The World Health Organisation has issued a ‘high’ risk warning after 26 cases and eight fatalities were linked to the spread of the deadly and incurable Marburg Virus Disease. Efforts are under way to trace 300 individuals who may have been in contact with those infected.
Rwanda’s Ministry of Health has announced the nation’s first outbreak, with cases detected across seven districts out of thirty. Notably, over 70% of those affected are healthcare workers from two Kigali health facilities.
The threat of international spread of the disease has been heightened by confirmed cases in Kigali, the capital city, which boasts an international airport and road networks to several cities in East Africa. Because of these risks, the World Health Organisation advises against any travel and trade restrictions with Rwanda based on the current risk assessment.
Currently, patients are receiving treatment in hospitals, while the Rwandan government is leading the response efforts, backed by WHO and its partners. There are no treatments or vaccines available for MVD at this time.
A WHO representative stated: “This is why it is important for people showing Marburg-like symptoms to seek care early for supportive treatment which can improve patient survival. WHO assesses the risk of this outbreak as very high at the national level, high at the regional level, and low at the global level.”
In one case, an individual who had contact with the virus travelled internationally but remained symptom-free after the monitoring period, suggesting no further spread. Investigations continue to determine the source of the infection, reports Bristol Live.
MVD is a highly potent disease that can trigger haemorrhagic fever and bears clinical similarities to Ebola. Both Marburg and Ebola viruses belong to the Filoviridae family, also known as filovirus.
Initial infection with the Marburg virus occurs when humans come into close contact with Rousettus bats. This is a species of fruit bat often found in mines or caves, which are carriers of the virus.
The Marburg virus spreads among humans through direct contact, either via broken skin or mucous membranes, with the blood, secretions, organs or other bodily fluids of infected individuals, as well as surfaces and materials such as bedding or clothing contaminated with these fluids. Healthcare professionals have been known to contract the virus while treating patients suspected or confirmed to have MVD.
Burial ceremonies involving direct contact with the body of the deceased can also facilitate the transmission of the Marburg virus. The incubation period for Marburg virus disease (MVD) can range from two to 21 days. The illness typically begins abruptly, with symptoms including high fever, severe headache and extreme malaise.
By the third day, sufferers may experience severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting. While not all cases present with haemorrhagic signs, severe bleeding may occur between five and seven days after symptom onset in severe cases.
Death often occurs between eight and nine days after symptoms begin, usually following significant blood loss and shock. Currently, there is no available treatment or vaccine for MVD, although some candidate vaccines are under development.
Several outbreaks of MVD have been reported in countries neighbouring Rwanda, such as the Democratic Republic of the Congo, Uganda and the United Republic of Tanzania. The most recent outbreaks occurred in Equatorial Guinea and the United Republic of Tanzania between February and June 2023.
Other African countries that have previously reported MVD outbreaks include Angola, Ghana, Guinea, Kenya, and South Africa. The risk of the outbreak spreading to neighbouring countries is high, with cases reported in districts bordering the Democratic Republic of the Congo, Tanzania, and Uganda.