As Rwanda battles its first Marburg virus outbreak, the country’s health ministry yesterday reported seven more cases, along with one more death. At briefings today, the country’s health minister shared more details about the outbreak, including that a vaccine trial is slated to begin soon.
In other developments, German officials reported negative results on two travelers who returned from Rwanda and were isolated in Hamburg due to a history of exposure in a Rwandan hospital where Marburg patients were being treated.
29 health workers among confirmed cases
The new illness confirmations and deaths bring Rwanda’s Marburg virus total to 36 cases, 11 of them fatal, making it one of the world’s biggest outbreaks involving the virus.
At an Africa Centres for Disease Control and Prevention (Africa CDC) media briefing today, Rwanda’s health minister, Sabin Nsanzimana, MD, PhD, said 29 (80%) of the patients are healthcare workers. Currently, 25 people are being treated in isolation. Health officials have identified 323 contacts for monitoring.
Like past Marburg outbreaks in other countries, Rwanda’s came to the attention of health officials when healthcare workers got sick. The virus is known to transmit through contact with infected body fluids. He noted that the first two patients didn’t respond to usual treatment for other conditions such as malaria, which has a similar initial clinical presentation.
Many of the patients are part of a cluster of people who had close contact in the intensive care unit (ICU) of a hospital where the probable index patient was treated.
At a World Health Organization (WHO) briefing today, Brian Chirombo, MD, MPH, said the index patient died on September 8 and that the outbreak involves patients at two Kigale hospitals, King Faisal and University Teaching Hospital.
Nsanzimana said the ministry expects to receive about 5,000 doses of remdesivir to provide advanced treatment for Marburg patients.
He also said officials expect to launch a vaccine trial in the days ahead, and details about the vaccine and the official launch date will be announced soon. Currently, there are no approved specific Marburg virus treatments or vaccines.
The epidemiologic investigation and genetic sequencing are still under way. He characterized the outbreak as “controlled but not contained.”
Negative tests for German passengers, CDC alert for health providers
Yesterday, German health officials transported two train passengers to a hospital in Hamburg for testing after a history of exposure in a Rwandan medical facility where Marburg patients are being treated.
The European Centre for Disease Prevention and Control (ECDC) said today that it has been in close contact with German public health authorities, who reported today that the tests were negative.
It said the risk of Marburg illness in European residents traveling or living in affected parts of Rwanda is still considered low, but the risk of exposure in healthcare settings there is moderate. It urged travelers to avoid contact with symptomatic people and the dead bodies of infected people.
Meanwhile, the US Centers for Disease Control and Prevention (CDC) today issued a Health Alert Network notice to health providers, filling them in about the outbreak and urging them to be alert to the possibility of imported cases.
Though most of Rwanda’s cases involve health workers, the CDC noted that there are also cases that aren’t linked to known transmission chains, suggesting that additional cases may have been undetected or unreported.
Though cases have been reported from seven of Rwanda’s districts, three in Kigali have reported the highest number of cases.
