🟡 WHO SURVEILLANCE — No active PHEIC in 2026

Marburg Virus Disease

Clinical guide — patients & healthcare workers
Viral hemorrhagic fever · Filoviridae family (Ebola relative)

24–88%
case fatality rate (varies by outbreak)
2–21d
incubation period
0
approved vaccines
MNR
mandatory notifiable disease
⚠️ Public health information — Not a medical device. This page is an information tool based on official WHO, CDC and ECDC data. It does not replace medical consultation. If in doubt, call your local emergency number.
🚨 If you think you may have been exposed to Marburg virus
Call immediately
Emergency services
DO NOT go to the ER without calling first
  • 1 Stay home — do NOT go to the emergency room without calling first
  • 2 Call emergency services and mention your travel (sub-Saharan Africa, caves, mines)
  • 3 Isolate in a separate room, avoid all physical contact
  • 4 Follow the instructions of the medical dispatcher

🌡️ When should I be concerned?

Marburg spreads through direct contact with blood or body fluids of an infected person, or through contact with Egyptian fruit bats (Rousettus aegyptiacus) in caves and mines. It does NOT spread through the air.

⚠️ Call emergency services if you have BOTH of these:
  • Fever ≥ 38°C (100.4°F) within 21 days of travel in sub-Saharan Africa (especially cave visits), or contact with a Marburg case
  • + any of these: unexplained bleeding, severe vomiting, severe diarrhea, skin rash, intense muscle pain
🦇 Marburg-specific risk factors:
  • Visiting caves or mines with fruit bats (Africa, equatorial regions)
  • Direct contact with a confirmed Marburg case (healthcare worker, family member)
  • Handling bats or non-human primates
  • Laboratory worker handling potentially infected specimens
✅ Marburg does NOT spread through:
  • Air or breathing
  • Coughing or sneezing
  • Water or food (in Europe)
  • Mosquitoes or insects
  • Contact with asymptomatic people
  • Public transportation

📅 Day-by-day disease progression

Incubation: 2 to 21 days (median: 5–9 days)

Prodromal phase — severe flu-like illness

  • Sudden fever ≥ 38.5°C, chills
  • Severe headache
  • Myalgias and arthralgias
  • Severe fatigue, general malaise

⚠️ Patient is contagious as soon as symptoms appear. Difficult to distinguish from malaria or influenza without epidemiological context.

GI phase and skin rash

  • Nausea, vomiting, watery diarrhea
  • Abdominal and chest pain
  • Non-pruritic maculopapular rash (trunk, back)
  • Conjunctivitis (red eyes)

The skin rash is characteristic and points toward a viral hemorrhagic fever. Risk of severe dehydration.

Hemorrhagic phase (severe cases)

  • Bleeding from gums, nose, ears
  • Hematemesis (bloody vomit)
  • Melena (bloody stools)
  • Multi-organ failure (liver, kidney, CNS)
  • Confusion, extreme agitation (neurological involvement)

Neurological signs — confusion and agitation — are more prominent in Marburg than Ebola. All body fluids are highly infectious.

Recovery or death

  • Death: average D8–D9 in fatal cases (hemorrhagic shock or sepsis)
  • Survivors: prolonged fatigue, arthralgias, orchitis in males
  • Sequelae: uveitis, residual hepatitis, post-viral psychosis
  • Recovery confirmed by 2 negative PCR tests 48h apart

Note: virus may persist in semen after recovery. Serological follow-up recommended for 3 months.

❓ Frequently asked questions

Both viruses belong to the same family (Filoviridae) and cause nearly identical clinical presentations. Key differences: Marburg is a single genus (Marburgvirus) with two variants (Marburg and Ravn), while Ebola has 5 distinct species. Clinically, Marburg causes more prominent early neurological symptoms. Neither has an approved vaccine for general use.
No approved vaccine as of 2026. Phase 1–2 trials are underway (saRNA vaccine, MVA-based, rVSV). During the 2024 Rwanda outbreak, an experimental vaccine was administered on a compassionate basis. Research is advancing but no product is available to the general public.
The risk is very low but real. Tourist visits to caves housing fruit bats in Africa are a recognized risk factor. If you develop fever within 21 days of the visit, inform the doctor of this exposure. Without symptoms after 21 days, you are not at risk.

📊 Major outbreaks (1967–2026)

YearCountryCasesDeathsCFR
1967Germany / Yugoslavia31723%
1998–2000DR Congo15412883%
2005Angola25222790%
2007Uganda4375%
2012Uganda15427%
2023Equatorial Guinea171271%
2023Tanzania9667%
2024Rwanda661523%
2026No active outbreak———

Sources: WHO Disease Outbreak News · CDC Marburg hemorrhagic fever · Data as of June 21, 2026

🔗 Related pages

📚 Official sources

Last updated: June 21, 2026 · By Dr Clément MÉDEAU, MD (La Rochelle, France)