MHF is caused by the filovirus Lake Victoria marburgvirus (MARV).
Sources of exposure:
(1) direct contact with a patient with symptomatic MHF
(2) direct contact with blood or a body fluid from an infected patient
(3) direct contact with the dead body
(4) direct contact with infected primates
Putative incubation period: 2 to 21 days
The onset of symptoms is sudden with:
(1) fever
(2) chills
(3) headache
(4) myalgias and/or arthralgias
Several days (4 to 6) later the patient develops:
(1) a nonpruritic skin rash
(2) nausea
(3) vomiting
(4) diarrhea
(5) bone pain
(6) abdominal pain
The patient course deteriorates thereafter with:
(1) hemorrhages, which may be massive (bloody diarrhea, bleeding gums, epistaxis, hematemesis, from an injection site, other)
(2) multi-organ failure (MOF)
(3) death during the second week of the illness
A bedside clotting test may be helpful in identifying a patient before definitive test results are available.