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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2016

Open Access 01-12-2016 | Research article

How severe and prevalent are Ebola and Marburg viruses? A systematic review and meta-analysis of the case fatality rates and seroprevalence

Authors: Luke Nyakarahuka, Clovice Kankya, Randi Krontveit, Benjamin Mayer, Frank N. Mwiine, Julius Lutwama, Eystein Skjerve

Published in: BMC Infectious Diseases | Issue 1/2016

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Abstract

Background

Ebola and Marburg virus diseases are said to occur at a low prevalence, but are very severe diseases with high lethalities. The fatality rates reported in different outbreaks ranged from 24–100%. In addition, sero-surveys conducted have shown different seropositivity for both Ebola and Marburg viruses. We aimed to use a meta-analysis approach to estimate the case fatality and seroprevalence rates of these filoviruses, providing vital information for epidemic response and preparedness in countries affected by these diseases.

Methods

Published literature was retrieved through a search of databases. Articles were included if they reported number of deaths, cases, and seropositivity. We further cross-referenced with ministries of health, WHO and CDC databases. The effect size was proportion represented by case fatality rate (CFR) and seroprevalence. Analysis was done using the metaprop command in STATA.

Results

The weighted average CFR of Ebola virus disease was estimated to be 65.0% [95% CI (54.0–76.0%), I2 = 97.98%] whereas that of Marburg virus disease was 53.8% (26.5–80.0%, I2 = 88.6%). The overall seroprevalence of Ebola virus was 8.0% (5.0%–11.0%, I2 = 98.7%), whereas that for Marburg virus was 1.2% (0.5–2.0%, I2 = 94.8%). The most severe species of ebolavirus was Zaire ebolavirus while Bundibugyo Ebolavirus was the least severe.

Conclusions

The pooled CFR and seroprevalence for Ebola and Marburg viruses were found to be lower than usually reported, with species differences despite high heterogeneity between studies. Countries with an improved health surveillance and epidemic response have lower CFR, thereby indicating need for improving early detection and epidemic response in filovirus outbreaks.
Literature
1.
2.
Team WHOER. Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections. N Engl J Med. 2014;371(16):1481–95.CrossRef
3.
Wamala JF, Lukwago L, Malimbo M, Nguku P, Yoti Z, Musenero M, Amone J, Mbabazi W, Nanyunja M, Zaramba S, et al. Ebola hemorrhagic fever associated with novel virus strain, Uganda, 2007–2008. Emerg Infect Dis. 2010;16(7):1087–92.CrossRefPubMedPubMedCentral
4.
Lefebvre A, Fiet C, Belpois-Duchamp C, Tiv M, Astruc K, Aho Glele LS. Case fatality rates of ebola virus diseases: a meta-analysis of World Health Organization data. Med Mal Infect. 2014;44(9):412–6.CrossRefPubMed
5.
Van Kerkhove MD, Bento AI, Mills HL, Ferguson NM, Donnelly CA. A review of epidemiological parameters from ebola outbreaks to inform early public health decision-making. Sci Data. 2015;2:150019.CrossRefPubMedPubMedCentral
6.
Formenty P, Hatz C, Le Guenno B, Stoll A, Rogenmoser P, Widmer A. Human infection due to Ebola virus, subtype Cote d’Ivoire: clinical and biologic presentation. J Infect Dis. 1999;179 Suppl 1:S48–53.CrossRefPubMed
7.
Shoemaker T, MacNeil A, Balinandi S, Campbell S, Wamala JF, McMullan LK, Downing R, Lutwama J, Mbidde E, Stroller U, et al. Reemerging Sudan ebola virus disease in Uganda, 2011. Emerg Infect Dis. 2012;18(9):1480–3.CrossRefPubMedPubMedCentral
8.
Heymann DL, Weisfeld JS, Webb PA, Johnson KM, Cairns T, Berquist H. Ebola hemorrhagic fever: Tandala, Zaire, 1977–1978. J Infect Dis. 1980;142(3):372–6.CrossRefPubMed
9.
10.
Towner JS, Khristova ML, Sealy TK, Vincent MJ, Erickson BR, Bawiec DA, Hartman AL, Comer JA, Zaki SR, Stroher U, et al. Marburgvirus genomics and association with a large hemorrhagic fever outbreak in Angola. J Virol. 2006;80(13):6497–516.CrossRefPubMedPubMedCentral
11.
Bausch DG, Nichol ST, Muyembe-Tamfum JJ, Borchert M, Rollin PE, Sleurs H, Campbell P, Tshioko FK, Roth C, Colebunders R, et al. Marburg hemorrhagic fever associated with multiple genetic lineages of virus. N Engl J Med. 2006;355(9):909–19.CrossRefPubMed
12.
Becquart P, Wauquier N, Mahlakoiv T, Nkoghe D, Padilla C, Souris M, Ollomo B, Gonzalez JP, De Lamballerie X, Kazanji M, et al. High prevalence of both humoral and cellular immunity to Zaire ebolavirus among rural populations in Gabon. PLoS One. 2010;5(2):e9126.CrossRefPubMedPubMedCentral
13.
Nkoghe D, Padilla C, Becquart P, Wauquier N, Moussavou G, Akue JP, Ollomo B, Pourrut X, Souris M, Kazanji M, et al. Risk factors for Zaire ebolavirus--specific IgG in rural Gabonese populations. J Infect Dis. 2011;204 Suppl 3:S768–75.CrossRefPubMed
14.
Gonzalez JP, Nakoune E, Slenczka W, Vidal P, Morvan JM. Ebola and marburg virus antibody prevalence in selected populations of the Central African Republic. Microbes Infect. 2000;2(1):39–44.CrossRefPubMed
15.
Bausch DG, Borchert M, Grein T, Roth C, Swanepoel R, Libande ML, Talarmin A, Bertherat E, Muyembe-Tamfum JJ, Tugume B, et al. Risk factors for marburg hemorrhagic fever, Democratic Republic of the Congo. Emerg Infect Dis. 2003;9(12):1531–7.CrossRefPubMedPubMedCentral
16.
