Rwanda is currently facing its first-ever outbreak of the deadly Marburg virus, with 36 confirmed cases and 11 reported deaths. The World Health Organization (WHO) has classified the risk as very high within Rwanda, high across the African region, but low globally. With growing concerns about the virus’s spread, it’s essential to understand what the Marburg virus is, how it spreads, and what steps are being taken to control it.
What is the Marburg Virus?
The Marburg virus is a highly infectious pathogen that belongs to the same family as the Ebola virus. Both viruses cause hemorrhagic fevers, which are characterized by severe bleeding, organ failure, and often death. The average fatality rate for Marburg is approximately 50%, though in some previous outbreaks, the death rate has reached as high as 88%. However, early intervention, such as rehydration and supportive care, can significantly increase the chances of survival.
Common symptoms of the virus include a sudden onset of high fever, severe headache, and body aches. This is often followed by vomiting, diarrhea, and in more severe cases, uncontrolled bleeding from multiple areas of the body. The progression of the disease can be rapid, leading to shock and multi-organ failure.
The Marburg virus was first discovered in 1967 during simultaneous outbreaks in Marburg, Germany, and Belgrade, Serbia. The outbreak was traced back to laboratory workers who had been exposed to African green monkeys imported from Uganda. Since its discovery, there have been several outbreaks across Africa, with Angola, Uganda, Kenya, the Democratic Republic of Congo, and South Africa among the affected countries.
How Does the Virus Spread?
The primary way Marburg spreads to humans is through contact with Rousettus fruit bats, which are natural hosts for the virus. These bats are commonly found in mines or caves, where prolonged exposure can lead to human infection. Once a human is infected, the virus can spread from person to person through direct contact with bodily fluids, such as blood, saliva, vomit, or urine, of an infected individual. Additionally, contaminated surfaces or materials, like bedding or clothing, can also facilitate the spread of the virus.
Human-to-human transmission often occurs in healthcare settings, where medical professionals treating patients can inadvertently become exposed to the virus. This risk is heightened in regions with limited protective equipment and sanitation measures. Funerals of individuals who have died from the virus also pose a high risk of transmission, as close physical contact with the deceased is common in some cultural practices.
Is There a Vaccine?
Currently, there are no approved vaccines or specific antiviral treatments for the Marburg virus. However, there are promising vaccine candidates under development. Several organizations are collaborating with Rwandan health authorities to initiate trials. One of the most notable efforts is led by the Sabin Vaccine Institute, which is working with the Rwandan government on potential solutions. In addition, the International AIDS Vaccine Initiative (IAVI) is exploring options to combat the virus.
In the UK, a research team at Oxford University, known for developing the AstraZeneca COVID-19 vaccine, began testing a Marburg virus vaccine candidate in mid-2024. The vaccine uses a similar technology to the COVID-19 shot, and if successful, it could play a critical role in preventing future outbreaks.
How is Rwanda Handling the Outbreak?
Rwanda’s health authorities are taking significant measures to contain the spread of the virus. They are actively monitoring around 300 individuals who have had contact with confirmed cases. Alarmingly, about 70% of the confirmed cases so far are healthcare workers, highlighting the risks faced by frontline workers dealing with the outbreak. The virus has spread beyond the capital city of Kigali, with cases reported in seven of Rwanda’s 30 districts.
Efforts to control the outbreak also extend to limiting the spread of the virus during funerals, where traditional burial practices involve close contact with the deceased. Public health experts, including Paul Hunter, a professor of medicine at the University of East Anglia, have emphasized the need to modify these practices to prevent further transmission.
The international community is closely watching the situation, particularly neighboring countries, which may be at risk of cross-border infections. While the current outbreak has not yet spread outside Rwanda, global health authorities are maintaining vigilance to prevent further escalation.
Is the Marburg Virus Spreading to New Regions?
In recent years, the Marburg virus has made appearances in new regions, raising concerns about its potential spread. In 2021, Guinea reported the first case of Marburg in West Africa. The following year, Ghana experienced its first outbreak, and in 2023, both Tanzania and Equatorial Guinea also reported cases of the virus for the first time.
While these outbreaks have been relatively small and contained through rapid public health interventions, experts believe that increasing human encroachment into wildlife habitats may be contributing to the virus’s more frequent emergence. As humans come into closer contact with animals that host the virus, the risk of transmission increases.
The ongoing outbreak in Rwanda is one of the largest Marburg virus outbreaks on record, and while global risk remains low, the situation is a reminder of the need for continuous surveillance, research, and preparation to manage future outbreaks.
Final Thoughts
The Marburg virus, though rare, poses a significant threat when outbreaks do occur. With no approved vaccine or treatment available, prevention through public health measures and rapid response is the key to controlling its spread. Rwanda’s current outbreak is being closely monitored, and efforts are underway to test vaccine candidates and contain the virus. While global risk is currently low, the situation underscores the importance of staying prepared for potential viral outbreaks in the future.