Document Detail

Marburg hemorrhagic fever associated with multiple genetic lineages of virus.
MedLine Citation:
PMID:  16943403     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: An outbreak of Marburg hemorrhagic fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998. METHODS: We investigated the outbreak of Marburg hemorrhagic fever most intensively in May and October 1999. Sporadic cases and short chains of human-to-human transmission continued to occur until September 2000. Suspected cases were identified on the basis of a case definition; cases were confirmed by the detection of virus antigen and nucleic acid in blood, cell culture, antibody responses, and immunohistochemical analysis. RESULTS: A total of 154 cases (48 laboratory-confirmed and 106 suspected) were identified (case fatality rate, 83 percent); 52 percent of cases were in young male miners. Only 27 percent of these men reported having had contact with other affected persons, whereas 67 percent of patients who were not miners reported such contact (P<0.001). Most of the affected miners (94 percent) worked in an underground mine. Cessation of the outbreak coincided with flooding of the mine. Epidemiologic evidence of multiple introductions of infection into the population was substantiated by the detection of at least nine genetically distinct lineages of virus in circulation during the outbreak. CONCLUSIONS: Marburg hemorrhagic fever can have a very high case fatality rate. Since multiple genetic variants of virus were identified, ongoing introduction of virus into the population helped perpetuate this outbreak. The findings imply that reservoir hosts of Marburg virus inhabit caves, mines, or similar habitats.
Daniel G Bausch; Stuart T Nichol; Jean Jacques Muyembe-Tamfum; Matthias Borchert; Pierre E Rollin; Hilde Sleurs; Patricia Campbell; Florimund K Tshioko; Catherine Roth; Robert Colebunders; Patricia Pirard; Simon Mardel; Loku A Olinda; Hervé Zeller; Antoine Tshomba; Amayo Kulidri; Modeste L Libande; Sabue Mulangu; Pierre Formenty; Thomas Grein; Herwig Leirs; Leo Braack; Tom Ksiazek; Sherif Zaki; Michael D Bowen; Sheilagh B Smit; Patricia A Leman; Felicity J Burt; Alan Kemp; Robert Swanepoel;
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  355     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-31     Completed Date:  2006-09-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  909-19     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2006 Massachusetts Medical Society.
Centers for Disease Control and Prevention, Atlanta, USA.
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MeSH Terms
Child, Preschool
Democratic Republic of the Congo / epidemiology
Disease Outbreaks*
Disease Reservoirs
Infant, Newborn
Marburg Virus Disease / epidemiology*,  mortality,  transmission,  virology
Marburgvirus / genetics*,  isolation & purification
Middle Aged
Sequence Analysis, DNA
Reg. No./Substance:
Comment In:
N Engl J Med. 2006 Aug 31;355(9):866-9   [PMID:  16943398 ]

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