Screening Patients

Marburg virus disease (MVD) is a rare and deadly viral illness that is reportable to the National Notifiable Disease Surveillance System (NNDSS) in all U.S. states and territories. Healthcare providers should be on alert for and evaluate any patients that are suspected of having MVD.

MVD Case Definitions

Early recognition of MVD is critical for infection control, given it is spread through person-to-person transmission.

Suspect Case

  1. Signs and symptoms compatible with MVD.


  1. An epidemiological risk factor within 21 days (i.e., the incubation period) before the onset of symptoms.

Confirmed Case

Laboratory-confirmed diagnostic evidence of MVD (i.e., through molecular and/or serologic testing).

Evaluating a Patient for MVD

The majority of febrile patients presenting in U.S. healthcare facilities do not have MVD, but early symptoms of the disease are similar to other febrile illnesses. It is important to systematically assess patients for the possibility of MVD through a triage and evaluation process.

Identify potential exposures
Getting a thorough history is important for all patients exhibiting symptoms compatible with MVD who may have had an exposure to the virus.

Important questions to ask to begin assessing exposure risk:

  • Have you been in contact with a person with suspect or confirmed MVD in the past 21 days (for example touching, caring for, etc.)?
  • Have you been to an area with an active MVD outbreak in the past 21 days? Stay up to date on active travel notices by consulting Ebola and Marburg: Travel information.

Ask about MVD disease risk factors

Exposure risks for MVD may include the following activities.

  • Contact with a symptomatic person with suspected or confirmed MVD, or any objects contaminated by their body fluids
  • Experienced a breach in infection prevention and control precautions that result in the potential for contact with body fluids of a patient with suspected or confirmed MVD
  • Contact with semen from a person who has recovered from MVD
  • Participated in any of the following activities while in an area with an active MVD outbreak:
    • Having contact with someone who was sick or died, or any objects contaminated by their body fluids
    • Attending/participating in funeral rituals, including preparing bodies for funeral or burial
    • Working in a healthcare facility or laboratory
    • Visiting a healthcare facility or traditional healer
    • Having contact with bats or wild animals
    • Working or spending time in a mine/cave
Ask about signs or symptoms compatible with MVD
Signs and symptoms of MVD are nonspecific and similar to many other common causes of febrile illness in returning travelers. Assess a patient’s signs and symptoms along with their travel history and epidemiologic risk factors before initiating immediate infection control measures.

MVD symptoms can appear anywhere from 2 to 21 days after exposure to the virus.

Illness typically progresses from “dry” symptoms (fever, aches, fatigue) to “wet” symptoms (diarrhea, vomiting, and in some cases, bleeding). A person with MVD is not contagious until the appearance of symptoms.

Primary signs and symptoms of Marburg often include some or several of the following:

  • Fever (≥100.4°F/38.0°C)
  • Aches and pains, such as severe headache and muscle and/or joint pain
  • Weakness and fatigue
  • Sore throat
  • Loss of appetite
  • Gastrointestinal symptoms including abdominal pain, diarrhea, and vomiting
  • Unexplained hemorrhaging, bleeding or bruising
  • Red eyes, skin rash, and hiccups

If Patient Evaluation Indicates Possible Infection with a Marburgvirus, Take Action

If a relevant exposure history is reported AND signs or symptoms are consistent with MVD, take the following steps.

  • Isolate the patient in a single room with a private bathroom or a covered bedside commode.
  • Adhere to infection prevention and control procedures to prevent transmission through direct or indirect contact, including wearing appropriate PPE and using dedicated equipment.
  • Use only essential healthcare workers trained in their designated roles for patient care and keep a log of everyone who enters and leaves the patient’s room.
  • Perform only necessary tests and procedures and avoid aerosol-generating procedures.
  • Notify your facility’s Infection Prevention and Control Program of a suspect case of MVD and other healthcare personnel that may be involved in their care.
  • Contact the local or state health department for consultation about testing for MVD.

If the patient is not reporting signs and symptoms compatible with MVD but concern remains, consult Local/State Health Department for additional guidance on testing recommendations.

Tools To Assess Fever in Returning Travelers

Use these assessment tools to help when evaluating fever, and risk of viral hemorrhagic fevers, in returning travelers.

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