Amman BR, Carroll SA, Reed ZD, Sealy TK, Balinandi S, Swanepoel R, Kemp A, Erickson BR, Comer JA, Campbell S, et al. Seasonal pulses of marburg virus circulation in juvenile Rousettus aegyptiacus bats coincide with periods of increased risk of human infection. PLoS Pathog. 2012;8(10):e1002877.CrossRefPubMedPubMedCentral
17.
Amman BR, Jones ME, Sealy TK, Uebelhoer LS, Schuh AJ, Bird BH, Coleman-McCray JD, Martin BE, Nichol ST, Towner JS. Oral shedding of marburg virus in experimentally infected Egyptian fruit bats (Rousettus aegyptiacus). J Wildl Dis. 2015;51(1):113–24.CrossRefPubMedPubMedCentral
18.
Amman BR, Nyakarahuka L, McElroy AK, Dodd KA, Sealy TK, Schuh AJ, Shoemaker TR, Balinandi S, Atimnedi P, Kaboyo W, et al. Marburgvirus resurgence in kitaka mine bat population after extermination attempts, Uganda. Emerg Infect Dis. 2014;20(10):1761–4.CrossRefPubMedPubMedCentral
19.
Towner JS, Amman BR, Sealy TK, Carroll SA, Comer JA, Kemp A, Swanepoel R, Paddock CD, Balinandi S, Khristova ML, et al. Isolation of genetically diverse marburg viruses from Egyptian fruit bats. PLoS Pathog. 2009;5(7):e1000536.CrossRefPubMedPubMedCentral
20.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Open Med. 2009;3(3):e123–30.PubMedPubMedCentral
21.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12.CrossRefPubMed
22.
23.
Borenstein M, Hedges LV, Higgins J, Rothstein HR. Subgroup analyses, Introduction to meta-analysis. 2009. p. 149–86.
24.
Borenstein M, Hedges LV, Higgins J, Rothstein HR. Publication bias, Introduction to meta-analysis. 2009. p. 277–92.
25.
Higgins J, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Stat Med. 2002;21(11):1539–58.CrossRefPubMed
26.
Sterne J. Comprar Meta-Analysis In Stata: An Updated Collection From The Stata Journal| Jonathan Sterne| 9781597180498| CRC PRESS: CRC PRESS, 2009.
27.
Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team. Bull World Health Organ. 1978;56(2):247–270.
28.
Burke J, Declerq R, Ghysebrechts G, Pattyn SR, Piot P, Ronsmans M, Ruppol JF, Thonon D, Van Der Groen G, Van Nieuwenhove S, et al. Ebola hemorrhagic-fever in Zaire, 1976 - report of an International-Commission. Bull World Health Organ. 1978;56(2):271–93.
29.
Baron RC, McCormick JB, Zubeir OA. Ebola virus disease in southern Sudan: hospital dissemination and intrafamilial spread. Bull World Health Organ. 1983;61(6):997–1003.PubMedPubMedCentral
30.
Amblard J, Obiang P, Edzang S, Prehaud C, Bouloy M, Guenno BL. Identification of the ebola virus in Gabon in 1994. Lancet. 1997;349(9046):181–2.CrossRefPubMed
31.
Georges AJ, Leroy EM, Renaut AA, Benissan CT, Nabias RJ, Ngoc MT, Obiang PI, Lepage JP, Bertherat EJ, Benoni DD, et al. Ebola hemorrhagic fever outbreaks in Gabon, 1994–1997: epidemiologic and health control issues. J Infect Dis. 1999;179 Suppl 1:S65–75.CrossRefPubMed
32.
Khan AS, Tshioko FK, Heymann DL, Le Guenno B, Nabeth P, Kerstiens B, Fleerackers Y, Kilmarx PH, Rodier GR, Nkuku O, et al. The reemergence of Ebola hemorrhagic fever, Democratic Republic of the Congo, 1995. Commission de lutte contre les epidemies a kikwit. J Infect Dis. 1999;179 Suppl 1:S76–86.CrossRefPubMed
33.
Okware SI, Omaswa FG, Zaramba S, Opio A, Lutwama JJ, Kamugisha J, Rwaguma EB, Kagwa P, Lamunu M. An outbreak of ebola in Uganda. Trop Med Int Health. 2002;7(12):1068–75.CrossRefPubMed
34.
Milleliri JM, Tevi-Benissan C, Baize S, Leroy E, Georges-Courbot MC. [Epidemics of ebola haemorrhagic fever in Gabon (1994–2002). epidemiologic aspects and considerations on control measures]. Bull Soc Pathol Exot. 2004;97(3):199–205.PubMed
35.
Boumandouki P, Formenty P, Epelboin A, Campbell P, Atsangandoko C, Allarangar Y, Leroy EM, Kone ML, Molamou A, Dinga-Longa O, et al. [Clinical management of patients and deceased during the ebola outbreak from October to December 2003 in Republic of Congo]. Bull Soc Pathol Exot. 2005;98(3):218–23.PubMed
36.
Nkoghe D, Nnegue S, Mve MT, Formenty P, Thompson G, Iba Ba J, Okome Nkoumou M, Leroy E. [Isolated case of haemorrhagic fever observed in Gabon during the 2002 outbreak of ebola but distant from epidemic zones]. Med Trop (Mars). 2005;65(4):349–54.
37.
Rouquet P, Froment JM, Bermejo M, Kilbourn A, Karesh W, Reed P, Kumulungui B, Yaba P, Delicat A, Rollin PE, et al. Wild animal mortality monitoring and human ebola outbreaks, Gabon and Republic of Congo, 2001–2003. Emerg Infect Dis. 2005;11(2):283–90.CrossRefPubMedPubMedCentral
38.
Onyango CO, Opoka ML, Ksiazek TG, Formenty P, Ahmed A, Tukei PM, Sang RC, Ofula VO, Konongoi SL, Coldren RL, et al. Laboratory diagnosis of ebola hemorrhagic fever during an outbreak in Yambio, Sudan, 2004. J Infect Dis. 2007;196 Suppl 2:S193–8.CrossRefPubMed
39.
Leroy EM, Epelboin A, Mondonge V, Pourrut X, Gonzalez JP, Muyembe-Tamfum JJ, Formenty P. Human ebola outbreak resulting from direct exposure to fruit bats in Luebo, Democratic Republic of Congo, 2007. Vector Borne Zoonotic Dis. 2009;9(6):723–8.CrossRefPubMed
40.
Grard G, Biek R, Tamfum JJ, Fair J, Wolfe N, Formenty P, Paweska J, Leroy E. Emergence of divergent Zaire ebola virus strains in Democratic Republic of the Congo in 2007 and 2008. J Infect Dis. 2011;204 Suppl 3:S776–84.CrossRefPubMedPubMedCentral
41.
Nkoghe D, Kone ML, Yada A, Leroy E. A limited outbreak of ebola haemorrhagic fever in Etoumbi, Republic of Congo, 2005. Trans R Soc Trop Med Hyg. 2011;105(8):466–72.CrossRefPubMed
42.
Albarino CG, Shoemaker T, Khristova ML, Wamala JF, Muyembe JJ, Balinandi S, Tumusiime A, Campbell S, Cannon D, Gibbons A, et al. Genomic analysis of filoviruses associated with four viral hemorrhagic fever outbreaks in Uganda and the Democratic Republic of the Congo in 2012. Virology. 2013;442(2):97–100.CrossRefPubMed
43.
Maganga GD, Kapetshi J, Berthet N, Kebela Ilunga B, Kabange F, Mbala Kingebeni P, Mondonge V, Muyembe JJ, Bertherat E, Briand S, et al. Ebola virus disease in the Democratic Republic of Congo. N Engl J Med. 2014;371(22):2083–91.CrossRefPubMed
44.
Siegert R. Marburg virus. In: Canine Distemper Virus: Springer. 1972:97–153.
45.
Feldmann H, Slenczka W, Klenk H-D. Emerging and reemerging of filoviruses. In: Imported Virus Infections. edn.: Springer; 1996:77–100.
46.
Gear JS, Cassel GA, Gear AJ, Trappler B, Clausen L, Meyers AM, Kew MC, Bothwell TH, Sher R, Miller GB, et al. Outbreake of marburg virus disease in Johannesburg. Br Med J. 1975;4(5995):489–93.CrossRefPubMedPubMedCentral
47.
Smith DH, Johnson BK, Isaacson M, Swanapoel R, Johnson KM, Killey M, Bagshawe A, Siongok T, Keruga WK. Marburg-virus disease in Kenya. Lancet. 1982;1(8276):816–20.CrossRefPubMed
48.
Nikiforov V, Turovskiĭ I, Kalinin P, Akinfeeva L, Katkova L, Barmin V, Riabchikova E, Popkova N, Shestopalov A, Nazarov V: [A case of a laboratory infection with Marburg fever]. Zhurnal mikrobiologii, epidemiologii, i immunobiologii. 1993;(3):104–106.
