Rwanda’s health ministry told the World Health Organization (WHO) on 28 September 2024 that Marburg virus had reached the country for the first time. By then, 26 people were sick and eight had died, according to CIDRAP, which put the spread across 7 of Rwanda’s 30 districts. WHO’s own count that day listed six deaths.
Most of the patients were health workers, especially staff in intensive care units at several medical facilities, Rwandan media reported, citing health minister Sabin Nsanzimana.
Early response
Twenty patients were in isolation and being treated. Another 161 people who had been in contact with cases were identified and put under monitoring. WHO said it was preparing a shipment of clinical care and infection-control supplies from its Emergency Response Hub in Nairobi, Kenya, for delivery to Kigali.
“We’re rapidly setting all the critical outbreak response aspects in motion to support Rwanda halt the spread of this virus swiftly and effectively,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. She said the country’s “already robust public health emergency response system” would help.
The government capped funerals for those who died of the disease at 50 people. Hospitalized patients were allowed one caregiver each, the BBC reported. The US Embassy in Kigali told authorized staff to work remotely through 4 October and suspended in-person services.
The outbreak came as Africa was already handling several infectious disease events, including the spread of multiple mpox clades. CIDRAP noted it followed 2023 outbreaks that were firsts for two other African countries, Tanzania and Equatorial Guinea.
How the numbers grew
By 3 October there were 36 confirmed cases, at least 19 of them health workers, and 11 deaths. Three Kigali districts reported the most cases: Gasabo, Kicukiro and Nyarugenge. Others included Nyagatare and Gatsibo in the northeast, which border Tanzania, Rubavu in the northwest next to the Democratic Republic of the Congo, and Kamonyi, beside Kigali. About 3,000 contacts were being monitored by then.
The count reached 49 cases and 12 deaths on 6 October. On 7 October, 56 cases turned up among 2387 tests. As of 10 October there were 58 confirmed cases and 13 deaths. Wikipedia describes it as one of the biggest Marburg outbreaks ever documented.
The index case is believed to be a 27-year-old man treated at King Faisal Hospital in Kigali, who had been exposed to the virus through bats.
Vaccines, drugs and travel advice
There is no licensed vaccine or treatment for Marburg. Several candidates were in clinical development. Gilead Sciences donated 5,000 vials of remdesivir as emergency treatment. On 6 October, Nsanzimana confirmed Rwanda had received about 700 trial vaccine doses from the Sabin Vaccine Institute, to go first to health workers, frontline responders and contacts of confirmed cases. More than 200 people had been vaccinated by 14 October. On 31 October the institute sent 1,000 more doses, and over 1,500 frontline workers had been vaccinated by the end of the month.
WHO advised against travel and trade restrictions with Rwanda. The US Centers for Disease Control issued a travel alert anyway. Africa CDC director-general Jean Kaseya called it “unnecessary” and said it was made without input from local authorities, pointing to Rwanda’s rapid response.
The disease
Marburg causes a hemorrhagic fever in the same family as Ebola. It starts abruptly with high fever, severe headache and severe malaise, and many patients develop severe bleeding symptoms within seven days. Fruit bats carry the virus, and people pass it on through direct contact with bodily fluids, surfaces and materials. The fatality rate is around 50 percent but has ranged from 24 to 88 percent.
On 20 October, authorities said no community transmission had occurred after six days without new cases. By 30 October Rwanda had recorded 66 illnesses and 15 deaths, and 75 percent of patients had recovered. The last patient left hospital on 8 November. WHO and the Rwandan government declared the outbreak over on 20 December 2024, after 42 days with no new cases.
Sources
- 2024 Rwanda Marburg virus disease outbreak – Wikipedia
- Rwanda reports first-ever Marburg virus disease outbreak, with 26 cases confirmed
- Rwanda reports first Marburg virus outbreak
Sources
- Rwanda Marburg virus disease outbreak – Wikipedia
- Rwanda reports first-ever Marburg virus disease outbreak, with 26…
