What to know about the outbreak of ‘bleeding eye’ virus

As COVID-19 and flu season ramp up, another virus is making headlines: the “Bleeding eyes” virus, also known as the Marburg virus. The U.S. State Department is warning Americans against traveling to Rwanda due to an outbreak. So far, 15 people have died from the disease.A travel alert from the Centers for Disease Control and Prevention (CDC) urges people to “practice enhanced precautions” if traveling to Rwanda, noting that Marburg virus disease is “rare and deadly.” But what is Marburg virus disease and why is it so concerning? We tapped infectious disease physicians for more.What is Marburg virus disease?Marburg virus disease is a rare and severe viral hemorrhagic (i.e. bleeding) fever that impacts people and other primates, including monkeys and apes, per the CDC. It’s caused by infection with orthomarburgviruses, which are naturally found in the Egyptian rousette bat, according to the CDC. “It can spread from bats to people, and then you can have human-to-human spread,” says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. The virus spreads between humans through exposure to blood and bodily fluids, says infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security.While Marburg virus isn’t well-known to most Americans, Dr. Russo points out that it’s a “cousin of Ebola.” Marburg virus is most commonly found in sub-Saharan Africa, per the CDC. It’s named for the German city where scientists became sick with the disease’s first known cases in 1967 while they were handling monkeys imported from Africa.Marburg virus symptomsInitial symptoms of Marburg virus are non-specific—meaning, they could be signs of a lot of different illnesses. “The disease begins with some influenza-like symptoms,” Dr. Adalja says. According to the CDC, those include: Fever Chills Headache Muscle aches Rash with flat and raised bumps, usually on the torso Chest pain Sore throat Nausea, vomiting, and diarrheaBut symptoms become more severe as the disease progresses, causing liver failure, delirium, shock, bleeding (including from the eyes), and multi-organ dysfunction, according to the CDC. Around day five of the disease, people may have blood in their vomit and poop, as well as bleeding from the nose, gums, vagina, and more, according to the WHO. Marburg virus disease can also be deadly, with people dying between eight and nine days after symptoms start. “The lethality rate is pretty high—usually 50% or higher,” Dr. Russo says. What is happening with the Marburg outbreak?Health officials in Rwanda declared a Marburg virus disease outbreak in late September, according to the World Health Organization (WHO). As of the end of October, there have been 66 confirmed cases and 15 deaths.Almost 80% of the confirmed cases are in healthcare workers from two health facilities.How is Marburg virus disease treated?There are no specific treatments for Marburg virus disease. Instead, people are given supportive care, like rest, hydration, managing oxygen levels and blood pressure, and treating any secondary infections that someone has, according to the CDC.“There is no widely available vaccine, though an experimental one from the Sabin Vaccine Institute is in clinical trials, and no specific treatment—although clinical trials are ongoing,” Dr. Adalja says. How to prevent Marburg virus diseaseThere are a few ways to prevent Marburg disease, according to the CDC: Avoid contact with the blood and body fluids of people who are sick. Avoid contact with semen from a person who recovered from Marburg until testing shows that the virus is gone from their semen. Don’t handle items that may have come in contact with an infected person’s body fluids. Avoid contact with Egyptian rousette bats and non-human primates if you’re in areas where Marburg virus is found.While the Marburg virus is making headlines, doctors stress that this is currently a regional disease. “As Marburg is a disease restricted to specific African countries, be aware of travel advisories to those countries issued by the WHO, CDC, and the Department of State,” Dr. Adalja says. While news of a disease that can make you bleed from your eyes is terrifying, Dr. Russo says that “the average American should have zero concern if they’re not traveling to Rwanda.”