Introduction

Picture in your mind a deadly virus circulating silently in some remote village, jumping from animals to humans and killing people just days after infection and falling seriously ill. That is the reality of the marburg virus, a disease with similar characteristics to the ebola virus. There is no vaccine or specific treatment strategy for marburg virus, and it poses a significant threat. 

Because of its rapid transmission after reaching humans, marburg virus disease is a disease that often leads to outbreaks difficult to control in a population. Understanding the mode of transmission of the virus and what can be done to avoid such an outbreak is important and begins the fight to prevent infection from this virus. We shall consider some of the best measures that could be employed to prevent marburg virus infection both at the individual and community levels.

Transmission dynamics

Marburg virus is transmitted mainly from animals to humans and from person to person within a population. The putative natural hosts of this virus are fruit bats, especially the Egyptian fruit bat (Rousettus aegyptiacus).¹ These bats can naturally harbour this virus without being sick from it. People get infected after getting into contact with bats or other animals that have been contaminated, such as monkeys.² This mostly occurs during hunting or when manipulating the wild animal's meat. 

The virus presents with symptoms that include headache, high fever, diarrhoea, a very characteristic rash, serious bleeding tendency, and involvement of the central nervous system.³ It is transmitted from one person to another due to direct contact with body fluids such as blood, saliva, and urine. The virus can also be transmitted due to contact with contaminated surfaces or medical equipment. The first way of preventing the virus involves knowledge of how it spreads and prevention occurs by avoiding body fluids from infected animals and humans.

General preventive measures

The most critical way of preventing infection of the marburg virus is to avoid contact with wildlife. Avoid visiting caves where fruit bats live, especially in areas prone to the virus. Refrain from touching or eating wild animals, bats, and monkeys, especially in regions of Africa where there have been outbreaks of the marburg virus. Another personal protective measure that may reduce the risk of infection include frequent handwashing.⁴ The public is recommended to wash hands with soap and water or use an alcohol-based hand sanitizer, particularly after contacting others. 

In at-risk areas, if dealing with sick individuals or animals directly, wearing protective clothing including gloves, masks, and goggles is essential. Further, keeping a distance from those infected would reduce the chances of getting the virus.⁵ In communities, there are certain practices done, such as safe burials. Some cultures involve touching or washing a dead person's body due to the type of burial they do. This increases the chances of transmission because shortly after death, the virus might still be active inside the body. Infection in families and communities can be avoided by the use of proper protective equipment and following safe burial practices.^6,7

Healthcare-related preventive measures

This principally relates to hospitals and clinics during the outbreaks. Control and care are essential in the prevention of marburg virus transmission. It is deemed significant in healthcare to follow infection control practices. In treating the infected patients, healthcare workers should make use of isolation units to keep them away from other patients.⁸ There should be proper use of personal protective equipments such as gloves, gowns, masks, and face shields. Wearing protective gear creates a barrier that can prevent the virus from reaching the skin or clothes. 

Training the healthcare workers is also one of the preventive measures. The workers should be aware of the symptoms of marburg virus disease, so that they can identify such symptoms in patients without wasting any time in isolating them for treatment. Medical equipments and surfaces should also be disinfected to prevent the spread of the virus within the healthcare facilities themselves.⁹ Contaminations can be avoided by proper disposal of used medical items like syringes and gloves. 

Finally, surveillance and contact tracing restricts virus spread.¹⁰ Once a person has been diagnosed with the marburg virus, health authorities should trace anyone who comes into close contact with an infected person. These contacts will have to be kept under observation, for the development of symptoms and admission into quarantine if required. Quick identification of the infected person and their contacts can prevent the virus from spreading further.

Public health interventions

Public health campaigns are among the most powerful tools in the fight against marburg virus. Awareness campaigns may be staged to educate people on how the virus spreads and what people can do to protect themselves. Health authorities in high-risk areas should focus on teaching communities about the dangers of handling wildlife, hygiene, and the use of protective clothes when attending to the sick.¹¹ 

Travel advisories and border control can also minimise the spread of  marburg virus across regions or countries. Symptoms of the virus, along with recent exposure, can be checked at airports and border crossings. Quarantine measures are instituted on persons who have a possible contact with the virus. Quarantine zones may be imposed in the affected area in the case of outbreaks, as a means of containing viruses.¹² These zones restrict movements and reduce contact between infected and healthy people. 

Outbreak response teams, which include the local health authorities and their international counterparts like the World Health Organization, can work in tandem to contain viruses by establishing treatment centres and sending much-needed medical supplies.

Investigational and emerging prevention strategies

One of the biggest problems with marburg virus infection is that there is no vaccine or specific treatment, but research is underway, and hopefully, new preventive tools will be developed in the near future.¹³ The development of vaccines is a top priority for scientists and researchers. A VSV-based vaccine that has shown certain success against similar viruses such as ebola would be one good candidate.¹⁴ 

Presently, clinical trials are in the process of testing this VSV-based vaccine against marburg virus to test its safety and efficacy. Along with vaccines, scientists work on post-exposure treatments like antibodies and antiviral drugs, that can prevent further advancement of the virus in people who have gotten exposed but are not showing any symptoms.¹⁵ As scientists learn more about the marburg virus, they are investigating new ways to stop it. More research and international cooperation should be done to enhance the rate of prevention.

Ethical and socio-economic considerations

Marburg virus prevention involves not only medical interventions, but also a host of ethical and socio-economic challenges. Quarantine measures or movement restrictions in general, may be necessary government actions in outbreaks of the virus. Such a measure, while it saves lives, is again bound to raise ethical issues relating to personal freedom and the right to move freely.¹⁶ 

Policymakers have to strike a balance between public safety and individual rights. The socio-economic consequences of marburg virus outbreaks are significant. Quite often, communities in areas where the outbreak of the marburg virus happens, face economic hardship when trade, travel, and tourism come to a stop.¹⁷ These economies suffer at a local level, and health systems can be overwhelmed. International aid and support are more often than not required to help such communities get their way back after an outbreak.

Conclusion

Individual, health care, and public health measures all combine in an attempt to help prevent the spread of marburg virus. This would involve contact with wildlife, good hygiene practices, use of protective equipment, and proper infection control within a healthcare environment. Some public health interventions, awareness campaigns, and quarantine measures can play a critical role in halting outbreaks before further dissemination occurs. 

There is still no vaccine, but ongoing research holds the promise of future prevention tools. Prevention of a marburg virus infection requires collective responsibility from the communities, healthcare providers, and governments. With the right measures in place, we can protect ourselves and others from this deadly virus.