Marburg Virus Disease: Travel warning in place as 10 die from incurable virus

At least ten people in Rwanda are understood to have died as a result of the Marburg virus disease (MVD), with around 29 cases now confirmed and a number of individuals receiving treatment in isolation. Of the confirmed cases, more than 70% are healthcare workers from two different health facilities.

Clinically similar to Ebola diseases, the Marburg virus spreads through direct contact with bodily fluids of infected people, such as blood, and with surfaces contaminated with these fluids. It has an average fatality rate of around 50%, though this can increase to 88%.

Illness caused by the virus can begin abruptly with symptoms including high fever, severe headaches, muscle aches, vomiting and diarrhoea. Although not all cases present with haemorrhagic signs, severe manifestations of this symptom - such as bleeding - are likely to appear between five and seven days from the onset of symptoms.

According to WHO, in fatal cases death most often occurs between eight and nine days after the onset of symptoms, usually preceded by “severe blood loss and shock”.

There is currently no available treatment or vaccine for MVD, although they are being developed, with early supportive care key to improving survival.

Warning against Rwanda travel amid Marburg virus disease outbreak

As a result of the outbreak, the Rwanda Ministry of Health has urged the public to avoid close contact with "symptomatic individuals" as well as banning visits to hospitalised patients and restricting the number of people allowed at funeral services.

Contact tracing is currently under way with around 300 people who had contact with infected individuals having been located, including one who travelled to Belgium from Rwanda who has since been cleared of the disease by Belgian public health authorities.

Cases have appeared in around 30 Rwandan districts, with WHO working with neighbouring countries such as the Democratic Republic of Congo, Burundi, Kenya, Tanzania and Uganda in case of any spill over.

WHO have assessed the risk of MVD as “very high” at national level, “high” at regional level and “low” at a global level.

The Rwanda Ministry of Health has issued guidance allowing normal activities to continue, but with a continued emphasis of personal hygiene measures in addition to restricting funeral sizes and hospital visits.

Those experiencing symptoms should seek immediate care to reduce the risk of community transmission, with identification of deceased patients key to keeping people safe.

Initially, human MVD infection is the result of prolonged exposure to mines or caves inhabited by Rousettus bat colonies with two large outbreaks having occurred simultaneously in 1967, impacting Marburg and Frankfurt in Germany and Belgrade in Serbia.