What Is Marburg Virus Disease? Symptoms, Transmission, Diagnosis and Treatment

Created: 04.10.2024 · Last Updated: 11.08.2026 · Category: Internal Medicine · Prepared by the Academic Hospital Web and Editorial Board.

Marburg virus disease (MVD) is a rare but severe viral haemorrhagic fever caused by Marburg virus or the closely related Ravn virus.

The viruses that cause Marburg disease and Ebola diseases belong to the same Filoviridae family and can cause clinically similar severe illnesses.

MVD may begin abruptly with fever, severe headache, profound malaise and muscle pain. Severe diarrhoea, abdominal pain, nausea and vomiting may develop over the following days. Some patients with severe disease develop bleeding, shock and multiorgan failure.

An 88% fatality rate is not a fixed outcome for Marburg virus disease. WHO reports that case-fatality rates in previous outbreaks have ranged from approximately 24% to 88%, with an average of around 50%. Early intensive supportive care can improve survival.

What Is Filoviridae?

Filoviridae is a family of viruses that includes pathogens capable of causing severe viral disease in humans and non-human primates.

Important members include:

  • Marburg virus and Ravn virus
  • Orthoe­bolaviruses capable of causing Ebola diseases

Marburg and Ebola diseases are caused by different viruses, but their clinical presentations can overlap considerably.

What Is Marburg Virus Disease?

MVD is a zoonotic viral infection capable of causing severe systemic disease in humans.

The Egyptian fruit bat (Rousettus aegyptiacus) is considered the natural reservoir of Marburg virus.

The virus can initially spill over from animals to humans. Once introduced into the human population, it can spread through direct contact with the blood or other bodily fluids of an infected person.

The illness was previously widely called Marburg haemorrhagic fever. However, because bleeding does not occur in every patient, Marburg virus disease is now the preferred term.

When Was Marburg Virus First Identified?

MVD was first recognised in 1967 during simultaneous outbreaks in Marburg and Frankfurt in Germany and Belgrade in the former Yugoslavia.

The outbreaks were associated with laboratory work involving African green monkeys imported from Uganda.

Although monkeys were the source of exposure during the first recognised outbreak, they are not considered the natural reservoir. Egyptian fruit bats are the recognised natural host.

How Does Marburg Virus Spread?

Bat-to-Human Transmission

Initial human infection has been associated particularly with prolonged exposure to mines or caves inhabited by Rousettus fruit-bat colonies.

Human-to-Human Transmission

MVD can spread when infected blood or other bodily fluids come into direct contact with broken skin or mucous membranes such as the eyes, nose or mouth.

Potentially infectious materials include:

  • Blood
  • Vomit
  • Faeces
  • Urine
  • Other bodily secretions
  • Contaminated medical equipment
  • Clothing or bedding contaminated with bodily fluids

Direct contact with the body of a person who has died from MVD can also transmit infection, making safe and dignified burial practices an important component of outbreak control.

When Is Marburg Contagious?

According to WHO, people do not transmit Marburg virus disease before symptoms begin.

Once illness develops, a person can remain infectious while the virus is present in blood and other infectious bodily fluids.

The principal route of human-to-human transmission is direct contact with infected blood or bodily fluids. Strict infection-prevention measures and appropriate personal protective equipment are therefore essential when caring for a suspected or confirmed patient.

Marburg virus may persist for a period after recovery in immune-privileged sites such as the testes and eyes. Survivors should therefore follow public-health guidance concerning testing and safer sexual practices.

Who Is at Higher Risk of Marburg Virus Disease?

MVD is extremely rare in the general population.

Higher-risk groups can include:

  • Healthcare workers caring for patients without appropriate infection-control precautions
  • Family members and caregivers of infected patients
  • People with direct exposure to infected blood or bodily fluids
  • People participating in burial practices involving unprotected contact with the deceased
  • People entering caves or mines inhabited by Egyptian fruit bats in areas where the virus occurs
  • Laboratory workers handling infected biological material or non-human primates

What Are the Symptoms of Marburg Virus Disease?

