[4] The most detailed study on the frequency, onset, and duration of MVD clinical signs and symptoms was performed during the 1998–2000 mixed MARV/RAVV disease outbreak.

[5] A skin rash, red or purple spots (e.g. petechiae or purpura), bruises, and hematomas (especially around needle injection sites) are typical hemorrhagic manifestations.

However, contrary to popular belief, hemorrhage does not lead to hypovolemia and is not the cause of death (total blood loss is minimal except during labor).

The WHO also writes that at the phase of gastrointestinal symptoms' predomination, "the appearance of patients...has been described as showing 'ghost-like' drawn features, deep-set eyes, expressionless faces, and extreme lethargy.

In 2009, the successful isolation of infectious MARV and RAVV was reported from healthy Egyptian fruit bat caught in caves.

[17] Contrary to Ebola virus disease (EVD), which has been associated with heavy rains after long periods of dry weather,[14][18] triggering factors for spillover of marburgviruses into the human population have not yet been described.

Transmission most likely occurs from Egyptian fruit bats or another natural host, such as non-human primates or through the consumption of bushmeat, but the specific routes and body fluids involved are unknown.

The most common diagnostic methods are therefore RT-PCR[27][28][29][30][31] in conjunction with antigen-capture ELISA,[32][33][34] which can be performed in field or mobile hospitals and laboratories.

Due to the absence of an approved vaccine, prevention of MVD therefore relies predominantly on quarantine of confirmed or high probability cases, proper personal protective equipment, and sterilization and disinfection.

[citation needed] Since marburgviruses are not spread via aerosol, the most straightforward prevention method during MVD outbreaks is to avoid direct (skin-to-skin) contact with patients, their excretions and body fluids, and any possibly contaminated materials and utensils.

Medical staff should be trained in and apply strict barrier nursing techniques (disposable face mask, gloves, goggles, and a gown at all times).

The outbreak was traced to infected grivets (species Chlorocebus aethiops) imported from an undisclosed location in Uganda and used in developing poliomyelitis vaccines.

The monkeys were received by Behringwerke, a Marburg company founded by the first winner of the Nobel Prize in Medicine, Emil von Behring.

A French man, who worked as an electrical engineer in a sugar factory in Nzoia (close to Bungoma) at the base of Mount Elgon (which contains Kitum Cave), became infected by unknown means and died on 15 January shortly after admission to Nairobi Hospital.

[76] A popular science account of these cases can be found in Richard Preston's book The Hot Zone (the French man is referred to under the pseudonym "Charles Monet", whereas the physician is identified under his real name, Shem Musoke).

[77] In 1987, a single lethal case of RAVV infection occurred in a 15-year-old Danish boy, who spent his vacation in Kisumu, Kenya.

He had visited Kitum Cave on Mount Elgon prior to travelling to Mombasa, where he developed clinical signs of infection.

[78] A popular science account of this case can be found in Richard Preston's book The Hot Zone (the boy is referred to under the pseudonym "Peter Cardinal").

[77] In 1988, researcher Nikolai Ustinov infected himself lethally with MARV after accidentally pricking himself with a syringe used for inoculation of guinea pigs.

Médecins Sans Frontières (MSF) reported that when their team arrived at the provincial hospital at the center of the outbreak, they found it operating without water and electricity.

Contact tracing was complicated by the fact that the country's roads and other infrastructure were devastated after nearly three decades of civil war and the countryside remained littered with land mines.

[84] Americo Boa Vida Hospital in the Angolan capital, Luanda, set up a special isolation ward to treat patients from the countryside.

For instance, a specially-equipped isolation ward at the provincial hospital in Uíge was reported to be empty during much of the epidemic, even though the facility was at the center of the outbreak.

WHO was forced to implement what it described as a "harm reduction strategy" by distributing disinfectants to affected families who refused hospital care.

[92] On January 9 of that year an infectious diseases physician notified the Colorado Department of Public Health and the Environment that a 44-year-old American woman who had returned from Uganda had been hospitalized with a fever of unknown origin.

[94][95] In August 2021, two months after the re-emergent Ebola epidemic in the Guéckédou prefecture was declared over, a case of the Marburg disease was confirmed by health authorities through laboratory analysis.

The Rwandan Minister of Health, Sabin Nsanzimana, confirmed that the infected were mostly healthcare workers and that contact tracing had been initiated in the country.

[113][114] Experimentally, recombinant vesicular stomatitis Indiana virus (VSIV) expressing the glycoprotein of MARV has been used successfully in nonhuman primate models as post-exposure prophylaxis.

[116] Experimental therapeutic regimens relying on antisense technology have shown promise, with phosphorodiamidate morpholino oligomers (PMOs) targeting the MARV genome[117] New therapies from Sarepta[118] and Tekmira[119] have also been successfully used in humans as well as primates.