in nzoia (close to bungoma) at the base of mount elgon (which contains kitum cave), became infected by unknown means and died on 15 january shortly after admission to nairobi hospital. the attending physician contracted mvd, but survived. a popular science account of these cases can be found in richard preston’s book the hot zone (the french man is referred to under the pseudonym “charles monet”, whereas the physician is identified under his real name, shem musoke). 1987 case in 1987, a single lethal case of ravv infection occurred in a 15-year-old danish boy, who spent his vacation in kisumu, kenya. he had visited kitum cave on mount elgon prior to travelling to mombasa, where he developed clinical signs of infection. the boy died after transfer to nairobi hospital. a popular science account of this case can be found in richard preston’s book the hot zone (the boy is referred to under the pseudonym “peter cardinal”). 1988 laboratory infection in 1988, researcher nikolai ustinov infected himself lethally with marv after accidentally pricking himself with a syringe used for inoculation of guinea pigs. the accident occurred at the scientific-production association "vektor" (today the state research center of virology and biotechnology "vektor") in koltsovo, ussr (today russia). very little information is publicly available about this mvd case because ustinov's experiments were classified. a popular science account of this case can be found in ken alibek’s book biohazard. 1990 laboratory infection another laboratory accident occurred at the scientific-production association "vektor" (today the state research center of virology and biotechnology "vektor") in koltsovo, ussr, when a scientist contracted marv by unknown means. 1998–2000 outbreak a major mvd outbreak occurred among illegal gold miners around goroumbwa mine in durba and watsa, democratic republic of congo from 1998 to 2000, when co-circulating marv and ravv caused 154 cases of mvd and 128 deaths. the outbreak ended with the flooding of the mine. 2004–2005 outbreak in early 2005, the world health organization (who) began investigating an outbreak of viral hemorrhagic fever in angola, which was centered in the northeastern uíge province but also affected many other provinces. the angolan government had to ask for international assistance, pointing out that there were only approximately 1,200 doctors in the entire country, with some provinces having as few as two. health care workers also complained about a shortage of personal protective equipment such as gloves, gowns, and masks. médecins sans frontières (msf) reported that when their team arrived at the provincial hospital at the center of the outbreak, they found it operating without water and electricity. contact tracing was complicated by the fact that the country's roads and other infrastructure were devastated after nearly three decades of civil war and the countryside remained littered with land mines. americo boa vida hospital in the angolan capital luanda set up a special isolation ward to treat infected people from the countryside. unfortunately, because mvd often results in death, some people came to view hospitals and medical workers with suspicion and treated helpers with hostility. for instance, a specially-equipped isolation ward at the provincial hospital in uíge was reported to be empty during much of the epidemic, even though the facility was at the center of the outbreak. who was forced to implement what it described as a "harm reduction strategy", which entailed distributing disinfectants to affected families who refused hospital care. of the 252 people who contracted mvd during outbreak, 227 died. 2007 cases in 2007, four miners became infected with marburgviruses in kamwenge district, uganda. the first case, a 29-year-old man, became symptomatic on july 4, 2007, was admitted to a hospital on july 7, and died on july 13. contact tracing revealed that the man had had prolonged close contact with two colleagues (a 22-year-old man and a 23-year-old man), who experienced clinical signs of infection before his disease onset. both men had been admitted to hospitals in june and survived their infections, which were proven to be due to marv. a fourth, 25-year-old man, developed mvd clinical signs in september and was shown to be infected with ravv. he also survived the infection. 2008 cases on july 10, 2008, the netherlands national institute for public health and the environment reported that a 41-year-old dutch woman, who had visited python cave in maramagambo forest during her holiday in uganda had mvd due to marv infection, and had been admitted to a hospital in the netherlands. the woman died under treatment in the leiden university medical centre in leiden on july 11. the ugandan ministry of health closed the cave after this case. on january 9 of that year an infectious diseases physician notified the colorado department of public health and the environment that a 44-year-old american woman who had returned from uganda had been hospitalized with a fever of unknown origin. at the time, serologic testing was negative for viral hemorrhagic fever. she was discharged on january 19, 2008. after the death of the dutch patient and the discovery that the american woman had visited python cave, further testing confirmed the patient demonstrated marv antibodies and rna. 2017 uganda outbreak kween district in uganda main article: 2017 uganda marburg virus outbreak in october 2017 an outbreak of marburg virus disease was detected in kween district, eastern uganda. all three initial cases (belonging to one family – two brothers and one sister) had died by 3 november. the fourth case – a health care worker – developed symptoms on 4 november and was admitted to a hospital. the first confirmed case traveled to kenya before the death. a close contact of the second confirmed case traveled to kampala. it is reported that several hundred people may have been exposed to infection. 2021 guinean cases main article: 2021 marburg virus disease outbreak in guinea in august 2021, two months after the re-emergent ebola epidemic in the guéckédou prefecture was declared over, a case of the marburg disease was confirmed by health authorities through laboratory analysis. other potential case of the disease in a contact awaits official results. this was the first case of the marburg hemorrhagic fever confirmed to happen in west africa. the case of marburg also has been identified in guéckédou. during the outbreak, a total of one confirmed case who died, (cfr=100%) and 173 contacts were identified, including 14 high risk contacts based on exposure. among them, 172 were followed for a period of 21 days, of which none developed symptoms. one high-risk contact was lost to follow up. sequencing of an isolate from the guinean patient showed that this outbreak was caused by the angola-like marburg virus. a colony of egyptian rousettus bats (reservoir host of marburg virus) was found in close proximity (4.5 km) to the village, where the marburg virus disease outbreak emerged in 2021. two of sampled fruit bats from this colony were pcr-positive on the marburg virus. 2022 ghanaian cases in july 2022, preliminary analysis of samples taken from two patients – both deceased – in ghana indicated the cases were positive for marburg. however, per standard procedure, the samples were sent to the pasteur institute of dakar for confirmation. on 17 july 2022 the two cases were confirmed by ghana, which caused the country to declare a marburg virus disease outbreak. an additional case was identified, bringing the total to three. 2023 equatorial guinea outbreak main article: 2023 marburg virus disease outbreak in equatorial guinea in february 2023, equatorial guinea reported an outbreak of marburg virus disease. neighbouring cameroon detected two suspected cases of marburg virus disease on 13 february 2023. research experimentally, recombinant vesicular stomatitis indiana virus (vsiv) expressing the glycoprotein of marv has been used successfully in nonhuman primate models as post-exposure prophylaxis. a vaccine candidate has been effective in nonhuman primates. experimental therapeutic regimens relying on antisense technology have shown promise, with phosphorodiamidate morpholino oligomers (pmos) targeting the marv genome new therapies from sarepta and tekmira have also been successfully used in humans as well as primates.