Early Symptoms

  • High temperature or feeling feverish
  • Severe headache
  • Profound malaise
  • Muscle aches
  • Chills
  • Fatigue

Symptoms During Disease Progression

Several days after illness begins, patients may develop:

  • Severe watery diarrhoea
  • Abdominal pain and cramping
  • Nausea
  • Vomiting
  • Chest pain or shortness of breath
  • Headache
  • A non-itchy rash
  • Eye redness or irritation

Severe Disease

Some patients can develop:

  • Bleeding
  • Confusion or neurological symptoms
  • Low blood pressure
  • Shock
  • Multiorgan failure

Does Everyone With Marburg Develop Bleeding?

No. Being classified as a viral haemorrhagic fever does not mean that every patient experiences internal or external bleeding.

CDC specifically notes that bleeding is not universally present.

When bleeding does occur, manifestations may include:

  • Bleeding from the nose or gums
  • Petechiae or bruising
  • Oozing from intravenous or venepuncture sites
  • Blood in vomit or stool
  • Other mucosal bleeding

What Is the Incubation Period?

The incubation period for MVD is 2–21 days.

This is the interval between infection and the onset of symptoms.

People who have had a recognised exposure to a confirmed or probable case may be monitored by public-health teams for symptoms for 21 days after their last exposure.

What Is the Fatality Rate of Marburg Virus Disease?

Case-fatality rates vary substantially between outbreaks.

According to WHO:

  • Previous outbreak fatality rates have ranged from approximately 24% to 88%.
  • The average case-fatality rate is approximately 50%.

Outcome can be influenced by the outbreak, individual patient factors and how early high-quality supportive care is available.

Early supportive care can be lifesaving. Rapid replacement of fluids and electrolytes and treatment of respiratory, circulatory and organ complications can improve the chance of survival.

How Is Marburg Virus Disease Diagnosed?

Early symptoms of MVD are not specific and can resemble more common infectious diseases.

Differential diagnoses can include:

  • Malaria
  • Typhoid fever
  • Meningitis
  • Bacterial infections
  • Ebola and other viral haemorrhagic fevers

Both the clinical presentation and the patient's epidemiological exposure history are therefore important.

Laboratory confirmation may use:

  • RT-PCR
  • Antigen-detection tests
  • Antibody-capture ELISA
  • Virus isolation in maximum-containment laboratories

Samples from a patient with suspected MVD represent an extreme biohazard risk. Collection, transport and testing should follow specialist public-health and high-containment laboratory procedures.

How Is Marburg Virus Disease Treated?

As of 11 August 2026, there is no approved specific antiviral treatment for MVD.

Management is based on early intensive supportive care.

Depending on the patient's condition, care may include:

  • Oral or intravenous fluid replacement
  • Correction of electrolyte abnormalities
  • Oxygen support
  • Blood-pressure and circulatory support
  • Management of bleeding and coagulation abnormalities
  • Blood products when clinically required
  • Support for kidney, respiratory and other organ failure
  • Treatment of secondary infections
Antibiotics do not treat Marburg virus. They may be used only when a patient also has, or is strongly suspected to have, a bacterial infection requiring antibiotic treatment.

Candidate monoclonal antibodies, antivirals and other treatments are being investigated but are not yet standard approved therapies.

Is There a Vaccine for Marburg Virus?

As of 11 August 2026, there is no vaccine approved for general use against MVD.

Several candidate vaccines are being evaluated in clinical studies.

During outbreaks, investigational vaccines may be evaluated under approved research protocols in healthcare workers and other high-risk populations.

Existing vaccines against certain Ebola viruses should not be assumed to protect against Marburg virus.

How Can Marburg Virus Disease Be Prevented?

