The first case of Marburg virus has been confirmed in West Africa after a man died of the haemorrhagic fever disease in Guinea.

This is the first time Marburg, a highly infectious disease that causes haemorrhagic fever, has been identified in the country, and in West Africa.

The virus, which belongs to the same family as Ebola, spreads from human to human through bodily fluids and can have a fatality rate of up to 88%.

Symptoms include a high fever and muscle pain, but some patients later suffer bleeding from their eyes and ears.

After the male patient sought treatment and died in Gueckedou, the case was confirmed by a laboratory in Guinea and again by the Institute Pasteur in nearby Senegal.

Contact tracing is under way, according to the World Health Organization (W.H.O).

The patient had sought treatment at a local clinic in Koundou area of Gueckedou, where a medical investigation team had been dispatched to probe his worsening symptoms.

“We applaud the alertness and the quick investigative action by Guinea’s health workers. The potential for the Marburg virus to spread far and wide means we need to stop it in its tracks,” said Dr. Matshidiso Moeti, World Health Organisation Regional Director for Africa.

“We are working with the health authorities to implement a swift response that builds on Guinea’s past experience and expertise in managing Ebola, which is transmitted in a similar way,” Moeti said.

Gueckedou, where Marburg has been confirmed, is also the same region where cases of the 2021 Ebola outbreak in Guinea as well as the 2014–2016 West Africa outbreak were initially detected.

The WHO in a press statement says efforts are underway to find the people who may have been in contact with the patient.

“As the disease is appearing for the first time in the country, health authorities are launching public education and community mobilisation to raise awareness and galvanise support to help curb widespread infection.

“An initial team of 10 WHO experts, including epidemiologists and socio-anthropologists is on the ground helping to investigate the case and supporting the national health authorities to swiftly step up emergency response, including risk assessment, disease surveillance, community mobilisation, testing, clinical care, infection prevention as well as logistical support.

“Cross-border surveillance is also being enhanced to quickly detect any cases, with neighbouring countries on alert. The Ebola control systems in place in Guinea and in neighbouring countries are proving crucial to the emergency response to the Marburg virus,” the statement read in part.

Marburg is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials.

Illness begins abruptly, with high fever, severe headache and malaise. Many patients develop severe haemorrhagic signs within seven days. Case fatality rates have varied from 24 percent to 88 percent in past outbreaks depending on virus strain and case management.

“Although there are no vaccines or antiviral treatments approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improves survival. A range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated.

“In Africa, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda,” WHO said.

The National Agency for the Control of Aids (NACA), says a new research “Estimating Modes of HIV Transmission in Nigeria”, has identified never married adults and key population as increasing HIV rates in Nigeria.

The Director General of the agency, Dr. Gambo Aliyu, disclosed the statistics in Abuja.

He said that the research gives estimates of where new HIV infections are occurring and can aid prevention planning and focus efforts where they will be most effective.

“The largest number of new infections in the adult population is estimated to occur among Never Married Females and Never Married Males. The next largest number of new infections occurs among Female Sex Workers and Men who have Sex with Men. These four population groups account for about 91% of all new infections among adults. Key populations (FSW, MSM, PWID) are estimated to account for about 11% of new infections although they represent less than 2% of the total population. New child infections due to mother-to-child transmission represent the second largest source new infection accounting for 22% of all new infections. In many states new child infections account for an even larger proportion, up to 50%,” Dr Aliyu said.

He said that the distribution of new infections varies by state.

“However, a large proportion of new infections generally occur among never married individuals or in Sero-concordant negative couples. Overall, young people and Female Sex Workers appear to be playing an important role in the dynamics of the incidence.

“A study of formation and dissolution of partnerships among these groups may help understanding this dynamic. Mother to-child transmission represents a large source of new infections nationally and is the largest source in several states. Most of those women who do attend ANC get tested for HIV but over 60% of pregnant women do not attend ANC. Increasing ANC attendance would have benefits not only for reducing HIV transmission,” He said.

According to Dr. Aliyu, the National Agency for the Control of AIDS (NACA), in collaboration with development partners, has been working tirelessly in coming up with strategies to halt the spread of the HIV virus and sustain the epidemic.

“To this end, the Mode of Transmission Study (MOT), which focuses on identifying the sources of new HIV infections in the country and was first conducted in 2009, was recently repeated using an updated model known as the Incidence Pattern Model. This was done to support efforts geared towards preventing new HIV infections using information that was accurate and clearly show where new infections are occurring and among which population group“. He noted.

The Director General also said that it was noteworthy to state that data from the 2018 Nigeria AIDS Indicator Impact Survey (NAIIS) supplied most of the information on population size and characteristics used for the study. The Key population (KP) size, prevalence rate for Key Populations and the number of new infections by State spread were estimated from the recent KP study.

Findings

The study found that the largest number of new infections in the adult population is occurring among Never Married Females and Never Married Males (i.e. Young people). The next largest number of new infections occurs among Female Sex Workers and Men who have Sex with Men. These four population groups account for about 91% of all new infections among adults.

Key populations which represent less than 2% of the total population account for about 11% of new infections. Child infections due to mother-to-child transmission represent the second- largest source of new infection accounting for 22% of all new infections. In many states, child infections account for an even larger proportion, up to 50%.

He noted that though Nigeria is working hard to close these gaps, the findings of the study will further help NACA and partners redirect resources for maximum yields as they look forward to attaining epidemic control with more targeted interventions.

Policy implications

“The policy implications are that efforts will be made to target the following population groups:

The never married population which is the largest source of new infections and are mostly between the ages of 17 to 34 for females and 19-31 for men. Special efforts are needed to be made to reach this population in schools, workplaces, gathering spots and through social media.

The new infections through newborns due to low coverage of PMTCT. Efforts will be targeted at encouraging women to attend ANC especially in high prevalence states.

Increased efforts especially for the highest risk FSW and MSM which has shown that even though the population is small, prevalence remains high among sex workers and MSM in spite of high levels of reported condom use.

The survey also announced a decrease of HIV prevalence amongst married couples in Nigeria while noting that Mother to Child Transmission stands at 22%.