Marburg virus: symptoms, how it spreads and what happens in the UK

Marburg virus disease is a viral haemorrhagic fever, a group of illnesses in which the virus damages blood vessels and can cause bleeding. UKHSA describes the virus as a filovirus, in the same family as Ebola. The disease was first recognised in 1967, when outbreaks occurred at the same time in laboratories in Marburg and Frankfurt in Germany and Belgrade in what was then Yugoslavia, in people who had been in contact with blood, organs or cell cultures from imported African green monkeys.

It is generally accepted that the virus is zoonotic, meaning it passes from animals to people. Fruit bats of the species Rousettus aegyptiacus are considered to be the natural host. UKHSA notes that monkeys are susceptible but are not considered reservoir hosts because they usually die rapidly once infected.

The acronym was updated by UKHSA in 2025 from MVD (Marburg virus disease) to MARD (Marburg disease), so both terms may be seen in guidance.

UKHSA says the onset of illness is sudden. Early symptoms include severe headache, malaise, high fever and progressive and rapid debilitation. By about the third day symptoms include watery diarrhoea, abdominal pain, cramping, nausea and vomiting. Many patients develop a rash after 5 to 7 days, and severe cases usually have bleeding of some form, including bleeding under the skin, from mucous membranes and from venepuncture sites.

Many of the early symptoms are similar to other infectious diseases, such as malaria or typhoid, which UKHSA points out is why confirmation requires laboratory testing. For anyone returning from an affected area, other infections are far more likely explanations for a fever.

• Sudden severe headache, high fever and marked weakness.

• Watery diarrhoea, abdominal pain, nausea and vomiting from around the third day.

• A rash that may develop after 5 to 7 days.

• Bleeding from different sites in severe cases.

UKHSA says natural infection is most likely associated with contact with Rousettus bat colonies, and that two travellers became ill in 2008 after visiting a cave in Uganda that is home to a large colony of Egyptian fruit bats. Person-to-person spread requires close contact with blood or bodily fluids from an infected patient. Faeces, vomit, urine, saliva and respiratory secretions contain a high concentration of virus, particularly when these fluids contain the patient's blood.

UKHSA also notes that sexual transmission can occur, and that the virus may remain in semen for several weeks after clinical recovery, and that close contact with the body or body fluids of people who have died of the disease during burial preparation is a recognised source of infection. The UKHSA blog stresses that the virus spreads through very close contact with the blood, bodily fluids or secretions of an infected person, either directly or from a surface.

In the UK, clinicians who suspect Marburg disease are advised to seek urgent advice from UKHSA's Imported Fever Service, which operates 24 hours a day and coordinates urgent testing at UKHSA's Rare and Imported Pathogens Laboratory at Porton Down, where PCR testing is available.

There are currently no licensed vaccines or specific antivirals. UKHSA lists supportive care: replacing blood components, balancing fluids and electrolytes, maintaining oxygen status and blood pressure, and organ support as needed. In the UK, confirmed cases are notified immediately to the High Consequence Infectious Diseases Network so that urgent transport to a High Level Isolation Unit can be arranged.

UKHSA says the UK has specialist guidance on managing patients with viral haemorrhagic fevers, including infection control, risk assessment and testing. The UKHSA blog states that UKHSA, the NHS and partner agencies have well-tested capabilities to detect, contain and treat novel infectious diseases and that healthcare professionals are equipped and prepared to respond to any confirmed cases in the UK.

Cases detected outside Africa are extremely rare. UKHSA lists a laboratory exposure in Russia in 1990 and two unrelated travel-associated cases in 2008 in the Netherlands and the United States.

The UKHSA blog advises anyone planning to travel to stay informed by regularly visiting the Travel Health Pro website for up-to-date information on affected areas and precautions. If you become ill within 21 days of returning home from an affected area, call NHS 111 or contact your GP by phone. Although it is very unlikely you have Marburg virus disease, you should mention your dates and itinerary of travel and any potential exposure to the virus.

Because natural infection is linked to fruit bat colonies and person-to-person spread to close contact with blood or body fluids, avoiding such contact and following local public health advice during an outbreak is the practical protection. People working in healthcare or outbreak response should follow the personal protective equipment guidance of their organisation.

The UKHSA blog says that if you become ill within 21 days of returning home from an affected area you should call NHS 111 or contact your GP by phone, and mention your dates and itinerary of travel and any potential exposure. Phoning rather than walking in lets the service arrange assessment safely.

Because many early symptoms are similar to other infections such as malaria or typhoid, UKHSA says confirmation requires laboratory testing. Other infections such as malaria are far more likely explanations for a fever after travel, which is another reason to get assessed rather than wait.

UKHSA explains that measures for preventing secondary transmission are similar to those used for other haemorrhagic fever viruses and focus on avoiding contact with infected bodily fluids. Suspected cases must be immediately isolated and assessed using appropriate personal protective equipment for viral haemorrhagic fevers.

Because there is no licensed vaccine, prevention relies on rapid recognition, isolation, contact tracing and safe burial practices in outbreak areas.

Marburg disease is a public health matter handled through UKHSA and the NHS. Suspected cases are assessed through NHS services using national protocols, with UKHSA coordinating testing.

For travel advice before a trip, many people use NHS travel health services, a pharmacy or a private travel clinic, which can explain which vaccines and precautions apply to a destination. There is no vaccine against Marburg virus, so advice centres on avoiding exposure.

Yes, but not easily. The UKHSA blog says Marburg virus does not spread easily and needs very close contact with the blood, bodily fluids or secretions of an infected person, either directly or from a surface. UKHSA says faeces, vomit, urine, saliva and respiratory secretions contain a high concentration of virus, particularly when they contain the patient's blood.

UKHSA also says sexual transmission can occur and that virus may remain in semen for several weeks after recovery, with some reports of virus present up to 203 days after disease onset. Transmission through contaminated injection equipment or needle-stick injuries is associated with more severe disease, and contact with the body of someone who has died of the disease during burial preparation is a recognised source of infection.

UKHSA says Marburg disease is clinically almost indistinguishable from Ebola virus disease, and that many early symptoms are similar to malaria or typhoid. In practice, a fever after travel to Africa is far more often malaria or another common infection.