## Green monkeys are to blame The first cases of the disease were recorded in 1967 in the laboratories of Marburg, Frankfurt, and Belgrade. During experiments on green monkeys brought from Africa, laboratory staff contracted a previously unknown disease. Later, outbreaks of the fever were identified in several African countries. > Currently, there is an outbreak of Marburg fever in Rwanda. ## No cure Marburg fever is a contagious viral disease that is often fatal. The average fatality rate is 50% but can be as high as 88%. Once inside a cell, the Marburg virus uses the cell to synthesize its cells. The newly created viruses escape into the intercellular space, enter the bloodstream, and infect other cells in the body. At the same time, large amounts of cytokines–biologically active molecules–enter the bloodstream and cause inflammation in the blood vessels, resulting in multiple hemorrhages throughout the body. There are currently no medications available to treat Marburg fever. ## Lethal outcome after one week The incubation period after infection can last from three days to three weeks. At this point, the person's temperature rises sharply to 102-104 °F, and there is a severe headache, pain in the muscles and joints, pain in the jaw when chewing and swallowing, dry mouth and throat, coughing, and weakness. On the third day, abdominal pain, severe diarrhea, nausea, and vomiting appear. Between days five and seven, red spots appear on the body, blisters and painful ulcers form in the mouth, and multiple instances of bleeding occur. If the body fails to fight the virus, the symptoms listed above typically lead to death at the beginning of the second week of the disease. The person may have a favorable outcome within two to three weeks, but the recovery lasts several months. ## Highly contagious The vectors of the virus are wild animals: bats and green monkeys. It is possible to become infected by an animal or its carcass. Then the virus begins to be transmitted from person to person either sexually, through damaged skin or mucous membranes, or household items used by the sick person. Even after recovery, the person remains contagious for up to three months. Marburg virus is resistant to high temperatures but is destroyed by ultraviolet radiation, ethyl alcohol, and chloroform. ## Good news for those not in Africa The World Health Organization (WHO) estimates that the risk of a Marburg fever outbreak in 2024 is low globally but very high nationally. In other words, an international pandemic is unlikely, but the incidence rate in African countries may increase. ## For the rest of us The likelihood of the disease migrating into the EU is considered very low, provided appropriate public health measures are in place. However, in early October 2024, suspected Marburg fever was reported in Germany, where a medical student arrived from Rwanda after coming into contact with an infected virus. He and his traveling companions felt unwell and were referred for evaluation, but the infection has not been officially confirmed. In the U.S., the risk is also assessed as low, however, the Centers for Disease Control and Prevention will begin screening those admitted to hospitals with characteristic symptoms to rule out the spread of the virus.