1967 Marburg virus outbreak in West Germany


The 1967 Marburg virus outbreak in West Germany was the first outbreak of Marburg virus disease. It started in West Germany in early August 1967 when 30 people became ill in the German towns of Marburg and Frankfurt and 2 in Belgrade, Yugoslavia. One of these cases was diagnosed retrospectively. The outbreak involved 25 primary Marburg virus infections and seven deaths, and six non-lethal secondary cases.

Overview

In early August 1967, patients with unusual symptoms indicating an infectious disease were admitted to the university hospitals in Marburg and Frankfurt. The first patients were treated in their homes for up to 10 days, even though the illness was described as beginning suddenly with extreme malaise, myalgia, headache, and a rapid increase in body temperature to as high as 39 °C or more. Although the clinical symptoms were not very alarming during the first 3–4 days, additional symptoms and signs appeared at the end of the first week. The patients were therefore admitted to a hospital. In some cases, patients died from severe hemorrhagic shock on the day after hospital admission. Severe hemorrhagic shock occurred in ∼25% of patients. All patients who died had hemorrhagic shock. The first person was infected some way from imported African green monkeys.
The incubation time of Marburg virus disease could only be estimated retrospectively, after the source of infection and the date of exposure were known. Incubation ranged from 5 to 9 days, with an average of 8 days. The ratio of primary to secondary infections was 21:3 in Marburg, 4:2 in Frankfurt, and 1:1 in Belgrade. Three cases of secondary infection resulted from inadvertent needle-stick inoculations; in 1 case, a pathology technician cut himself on the forearm with a knife during a postmortem examination. Airborne transmission between humans did not occur, as indicated, for example, by the instance of a young man who slept in the same bed with his brother only a couple of days before he died; the brother did not develop disease and was seronegative for Marburg virus disease 6 months later.

History

The Marburg virus disease made reappearance in 1975, 1980, 1987, 1990, 1998–00, 2004–05, 2007, 2008 and 2017. The 7 death out of 32 infection stated that Case Fatality Rate during the 1967 Marburg virus outbreak in West Germany was 23%.