seven, bleeding may begin, manifesting as:
- Bleeding from the nose, gums, or injection sites
- Blood in vomit and stool
- Spontaneous eye bleeding, lending the virus its nickname
“Being hemorrhagic, it damages blood vessels and causes bleeding—frequently from the eyes, nose, mouth, or vagina,” experts explain.
- Neurological Symptoms: Later stages may include confusion, irritability, and aggression.
- Fatal Outcomes: In severe cases, death occurs within eight to nine days after symptoms begin, often due to massive blood loss and shock.
How Can the Spread Be Prevented?
Preventing Marburg virus disease requires caution, especially in high-risk areas such as caves or mines inhabited by bats. Key measures include:
- Protective Gear: Wear gloves and masks to minimize exposure to infected bats or animals.
- Food Safety: Cook all animal products thoroughly to avoid transmission.
- Avoid Direct Contact: Refrain from handling the bodily fluids of infected individuals or contaminated materials like bedding and clothing.
- Isolation and Monitoring: Isolate suspected or confirmed cases and monitor exposed individuals for 21 days to limit further spread.
- Safe Burial Practices: Handle deceased individuals with care, as their bodies can remain infectious.
Travelers should avoid contact with potential animal carriers, such as Egyptian fruit bats and non-human primates, in affected regions.
Should You Be Concerned About the Marburg Virus in the U.S.?
With the recent outbreak in Rwanda, it’s natural to question whether Marburg poses a risk in the U.S. Fortunately, the CDC has assessed the risk to the general U.S. population as “low,” with “moderate confidence.”
The outbreak in Rwanda remains contained within specific clusters, with no evidence of widespread community transmission. Additionally, travel routes between Rwanda and the U.S. are limited, reducing the likelihood of the virus reaching American soil.
Even if a case were to emerge in the U.S., the country’s robust public health infrastructure is well-equipped to manage it. During the 2014-2015 Ebola outbreak, for instance, only two U.S. infections occurred, both of which were contained without further spread.
For most Americans, the situation calls for staying informed rather than alarmed. However, recent travelers to Rwanda should remain vigilant and adhere to health guidelines.
Is There a Cure or Vaccine for the Marburg Virus?
Currently, no approved cure or vaccine exists for MVD. However, promising research is underway. The Sabin Vaccine Institute, the International AIDS Vaccine Initiative (IAVI), and Oxford University (developers of the AstraZeneca COVID-19 vaccine) are among those advancing potential vaccine candidates, with trials already in progress.
In the absence of a cure, healthcare professionals rely on supportive care, such as rehydration and symptom management, to improve survival rates. Diagnosing MVD remains challenging, as its symptoms overlap with other diseases like malaria. Confirmation requires specialized diagnostic tools like antibody-capture ELISA tests.
Staying Vigilant Against the Marburg Threat
With its high mortality rate and rapid spread, the Marburg virus remains a serious global health concern. Its recent outbreaks emphasize the need for heightened awareness, effective prevention, and continued research into treatments.
By staying informed, practicing good hygiene, and following travel advisories, we can reduce risks and support global efforts to combat the Marburg virus. Prioritizing education and vigilance will help minimize its spread and protect public health.