title: Marburg haemorrhagic fever in returning travellers: an overview aimed at clinicians.
abstract: Marburg virus haemorrhagic fever (MARV HF) is a dramatic disease that can occur in a traveller returning from an area where the virus is endemic. In this article, we provide an overview of MARV HF as an imported infection with an emphasis on clinical aspects. Although late features such as rash, signs of haemorrhagic diathesis and liver necrosis may point to the diagnosis, the initial clinical picture is non-specific. If in this early phase the patient's epidemiological exposure history is compatible with MARV HF, the patient should be isolated and managed according to viral haemorrhagic fever protocol and RT-PCR should be performed on the patient's blood as soon as possible to rule out MARV HF (or other possible viral haemorrhagic fevers). In severe cases, direct electron microscopy of blood in specialized centres (e.g. Bernhard-Nocht Institute in Hamburg, Germany) may be considered if the result of the RT-PCR is not readily available. Adequate diagnostics and empirical treatment for other acute life-threatening illnesses should not be withheld while test results are awaited, but all management and diagnostics should be weighed against the risks of nosocomial transmission.
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Bauer
authors.affiliation: National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Timen
authors.affiliation: Department Medical Microbiology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: A C T M
authors.initials: ACTM
authors.lastname: Vossen
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: e.j.t.van_dissel@lumc.nl.
authors.forename: J T
authors.initials: JT
authors.lastname: van Dissel
mesh_terms: D000818:Animals; D004196:Disease Outbreaks / Q000517:prevention & control; D042241:Early Diagnosis; D006801:Humans; D017053:Infection Control; D008379:Marburg Virus Disease / Q000175:diagnosis* / Q000473:pathology / Q000517:prevention & control* / Q000628:therapy; D029024:Marburgvirus / Q000302:isolation & purification* / Q000472:pathogenicity; D000076082:Travel-Related Illness
keywords: Bats bite; Haemorrhagic fever; Marburg; Travellers