Rwanda Faces First Outbreak of Deadly Marburg Virus

On September 27, 2024, Rwanda reported its first case of Marburg Hemorrhagic Fever, a lethal Ebola-like virus, setting off alarms in the international health community. The day after, the country reported its first six deaths from the disease. As of today, the death toll has reached 11, with 25 additional confirmed cases who have been placed in isolation. According to health authorities, the first cases were found among patients in health facilities and investigations were underway.

Marburg is caused by a rare but deadly virus from the Filoviridae family, which also contains the infamous Ebola virus that killed more than 11,000 people in 2014. It causes severe viral hemorrhagic fever in humans, which is often fatal. The virus was first identified in 1967, during simultaneous outbreaks in Marburg and Frankfurt in Germany, and Belgrade in the former Yugoslavia. These outbreaks were linked to lab workers exposed to infected monkeys imported from Uganda for medical research. Since then, sporadic outbreaks have occurred, mostly affecting African countries including Angola, the Democratic Republic of the Congo, and Uganda.

It is essential to not underestimate this virus, as it is an epidemic-prone disease associated with a fatality rate of up to 88%. The disease usually starts from infected Egyptian Rousette bats, with the virus found in their saliva, urine, and feces. Once the virus moves to people, those who are sick can spread the disease to other people through close contact with the bodily fluids of infected individuals or surfaces.

Marburg is typically found in bats but can spark chaos when it makes the jump to humans.

Patients infected with Marburg typically exhibit symptoms such as fever, severe headache, muscle pain, and malaise. As the disease progresses, many develop severe hemorrhagic symptoms such as bleeding from the gums, nose, and other body orifices, alongside multiple organ failure. The early symptoms are nonspecific, resembling those of many other diseases like malaria, typhoid fever, and even COVID-19, making diagnosis difficult in the early stages. There is currently no specific antiviral treatment or vaccine for Marburg, though quality healthcare can improve patient outcomes.

The current outbreak is concentrated in the Rwandan capital city of Kigali, which is home to over a million people and an international airport, raising concerns about global spread. In one case, a person who may have been exposed to Marburg traveled to Belgium. Additionally, two people in the northern German city of Hamburg were isolated after returning from Rwanda, where they had been in a medical facility with Marburg virus patients. They have since tested negative, but the train station they had arrived in was cordoned off after a medical student developed flu-like symptoms and contacted the authorities. So far, the Marburg virus remains a high national and regional threat but doesn’t quite constitute a global threat for the WHO.

Public health experts emphasize the need for swift containment measures and a coordinated international response to stop the virus from spreading further. Though Marburg outbreaks have been relatively contained in the past, global interconnectedness and the potential for the virus to spread across continents pose a significant risk.

Rwanda’s Ministry of Health has swiftly responded to the outbreak, implementing quarantine measures to isolate suspected and confirmed cases. Health workers are tracing contacts of infected individuals to identify anyone who may have been exposed. Those who have come into close contact with Marburg patients are being monitored for symptoms and are placed in isolation if necessary. Additionally, the country has obtained 5000 doses of remdesivir, an antiviral drug, and is planning a vaccine trial to help combat the disease.

If the outbreak is contained quickly, its impact on Rwanda and the rest of the world may remain limited. However, if containment efforts fail or if the virus spreads within densely populated areas, the situation could become more severe, especially given the absence of a vaccine or specific treatment. Research into Marburg vaccines and treatments could accelerate if the virus becomes a larger global concern, much like how Ebola vaccine development sped up following major outbreaks in West Africa.