Marburg: category 4 contact information
Advice for people who have come into direct contact with someone who has the Marburg virus disease.
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Marburg virus disease: information sheet for category 4 contacts
You have been given this information sheet because you have had direct contact with someone with Marburg virus disease, or material contaminated with Marburg virus. You should follow the advice in this information sheet and check yourself for symptoms for 21 days after you had possible contact with Marburg virus. If you develop symptoms of Marburg virus disease within 21 days of your last exposure to Marburg virus, you should stay at home and call your designated contact immediately.
About Marburg virus disease
Marburg virus disease is a rare but serious disease caused by Marburg virus. Outbreaks and sporadic cases have previously been reported in Angola, the Democratic Republic of the Congo, Equatorial Guinea, Kenya, Ghana, Guinea, Uganda, South Africa, Rwanda and Tanzania.
How Marburg virus spreads
Marburg virus can spread by:
- direct contact with the organs, blood, secretions, or other bodily fluids of an infected person (including sexual transmission)
- contact with objects, such as needles or soiled clothing, that have been contaminated with infected secretions
- contact with an infected animal, such as chimpanzees, gorillas or fruit bats, either if they are found ill or dead, or collected as bushmeat
Marburg is not spread through routine, social contact (such as shaking hands or sitting next to someone) with people who do not have symptoms. There is no evidence that Marburg virus can spread through the air.
It takes up to 21 days from when someone is exposed to the virus for symptoms to appear.
Symptoms of Marburg virus disease
The onset of illness is sudden, with:
- high fever
- severe headache
- intense weakness
By about the third day, symptoms include:
- severe watery diarrhoea
- abdominal pain
- abdominal cramping
- nausea
- vomiting
Some patients with severe illness may develop internal and external bleeding.
Marburg virus disease is fatal in between 24% to 88% of all cases, depending on the virus strain, the person’s age, and other factors including whether the person has a weakened immune system. Starting supportive treatment promptly after symptoms begin can improve the likelihood of surviving the disease.
Preventing and treating Marburg virus disease
There is currently no licensed vaccine for Marburg virus. To avoid person-to-person transmission of Marburg virus, those caring for individuals with possible or suspected Marburg virus disease should avoid contact with the patient’s bodily fluids and should wear personal protective equipment (PPE).
Treatment for Marburg virus disease is with supportive care, including balancing fluids and electrolytes, maintaining a person’s oxygen status and blood pressure, and treating any co-infections. Supportive care improves survival, particularly if started early.
Your risk of developing Marburg virus disease
You reported that one or more of the following happened:
- you had direct contact with someone who had Marburg virus disease without appropriate PPE, or there was a breach in your PPE. This includes exposure to their body fluids, such as blood, vomit, faeces or saliva, or kissing and/or sexual contact
- your skin or mucous membranes were exposed to an environment potentially contaminated with the blood or body fluids of someone who had Marburg virus disease, including on clothing or bedding, without wearing appropriate PPE
- you had unprotected sexual contact with someone who previously had Marburg virus disease within 3 months of their illness
- you handled clinical or laboratory specimens from someone who had Marburg virus disease without adequate protection, for example without appropriate PPE or laboratory practices
We would like to monitor you for a period of 21 days from when you were last exposed to Marburg virus. This will mean that we can act quickly in case you do develop symptoms, reducing the risks to you and to others close to you.
What you need to do
Your family and household contacts are not at risk of catching Marburg virus from you while you do not have any symptoms.
You should take the following actions for the 21 days from when you were last exposed to Marburg virus:
- record your temperature and monitor yourself for other symptoms suggestive of Marburg virus disease twice per day at the same times each day
- report these temperatures to your designated contact (see below for contact details) by 12 noon each day. They will want to know whether your temperature is below, equal to, or above 37.5°C, and will arrange further evaluation as necessary. They will explain the local arrangements for accessing healthcare
- if you become ill with any of the symptoms listed above in between reporting to your designated contact, you should phone your designated contact immediately. See below for further information on what you should do if you become ill
- if you are a healthcare worker, you should not have any contact with patients for 21 days. You may need to speak to your line manager about options for redeployment to non-patient facing roles during this period. UKHSA will contact your occupational health department before you can return to a patient facing role
- if you have direct contact with other people as part of your work, speak to your manager about possible options to reduce the amount of contact you have with other people for 21 days from when you were last exposed to Marburg virus
In addition, for the 21 days from when you were last exposed to Marburg virus:
- after arriving home, and as long as you do not have any symptoms, you may undertake the following travel:
- any length of trip by private car within the UK
- local travel on local commuter/public transport, principally for work. However, you should avoid having to travel by public transport if possible, and keep any trips you make as short as possible
- you should not travel internationally, or via air within the UK
- avoid situations where it would be impossible for you to self-isolate if you became ill (such as crowded public places)
- do not share towels, bed linen, toothbrushes or razors
- avoid sexual contact with other people
- you should postpone any non-essential medical or dental treatment, including vaccination. If you need essential medical or dental treatment, inform your healthcare provider about your exposure to Marburg virus
If you have a holiday planned
If you have a holiday planned within the 21 days since you were last exposed to Marburg virus, you should not travel abroad.
Use of medicines such as aspirin, paracetamol or ibuprofen
Certain medicines, such as paracetamol, ibuprofen and aspirin, can reduce your body temperature during a fever (antipyretic) for up to 8 hours. Thermometer measurements may therefore show a lower temperature than would be expected for up to 8 hours after taking an antipyretic.
You must call your designated contact for further advice if you need to take an antipyretic medicine.
Please take your temperature before you take paracetamol, ibuprofen or aspirin, and if your temperature is 37.5ºC or higher, you must call your contact immediately.
A temperature of 37.5ºC or higher is always significant, whether you are taking one of these medicines or not, and must be reported urgently.
What to do if you become ill
If you are feeling unwell or develop any of the symptoms of Marburg virus disease (including a temperature of 37.5°C or higher) in the 21 days from when you were last exposed to Marburg virus, please stay at home. Take your temperature if you have not done this already. Phone your designated contact immediately (see below for details), who will arrange for you to be assessed by an appropriate clinician. In an emergency, you should call 999 and tell them about your symptoms and your recent contact with Marburg virus.
You will get your designated contact number from the UK Health Security Agency (UKHSA).
Further information
More information about Marburg can be found on the following websites: