Historically, Marburg virus disease is often fatal, with death occurring in approximately 70% of historical cases, although case fatality rates of 23% to 100% have been reported.[5]Centers for Disease Control and Prevention. History of Marburg virus disease (MVD) outbreaks. Jun 2023 [internet publication].
https://www.cdc.gov/vhf/marburg/outbreaks/chronology.html
The average case fatality rate is 50%, and case fatality rates of 100% have been reported in small outbreaks (1 to 3 cases).[2]World Health Organization. Marburg virus disease fact sheet. Aug 2021 [internet publication].
https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease
High case fatality rates in Marburg and Ebola virus disease patients in sub-Saharan Africa may be related to the lack of full supportive care available in resource-poor, rural settings where outbreaks have occurred.[51]WHO Ebola Response Team. Ebola virus disease in West Africa - the first 9 months of the epidemic and forward projections. N Engl J Med. 2014 Oct 16;371(16):1481-95.
http://www.nejm.org/doi/full/10.1056/NEJMoa1411100
http://www.ncbi.nlm.nih.gov/pubmed/25244186?tool=bestpractice.com
Among survivors, complications such as myalgia, arthralgia, asthenia, hepatitis, ocular disease, psychosis and ostracisation are thought common.[13]Mehedi M, Groseth A, Feldmann H, et al. Clinical aspects of Marburg hemorrhagic fever. Future Virol. 2011 Sep;6(9):1091-1106.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201746
http://www.ncbi.nlm.nih.gov/pubmed/22046196?tool=bestpractice.com
Survivors develop long-lasting antibody response and are considered immune to reinfection by the same filovirus strain.
Pregnant women
Historically, survival among pregnant women with filovirus disease was very low and a poor prognosis was associated with pregnancy.[4]Bebell LM, Riley LE. Ebola virus disease and Marburg disease in pregnancy: a review and management considerations for filovirus infection. Obstet Gynecol. 2015 Jun;125(6):1293-8.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443859
http://www.ncbi.nlm.nih.gov/pubmed/26000499?tool=bestpractice.com
[13]Mehedi M, Groseth A, Feldmann H, et al. Clinical aspects of Marburg hemorrhagic fever. Future Virol. 2011 Sep;6(9):1091-1106.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201746
http://www.ncbi.nlm.nih.gov/pubmed/22046196?tool=bestpractice.com
However, data from the 2014 to 2016 West Africa Ebola virus disease outbreak suggest that survival rates among pregnant women may equal those of other reproductive-aged women.[61]Henwood PC, Bebell LM, Roshania R, et al. Ebola virus disease and pregnancy: a retrospective cohort study of patients managed at 5 Ebola treatment units in West Africa. Clin Infect Dis. 2017 Jul 15;65(2):292-9.
https://academic.oup.com/cid/article/65/2/292/3097901
http://www.ncbi.nlm.nih.gov/pubmed/28379374?tool=bestpractice.com
With appropriate and aggressive supportive care, it is likely that pregnant women with Ebola or Marburg virus disease have a similar prognosis to other reproductive-aged women.
Fetuses and neonates
Marburg virus infection during pregnancy is associated with nearly 100% incidence of spontaneous abortion and stillbirth.[13]Mehedi M, Groseth A, Feldmann H, et al. Clinical aspects of Marburg hemorrhagic fever. Future Virol. 2011 Sep;6(9):1091-1106.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201746
http://www.ncbi.nlm.nih.gov/pubmed/22046196?tool=bestpractice.com
Only one child born to an Ebola virus-infected mother is known to have survived longer than 19 days postpartum.[4]Bebell LM, Riley LE. Ebola virus disease and Marburg disease in pregnancy: a review and management considerations for filovirus infection. Obstet Gynecol. 2015 Jun;125(6):1293-8.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443859
http://www.ncbi.nlm.nih.gov/pubmed/26000499?tool=bestpractice.com
[62]Médecins Sans Frontières (MSF). Nubia: first newborn to survive Ebola. Dec 2015 [internet publication].
https://msf.exposure.co/nubia
Thus, prognosis among congenitally infected fetuses and neonates is extremely poor.
Children
Data are limited for paediatric survival in Marburg virus infection. However, the first confirmed paediatric Marburg virus disease case survived, an 8-month old infant breastfed and cared for by her mother.[63]Borchert M, Muyembe-Tamfum JJ, Colebunders R, et al. Short communication: a cluster of Marburg virus disease involving an infant. Trop Med Int Health. 2002 Oct;7(10):902-6.
http://onlinelibrary.wiley.com/doi/10.1046/j.1365-3156.2002.00945.x/full
http://www.ncbi.nlm.nih.gov/pubmed/12358627?tool=bestpractice.com