The Marburg virus
Because many of the signs and symptoms of Marburg hemorrhagic fever are similar to those of other infectious diseases, such as malaria or typhoid, diagnosis of the disease can be difficult, especially if only a single case is involved.
The disease is spread through bodily fluids, including blood, excrement, saliva, and vomit. Early symptoms are often non-specific, and usually include fever, headache and myalgia after an incubation period of 3-9 days.. After five days, a macropaular rash is often present on the trunk. Later-stage Marburg infection is acute and can include jaundice, pancreatitis, weight loss, delirium and neuropsychiatric symptoms, hemorrhaging, hypovolemic shock and multi-organ dysfunction with liver failure most common. Accounts of external hemorrhaging from bodily orifices are pervasive in popular references to the disease but are in fact rare. Time course varies but symptoms usually last for one to three weeks until the disease either resolves. The fatality rate is between 23-25%.
If a patient survives, recovery is usually prompt and complete, though it may be prolonged in some cases. These symptoms may include inflammation or secondary infection of various organs, including: orchitis (testicles), hepatitis (liver), transverse myelitis (spinal cord), uveitis (eyes), or parotitis (salivary glands).

Infection
There is no specific antiviral therapy indicated for treatment Marburg, and hospital care is usually supportive in nature. Hypotension and shock may require early administration of vasopressors and haemodynamic monitoring with attention to fluid and electrolyte balance, circulatory volume, and blood pressure. Viral hemorrhagic fever (VHF) patients tend to respond poorly to fluid infusions and may develop pulmonary edema.
Caregivers require barrier infection control measures including double gloves, impermeable gowns, face shields, eye protection, leg and shoe coverings.
A few research groups are working on drugs and vaccines to fight the virus. In 1998, a group at the United States Army Medical Research Institute of Infectious Diseases (USMARIID) published the first peer reviewed article detailing the development of the first experimental Marburg virus vaccine demonstrated to completely protect animals from lethal Marburg virus infection

Treatment and prevention
This virus was first documented in 1967, when 31 people became ill in the German town of Marburg, after which it is named, as well as in Frankfurt am Main and the then Yugoslavian city of Belgrade. The outbreak involved 25 primary infections, with 7 deaths, and 6 secondary cases, with no deaths. The primary infections were in laboratory staff exposed to the Marburg virus while working with monkeys or their tissues. The secondary cases involved two doctors, a nurse, a post-mortem attendant, and the wife of a veterinarian. All secondary cases had direct contact, usually involving blood, with a primary case. Both doctors became infected through accidental skin pricks when drawing blood from patients.
The outbreak was traced to infected African grivets of the species Cercopithecus aethiops taken from Uganda and used in developing polio vaccines. The monkeys were imported by Behringwerke, a Marburg company founded by the first winner of the Nobel Prize in Medicine, Emil von Behring. The company, which at the time was owned by Hoechst, was originally set up to develop sera against tetanus and diphtheria.
In 1975, three people in the South African town of Johannesburg were infected by the Marburg virus by a man returning from Zimbabwe, resulting in one death. Two similar cases in 1980 and 1987 occurred in Kenya after European visitors went to Kitum Cave. Both later died. The next major outbreak occurred in the Democratic Republic of Congo from 1998 to 2000, where 123 of 149 cases were fatal. This outbreak originated with miners in Durba and Watsa in Orientale, Congo.

Early outbreaks
In early 2005, the World Health Organization began investigating an outbreak of a then-undiagnosed hemorrhagic fever in Angola, which was centered around the northeastern Uige Province. The disease may have surfaced as early as March 2004 in a crowded children's ward. A doctor noted that a child, who subsequently died, was displaying signs of hemorrhagic fever. By October, the death rate on the ward went from three to five children a week to three to five a day. On March 22, 2005, as the death toll neared 100, the cause of the illness was identified as the Marburg virus. By July, 2005, Angola's health department reported more than 300 cases were fatal. There were cases in 7 of 18 provinces but the outbreak was mostly confined to Uige province.
According to the World Health Organization, 80% of the deaths in the early stages of the Angola outbreak were children under the age of 15, but that dropped to 30 to 40% in later stages. The virus has also taken a toll on health care workers, including 14 nurses and two doctors.
There has been speculation that the high death rate among children in the early stages of this outbreak may simply be due to the initial appearance of the disease in the children's ward at the Uige hospital. Early death rates (prior to effective monitoring) are meaningless as only the dead are adequately counted.

2004-2005 outbreak in Angola

*This represents the difference between WHO reports of April 1 and April 29..
**This represents the difference between WHO reports of April 29 and May 27. Deaths by month

*No WHO report was issued between the 15th and the 21st. This appears associated with the administrative reclassification of cases.
**Not an entire week. No WHO report for the 13th.
***Over a week.
**** No explanation provided for the decrease in cumulative deaths.
***** Report states that a review of data has led to a downward estimation in total deaths. Deaths by week
Marburg haemorrhagic fever (MHF) has been confirmed in a 29-year-old man in Uganda. The man became symptomatic on 4 July 2007, was admitted to hospital on 7 July and died on 14 July. The disease was confirmed by laboratory diagnosis on 30 July.
The man had had prolonged close contact with a 21-year-old co-worker with a similar illness to whom he had been providing care. The 21-year-old had developed symptoms on 27 June and was hospitalized with a haemorrhagic illness. He then recovered and was discharged on 9 July. Both men were working in a mine in western Uganda.

2007 Uganda cases
Countries with direct airline links, such as Portugal, screened passengers arriving from Angola. The Angolan government asked for international assistance, pointing out that there are only about 1,200 doctors in the entire country, with some provinces having as few as two. Health care workers also complained about a shortage of personal protection equipment such as gloves, gowns and masks. Médecins Sans Frontières (MSF) reported that when their team arrived at the provincial hospital at the center of the outbreak, they found it operating without water and electricity. Contact tracing is complicated by the fact that the country's roads and other infrastructure have been devastated after nearly three decades of civil war and the countryside remains littered with land mines.
One innovation in the Angola outbreak has been the use of a portable laboratory operated by a team of Canadian doctors and technicians. The lab, which can operate on a car battery, has eliminated the need to send blood samples outside the country for testing. This has reduced the turnaround time from days or weeks to about four hours.
Meanwhile, at Americo Boa Vida Hospital in the capital, Luanda, an international team prepared a special isolation ward to handle cases from the countryside. The ward was able to accommodate up to 40 patients, but there was some resistance to medical treatment. Because the disease almost invariably resulted in death, some people came to view hospitals and medical workers with suspicion and there was a brief period when medical teams were attacked in the countryside.

Control efforts
The former Soviet Union reportedly had a large biological weapons program involving Marburg. The development was conducted in Vector Institute under leadership of Dr. Ustinov who accidentally died from the virus. The samples of Marburg taken from Ustinov's organs were more powerful than the original strain. New strain called "Variant U" had been successfully weaponized and approved by Soviet Ministry of Defense in 1990.

Fiction

Ebola
Biohazard, a book by Ken Alibek
The Hot Zone, a book by Richard Preston ISBN 0-517-17158-9
The Coming Plague, a book by Laurie Garrett ISBN 0-374-12646-1
Plagues and Peoples, a book by William McNeill ISBN 0-8446-6492-8
Lassa fever