#18,324
On Friday, Sept 27th the Rwandan MOH announced that `a few' cases of Marburg virus disease had been reported in the country, making this the first outbreak reported from that country. While less common than Ebola, Marburg was the first of the filovirus family of hemorrhagic diseases to be recognized.
This is the 5th report of Marburg in a new African nation since the summer of 2021 (see recent reports from Equatorial Guinea, Guinea, Ghana, and Tanzania), suggesting the virus is increasing its geographic range. A total of 10 African nations have now reported outbreaks.As the CDC map above illustrates, Rwanda is nestled between several countries (DRC, Uganda, Kenya, Tanzania) which have all reported cases in the past.
Since 2012 the CDC has recorded 47 confirmed cases across 7 outbreaks in Africa - with 25 deaths - although additional cases are likely to have gone unrecognized or reported.
Over the weekend the WHO African Region released a statement upping the ante from `a few' cases to 26, with 6 known fatalities. This report indicates the virus has spread to 7 different districts (of 30), suggesting this outbreak has been ongoing for some time.
Rwanda reports first-ever Marburg virus disease outbreak, with 26 cases confirmed
28 September 2024
Brazzaville/Kigali – Rwandan health authorities are intensifying outbreak control efforts following the detection of Marburg virus disease, with 26 cases confirmed and six deaths reported currently.
Cases of the virus have been reported in seven of the country’s 30 districts. Twenty cases are in isolation and receiving treatment, while 161 people who came into contact with the reported cases have so far been identified and are being monitored as the authorities ramp up comprehensive response measures and deepen investigation to determine the origin of the infection.
In support of the ongoing efforts, World Health Organization (WHO) is mobilizing expertise, outbreak response tools, including emergency medical supplies to help reinforce the control measures being rolled out to curb the virus. A consignment of clinical care and infection prevention and control supplies is being readied and will be delivered to Kigali in the coming days from WHO’s Emergency Response Hub in Nairobi, Kenya.
“We’re rapidly setting all the critical outbreak response aspects in motion to support Rwanda halt the spread of this virus swiftly and effectively,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “With the country’s already robust public health emergency response system, WHO is collaborating closely with the national authorities to provide the needed support to further enhance the ongoing efforts.”
WHO is also coordinating efforts to reinforce collaborative cross-border measures for readiness and response in countries neighbouring Rwanda to ensure timely detection and control of the virus to avert further spread.
Although there are several promising candidate medical countermeasures that are progressing through clinical development, there is no licensed vaccine currently available to effectively combat Marburg virus disease. WHO is coordinating a consortium of experts to promote preclinical and clinical development of vaccines and therapeutics against Marburg virus disease.
Marburg virus disease is highly virulent and causes haemorrhagic fever, with a fatality ratio of up to 88%. It is in the same family as the virus that causes Ebola virus disease. Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Many patients develop severe haemorrhagic symptoms within seven days. The virus is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials.
Yesterday the Rwanda MOH posted an update on Twitter/X, indicating two more fatalities.
Eight weeks ago the WHO released their updated 2024 Pathogens Prioritization Report which lists filoviridae viruses (Ebola & Marburg) as high risk diseases for sparking a PHEIC (Public Health Emergency of International Concern).
While most cases have occurred in central Africa, a few cases have been exported, via humans or lab animals, to other regions. The first known outbreak (in 1967) occurred at a laboratory working with green monkeys from Uganda in Marburg, Germany.
In 2019 the CDC released a list of the 56 zoonotic diseases of greatest concern to the United States, and while Ebola came in at number 16, Marburg was much further down the list at #38.
Since then, we've seen a flurry of new outbreaks, and an expansion of the virus to 5 new countries in Africa. While this is likely to remain a regional concern, the unprecedented 2014 3-nation outbreak of Ebola taught us the folly of underestimating these viruses.
Stay tuned.