49.
Johnson ED, Johnson BK, Silverstein D, Tukei P, Geisbert TW, Sanchez AN, Jahrling PB. Characterization of a new marburg virus isolated from a 1987 fatal case in Kenya. Arch Virol Suppl. 1996;11:101–14.PubMed
50.
Centers for Disease C, Prevention. Imported case of marburg hemorrhagic fever - Colorado, 2008. Morb Mortal Wkly Rep. 2009;58(49):1377–81.
51.
Adjemian J, Farnon EC, Tschioko F, Wamala JF, Byaruhanga E, Bwire GS, Kansiime E, Kagirita A, Ahimbisibwe S, Katunguka F, et al. Outbreak of marburg hemorrhagic fever among miners in Kamwenge and Ibanda Districts, Uganda, 2007. J Infect Dis. 2011;204 Suppl 3:S796–9.CrossRefPubMedPubMedCentral
52.
Van der Groen G, Pattyn SR. Measurement of antibodies to ebola virus in human sera from N. W.-Zaire. Ann Soc Belg Med Trop. 1979;59(1):87–92.PubMed
53.
Saluzzo JF, Gonzalez JP, Herve JP, Georges AJ, Johnson KM. [Preliminary note on the presence of antibodies to ebola virus in the human population in the eastern part of the Central African Republic]. Bull Soc Pathol Exot Filiales. 1980;73(3):238–41.PubMed
54.
Saluzzo JF, Gonzalez JP, Mccormick J, Herve JP, Georges AJ, Degallier N, Johnson KM. Epidemiology of hemorrhagic fevers (Lassa, Ebola and Marburg) in human, rodent and animal populations in the Republic-of-Central-Africa. Ann Inst Pasteur Mic. 1982;A133(3):493.
55.
Bouree P, Bergmann JF. Ebola virus infection in man: a serological and epidemiological survey in the Cameroons. AmJTrop Med Hyg. 1983;32(6):1465–6.
56.
Johnson BK, Ocheng D, Gichogo A, Okiro M, Libondo D, Tukei PM, Ho M, Mugambi M, Timms GL, French M. Antibodies against haemorrhagic fever viruses in Kenya populations. Trans R Soc Trop Med Hyg. 1983;77(5):731–3.CrossRefPubMed
57.
Van der Waals FW, Pomeroy KL, Goudsmit J, Asher DM, Gajdusek DC. Hemorrhagic fever virus infections in an isolated rainforest area of central Liberia. Limitations of the indirect immunofluorescence slide test for antibody screening in Africa. Trop Geogr Med. 1986;38(3):209–14.PubMed
58.
Meunier DM, Johnson ED, Gonzalez JP, Georges-Courbot MC, Madelon MC, Georges AJ. [Current serologic data on viral hemorrhagic fevers in the Central African Republic]. Bull Soc Pathol Exot Filiales. 1987;80(1):51–61.PubMed
59.
Paix MA, Poveda JD, Malvy D, Bailly C, Merlin M, Fleury HJ. [Serological study of the virus responsible for hemorrhagic fever in an urban population of Cameroon]. Bull Soc Pathol Exot Filiales. 1988;81(4):679–82.PubMed
60.
Tomori O, Fabiyi A, Sorungbe A, Smith A, McCormick JB. Viral hemorrhagic fever antibodies in Nigerian populations. Am J Trop Med Hyg. 1988;38(2):407–10.PubMed
61.
Mathiot CC, Fontenille D, Georges AJ, Coulanges P. Antibodies to haemorrhagic fever viruses in Madagascar populations. Trans R Soc Trop Med Hyg. 1989;83(3):407–9.CrossRefPubMed
62.
Becker S, Feldmann H, Will C, Slenczka W. Evidence for occurrence of filovirus antibodies in humans and imported monkeys: do subclinical filovirus infections occur worldwide? Med Microbiol Immunol. 1992;181(1):43–55.CrossRefPubMed
63.
Johnson ED, Gonzalez JP, Georges A. Filovirus activity among selected ethnic groups inhabiting the tropical forest of equatorial Africa. Trans R Soc Trop Med Hyg. 1993;87(5):536–8.CrossRefPubMed
64.
Johnson ED, Gonzalez JP, Georges A. Haemorrhagic fever virus activity in equatorial Africa: distribution and prevalence of filovirus reactive antibody in the Central African Republic. Trans R Soc Trop Med Hyg. 1993;87(5):530–5.CrossRefPubMed
