From the Tartar army catapulting bubonic plague victims to their enemies in the 14th century (Hale, n.d.) to the 2001 Anthrax attacks, bioterrorism has a long, but often understated, history. When thinking of terrorism, the general population generally focuses on the prospect of nuclear weapons. However, given the increasing issue of microbial resistance and rapid mutation of viruses, we must not ignore the potential of bioterrorism. In particular, Marburg Virus, a viral hemorrhagic fever closely related to Ebola, is one of the most promising potential biological weapons that should be further studied for prevention measures.
Background
Marburg Virus (MARV) was first discovered through simultaneous outbreaks of the virus in German and Yugoslavian laboratories in 1967, which is believed to have been caused by exposure to Ugandan African green monkeys. 31 people fell ill, and 7 deaths were recorded (Centers of Disease Control and Prevention, n.d.). Since the initial outbreak, there have been irregular outbreaks in Africa throughout the years, ranging from 1 to over 250 reported human cases (Centers of Disease Control and Prevention, n.d.).
MARV is categorized as a filovirus, which is the same virus classification as Ebola. MARV is a severe hemorrhagic fever, defined by its high mortality rate of up to 90% (Centers of Disease Control and Prevention, n.d.; Leroy et al., 2011). A MARV infection starts off with common symptoms such as a fever, nausea, headaches, and muscle pain, but quickly escalates to gastrointestinal problems (stomach pain and vomiting), respiratory problems (chest pains and coughing), neurological issues (delirium), and hemorrhagic manifestations (skin rashes, nosebleeds, and vomiting blood) (Leroy et al., 2011). Unfortunately, the severity of a MARV infection has made it a contender as a biological weapon.
Potential for Bioterrorism
MARV is often considered to be an effective agent of bioterrorism. According to the Centers for Disease Control and Prevention, MARV is a Category A (high-priority) pathogen based on the following criteria: a high transmission rate, high mortality rate and potential for major public health impact, potential for public panic, and requires special action for public health preparation (Centers for Disease Control and Prevention, 2024). MARV can also be aerosolized (turning infected body fluids or excrements into a fine mist) for higher transmission through the air, produced in large industrial quantities, and is spread from person to person (Filoviridae, n.d., Texas Department of State Health Services). In the Soviet Union’s Biological Weapons program, MARV was one of the strategic-operational weapons (meant for long-distance and short-distance targets) that would have been used in future wars (Tucker, 1999). The Soviet Union actually preferred MARV over Ebola because MARV’s weaponized form was more stable than Ebola’s (Filoviridae, n.d.). Considering MARV’s potential for bioterrorism, it is essential to develop prevention methods.
Vaccines in Development
While MARV is widely regarded as a high-priority pathogen with likely devastating consequences, there is still no known treatment or vaccine. However, within the last 5 years, two vaccine trials show great potential. One of the trials was tested on nonhuman primates, while the other trial was tested on humans. Both trials were successful in developing antibodies against MARV and didn’t have any severe side effects on the participants (O’donnell et al., 2023; Hamer et al., 2023). These trials display promising results that can potentially mark a significant advancement in reducing the spread of MARV.
Initially only causing irregular outbreaks, MARV now has the potential to become a huge public health issue due to its potential for bioterrorism and high mortality rate. Therefore, the Biomedical Advanced Research and Development Authority (BARDA) of the U.S. Department of Health and Human Services awarded $21.8 million to the Sabin Vaccine Institute to continue developing a vaccine for MARV (Sabin Receives, 2022). Current vaccines in development show great potential to lessen MARV outbreak, though future studies need to continue monitoring the efficacy and safety of these vaccines. These measures highlight the importance of MARV vaccine research to protect global health from potential bioterrorism.
References
Centers of Disease Control and Prevention. (n.d.). About Marburg Virus Disease. Centers for Disease Control and Prevention. Retrieved July 15, 2023, from https://www.cdc.gov/vhf/marburg/about.html#:~:text=Marburg%20virus%20disease%20(MVD)%20is,within%20the%20virus%20family%20Filoviridae
Centers for Disease Control and Prevention. (n.d.). Marburg Virus Disease Outbreaks. Centers for Disease Control and Prevention. Retrieved July 15, 2023, from https://www.cdc.gov/vhf/marburg/outbreaks/chronology.html
Centers for Disease Control and Prevention. (2024, November 21). Emergency Preparedness and Response. Emergency Preparedness and Response. https://www.cdc.gov/emergency/index.html
Filoviridae. (n.d.). Federation of American Scientists. Retrieved December 7, 2024, from https://programs.fas.org/bio/factsheets/ebolamarburgfs.html
Hale, Kristina. (n.d.) Yersinia pestis as a Biological Weapon—Insects, Disease, and History | Montana State University. (n.d.). Retrieved December 7, 2024, from https://www.montana.edu/historybug/yersiniaessays/hale.html
Hamer, M. J., Houser, K. V., Hofstetter, A. R., Ortega-villa, A. M., Lee, C., Preston, A., Augustine, B., Andrews, C., Yamshchikov, G. V., Hickman, S., Schech, S., Hutter, J. N., Scott, P. T., Waterman, P. E., Amare, M. F., Kioko, V., Storme, C., Modjarrad, K., Mccauley, M. D., . . . Stanley, D. A. (2023). Safety, tolerability, and immunogenicity of the chimpanzee adenovirus type 3-vectored marburg virus (cAd3-Marburg) vaccine in healthy adults in the usa: A first-in-human, phase 1, open-label, dose-escalation trial. The Lancet, 401(10373), 294-302. https://doi.org/10.1016/s0140-6736(22)02400-x
Leroy, E.m., Gonzalez, J.-P., & Baize, S. (2011). Ebola and marburg haemorrhagic fever viruses: Major scientific advances, but a relatively minor public health threat for africa. Clinical Microbiology and Infection, 17(7), 964-976. https://doi.org/10.1111/j.1469-0691.2011.03535.x
O’donnell, K. L., Feldmann, F., Kaza, B., Clancy, C. S., Hanley, P. W., Fletcher, P., & Marzi, A. (2023). Rapid protection of nonhuman primates against marburg virus disease using a single low-dose vsv-based vaccine. EBioMedicine, 89, 104463. https://doi.org/10.1016/j.ebiom.2023.104463
Sabin Receives Additional $21.8 Million From BARDA to Advance Marburg Vaccine. (2022, September 13). Sabin Vaccine Institute. Retrieved July 21, 2023, from https://www.sabin.org/resources/sabin-receives-additional-21-8-million-from-barda-to-advance-marburg-vaccine/
Texas Department of State Health Services. (n.d.). Viral Hemorrhagic Fevers and Bioterrorism.
Tucker, J. B. (1999). Biological weapons in the former Soviet Union: An interview with Dr. Kenneth Alibek. The Nonproliferation Review, 6(3), 1–10. https://doi.org/10.1080/10736709908436760