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Viruses 2016, 8(4), 87;

Natural History of Aerosol Exposure with Marburg Virus in Rhesus Macaques

Department of Medicine, Tripler Army Medical Center, Honolulu, HI 96859, USA
US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA
Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD 21702, USA
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Christopher C. Broder
Received: 1 December 2015 / Revised: 20 February 2016 / Accepted: 20 February 2016 / Published: 30 March 2016
(This article belongs to the Collection Advances in Ebolavirus, Marburgvirus, and Cuevavirus Research)
PDF [3537 KB, uploaded 30 March 2016]


Marburg virus causes severe and often lethal viral disease in humans, and there are currently no Food and Drug Administration (FDA) approved medical countermeasures. The sporadic occurrence of Marburg outbreaks does not allow for evaluation of countermeasures in humans, so therapeutic and vaccine candidates can only be approved through the FDA animal rule—a mechanism requiring well-characterized animal models in which efficacy would be evaluated. Here, we describe a natural history study where rhesus macaques were surgically implanted with telemetry devices and central venous catheters prior to aerosol exposure with Marburg-Angola virus, enabling continuous physiologic monitoring and blood sampling without anesthesia. After a three to four day incubation period, all animals developed fever, viremia, and lymphopenia before developing tachycardia, tachypnea, elevated liver enzymes, decreased liver function, azotemia, elevated D-dimer levels and elevated pro-inflammatory cytokines suggesting a systemic inflammatory response with organ failure. The final, terminal period began with the onset of sustained hypotension, dehydration progressed with signs of major organ hypoperfusion (hyperlactatemia, acute kidney injury, hypothermia), and ended with euthanasia or death. The most significant pathologic findings were marked infection of the respiratory lymphoid tissue with destruction of the tracheobronchial and mediastinal lymph nodes, and severe diffuse infection in the liver, and splenitis. View Full-Text
Keywords: filovirus; nonhuman primate; Marburg virus; aerosol; telemetry; animal model filovirus; nonhuman primate; Marburg virus; aerosol; telemetry; animal model

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Ewers, E.C.; Pratt, W.D.; Twenhafel, N.A.; Shamblin, J.; Donnelly, G.; Esham, H.; Wlazlowski, C.; Johnson, J.C.; Botto, M.; Hensley, L.E.; Goff, A.J. Natural History of Aerosol Exposure with Marburg Virus in Rhesus Macaques. Viruses 2016, 8, 87.

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