Reducing Animal Exposure

  • Avoid unnecessary exposure to caves or mines inhabited by Rousettus fruit bats in affected regions
  • Use appropriate protective equipment when occupational exposure is unavoidable
  • Avoid unprotected contact with sick or dead wildlife

Preventing Human-to-Human Transmission

  • Avoid direct contact with blood and bodily fluids of infected patients
  • Use appropriate personal protective equipment in healthcare settings
  • Perform careful hand hygiene
  • Safely disinfect or dispose of contaminated materials
  • Use safe injection practices
  • Follow safe and dignified burial procedures

Contact Monitoring

People who have been exposed to a confirmed case may be monitored for symptoms for 21 days after their last potential exposure.

What Should You Do After Possible Marburg Exposure?

Prompt medical assessment is important if a person develops fever, severe malaise, headache, muscle pain, vomiting or diarrhoea within 21 days of:

  • Close contact with a confirmed or suspected Marburg patient
  • Exposure to the patient's blood or bodily fluids
  • Entering a cave or mine inhabited by fruit bats in an affected region

If Marburg exposure is possible, tell the healthcare service about recent travel and exposure before or at the time of seeking care. This allows appropriate isolation, infection-control precautions and public-health assessment to be arranged promptly.

Fever, headache or diarrhoea alone does not mean that a person has Marburg virus disease. Travel and exposure history are particularly important, and more common conditions such as malaria or typhoid fever may cause similar symptoms.

Have Your Symptoms Assessed

Fever, severe fatigue, vomiting or diarrhoea associated with relevant travel or exposure history should be medically assessed.

Frequently Asked Questions

What is Marburg virus disease?
Marburg virus disease is a rare but severe viral haemorrhagic fever caused by Marburg virus or Ravn virus. Marburg virus belongs to the same Filoviridae family as the viruses that cause Ebola diseases.
How does Marburg virus spread?
Initial human infection can follow prolonged exposure to caves or mines inhabited by Rousettus aegyptiacus fruit bats. Between people, infection can spread through direct contact of broken skin or mucous membranes with infected blood or other bodily fluids and with materials contaminated by those fluids.
Can Marburg virus spread before symptoms begin?
According to WHO, people do not transmit Marburg virus disease before symptoms begin. A person can remain infectious after symptoms develop while the virus remains present in blood or other infectious bodily fluids.
What is the incubation period for Marburg virus?
The incubation period for Marburg virus disease is 2–21 days. People exposed to a confirmed or probable case may be monitored for symptoms for 21 days after their last exposure.
Does everyone with Marburg virus disease develop bleeding?
No. Bleeding can occur in severe Marburg virus disease but is not present in every patient. When it occurs, it can include bleeding from the nose or gums, oozing from intravenous sites, or blood in vomit or stool.
Is the fatality rate of Marburg virus disease 88%?
No. WHO reports that case-fatality rates in previous Marburg outbreaks have ranged from approximately 24% to 88%, with an overall average of around 50%. Fatality varies between outbreaks and can be influenced by access to early supportive care.
Is there a treatment for Marburg virus disease?
As of 11 August 2026, there is no approved specific antiviral treatment for Marburg virus disease. Early intensive supportive care includes fluid and electrolyte replacement, oxygen and circulatory support and treatment of complications. Candidate antivirals and monoclonal antibodies remain under investigation.
Is there a vaccine against Marburg virus?
As of 11 August 2026, there is no vaccine approved for general use against Marburg virus disease. Several candidate vaccines are being evaluated in clinical studies.
Academic Hospital note: Marburg virus disease is extremely rare. Symptoms alone do not establish the diagnosis; recent travel to an affected area, exposure to fruit bats or direct contact with a confirmed case are important parts of clinical risk assessment. You can book an appointment.

References

  1. Academic Hospital. Marburg Virüsü Nedir? Belirtileri Nelerdir?
  2. World Health Organization. Marburg Virus Disease – Fact Sheet
  3. World Health Organization. Marburg Virus Disease
  4. Centers for Disease Control and Prevention. About Marburg
  5. Centers for Disease Control and Prevention. Clinical Overview of Marburg Virus Disease
  6. World Health Organization. Marburg Virus Disease – Ethiopia, January 2026