Table 3

Risk Factors for Marburg Hemorrhagic Fever, Democratic Republic of the Congo

Daniel G. Bausch*¹

, Matthias Borchert†², Thomas Grein‡, Cathy Roth‡, Robert Swanepoel§, Modeste L. Libande¶, Antoine Talarmin#³, Eric Bertherat**⁴, Jean-Jacques Muyembe-Tamfum¶, Ben Tugume††, Robert Colebunders†, Kader M. Kondé‡‡⁵, Patricia Pirard§§, Loku L. Olinda¶, Guénaël R. Rodier‡, Patricia Campbell¶¶, Oyewale Tomori‡‡, Thomas G. Ksiazek*, and Pierre E. Rollin*

Author affiliations: *Centers for Disease Control and Prevention, Atlanta Georgia, USA; †Institute of Tropical Medicine, Antwerp, Belgium; ‡World Health Organization, Geneva, Switzerland; §National Institute for Communicable Diseases, Johannesburg, South Africa; ¶Ministry of Health, Kinshasa, Democratic Republic of the Congo; #Institut Pasteur, Cayenne, French Guiana; **Le Pharo, Marseille, France; ††Uganda Virus Research Institute, Entebbe, Uganda; ‡‡World Health Organization, AFRO, Harare, Zimbabwe; §§Doctors without Borders, Brussels, Belgium; ¶¶Doctors without Borders, Amsterdam, the Netherlands; 1Present address: Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA.; 2Present address: London School of Hygiene and Tropical Medicine, London, England.; 3Present address: Institut Pasteur, Bangui, Central African Republic.; 4Present address: World Health Organization, Geneva, Switzerland.; 5Present address: World Health Organization, AFRO, Ouagadougou, Burkina Faso.

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Antibody to Marburg virus and possible risk factors for Marburg hemorrhagic fever in Durba, Democratic Republic of the Congo, 1999^a

Characteristic	All participants (%)	Antibody positive (%)		Antibody negative (%)		OR (95% CI)	p value
Behavior in the mines^b
Wear mask	4/289 (1)	1/13 (8)		3/276 (1)		7.6 (0. to 78.4)	0.17
Drink water from sources in the mine	160/289 (55)	9/13 (69)		151/276 (55)		1.9 (0.6 to 6.2)	0.40
Use explosives	129/289 (45)	7/13 (54)		122/276 (44)		1.5 (0.5 to 4.5)	0.57
Wear boots	46/289 (16)	2/13 (15)		44/276 (16)		1.0 (0.2 to 4.5)	1.00
Household/village exposures to someone with Durba syndrome^c
Touched corpse	88/905 (10)	4/15 (27)		84/890 (9)		3.5 (1.1 to 11.2)	0.05
Touched blood, feces, or urine	60/903 (7)	3/15 (20)		57/888 (6)		3.6 (1.0 to 13.3)	0.07
Worked with someone with syndrome	248/906 (27)	7/15 (47)		241/891 (27)		2.4 (0.8 to 6.6)	0.15
Been in the same room with someone with syndrome	179/902 (20)	4/15 (27)		175/887 (20)		1.5 (0.5 to 4.7)	0.51
Touched skin of person during illness	286/903 (32)	6/15 (40)		280/888 (32)		1.4 (0.5 to 4.1)	0.58
Someone in the household sick with syndrome	210/906 (23)	4/15 (27)		206/891 (23)		1.2 (0.4 to 3.8)	0.76
Participated in burial	393/904 (43)	6/15 (40)		387/889 (44)		0.9 (0.3 to 2.5)	1.00
Healthcare-related exposures
Had Durba syndrome yourself	60/912 (7)	4/15 (27)		56/897 (6)		5.4 (1.7 to 17.7)	0.01
Received injections in the last year	505/907 (56)	13/15 (87)		492/892 (55)		5.2 (1.2 to 23.6)	0.02
Underwent surgery in the last year	85/905 (9)	2/15 (13)		83/890 (9)		1.5 (0.3 to 6.7)	0.64
Received scarification^d in the last year	209/906 (23)	4/15 (27)		205/891 (23)		1.2 (0.4 to 3.9)	0.76
Animal exposures
Rodents
Touched	437/897 (49)	4/14 (29)	433/883 (49)		0.4 (0.1 to 1.3)		0.18
Ate	271/892 (30)	1/15 (7)	270/877 (31)		0.2 (0.0 to 1.2)		0.05
Bitten by	200/896 (22)	3/15 (20)	197/881 (22)		0.9 (0.2 to 3.1)		1.00
Bats
Touched	169/901 (19)	4/14 (29)	165/887 (19)		1.8 (0.5 to 5.6)		0.31
Ate	31/898 (3)	0/15 (-)	31/883 (4)		-		1.00
Bitten by	8/896 (1)	0/15 (-)	8/881 (1)		-		1.00
Monkeys
Touched	502/892 (56)	6/14 (43)	496/878 (57)		0.6 (0.2 to 1.7)		0.42
Ate^e	682/895 (76)	11/14 (79)	671/881 (76)		1.1 (0.3 to 4.2)		1.00
Bitten by	76/895 (8)	1/15 (7)	75/880 (9)		0.8 (0.1 to 5.9)		1.00

^aOdds ratios (OR) and p values are for the comparison between antibody-positive and -negative participants. CI, confidence interval.
     ^bIncludes only responses from persons who stated that they currently worked in the mines.
     ^cBefore questioning began, Durba syndrome was described to the participant as “a severe illness with high fever and bleeding from the nose, mouth, and/or anus.”
     ^dScarification is the practice of intentionally scarring the skin with sharp instruments. It may be done for aesthetic reasons or because of a belief that it has medicinal or spiritual value.
     ^eMany participants reported the meat was smoked or cured at the time of purchase, so potential exposure to viable virus may have been limited.

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