An early positive PCR test may confirm the diagnosis, but a negative, test does not refute it. The incubation period of Marburg disease in the European outbreak was 3-9 days. The course of the illness is similar to that of Ebola, though Marburg virus infection tends to be less severe and has a lower case fatality rate. Aerosol transmission has not been described in the clinical setting, but it would be unwise to disregard the possibility of this occurring when the patient is seriously ill with pulmonary involvement. Similarly, in the laboratory and other experimental settings, aerosol transmission between animals has not been entirely excluded.
Treatment is generally a matter of applying intensive supportive measures.
Public Health Measures Marburg disease is notifiable or reportable in most Western countries. Cases or outbreaks should also be reported to the World Health Organisation. Marburg virus is a hazard category 4 virus, and should be handled in a containment level 4 laboratory. Large outbreaks of Marburg fever have not been recognised in endemic areas, but would be managed in a similar way to outbreaks of Ebola fever, if they occurred. Contacts of cases, or individuals with exposure in laboratories are placed under health surveillance for 21 days after their last exposure to infection.