A Colorado woman who contracted Marburg fever while in Uganda should serve as a reminder to health-care workers that diseases that were once just exotic names in medical textbooks can show up in emergency departments in North American hospitals, experts say.
The speed of global travel and the popularity of adventure tourism combine to increase the risk that bad bugs can travel from their homes to ours, they warn.
“Most of the time when you hear hoof beats in the infectious disease world, it really is likely a neighbourhood horse,” said Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.
“But there are those rare and ever-growing chances that it could be a zebra. And unless we stay vigilant to that point, if it is a zebra, one day you could be in a big amount of trouble.”
Fortunately, the unusual year-old Marburg case — which came to light on the weekend — did not end tragically. The woman, who is the first reported case of the fever in North America, survived and appears not to have infected any of her caregivers.
She is thought to have been infected in December 2007, while touring an attraction known as the python cave in the Maramagambo forest of Queen Elizabeth Park in western Uganda. The cave is home to thousands of bats; some species of bats are thought to be the reservoir of the Marburg virus.
She became ill about two weeks later, after returning to Colorado. (The incubation period for the disease ranges from two to 21 days.) But it wasn’t until a year later, in January 2009, that it was confirmed the women had suffered from Marburg.
Diagnosing the disease isn’t always straightforward. While the tell-tale sign seen in the worst cases — blood gushing from multiple orifices — would immediately bring hemorrhagic fevers to mind, only about half of cases develop that symptom, said Dr. Eileen Farnon, chief of epidemiology in the special pathogens branch of the U.S. Centers for Disease Control.