65.
Bertherat E, Renaut A, Nabias R, Dubreuil G, Georges-Courbot MC. Leptospirosis and Ebola virus infection in five gold-panning villages in northeastern Gabon. AmJTrop Med Hyg. 1999;60(4):610–5.
66.
Busico KM, Marshall KL, Ksiazek TG, Roels TH, Fleerackers Y, Feldmann H, Khan AS, Peters CJ. Prevalence of IgG antibodies to ebola virus in individuals during an ebola outbreak, Democratic Republic of the Congo, 1995. J Infect Dis. 1999;179 Suppl 1:S102–7.CrossRefPubMed
67.
Nakounne E, Selekon B, Morvan J. [Microbiological surveillance: viral hemorrhagic fever in Central African Republic: current serological data in man]. Bull Soc Pathol Exot. 2000;93(5):340–7.PubMed
68.
Allela L, Bourry O, Pouillot R, Delicat A, Yaba P, Kumulungui B, Rouquet P, Gonzalez JP, Leroy EM. Ebola virus antibody prevalence in dogs and human risk. Emerg Infect Dis. 2005;11(3):385–90.CrossRefPubMedPubMedCentral
69.
Heffernan RT, Pambo B, Hatchett RJ, Leman PA, Swanepoel R, Ryder RW. Low seroprevalence of IgG antibodies to ebola virus in an epidemic zone: Ogooue-Ivindo region, Northeastern Gabon, 1997. J Infect Dis. 2005;191(6):964–8.CrossRefPubMed
70.
Lahm SA, Kombila M, Swanepoel R, Barnes RF. Morbidity and mortality of wild animals in relation to outbreaks of ebola haemorrhagic fever in Gabon, 1994–2003. Trans R Soc Trop Med Hyg. 2007;101(1):64–78.CrossRefPubMed
71.
Johnson BK, Ocheng D, Gitau LG, Gichogo A, Tukei PM, Ngindu A, Langatt A, Smith DH, Johnson KM, Kiley MP, et al. Viral haemorrhagic fever surveillance in Kenya, 1980–1981. Trop Geogr Med. 1983;35(1):43–7.PubMed
72.
Gonzalez JP, Josse R, Johnson ED, Merlin M, Georges AJ, Abandja J, Danyod M, Delaporte E, Dupont A, Ghogomu A, et al. Antibody prevalence against haemorrhagic fever viruses in randomized representative Central African populations. Res Virol. 1989;140(4):319–31.CrossRefPubMed
73.
Borchert M, Mulangu S, Swanepoel R, Libande ML, Tshomba A, Kulidri A, Muyembe-Tamfum JJ, Van der Stuyft P. Serosurvey on household contacts of marburg hemorrhagic fever patients. Emerg Infect Dis. 2006;12(3):433–9.CrossRefPubMedPubMedCentral
74.
Rollin PE, Williams RJ, Bressler DS, Pearson S, Cottingham M, Pucak G, Sanchez A, Trappier SG, Peters RL, Greer PW, et al. Ebola (subtype Reston) virus among quarantined nonhuman primates recently imported from the Philippines to the United States. J Infect Dis. 1999;179 Suppl 1:S108–14.CrossRefPubMed
75.
Miranda ME, Miranda NL. Reston ebolavirus in humans and animals in the Philippines: a review. J Infect Dis. 2011;204 Suppl 3:S757–60.CrossRefPubMed
76.
Maganga GD, Kapetshi J, Berthet N, Ilunga BK, Kabange F, Kingebeni PM, Mondonge V, Muyembe JJT, Bertherat E, Briand S, et al. Ebola virus disease in the Democratic Republic of Congo. New Engl J Med. 2014;371(22):2083–91.CrossRefPubMed
77.
Okware SI, Omaswa FG, Zaramba S, Opio A, Lutwama JJ, Kamugisha J, Rwaguma EB, Kagwa P, Lamunu M. An outbreak of ebola in Uganda. Tropical Med Int Health. 2002;7(12):1068–75.CrossRef
78.
Nkoghe D, Formenty P, Leroy EM, Nnegue S, Edou SY, Ba JI, Allarangar Y, Cabore J, Bachy C, Andraghetti R, et al. [Multiple ebola virus haemorrhagic fever outbreaks in Gabon, from October 2001 to April 2002]. Bull Soc Pathol Exot. 2005;98(3):224–9.PubMed
79.
80.
