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At least eight people have died in Rwanda as the East African country deals with its first major outbreak of Marburg virus.
Rwanda has confirmed that more than 26 cases of the rare virus have been identified — and it is continuing to monitor any further cases closely.
The UK’s Foreign Office has updated its travel advice for Rwanda to reflect the latest outbreak, citing reports of the virus in Kigali hospitals.
It encourages people to practice increased hygiene measures and avoid symptomatic people.
The World Health Organisation’s regional director for Africa, Dr Matshidiso Moeti, said: “We’re rapidly setting all the critical outbreak response aspects in motion to support Rwanda halt the spread of this virus swiftly and effectively.
“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.”
Rwandan authorities have also limited the size of funerals in an attempt to contain the further spread of the virus.
The WHO said the initial spread of the virus was attributed to laboratories that were testing Ugandan African green monkeys.
On Wednesday (October 2), German police cordoned off a high-speed train after a passenger who had travelled from Rwanda started to display symptoms that may be associated with Marburg.
Here’s what you need to know about it.
What is the Marburg virus?
The Marburg virus is a highly infectious virus that causes Marburg virus disease (MVD), a severe haemorrhagic fever similar to Ebola. It belongs to the same family, Filoviridae, and can result in fatal outbreaks with mortality rates ranging from 24 per cent to 88 per cent, depending on the strain and quality of care.
- Transmission: The Marburg virus is primarily transmitted to humans through contact with Rousettus bats, particularly in environments including mines or caves where these bats inhabit. These bats are considered the natural reservoir of the virus, and initial outbreaks often occur after exposure to infected bats or their droppings.
- Treatment: There is no specific antiviral treatment for the Marburg virus. Supportive care, such as hydration, maintaining oxygen levels, and treating specific symptoms, can improve survival chances. Experimental treatments and vaccines are being researched, but none have been widely approved.
- Prevention: Measures include avoiding contact with fruit bats and infected individuals, proper use of personal protective equipment (PPE), and strict infection control practices in healthcare settings.
The virus was first identified in 1967 during outbreaks in Germany (Marburg and Frankfurt) and in Belgrade, Yugoslavia (now Serbia), linked to laboratory workers exposed to infected monkeys imported from Uganda.
Marburg virus symptoms
When someone contracts the Marburg virus, they may suffer several symptoms before things worsen.
The initial symptoms of the virus are the following:
- severe headache
- malaise
- high fever
- progressive and rapid debilitation
Around three days later, symptoms include:
- watery diarrhoea
- abdominal pain
- cramping
- nausea
- vomiting
Symptoms become increasingly worse, and after about five to seven days, many patients will develop severe haemorrhagic fever. Fatal cases will usually involve bleeding.
The incubation period of the virus is typically between three and 10 days.
Marburg virus transmission
Once the virus is in humans, person-to-person transmission happens through direct contact with the blood, bodily fluids (such as saliva, vomit, urine, sweat, semen, or breast milk), or tissues of an infected person. The virus concentration is particularly high in these fluids during the acute phase of the disease, making close contact especially risky.
- Sexual transmission: Marburg virus can be transmitted sexually. The virus can persist in semen for up to seven weeks (and potentially longer) after recovery, posing a risk of transmission even after clinical recovery.
- Contaminated surfaces and equipment: The virus can also spread through contact with surfaces, objects, or medical equipment contaminated by bodily fluids. Infected needles or syringes are especially dangerous, leading to a higher dose of the virus being transmitted directly into the bloodstream.
- Post-mortem transmission: People who have died from Marburg can still transmit the virus. Contact with their bodies or bodily fluids during funeral practices presents a significant risk of infection.
"Marburg is highly infectious," warned the WHO’s Dr Moet.
Should we be worried about the Marburg virus?
The WHO said local and regional outbreaks were much more likely than a global one.
Experts said the risk was “very high at the national level, high at the regional level, and low at the global level”.
Public health systems have become better at handling such outbreaks, making it unlikely for the virus to become a widespread concern.
The key is vigilance, preparedness, and rapid response in the regions where outbreaks may occur.
There’s no immediate cause for worry for most people, especially those not in affected areas. It’s also still a relatively rare virus and the chances of it becoming a pandemic are unlikely.
