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Disease Information for African hemorrhagic (Marburg) virus disease: Definition
- Clinical Manifestations (73)
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An RNA virus infection of rhesus, vervet, and squirrel monkeys transmissible to man; major hemorrhagic and hepatitis; minor encephalitis and absent renal involvement;incubation is 3-9 days;------------------------------------- FILOVIRAL HEMORRHAGIC FEVERS The hemorrhagic fevers associated with Marburg and Ebola viruses are among the deadliest: case fatality rates average 26% among those with Marburg disease and 53 to 88% in outbreaks of Ebola hemorrhagic fever; Four subtypes of Ebola virus (Reston, Sudan, Zaire, and Cote d"Ivoire) may be differentiated by their associated virulence in animals and pathogenicity in humans; Little is known about the natural reservoir of these viruses, and disease spread is a function of relentless, often nosocomial, chains of person-to-person transmission; Infection manifests with an abrupt onset of prostrating fever, headache, and myalgia; Patients frequently appear restless and anxious, and they later become apathetic and exhibit other encephalopathic signs; After 3 to 8 days, a morbilliform, usually confluent, nonpruritic rash starts on the upper trunk and spreads centrifugally to involve the entire body except the face and neck; Profuse vomiting and watery diarrhea commence, accompanied by intense abdominal pain; Chest pain is a variable feature that was often noted in the Ebola-Sudan outbreak in 1976, but not in other Marburg and Ebola-Zaire outbreaks; Bleeding, chiefly from the gastrointestinal tract in the form of melena and hematemesis, but also from the vagina and gums, occurs in about 50% of patients; Multisystem failure from pneumonitis, hepatitis, pancreatitis, and tubulointerstitial nephritis combined with intractable hypotension usually leads to death; Recovery can occur within 7 to 10 days, but convalescence is prolonged-----------[Rudolph"s Pediatrics 2002]----------------
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