Marburg Virus Disease (MVD): a rapid systematic review with narrative synthesis of epidemiology, clinical presentation, diagnostics, management, and public-health response
摘要
Marburg virus (MARV) is responsible for a severe viral hemorrhagic fever characterized by high case-fatality rates and epidemic potential. Recent outbreaks from 2021 to 2025 across various African nations have brought renewed global focus. We conducted a focused search across PubMed/PMC, WHO, CDC, NEJM, Lancet, Frontiers, and key public health sources up to 20 Nov 2025, using consistent search terms. We compiled evidence related to epidemiology, clinical features, diagnostics, management, prevention, and identified knowledge gaps. Priority was given to primary outbreak reports, systematic reviews, and WHO guidance. MARV reservoirs are Egyptian fruit bats; human infections result from zoonotic spillover and subsequent human-to-human transmission, particularly via direct contact with bodily fluids and funeral practices. Case-fatality rates vary widely (roughly 24–88% historically), and average estimates are near 50% when aggregated across outbreaks. Clinical presentation ranges from abrupt febrile illness with gastrointestinal symptoms to coagulopathy, multi-organ failure, and hemorrhage. RT-PCR and antigen detection are the mainstays of early diagnosis; supportive care is the primary treatment. No licensed vaccine or antiviral existed as of November 2025, but several candidates and monoclonal antibody therapies are in development and clinical testing. Outbreak control relies on rapid surveillance, contact tracing, infection prevention and control (IPC) in healthcare settings, safe burial practices, and community engagement. Marburg virus remains a high-consequence pathogen with substantial morbidity and mortality. Recent outbreaks have reinforced the need for rapid diagnostics, robust IPC in health facilities, accelerated clinical trials for therapeutics and vaccines, and improved ecological surveillance of bat populations and human exposures. Strengthening outbreak readiness and integrating MVD preparedness into routine public-health systems in at-risk countries should be a global priority.