The World Health Organization’s count as of 10 October 2024 reads 58 cases of Marburg virus disease in Rwanda, 13 of them fatal. That is a case fatality rate of 22%. Thirty-two of the cases were added after the agency’s first bulletin on 30 September.
Rwanda declared the outbreak on 27 September. It was the country’s first. The vast majority of cases are in three districts of Kigali, and the Rwandan Ministry of Health, as reported by Science Times, says the virus has now reached seven districts.
A hospital outbreak
The record shows who is being infected. According to the WHO, more than four in five confirmed cases are health workers from two Kigali facilities (over 80%). Every new case reported in the week before the update was linked to those two hospital clusters. The agency notes that health workers have been infected before while treating suspected or confirmed patients. The source of the outbreak was still under investigation.
By that date 15 confirmed patients had recovered and the remaining 30 were being treated at the designated Marburg treatment centre. At an online briefing on Friday, Health Minister Sabin Nsanzimana counted 12 recoveries, a lower figure. Jean Kaseya, director-general of Africa CDC, spoke alongside him. “Unfortunately, we have lost 13 people,” he said.
Testing and tracing
Rwanda had run 2949 tests, with roughly 200-300 samples a day passing through the Rwanda Biomedical Center. Over 700 contacts were being followed on 9 October. One contact had travelled to Germany and was being monitored by local authorities for the standard 21 days. Another, who went to Belgium, finished the 21 days and poses no public health risk, the WHO said.
“That is why intensifying testing is a key strategy along with contact tracing,” Nsanzimana said. He asked other countries not to close their borders to travellers from Rwanda or restrict movement. Kaseya backed him: with the contact-following mechanism in place, he said, “no contact can fly out of Rwanda”. Africa CDC sent a team of experts, which is working with Burundi, Uganda, Tanzania and the Democratic Republic of the Congo on cross-border surveillance.
What clinicians have
Marburg belongs to the filovirus family, as Ebola does, and the WHO describes the illness as clinically similar. Fruit bats of the Rousettus genus carry it. People catch it through direct contact with the blood, secretions or other fluids of an infected person, or with bedding and clothing contaminated by them. Incubation runs from two to 21 days, and in fatal cases death most often comes eight to nine days after symptoms begin.
There is no approved treatment or vaccine. Science Times reported that doctors in Rwanda were running clinical trials of an experimental vaccine and exploring remdesivir, which has shown promise in animals but is unproven in humans. The US Centers for Disease Control and Prevention has issued a Level 3 travel advisory for Rwanda.
Sources
- Marburg virus disease – Rwanda (WHO Disease Outbreak News)
- Rwanda's Marburg virus cases hit 58 with 13 deaths (Real News Magazine/Xinhua)
- Rwanda Battles Deadly Marburg Virus as Outbreak Kills 13 (Science Times)
