Marburg virus disease outbreak and response in South Ethiopia Region.

Abstract

Background: Marburg Virus Disease (MVD) is a highly virulent zoonotic infection associated with high case fatality rates and multi-organ dysfunction. Early recognition, timely supportive care, and appropriate clinical management are important in improving outcomes. We describe the clinical presentation, laboratory features, management strategies, and outcomes of five confirmed MVD survivors.

Case presentation: We present a case series of five patients with laboratory-confirmed MVD who recovered following treatment at Jinka General Hospital/MVD Treatment Center between November and December 2025. The cohort included four females and one male (median age: 18 years). All patients presented with fever, headache, and gastrointestinal (GI) symptoms, with three exhibiting hemorrhagic manifestations. Key laboratory findings included leukopenia (White Blood Cell (WBC) nadir 1.55 × 10³/µL), thrombocytopenia (platelet nadir 65 × 10³/µL), and elevated transaminases (Aspartate Aminotransferase (AST) peak 1,153 U/L). One patient developed severe neutropenia (Absolute Neutrophil Count (ANC) 107 cells/µL).

Management and outcome: All patients received remdesivir (in varying regimens) and supportive care. Viral clearance was confirmed by two consecutive negative Reverse Transcription Polymerase Chain Reaction (RT-PCR) tests within 48 h, achieved between days 6 and 12. All five patients (100%) achieved complete clinical recovery and were discharged.

Conclusion: This case series demonstrates that recovery from confirmed MVD is achievable with early diagnosis, comprehensive supportive care, and antiviral therapy, even in the presence of severe gastrointestinal hemorrhage. Dynamic monitoring of liver enzymes and viral clearance is essential. These findings underscore the potential for favorable outcomes with early diagnosis and antiviral treatment even in resource-limited settings.