Helleringer S, Grepin KA, Noymer A. Ebola virus disease in West Africa--the first 9 months. N Engl J Med. 2015;372(2):188–9.CrossRefPubMed
81.
Incident Management System Ebola Epidemiology Team CDC, Guinea Interministerial Committee for Response Against the Ebola V, World Health O, Team CDCGR, Liberia Ministry of H, Social W, Team CDCLR, Sierra Leone Ministry of H, Sanitation, Team CDCSLR, et al. Update: ebola virus disease epidemic - West Africa, February 2015. Morb Mortal Wkly Rep. 2015;64(7):186–7.
82.
Gostin LO, Friedman EA. A retrospective and prospective analysis of the west African Ebola virus disease epidemic: robust national health systems at the foundation and an empowered WHO at the apex. The Lancet. 2015;385(9980):1902–1909.
83.
Allam MF. Ebola hemorrhagic fever: case fatality rate 90%? 2014.
84.
Kinsman J. “A time of fear”: local, national, and international responses to a large ebola outbreak in Uganda. Globalization Health. 2012;8(1):1.CrossRef
85.
Borchert JN, Tappero JW, Downing R, Shoemaker T, Behumbiize P, Aceng J, Makumbi I, Dahlke M, Jarrar B, Lozano B, et al. Rapidly building global health security capacity--Uganda demonstration project, 2013. Morb Mortal Wkly Rep. 2014;63(4):73–6.
86.
McCormick JB, Bauer SP, Elliott LH, Webb PA, Johnson KM. Biologic differences between strains of ebola virus from Zaire and Sudan. J Infect Dis. 1983;147(2):264–7.CrossRefPubMed
87.
88.
Macneil A, Reed Z, Rollin PE. Serologic cross-reactivity of human IgM and IgG antibodies to five species of ebola virus. PLoS Negl Trop Dis. 2011;5(6):e1175.CrossRefPubMedPubMedCentral
89.
90.
91.
Gear JS, Cassel G, Gear A, Trappler B, Clausen L, Meyers A, Kew M, Bothwell T, Sher R, Miller G. Outbreake of marburg virus disease in Johannesburg. BMJ. 1975;4(5995):489–93.CrossRefPubMedPubMedCentral
92.
Smith D, Isaacson M, Johnson K, Bagshawe A, Johnson B, Swanapoel R, Killey M, Siongok T, Keruga WK. Marburg-virus disease in Kenya. Lancet. 1982;319(8276):816–20.CrossRef
93.
Timen A, Koopmans MP, Vossen AC, van Doornum GJ, Gunther S, van den Berkmortel F, Verduin KM, Dittrich S, Emmerich P, Osterhaus AD, et al. Response to imported case of marburg hemorrhagic fever, the Netherland. Emerg Infect Dis. 2009;15(8):1171–5.CrossRefPubMedPubMedCentral
94.
Knust B, Schafer IJ, Wamala J, Nyakarahuka L, Okot C, Shoemaker T, Dodd K, Gibbons A, Balinandi S, Tumusiime A, et al. Multidistrict outbreak of marburg virus disease-Uganda, 2012. J Infect Dis. 2015;212 Suppl 2:S119–28.CrossRefPubMed
95.
96.
Vandergroen G, Pattyn SR. Measurement of antibodies to ebola virus in human-sera from Nw-Zaire. Ann Soc Belg Med Tr. 1979;59(1):87–92.
97.
Saluzzo JF, Gonzalez JP, Herve JP, Georges AJ, Johnson KM. Ebola virus, serological survey, Central-African-Republic. B Soc Pathol Exot. 1980;73(3):238–41.
Metadata
Title
How severe and prevalent are Ebola and Marburg viruses? A systematic review and meta-analysis of the case fatality rates and seroprevalence
Authors
Luke Nyakarahuka
Clovice Kankya
Randi Krontveit
Benjamin Mayer
Frank N. Mwiine
Julius Lutwama
Eystein Skjerve
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2016
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-016-2045-6

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Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

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Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

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