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Marburg virus disease: information sheet for category 5 contacts

You have been given this information sheet because you have had very close or direct contact with someone with Marburg virus disease. You should stay at home and away from other people for 21 days after your last exposure to Marburg virus and regularly check yourself for symptoms of Marburg virus disease. 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:聽

• 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 virus 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 cases, depending on the virus strain, the person鈥檚 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 Marburg virus spreading between people, those caring for individuals with possible or suspected Marburg virus disease should avoid contact with the patient鈥檚 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鈥檚 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:

• you are a household or overnight contact of a confirmed symptomatic case

or

• you have had significant exposure to material from a confirmed case, for example a needlestick injury or body fluids from a case of Marburg virus disease splashed on your mucous membranes

Because of your level of exposure, you are at risk of developing Marburg virus disease. We would therefore like to closely monitor you for a period of 21 days from when you were last exposed to Marburg virus. You should also carry out the actions listed below to minimise the risk to you and others close to you.

What you need to do

Because you are at risk of developing Marburg virus disease, you should take the following actions for the 21 days from when you were last exposed to Marburg virus:

• self-isolate in private accommodation (unless an alternative arrangement has been agreed with UKHSA). See the information below on how to self-isolate
• 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 details) by 12 noon each day. They will want to know whether your temperature is below, equal to, or above 37.5掳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

How to self-isolate

You should self-isolate for 21 days from when you were last exposed to Marburg virus. This means you should stay at home and not go to work, school or public areas. You should not travel, either within the UK or internationally.

You should self-isolate in a separate room from other members of your household, and avoid all contact with them, including sexual contact. You should sleep in a separate room to other people and use separate bathroom facilities for going to the toilet and for washing.

You should only leave your home if it is essential, for example in an emergency, for an urgent medical appointment, or for urgent health and wellbeing issues. You should also not have visitors to your home.聽

If you need help with groceries or other essentials, ask friends or family to drop your shopping off, or order online. Ask your friends, family or delivery drivers to leave your shopping at your front door to avoid contact with them.

Do not share items which you use, such as bedding, towels, wash cloths, toothbrushes, or razors. You should also use separate items for eating and drinking, such as cutlery, cups, or plates, to other people in your household.

Postpone any non-essential medical or dental treatment. You should discuss any essential treatment required with your designated contact before attending a healthcare facility.

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 37.5潞C or higher, you must call your contact immediately.

A temperature of 37.5潞C 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掳C or higher) , please remain 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. If there is any delay in making contact, phone 111 reporting your recent contact with someone with Marburg virus disease. 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:

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