The Study of Marburg Virus Based on Preston's The Hot Zone

Introduction

The Marburg virus was first discovered from an outbreak during 1967 that occured in Marburg, Germany, and Belgrade, Yugoslavia (Nakayama 4). The people of Marburg, Germany came into contact with the virus from infectious African green monkeys, that were being transported from Uganda to Marburg, Germany (Nakayama 4). Once the virus arrived in Germany it jumped species and emerged in the human population, which is known as virus amplification (Preston 6). The Marburg virus belongs to the Filovirus family, and its closely related to the the other strands of Ebola: Zaire and Sudan (Preston 6). The Marburg virus was the first filovirus to be discovered, and the term filovirus means thread virus, which is how the filoviruses got their name; from their thread or rope like appearance when viewed under a microscope (Preston 6). The Marburg virus is made up of seven structural proteins, four of which make up the nucleocapsid complex that surround the genetic material of the virus (DiCarlo 1). The major nucleocapsid protein NP, automatically forms itself into tubular nucleocapsid protein like structures, which interact with one of the structural proteins VP35 (DiCarlo 1). After NP interacts with VP35, VP35 interacts with RNA polymerase (DiCarlo 1). The VP35 and L complex act like as the RNA polymerase, with VP35 acting as the polymerase cofactor (DiCarlo 1). Three of the four nucleocapsid proteins are in charge, and are crucial for the transcription and replication of the viral RNA of the Marburg Virus (DiCarlo 1). In this paper I will explain the effects of the Marburg virus on the human body, how it spreads from host to host, any possible treatments or cures for the virus; and emphasize how unsanitary tourist sites in third world countries help contribute to the spreading of viral diseases.

Epidemiology

For the Marburg virus to be created in its host, it first undergoes the formation of perinuclear inclusions, which are thought to be the sites of viral replication (Schudt 7). Later in the replication process, NC’s are detected in the cytosol, plasma membrane, and in the filopodia; which are all prefered sites for the growth and development of the Marburg virus (Schudt 7). The glycoprotein GP meets the plasma membrane with assistance from the vesicular secretory membrane traffic, then it's recruited to the sites where the viral protein VP40 accumulates (Schudt 7). The VP40 protein is a multifunctional viral protein that is also a peripheral membrane related protein, which is the place where virogenesis is conducted (Schudt 7).

In the first reported case of Marburg virus scientists thought the direct contact of bat feces by Charles Monet in the Kitum cave on Mount Elgon, led him to contracting the Marburg virus (Preston 6). With the advancement of research over the Marburg virus scientists and doctors believe that the Marburg virus is spread through direct contact of bodily fluid such as blood, sweat, and other bodily secretions (Preston 6). Even if a patient who is infected with the Marburg virus is deceased, the virus can still linger in their body, such as in the liquid that surrounds the eyeball (Preston 6). In one case a man infected with the Marburg virus was able to pass the virus to his wife through sexual intercourse (Preston 6).

Marburg virus also known as a hemorrhagic fever, completely destroys its host from the inside out (Slenczka 8). Patients that were infected with the Marburg virus in Marburg, Germany were admitted to the university hospitals of Marburg and Frankfurt (Slenczka 8). Over the first three to four days, the patients infected with the virus didn’t show any alarming symptoms outside of having discomfort, headaches, muscle pain, and fevers reaching 39 degrees celsius (Slenczka 8). During the second week of the patients being admitted to the hospital, their symptoms became more severe as many patients experienced complete liver failure, and began to bleed uncontrollably from needle puncture sites (Slenczka 8). The patient's conditions became fatal after about the ninth or tenth day, as numerous patients began to die from hemorrhagic shock (Slenczka 8). Being known as one of the first documented cases of a person infected with the Marburg virus, Charles Monet while on his way to Nairobi Hospital began to show severe symptoms of the Marburg virus, up until the moment he died in Nairobi hospital (Preston 6). While aboard the Fokker Friendship commuter aircraft, Monet's health quickly deteriorated as he began vomiting a mixture of tarry granules mixed with fresh red arterial blood into a paper bag, while his bloodstream began throwing clots into his liver, kidneys, hands, feet, and head (Preston 6). As Monet reached the Nairobi Hospital casualty department, he completely emptied out the entire contents of his stomach as he expelled enormous amounts of blood from his mouth before he crashed onto the floor of the hospital casualty department (Preston 6).

Treatment

Although there is currently no cure for the Marburg virus, there has been some breakthroughs with clinical experiments on non human primates, who have been exposed to filoviruses and have developed infections from the viruses (Dye 2). With the use of polyclonal IgG antibodies from the primates that survived the infections, scientists injected these antibodies into the non human primates that were infected by the filoviruses (Dye 2). In the first experiment the non human primates that were infected with the Marburg virus were treated approximately, fifteen to thirty minutes after exposure to the Marburg virus with the IgG antibodies (Dye 2). The non human primates were injected with the IgG antibodies again on day four and eight of postexposure to the Marburg virus (Dye 2). The post exposure treatments were successful, with no detectable signs of disease or viremia (Dye 2). The non human primates that were injected with Marburg specific IgM antibodies survived the virus, and showed signs that they developed an immune defense against virus replication (Dye 2). In the second trial the non human primates were infected with Marburg or the Ebola virus, and treatment was delayed for two days and treatment of the viruses was conducted on day four and eight of post exposure to the viruses (Dye 2). With the delayed treatments, non human primates that were infected by both Marburg and Ebola virus survived (Dye 2). In both trials two of the three non human primates had no physical signs of illness, while the third non human primate expressed mild symptoms, but experienced a full recovery (Dye 2).

Tourist sites in third world countries aren’t closely monitored. On January 9th, 2008 an infectious disease physician notified the Colorado Department of Public Health and Environment (CDPHE), of a patient that had an illness with an unexplained fever (Imported 3). The patient with this illness had to be hospitalized due to her severe condition on her way back from a trip to Uganda in an American hospital (Imported 3). While in Uganda, the patient was exploring the Python cave in Queen Elizabeth National Park (Imported 3). While exploring the cave the patient recalled touching bat feces, which was later linked to the patient developing symptoms that closely resembled symptoms other patients experienced that were positive for exposure and infection of the Marburg virus (Imported 3). Prior to the patients encounter with the infected bat feces, Python cave was not closed to the public, even though there was a clear and evident danger of contracting deadly viruses from the Python caves inhabitants (Imported 3). Python cave was only closed off to the public after a Dutch tourist contracted the Marburg virus, which occurred after the American tourist tested positive for the Marburg virus (Imported 3). Almost an entire year after the American tourist tested positive for the Marburg virus, the Center for Disease Control and the CDPHE oversaw a public health investigation, during 2009 from January to February (Imported 3).

Conclusion

After examining numerous academic journals and taking information from Richard Preston's’ book “The Hot Zone”, I have learned about the devastating effects of the Marburg virus, and its ability to completely destroy its host from the inside out. The ability of the Marburg virus to jump from one non human species to the human population is one main factor that makes this virus so deadly. The wildlife trade business that takes place in Africa, specifically Uganda, has allowed the Marburg virus to enter the human population through contact with African Green Monkeys. In order to prevent devastating viruses from entering into the human population and spreading on a global scale, major world health organizations such as WHO (The World Health Organization) should create and implement new protocols that can serve as a global standard that is followed in case of emergencies, such as a global epidemic. One way that world leaders could help prevent the spread of filoviruses could be by issuing out information about the viruses in a manner that average citizens could understand. There will always be viruses in the world capable of decimating the entire human population, but with the proper resources global health leaders will be able to develop a plan that can minimize the chance of a deadly virus spreading throughout the entire population, and the high mortality rate it will enact on the human population.