Early this year, Equatorial Guinea and Tanzania reported outbreaks of Marburg virus disease (MVD), the first-ever outbreak of the disease in these countries. As the countries respond to the outbreaks through contact tracing and restricting movement across affected regions, the World Health Organization (WHO) estimated the risk of spread of the disease as “very high” across both countries.

The Marburg virus was first identified in 1967 during outbreaks in Germany and Serbia and is known to cause severe and fatal viral haemorrhagic fevers in humans.

The virus is closely related to another deadly virus, Ebola and is rated as a high-risk pathogen by the WHO. Marburg virus is transmitted to humans through contact with infected animals such as fruit bats, and further human-to-human transmission can occur through direct contact with the bodily fluids of an infected patient or contaminated surfaces resulting in outbreaks.

Since its initial detection in 1967, several outbreaks of Marburg virus have been detected between 1975 and 2023, with African countries being the most affected and often with high fatality rates up to 90%, depending on the early access to quality care.

In recent years, and for the first time, isolated cases have been reported in Guinea and Ghana in 2021 and 2022, respectively.

New outbreaks

An outbreak of unknown haemorrhagic fever linked to a funeral ceremony was reported from Equatorial Guinea on February 7, 2023, which was later confirmed as Marburg virus on February 13 by the WHO. A month later, Tanzania reported an outbreak of MVD on March 21, after the detection of eight suspected cases, five of which were fatal. The genome sequence of a Marburg virus from Equatorial Guinea was quickly made available in public domain by researchers. The sequence shows high similarity with Marburg virus genomes previously found in fruit bats, suggesting a potential zoonotic origin.

Is there a concern?

There are no approved vaccines, antivirals or monoclonal antibodies for Marburg virus yet and supportive care to manage symptoms and prevent complications forms the mainstay. However, the WHO aims to accelerate trials of some investigational vaccines. Case detection through contact tracing, molecular diagnosis and quarantine is central to managing the spread of the disease.

While the two outbreaks have triggered a rapid res- ponse to control the spread, the outbreak in Equatorial Guinea has spread to multiple provinces and has even crept into a populous city, Bata. Equatorial Guinea has, so far, reported a total of 35 con- firmed cases and 27 deaths. The large geographic spread of the infection in the country and the unidentified epidemi- ological links between many of the reported cases suggest a wider range of transmission of the virus.

The large geographic spread of the infection in the country and the unidentified epidemiological links between many of the reported cases suggest a wider range of transmission of the virus.

Surveillance

As the affected countries continue to make efforts to contain the disease and another country, Burundi, investigates a suspected outbreak of viral haemorrhagic fever, surveillance of emerging viral diseases is crucial to help early detection, monitoring the circulation and evolution, and develop effective diagnostics, prevention and control measures.

It is only natural that the concept of One Health is increasingly taking centre-stage.

(The authors are researchers at the CSIR Institute of Genomics and Integrative Biology, New Delhi. All opinions expressed are personal)

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A new Canadian study of 4.8 million people says a daily alcoholic drink isn’t likely to send anyone to an early grave, nor will it offer any of the health benefits touted by previous studies, even if it is organic red wine.

Low and moderate drinkers have similar mortality rates to those who abstain entirely, researchers from the Canadian Institute for Substance Use Research explain. On the other hand, women who enjoy more than one standard drink per day are at least 20 per cent likely to die prematurely.

“In this updated systematic review and meta-analysis, daily low or moderate alcohol intake was not significantly associated with all-cause mortality risk,” the study’s authors write, “while increased risk was evident at higher consumption levels, starting at lower levels for women than men.”

Published Friday in the medical journal JAMA Open Network, the study comes on the heels of a report by the Canadian Centre on Substance Use and Addiction (CCSA) that said Canadians should have no more than two alcoholic drinks per week in order to minimize the health risks associated with alcohol.

Lead researcher Dr. Jinhui Zhao and his co-authors wanted to better understand the link between alcohol and all-cause death, including theories advanced by previous studies that a small amount of alcohol can provide health benefits, and that “moderate drinkers” live longer and are less likely to die from heart disease than non-drinkers.

They reviewed 107 studies from between 1980 and 2021 involving 4.8 million people and found that consuming more than one standard drink per day raised the risk of premature death significantly, especially for women.

In Canada, a standard drink is defined as a 341-ml bottle of five per cent alcohol beer or cider, a 142-ml glass of 12 per cent alcohol wine or a 43-ml shot glass of 40 per cent alcohol spirits. Each standard drink contains 13.45 grams of pure alcohol.

“There was a significantly increased risk of all-cause mortality among female drinkers who drank 25 or more grams per day and among male drinkers who drank 45 or more grams per day,” the authors wrote. “Low-volume alcohol drinking was not associated with protection against death from all causes.”

When they looked at previous studies that suggest people who drink a little are less likely to die early or from heart disease than people who don’t drink at all, they found the evidence was skewed by systematic bias.

“For example, light and moderate drinkers are systematically healthier than current abstainers on a range of health indicators unlikely to be associated with alcohol use, (like) dental hygiene, exercise routines, diet, weight (and) income,” they wrote.

Meanwhile, abstainers may be statistically more likely to experience poorer health, since many have had to stop – or never started drinking in the first place – for health reasons. They also found most of the studies they reviewed overrepresented older white men in their data, failing to account for the experiences of women, racialized people and people from diverse socioeconomic backgrounds.

When Zhao and his colleagues adjusted the data to account for these variables, they couldn’t find any evidence that drinking a low or moderate amount of alcohol had any kind of positive effect on life expectancy or heart health.

“Our meta-analysis… found no significant protective associations of occasional or moderate drinking with all-cause mortality, and an increased risk of all-cause mortality for drinkers who drank 25 g or more,” the authors conclude.

“Future longitudinal studies in this field should attempt to minimize lifetime selection biases by not including former and occasional drinkers in the reference group, and by using younger cohorts more representative of drinkers in the general population at baseline.”

If you or someone you know is struggling with addiction or mental health matters, the following resources may be available to you:

• Hope for Wellness Helpline for Indigenous Peoples (English, French, Cree, Ojibway and Inuktitut): 1-855-242-3310
• Wellness Together Canada: 1-866-585-0445
• Drug Rehab Services: 1-877-254-3348
• SMART Recovery: meetings.smartrecovery.org/meetings/
• Families for Addiction Recovery: 1-855-377-6677
• Kids Help Phone: 1-800-668-6868

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The game is one of many available on Virtual Gym, an exercise platform still in development, where gamers of all ages can slip into a virtual reality headset and try climbing mountains, a wide range of stretching, balloon popping, shooting arrows, or yes, even slicing through fruit that is flying at you in real-time.

The game’s co-creator and computing science professor Eleni Stroulia shared Virtual Gym with counterparts at the Ritsumeikan University, which according to the Ritsumeikan Center for Game Studies website, is the only academic organization in Japan that offers the field of game studies.

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