Two individuals in Germany who were transported from Hamburg Central Station to the University Medical Center Hamburg-Eppendorf (UKE) on Wednesday for precautionary examinations have tested negative for the Marburg virus, a deadly infectious disease.
The pair had been transferred to a special unit for highly contagious diseases at UKE after one of them had returned from Rwanda, where he had contact with a Marburg patient while working at a hospital.
Officials confirmed that the medical student, who had been in Rwanda as part of their studies, showed no symptoms of the Marburg virus and tested negative through a PCR test. The student had come into contact with a patient infected with the virus on September 25, but was properly equipped with protective gear during interactions.
The second person who traveled with the student also tested negative for Marburg, but is experiencing mild symptoms of an unrelated illness.
"There was never any danger to fellow passengers on the train or plane," authorities confirmed in a statement.
But while this event turned out to be a false alarm, international health agencies are on high alert as an outbreak in Rwanda continues to develop. Here's everything you need to know about the virus.
What Is the Marburg Virus?
The Marburg virus, while rare, is known to cause severe hemorrhagic fever and has a high mortality rate of up to 88 percent.
It is typically spread to humans from fruit bats, but can spread between people through direct contact with bodily fluids of an infected individual or through contaminated equipment and materials exposed to infectious blood or tissues.
Rwanda is currently in the throes of an outbreak of the virus, which has claimed the lives of 10 people so far.
Previous outbreaks have occurred across sub-Saharan Africa; however, the first cases were recorded in Germany and Serbia (then called Yugoslavia) in 1967 when laboratory workers handling African green monkeys imported from Uganda contracted the disease. That outbreak led to 31 cases and a total of 7 deaths.
The largest outbreak on record occurred in 2005 in Angola, where 329 people died.
Where Did This Outbreak Originate?
While the exact origins of this outbreak are unclear, past incidents offer experts some ideas.
Paul Hunter, a professor in medicine at Norwich Medical School at the University of East Anglia in the U.K., speculated that initial human-to-human transmission in Rwanda may have occurred at the funeral of a person who was initially infected by a fruit bat.
"Funeral practices in some cultures entail close physical contact with the newly deceased person as that person is prepared for burial. Time will tell whether my guess was correct or not," Hunter said in a statement to the Science Media Centre on Monday.
What Are the Symptoms?
Marburg virus belongs to the same family of viruses as Ebola, the virus responsible for a deadly outbreak in West Africa in 2014-2016. Both cause hemorrhagic fevers, with symptoms including high fever, severe headaches, muscle pains, diarrhea, abdominal pain, nausea and vomiting, according to the World Health Organization.
Patients may also appear "ghostlike," with drawn features, deep-set eyes, expressionless faces and extreme lethargy.
In fatal cases, death usually occurs between eight and nine days after the onset of symptoms and is usually preceded by severe blood loss and shock.
Are There Any Vaccines or Treatments?
Currently, there are no vaccines for Marburg Virus Disease, but some are in development. One promising candidate, developed by the Sabin Vaccine Institute in Washington D.C., is currently in the second phase clinical trials.
During the first trial, which involved 40 participants in the U.S., the vaccine was found to be safe and generated an immune response.
Treatments for the illness are lacking too. Early supportive care, including rehydration and managing symptoms, can improve survival chances, according to the Africa Centers for Disease Control and Prevention.
While no licensed treatment has been proven to neutralize the virus, various blood-based, immunologic, and drug therapies are currently under development.
Preventive measures against infection are also not well established, as transmission from wildlife to humans is still being researched.
However, avoiding contact with fruit bats and sick non-human primates in Central Africa can help reduce the risk. To prevent secondary transmission, or spread between humans, precautions similar to those used for other hemorrhagic fevers should be followed.
In cases where Marburg hemorrhagic fever is suspected or confirmed, barrier nursing techniques and isolation are employed to prevent physical contact with the patient.
Should We Be Worried?
No cases of Marburg have been detected in the U.S. so far, and the risk of infection in the country is low, according to the Centers for Disease Control and Prevention (CDC).
A Level 2 warning is in place by the CDC, meaning travelers to Rwanda should practice enhanced precautions. These include avoiding contact with sick people, avoiding healthcare facilities in the outbreak area for nonurgent medical care, avoiding contact with dead bodies and avoiding fruit bats.
The CDC is also advising travelers to keep a close eye on their health for symptoms of Marburg for 21 days after leaving an outbreak area.
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