Marburg virus disease outbreaks: A narrative review of epidemiology and response

The Marburg virus (MARV), a member of the Filoviridae family, constitutes a serious public health threat due to recurrent outbreaks of viral hemorrhagic fever in Africa. It is characterized by an exceptionally high case fatality rate, historically ranging from 24 to 88%, reaching up to 92% in certain outbreaks, and continues to pose a significant challenge to global health security. Recent outbreaks in Ethiopia and Rwanda underscore the persistent risks posed by MARV and highlight an urgent need for effective and comprehensive prevention and control strategies. This narrative review evaluates the interconnected clinical, public health, operational, and ecological constraints that complicate the prevention, control, and treatment of this deadly viral disease. In addition, it provides an overview of the epidemiological patterns, transmission dynamics, and outbreak responses reported across affected regions. The conclusions provided are largely based on a narrative synthesis of the existing literature rather than an analysis of primary data, and include an epidemiological perspective that integrates historical and recent outbreak data. Overall, this review aims to identify key challenges and priority areas for strengthening preparedness, surveillance, and response strategies, particularly in resource-limited settings where the impact of MARV outbreaks is most severe.