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The deadly Marburg viral disease has crippled the healthcare system in Rwanda, Africa, after 11 people died and at least 46 individuals were infected in late September. The virus has been quite active in several countries of Africa but never in Rwanda, in east-central Africa. At least 80% of the infection was reported among medical workers.
The Rwandan health minister announced the country will begin clinical trials of experimental vaccines and treatments. Marburg was first detected in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in the German cities of Marburg and Frankfurt and in Belgrade, now Serbia. The cases were linked to African green monkeys that had been imported from Uganda.
Other cases were later found in Angola, the Democratic Republic of Congo, Ghana, Kenya, South Africa and Uganda, according to the World Health Organization (WHO). Finding its origin from the same family as Ebola, Marburg is described as more severe than Ebola. It causes hemorrhagic fever, which is type of fever that can damage the walls of blood vessels, according to Mayo Clinic.
Yellow fever and dengue cause the same hemorrhagic fever. A hemorrhagic fever causes internal bleeding, which can be fatal, as per Mayo Clinic. The WHO estimates the case fatality rate to be between 24 and 88%.
On average, about half of all those who contract the virus die from it. After a person is exposed to the virus, it can take between two and 21 days for symptoms to show, according to the WHO. “Fatal cases usually have some form of bleeding, often from multiple areas,” the website says, adding that the onset of bleeding can occur within five to seven days.
According to the Centers for Disease Control and Prevention (CDC), Marburg virus symptoms include fever, headache, muscle and joint pain, fatigue, appetite loss, bleeding and gastrointestinal symptoms. Many patients develop hemorrhagic symptoms (bleeding), often in many places including the digestive system (faeces and vomit often come with fresh blood), the nose, gums, and vagina. Haemmorage leads to most fatalities, with death in fatal cases occurring 8 to 9 days after the onset of symptoms, usually of severe blood loss and shock.
It is unclear how the Rwanda outbreak spread, but some people have contracted the Marburg virus after coming in contact with Rousettus bats, a type of fruit bat found in mines and caves, that carry the virus. Once an individual contracts the virus, they can transmit it to others through direct contact with bodily fluids via broken skin or mucous membranes. The WHO website says even surfaces contaminated with bodily fluids, such as bedsheets or clothing, can spread the virus.
The virus, however, is not airborne. Around 13 outbreaks were recorded in 50 years between 1967 and 2017. Five outbreaks have been recorded since 2021, indicating that the disease is occurring more frequently.
In 2023, the WHO reported 17 confirmed and 23 probable cases in Equatorial Guinea, with 12 of the confirmed cases and all probable cases reported as deaths. Six deaths were reported in Tanzania in 2023, with nine confirmed cases. In 2022, Ghana’s health authorities declared an outbreak after three people were infected with Marburg and two of them died, according to the WHO.
The three were from the same household, and one victim was an infant. More than 200 people died in an outbreak in Angola from 2004 to 2005 and more than 100 died of the disease in the Democratic Republic of Congo from 1998 to 2000, according to the C.D.
C. Other outbreaks of Marburg have not involved as many cases. Experts believe people are coming into closer contact with wildlife everywhere, and both wildlife and humans are becoming less scared of each other.
The cases are rising due to increasing chronic conditions and immunocompromising conditions such as diabetes and heart disease. There are no vaccines or treatments for the virus. Some vaccines are being manufactured, including those developed by the International AIDS Vaccine Initiative (IAVI), US-based Sabin Vaccine Institute, and Oxford University which founded AstraZeneca.
The WHO told Reuters that it has released funding for vaccine trials in collaboration with the Canadian government and the European Union’s Health Emergency Preparedness and Response Authority (HERA). The Sabin Vaccine Institute has provided Rwanda with 700 doses of its experimental Marburg vaccine, which will be administered to healthcare professionals at the frontlines. To prevent the viral attack, the patient should take a painkiller medicine and stay well hydrated.
Individuals should maintain good hygiene and limit exposure to those who are sick..
