The family Filoviridae contains two genera, Marburgvirus and Ebolavirus, that consist of negative-sense, single-stranded RNA viruses. Ebolavirus has 5 species named for their original site of recognition.
Marburg virus was first identified in 1967; in 2004–2005, a Marburg virus epidemic occurred in Angola, with >250 cases and a case-fatality rate of 90%. Ebola virus was first identified in 1976 and has been associated with several epidemics of severe HF; the mortality rate ranges from 50 to 90%, depending on the species.
Both viruses replicate well in virtually all cell types, and viral replication is associated with cellular necrosis. Acute infection is associated with high levels of circulating virus and viral antigen. Fatal cases are associated with the lack of an antibody response, but clinical recovery is probably mediated by the cellular immune response since convalescent-phase plasma is not protective.
After a 7- to 10-day incubation period, pts experience an abrupt onset of fever, severe headache, myalgia, nausea, vomiting, diarrhea, prostration, and depressed mentation.
Thrombocytopenia, transaminitis, and jaundice are common.
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