Screening Patients

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

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

• 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.