Marburg hemorrhagic fever associated with multiple genetic lineages of virus

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 GreinHerwig Leirs, Leo Braack, Thomas Ksiazek, Sherif Zaki, Michael D. Bowen, Sheilagh B. Smit, Patricia A. Leman, Felicity J. Burt, Alan Kemp, Robert Swanepoel

Research output: Contribution to journalArticle

156 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)909-919
Number of pages11
JournalNew England Journal of Medicine
Volume355
Issue number9
DOIs
StatePublished - Aug 31 2006
Externally publishedYes

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Marburg Virus Disease
Disease Outbreaks
Viruses
Marburgvirus
Democratic Republic of the Congo
Mortality
Gold
Nucleic Acids
Population
Antibody Formation
Ecosystem
Blood Cells
Cell Culture Techniques
Antigens
Infection
Miners

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Bausch, D. G., Nichol, S. T., Muyembe-Tamfum, J. J., Borchert, M., Rollin, P. E., Sleurs, H., ... Swanepoel, R. (2006). Marburg hemorrhagic fever associated with multiple genetic lineages of virus. New England Journal of Medicine, 355(9), 909-919. https://doi.org/10.1056/NEJMoa051465

Marburg hemorrhagic fever associated with multiple genetic lineages of virus. / Bausch, Daniel G.; Nichol, Stuart T.; Muyembe-Tamfum, Jean Jacques; Borchert, Matthias; Rollin, Pierre E.; Sleurs, Hilde; Campbell, Patricia; Tshioko, Florimund K.; Roth, Catherine; Colebunders, Robert; Pirard, Patricia; Mardel, Simon; Olinda, Loku A.; Zeller, Hervé; Tshomba, Antoine; Kulidri, Amayo; Libande, Modeste L.; Mulangu, Sabue; Formenty, Pierre; Grein, Thomas; Leirs, Herwig; Braack, Leo; Ksiazek, Thomas; Zaki, Sherif; Bowen, Michael D.; Smit, Sheilagh B.; Leman, Patricia A.; Burt, Felicity J.; Kemp, Alan; Swanepoel, Robert.

In: New England Journal of Medicine, Vol. 355, No. 9, 31.08.2006, p. 909-919.

Research output: Contribution to journalArticle

Bausch, DG, Nichol, ST, Muyembe-Tamfum, JJ, Borchert, M, Rollin, PE, Sleurs, H, Campbell, P, Tshioko, FK, Roth, C, Colebunders, R, Pirard, P, Mardel, S, Olinda, LA, Zeller, H, Tshomba, A, Kulidri, A, Libande, ML, Mulangu, S, Formenty, P, Grein, T, Leirs, H, Braack, L, Ksiazek, T, Zaki, S, Bowen, MD, Smit, SB, Leman, PA, Burt, FJ, Kemp, A & Swanepoel, R 2006, 'Marburg hemorrhagic fever associated with multiple genetic lineages of virus', New England Journal of Medicine, vol. 355, no. 9, pp. 909-919. https://doi.org/10.1056/NEJMoa051465
Bausch DG, Nichol ST, Muyembe-Tamfum JJ, Borchert M, Rollin PE, Sleurs H et al. Marburg hemorrhagic fever associated with multiple genetic lineages of virus. New England Journal of Medicine. 2006 Aug 31;355(9):909-919. https://doi.org/10.1056/NEJMoa051465
Bausch, Daniel G. ; Nichol, Stuart T. ; Muyembe-Tamfum, Jean Jacques ; Borchert, Matthias ; Rollin, Pierre E. ; Sleurs, Hilde ; Campbell, Patricia ; Tshioko, Florimund K. ; Roth, Catherine ; Colebunders, Robert ; Pirard, Patricia ; Mardel, Simon ; Olinda, Loku A. ; Zeller, Hervé ; Tshomba, Antoine ; Kulidri, Amayo ; Libande, Modeste L. ; Mulangu, Sabue ; Formenty, Pierre ; Grein, Thomas ; Leirs, Herwig ; Braack, Leo ; Ksiazek, Thomas ; Zaki, Sherif ; Bowen, Michael D. ; Smit, Sheilagh B. ; Leman, Patricia A. ; Burt, Felicity J. ; Kemp, Alan ; Swanepoel, Robert. / Marburg hemorrhagic fever associated with multiple genetic lineages of virus. In: New England Journal of Medicine. 2006 ; Vol. 355, No. 9. pp. 909-919.
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abstract = "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.",
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T1 - Marburg hemorrhagic fever associated with multiple genetic lineages of virus

AU - Bausch, Daniel G.

AU - Nichol, Stuart T.

AU - Muyembe-Tamfum, Jean Jacques

AU - Borchert, Matthias

AU - Rollin, Pierre E.

AU - Sleurs, Hilde

AU - Campbell, Patricia

AU - Tshioko, Florimund K.

AU - Roth, Catherine

AU - Colebunders, Robert

AU - Pirard, Patricia

AU - Mardel, Simon

AU - Olinda, Loku A.

AU - Zeller, Hervé

AU - Tshomba, Antoine

AU - Kulidri, Amayo

AU - Libande, Modeste L.

AU - Mulangu, Sabue

AU - Formenty, Pierre

AU - Grein, Thomas

AU - Leirs, Herwig

AU - Braack, Leo

AU - Ksiazek, Thomas

AU - Zaki, Sherif

AU - Bowen, Michael D.

AU - Smit, Sheilagh B.

AU - Leman, Patricia A.

AU - Burt, Felicity J.

AU - Kemp, Alan

AU - Swanepoel, Robert

PY - 2006/8/31

Y1 - 2006/8/31

N2 - 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.

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