What is the ‘bleeding eye’ virus? Explained

The Marburg virus, is also known as the ‘bleeding eye’ virus, because of its most prominent symptom – bleeding in the eyes. It can also cause organ failure and death.  File photograph used for representational purposes only
| Photo Credit: BEN CURTIS

With an update the World Health Organization on November 9 2024 stating that the 42-day countdown to declare the Marburg virus disease (MVD) outbreak over (if there were no news cases), it seems as if Rwanda has seen the end of its recent health crisis. As of November 8, 66 confirmed cases, including 15 deaths with a case fatality ratio of 23% were reported, and 51 persons have recovered. The country has reported no new confirmed cases since October 30, 2024. Meanwhile, the WHO has called for enhanced surveillance, and infection prevention and control (IPC) measures to be maintained until the outbreak is formally declared to be over.

According to the WHO, 17 outbreaks of MVD have previously been reported globally, the earliest recorded in 1967. The most recent previous outbreaks were reported in Equatorial Guinea and the United Republic of Tanzania between February and June 2023. Additional countries that previously reported outbreaks of MVD in the African Region include Angola, the Democratic Republic of the Congo, Ghana, Guinea, Kenya, South Africa, and Uganda.

In this context, let’s understand what the Marburg virus disease is all about.

What is the Marburg virus?

The Marburg virus, is also known as the ‘bleeding eye’ virus, because of its most prominent symptom – bleeding in the eyes. It can also cause organ failure and death.

This is a virus that is transmitted from the fruit bat. Human to human transmission is known to happen via bodily fluids. It is considered to be highly contagious as it can be spread directly through the touching of body fluids or indirectly by fomites (surfaces exposed to body fluids). The incubation period ranges between 2 and 21 days.

What are the signs and symptoms?

To start with, the symptoms are similar to those of other viral infections. First reported symptoms are high fever, malaise and severe body ache. This is followed, usually, by watery diahorrea and abdominal cramps from the third day onwards. Non-itchy rashes can also develop between the second and the seventh day. Usually after the fifth day, the bleeding begins in the eye, defining the virus in popular speak, but also, in the nose, gums and vagina. Confusion or disorientation can happen because of the involvement of the brain. The virus can affect all parts of the body and can result in multiorgan failure.

How is it tested and treated?

Confirmation of the Marburg virus is either by ELISA or by RT-PCR tests.

It is estimated that 50% of the cases are fatal. Fatality occurs, as described above, because of multi-organ failure, blood loss from the bleeding and shock. There is no specific antiviral treatment for this virus; only supportive treatment is provided.

Since it is a very contagious condition, medical personnel and paramedical workers involved in the care of these patients, should be careful in handling them. Adequate protection should be taken; gloves and personal protective equipment (PPE) is recommended, and touching of any body fluids of the infected person is to be avoided.

(Dr. S. Soundari is Regional Medical Director, Dr. Agarwal’s Eye Hospital, Chennai: ssoundari@hotmail.com)