The head of the World Health Organization (WHO) yesterday praised Rwanda's Marburg virus outbreak response, including its success in treating patients infected with a disease known to have a high case-fatality rate.
Rwanda has gone 7 days with no new cases, and the number of patients who are still in treatment has dwindled to 1, according to a daily update today from Rwanda's health ministry.
Extubations thought to be a first for Africa
The comments from WHO Director-General Tedros Adhanom Ghebreyesus, PhD, came during a press briefing alongside Rwanda's health minister Sabin Nsanzimana, MD, PhD. Tedros was in Rwanda over the weekend, where he visited the country's Marburg treatment center, the outbreak command post, a vaccine manufacturing facility, and President Paul Kagame.
"Leadership from the highest levels of government is essential in any outbreak response, and that's what we see here in Rwanda," Tedros said.
The level of critical care that Marburg patients received in Rwanda was also impressive. He said two patients who had multiple organ failure and were put on life support were successfully intubated, then extubated as they recovered.
"We believe this is the first time patients with Marburg virus have been extubated in Africa. These patients would have died in previous outbreaks," Tedros said.
Nsanzimana said treatment focused on early management with antivirals, use of monoclonal antibodies, and supportive and clinical treatment.
The outbreak stands at 62 confirmed cases, 15 of them fatal. So far, 46 people have recovered from their infections.
At yesterday's briefing, Nsanzimana shared updates on the epidemiologic investigation, which included sequencing data, noting that the outbreak consists of one main cluster with three branches. He said 1,146 contacts have been identified. He said some of the early hospitalized patients were family and friends of the index patient. Health officials have said most cases were linked to two hospitals in Kigali, the country's capital.
Responding to questions from journalists, Nsanzimana said the index patient is a 27-year-old man who had been exposed to bats in a cave and that the bats in the region had been sequenced before.
Analysis points to single jump to humans, no red flags
Yvan Butera, MD, PhD, a researcher who is with the health ministry, said on X yesterday that all sequences share a single zoonotic origin, suggesting a single jump from animals to humans.
Phylogenetic analysis shows that all sequences from patients are closely related, including four that are identical, a sign of rapid spread in a short time, he said. "While we found some mutations, none suggest the virus is spreading more easily or becoming more severe."
The outbreak strain shares a common ancestor with a 2014 Marburg virus, which Butera said shows a limited mutation rate, which is a good sign. He said scientists continue to analyze the clinical data alongside genetic findings to learn more about transmission dynamics.
