Marburg Reaches the US

Via ProMED-mail: the CDC reports on an imported case of Marburg hemorrhagic fever in Colorado last year. A bat-cave tourist came home from Uganda in January 2008 and exhibited the less dramatic symptoms of Marburg. Tests for Marburg came back negative, but she was retested six months later at her own request and Marburg was confirmed, both then and in the original sample. (It seems the CDC has a big freezer.)

On January 22, 2009, CDC notified the World Health Organization and Uganda Ministry of Health of the imported MHF case. The Python Cave had already been closed to visitors in July 2008, during the response to the Dutch MHF case. CDPHE and CDC conducted a public health investigation during January--February 2009. Interviews were conducted with the patient and her spouse, the patient's medical records were reviewed, and a retrospective contact investigation was conducted to identify possible secondary transmission. A contact was defined as a person who had physical contact with the patient, her body fluids, or contaminated materials or was in the same room as the patient during her acute illness (January 4--19, 2008). Contacts included health-care workers (including health-care providers, housekeeping staff, and hospital laboratory staff), commercial laboratory staff, and social contacts.

No explanation for the six month delay in reporting to the WHO was provided, nor for the further year it took this information to appear on the CDC site. One imagines that it may be due to the fact that the victim, though now recovered, was quite ill with Marburg, including eleven days of hospitalization in "a community hospital," and no notable precautions were taken. The story has medical thriller written all over it. Or perhaps the bird flu/H1N1 story was considered to be enough for the public to panic about at the time.

PlagueBlog recommends against bat-cave tourism of any sort, locally or in Africa.