Lassa fever: A comprehensive review of virology, clinical management, and global health implications

Table 6 Comparative overview of Marburg, Ebola and Lassa viruses

Feature	MARV	EBOV	Lassa virus
Virus family	Filoviridae	Filoviridae	Arenaviridae
First identified outbreak	1967: Marburg and Frankfurt, Germany and Belgrade, Serbia	1976: Yambuku, Democratic Republic of the Congo and Nzara, Sudan	1969: Lassa, Nigeria
Origin of outbreaks	African green monkeys imported from Uganda	Suspected zoonotic transmission with bats as reservoirs and transmission to humans or other primates	Contact with Mastomys natalensis rodents
Reservoir hosts	Egyptian fruit bat (Rousettus aegyptiacus) suspected	Fruit bats (Pteropodidae family), particularly Eidolon helvum	Multimammate rats (Mastomys natalensis)
Case fatality rate	24%-90%, depending on outbreak and case management	25%-90%, depending on outbreak and case management	1% overall; up to 15%-20% in hospitalized patients; higher in pregnant females
Geographic distribution	Primarily sub-Saharan Africa	Primarily sub-Saharan Africa	West Africa: Nigeria, Sierra Leone, Liberia, Guinea, others
Symptoms	Hemorrhagic fever, severe malaise, high fever, vomiting, diarrhea, organ dysfunction	Similar to MARV: Hemorrhagic fever, malaise, vomiting, diarrhea, multiorgan failure	Fever, sore throat, vomiting, bleeding, neurological complications
Transmission	Direct contact with bodily fluids (e.g., blood, saliva, urine) of infected persons or animals	Direct contact with bodily fluids of infected persons or animals, contaminated surfaces	Exposure to rodent excreta; human-to-human via body fluids
Laboratory diagnosis	PCR, ELISA, virus isolation	PCR, ELISA, virus isolation	PCR, ELISA (IgM, IgG), virus isolation
Vaccines	No approved vaccine (research ongoing)	Approved vaccines available (e.g., recombinant vesicular stomatitis virus-ZEBOV for Zaire strain)	No approved vaccine (clinical trials ongoing)
Notable outbreaks	Angola (2004-2005), Democratic Republic of the Congo (1998-2000)	West Africa (2014-2016), Democratic Republic of the Congo (multiple outbreaks)	Nigeria (multiple outbreaks annually), Sierra Leone epidemics

EBOV: Ebola virus; MARV: Marburg virus.