The average MVD case fatality rate is around 50%. Case fatality rates have varied from 24% to 88% in past outbreaks.
By Kayitare Jean B.
Since the Rwandan Ministry of Health confirmed the outbreak of the deadly Marburg virus disease (MVD) on the 27th of September 2024, there have been heavy speculation on whether the government plans to effect a total or partial lockdown of the population. However, to date, that has not been the case.
Blood samples taken from people showing symptoms were tested by real-time reverse transcription polymerase chain reaction (RT-PCR) at the National Reference Laboratory of the Rwanda Biomedical Centre (RBC) and returned positive with the Marburg virus.
As of 29 September 2024, a total of 26 confirmed cases, including eight deaths have been reported. The cases are reported from seven of the 30 districts in the country. Among the confirmed cases, over 70% are healthcare workers from two health facilities in Kigali. The patients are being cared for in hospitals. Contact tracing is underway, with 300 contacts under follow-up. This is the first time MVD has been reported in Rwanda.
The Ministry of Health has urged Rwandans to remain vigilant and strengthen preventive measures by ensuring hygiene, washing hands with soap, sanitising hands, and taking necessary precautionary measures when in contact with other individuals.
According to Dr. Gallican Rwibasira, Division Manager, HIV, STI, Viral Hepatitis and Other Viral Diseases Control Division at RBC, Marburg virus disease (MVD), has been confirmed in a few patients in health facilities in the country.
“Investigations are being carried out to determine the origin of the infection, currently, we urge the population to take stringent measures as advised by our medical teams in their relative districts.” he said.
On October 5, 2024, Rwanda received 700 doses of a Marburg Virus vaccine in partnership with the Sabin Vaccine Institute from the United States. Vaccination efforts have begun with healthcare professionals, particularly those at the highest risk of infection.
Dr. Nsanzimana further announced the introduction of two medications to assist patients suffering from the illness: Remdesivir and monoclonal antibodies. Rwanda has received an additional lot of 1,000 vaccines.
About Marburg Virus Disease
According to the World Health Organisation (WHO), Marburg virus disease (MVD), formerly known as Marburg haemorrhagic fever, is a severe, often fatal illness in humans. The average MVD case fatality rate is around 50%. Case fatality rates have varied from 24% to 88% in past outbreaks. Early supportive care with rehydration, and symptomatic treatment improves survival.
The disease is a severe and often fatal zoonotic haemorrhagic illness caused by the Marburg virus. The virus is usually transmitted to humans from fruit bats. Human-to-human transmission occurs through direct contact with an infected person’s body fluids, or with equipment and materials contaminated with infectious blood or tissues. There is currently no vaccine or specific treatment for MVD, so supportive therapy should be initiated immediately for any individuals presenting with the disease. The same infection prevention and control protocols used for other viral haemorrhagic fevers, such as Ebola, should be followed to prevent transmission.
On September 29th, the Africa Centers for Disease Control and Prevention (Africa CDC) dispatched a team of experts to aid in response efforts in Rwanda. Africa CDC is also collaborating with the Ministry of Health and neighboring countries of Burundi, Uganda, Tanzania, and DR Congo to assist in addressing the cross-border aspects of the outbreak and to provide guidance on regional surveillance strategies to contain the outbreak.
Rwanda, DRC border the busiest in Africa
By 14th May 2018, the Rwanda-Democratic Republic of Congo (DRC) border was Africa’s busiest crossing with an average of over 90,000 people having been registered to have crossed it daily. That was also seen as a major challenge. Since the last Ebola and COVID-19 outbreaks, the Rwandan government has put permanent testing tests and isolation centers near its border crossings.
A statement from the World Health Organization states that since there is “currently no available treatment or vaccine for MVD, 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.”