Diagnostic toolkit aims to improve response to Marburg virus cases

Viral hemorrhagic fevers (VHF) such as Marburg virus disease have been in the news recently, with more than 60 cases of Marburg confirmed in Rwanda. Although there are currently no cases of Marburg in the United States, and the risk of infection in the U.S. remains low, Mass General Brigham experts have collaborated with the U.S. Department of Health and Human Services (HHS) Region 1 Regional Emerging Special Pathogens Treatment Center (RESPTC) at the Massachusetts General Hospital (MGH) to support frontline healthcare facilities in ensuring that patients who are being evaluated for VHF receive critical laboratory testing. As part of their work, the team developed a toolkit available for use in facilities across the U.S. A paper detailing the new toolkit is published in Infection Control & Hospital Epidemiology. 

While the risk of Marburg virus disease in the U.S. is currently low, early identification and isolation of persons presenting with signs and symptoms, and epidemiological risk factors for this infection is essential for patient and healthcare personnel safety. However, once an at-risk patient is identified and isolated, diagnostic capacity is critical to patient evaluation. As a Marburg virus disease suspect can present to any healthcare facility in the U.S., ensuring hospitals have a practical action plan for the isolation and initial care of these individuals is necessary. Our toolkit provides generalizable and scalable resources to facilitate development of this plan." 

Sarah E. Turbett, MD, co-lead author of the Division of Infectious Diseases and Department of Pathology, Massachusetts General Hospital

The toolkit includes a "base plan" that outlines how to collect, process, and report laboratory test results from VHF suspects, as well as guidance on infection prevention and control, waste management, and occupational health practices. 

"Because of the care that must be taken in handling laboratory samples in patients with possible VHF, getting a diagnostic program in place can appear quite daunting, especially for smaller facilities. But it's just not an option to be unprepared," said co-lead author Jacob E. Lazarus, MD, PhD, of the Division of Infectious Diseases at Massachusetts General Hospital. "We wanted to provide a place to start." Documents, templates and checklists are also provided which healthcare facilities can adapt for local needs. 

"In the 2014-2016 West African Ebola Virus Disease outbreak, the CDC reported failures to diagnose and treat malaria in travelers returning to the U.S. who were thought to potentially have Ebola," said senior author Erica S. Shenoy, MD, PhD, Division of Infectious Diseases, Massachusetts General Hospital and Infection Control, Mass General Brigham. "We need to do better. Safe and effective care relies on the diagnostic capacity of every frontline facility. Our team is hopeful that the tools provided can bolster local preparedness efforts." 

The Region 1 RESPTC provides tools and resources for healthcare organizations in New England to ensure appropriate readiness and preparedness for emerging pathogens. For more information, contact the Region 1 RESPTC at [email protected].