Transmission Potential and Design of Adequate Control Measures for Marburg Hemorrhagic Fever
Open accessAbstract
Marburg hemorrhagic fever is rare yet among the most severe diseases affecting humans, with case fatality ratio even higher than 80%. By analyzing the largest documented Marburg hemorrhagic fever epidemic, which occurred in Angola in 2005 and caused 329 deaths, and data on viral load over time in non-human primates, we make an assessment of transmissibility and severity of the disease. We also give insight into the control of new Marburg hemorrhagic fever epidemics to inform appropriate health responses. We estimated the distribution of the generation time to have mean 9 days (95%CI: 8.2-10 days) and standard deviation 5.4 days (95%CI: 3.9-8.6 days), and the basic reproduction number to be R(0) = 1.59 (95%CI: 1.53-1.66). Model simulations suggest that a timely isolation of cases, starting no later than 2-3 days after symptoms onset, is sufficient to contain an outbreak. Our analysis reveals that Marburg hemorrhagic fever is characterized by a relatively small reproduction number and by a relatively long generation time. Such factors, along with the extremely high severity and fatality, support the rare occurrence of large epidemics in human populations. Our results also support the effectiveness of social distancing measures--case isolation in particular--to contain or at least to mitigate an emerging outbreak. This work represents an advance in the knowledge required to manage a potential Marburg hemorrhagic fever epidemic.
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In the absence of mitigation efforts, the virus would be expected to propagate in a similar population.
“They found that R0 = 1.59 (95% CI: 1.53–1.66), suggesting that in the absence of mitigation efforts, the virus would be expected to propagate in a similar population (24).”
From Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review (2024) · cites this paper as [24]
Reproduction number estimates were reported in two studies.
“Reproduction number estimates were reported in two studies (24,25).”
From Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review (2024) · cites this paper as [24]
Ajelli et al. provided the only estimate of doubling time, at 12.4 days (95% CI: 11.3-13.6 days).
“They also provided the only estimate of doubling time, at 12.4 days (95% CI: 11.3–13.6 days) (24).”
From Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review (2024) · cites this paper as [24]
Ajelli et al. estimated the basic reproduction number R0 for the 2005 Angola outbreak at 1.59 (95% CI: 1.53-1.66).
“They found that R0 = 1.59 (95% CI: 1.53–1.66), suggesting that in the absence of mitigation efforts, the virus would be expected to propagate in a similar population (24).”
From Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review (2024) · cites this paper as [24]
A basic reproduction number of 1.59 (95% CI: 1.53-1.66) was estimated for the largest known MVD outbreak to date in Angola.
“A basic reproduction number of 1.59 (95% CI: 1.53-1.66) was estimated for the largest known outbreak to date in Angola (24).”
From Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review (2024) · cites this paper as [24]
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Virale hämorrhagische Fieber (VHF) mit Potenzial einer Mensch-zu-Mensch-Übertragung
Schmiedel, S., & Wolf, T. (2025) · Infektiologie up2date · doi:10.1055/a-2630-3361
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Deep neural network investigation for the transmission of Marburg virus with public health education
Khan, M. Y., Farhan, M., Ling, Z., & Waseem (2026) · The European Physical Journal Plus · doi:10.1140/epjp/s13360-026-08139-w
Machine learning-enhanced stochastic modeling of Marburg virus transmission in human–bat populations
Hussain, S. M., Ali, B., Jubair, S., Ishaq, W., & Akhmedova, D. (2026) · Next Materials · doi:10.1016/j.nxmate.2026.103628
- Authors
- Ajelli, M., & Merler, S.
- Affiliations
- Fondazione Bruno Kessler (IT)
- Corresponding author
- Ajelli, Marco
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2012-12-10
- Volume
- 7
- Issue
- 12
- Pages
- e50948
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3519495
- OpenAlex
- W2077422818
- Cited by
- 44
- References
- 46
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 3 · 2023: 15 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 2 · 2015: 2 · 2014: 1 · 2013: 1
- FWCI
- 0.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- European Commission (231807)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Vectors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mathematical and Theoretical Epidemiology and Ecology Models
- Keywords
- Marburg hemorrhagic fever, transmission potential, basic reproduction number, generation time, case isolation, social distancing, epidemic control, epidemic containment, non-human primates, viral load, case fatality rate
- MeSH terms
- Animals, Humans, Marburg Virus Disease, Models, Biological, Trauma Severity Indices, Basic Reproduction Number, Epidemics
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