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Review
. 2020 May 13;84(2):e00095-19.
doi: 10.1128/MMBR.00095-19. Print 2020 May 20.

A Forgotten Episode of Marburg Virus Disease: Belgrade, Yugoslavia, 1967

Elizabeta S Ristanović  1 , Nenad S Kokoškov  2 , Ian Crozier  3 , Jens H Kuhn  4 , Ana S Gligić  5
Affiliations
Review

A Forgotten Episode of Marburg Virus Disease: Belgrade, Yugoslavia, 1967

Elizabeta S Ristanović et al. Microbiol Mol Biol Rev. .

Abstract

In 1967, several workers involved in poliomyelitis vaccine development and production fell ill at three different locations in Europe with a severe and often lethal novel disease associated with grivets (Chlorocebus aethiops) imported from Uganda. This disease was named Marburg virus disease (MVD) after the West German town of Marburg an der Lahn, where most human infections and deaths had been recorded. Consequently, the Marburg episode received the most scientific and media attention. Cases that occurred in Frankfurt am Main, West Germany, were also described in commonly accessible scientific literature, although they were less frequently cited than those pertaining to the Marburg infections. However, two infections occurring in a third location, in Belgrade, Yugoslavia, have seemingly been all but forgotten. Due in part to their absence in commonly used databases and in part to the fact that they were written in languages other than English, the important articles describing this part of the outbreak are very rarely cited. Here, we summarize this literature and correct published inaccuracies to remind a younger generation of scientists focusing on Marburg virus and its closest filoviral relatives of this important historical context. Importantly, and unfortunately, the three episodes of infection of 1967 still represent the best in-depth clinical look at MVD in general and in the context of "modern" medicine (fully resourced versus less-resourced capacity) in particular. Hence, each individual case of these episodes holds crucial information for health care providers who may be confronted with MVD today.

Keywords: Belgrade; Filoviridae; MHF; MVD; Marburg hemorrhagic fever; Marburg virus; Marburg virus disease; Torlak; VHF; filovirus; marburgvirus; viral hemorrhagic fever.

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Figures

FIG 1
FIG 1
Timeline of grivet epizootics associated with three shipments imported from Uganda to the “Torlak” Institute and time association of epizootics with occurrence of Marburg virus disease in a veterinarian (Ž.St.) and secondary contact (R.St.). Red dots indicate grivets that died during the quarantine and peri-quarantine periods. (Based on data from reference .)
FIG 2
FIG 2
Clinical course of Marburg virus disease in the index patient (Ž.St.) of the Belgrade, Serbia, outbreak. Dots on curves in the bottom three panels likely represent sampling times on a 24-h clock scale. t, administration of convalescent-phase plasma from a Marburg virus disease patient from the 1967 Frankfurt am Main outbreak. (Adapted from reference with permission of the publisher.)
FIG 3
FIG 3
Clinical course of Marburg virus disease in the secondarily infected patient (R.St.) of the Belgrade, Serbia, outbreak. Dots on curves in the bottom three panels likely represent sampling times on a 24-h clock scale. t, administration of convalescent-phase plasma from a Marburg virus disease patient from the 1967 Frankfurt am Main outbreak. (Adapted from reference with permission of the publisher.)
See this image and copyright information in PMC

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