Preliminary analysis of samples taken from two patients by the country’s Noguchi Memorial Institute for Medical Research indicated the cases were positive for Marburg, and samples have been sent to the Institut Pasteur in Senegal, a World Health Organization (WHO) Collaborating Centre, for confirmation.

The two, unrelated, patients from the southern Ashanti region showed symptoms including diarrhoea, fever, nausea and vomiting. They have both died.

WHO mobilizes health experts

Preparations for a possible outbreak response are being set up swiftly as further investigations are underway, and WHO is deploying experts to support Ghana’s health authorities by bolstering disease surveillance, testing, tracing contacts, preparing to treat patients and working with communities to alert and educate them about the risks and dangers of the disease and to collaborate with the emergency response teams.

“The health authorities are on the ground investigating the situation and preparing for a possible outbreak response”, said Dr Francis Kasolo, World Health Organization (WHO) Representative in Ghana. “We are working closely with the country to ramp up detection, track contacts, be ready to control the spread of the virus”.

If confirmed, the cases in Ghana would mark the second time Marburg has been detected in West Africa. Guinea confirmed a single case in an outbreak that was declared over on 16 September 2021, five weeks after the initial case was detected.

High fatality rates

Previous outbreaks and sporadic cases of Marburg in Africa have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda.

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% to 88% 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.