Diagnostic and surveillance strategies for Marburg virus persistence in the male reproductive tract: insights from Ebola and Zika viruses

Abstract

The recent outbreak of the Marburg virus (MARV) in Rwanda was effectively controlled, but concerns remain regarding the virus's persistence and its long-term effects. MARV can remain in the testes of nonhuman primates, where it harms Sertoli cells and compromises the blood-testis barrier, which may have implications for male infertility. This persistence is aided by immunosuppressive regulatory T cells (Tregs), which allow the virus to evade the immune system. Drawing comparisons with Ebola and Zika viruses, we propose that MARV may contribute to male infertility and recommend further studies on human and nonhuman primate survivors. Quick and precise diagnosis is vital for controlling outbreaks. Current diagnostic methods include RT-PCR, ELISA (for antibody and antigen detection), virus isolation, and electron microscopy. Newer technologies like multiplex real-time PCR and CRISPR-based biosensors (e.g., SHERLOCK) provide faster, more sensitive, and on-site detection, which is especially useful in resource-limited areas. These advancements improve MARV monitoring; however, strict biosafety measures are still necessary due to its classification as a Risk Group 4 pathogen.