:Rwanda Marburg virus disease outbreak

File:Marburg virus.jpg]]

Marburg virus disease is a viral hemorrhagic fever which affects people and primates. The disease can cause serious illness or death.{{Cite web |date=1 May 2024 |title=About Marburg Disease |url=https://www.cdc.gov/marburg/about/index.html |url-status=live |archive-url=https://web.archive.org/web/20240927233805/https://www.cdc.gov/marburg/about/index.html |archive-date=27 September 2024 |access-date=29 September 2024 |website=CDC |language=en-us}} The virus was first discovered in 1967 after outbreaks in Marburg and Frankfurt, Germany, which had been linked to lab work involving African green monkeys from Uganda.{{Cite journal |last=Brauburger |first=Kristina |last2=Hume |first2=Adam J. |last3=Mühlberger |first3=Elke |last4=Olejnik |first4=Judith |date=1 October 2012 |title=Forty-Five Years of Marburg Virus Research |journal=Viruses |volume=4 |issue=10 |pages=1878–1927 |doi=10.3390/v4101878 |issn=1999-4915 |pmc=3497034 |pmid=23202446 |doi-access=free}} Since then outbreaks have been recorded in Uganda, Guinea, Ghana, Equatorial Guinea, and Tanzania.

Marburg virus can be transmitted to humans from fruit bats, and spreads through human-to-human contact, typically via bodily fluids and contaminated medical equipment.{{Cite web |date=27 September 2024 |title=Marburg Haemorrhagic Fever |url=https://www.afro.who.int/health-topics/marburg-haemorrhagic-fever |access-date=29 September 2024 |website=World Health Organization Africa |language=en}}

The fatality rate of Marburg virus disease is around 50 percent, but it can vary from 24 to 88 percent depending on several factors.{{Cite web |title=Marburg virus disease |url=https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease |url-status=live |archive-url=https://web.archive.org/web/20200411123405/https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease |archive-date=2020-04-11 |access-date=2024-09-29 |website=www.who.int |language=en}}

In contrast to Ebola which has an Ebola vaccine,{{Cite web |date=12 August 2024 |title=Ebola Vaccine Product Information |url=https://www.cdc.gov/ebola/hcp/vaccines/index.html |url-status=live |archive-url=https://web.archive.org/web/20240927130216/https://www.cdc.gov/ebola/hcp/vaccines/index.html |archive-date=27 September 2024 |access-date=29 September 2024 |website=CDC |language=en-us}} there is no treatment or vaccine for MVD. This is due to the economics of vaccines, and the fact that until the mid-2010s, there were few fatalities from filovirusses.{{Cite journal |vauthors=Reynolds P, Marzi A |date=August 2017 |title=Ebola and Marburg virus vaccines |journal=Virus Genes |volume=53 |issue=4 |pages=501–515 |doi=10.1007/s11262-017-1455-x |pmc=7089128 |pmid=28447193}} There are a number of candidate vaccines against Marburg virus disease. Legal monopolies are hindering production and testing of candidate vaccines.{{Cite web |date=September 25, 2018 |title=MSF's response to CEPI's policy regarding equitable access |url=https://msfaccess.org/msfs-response-cepis-policy-regarding-equitable-access |url-status=live |archive-url=https://web.archive.org/web/20210321163753/https://msfaccess.org/msfs-response-cepis-policy-regarding-equitable-access |archive-date=March 21, 2021 |access-date=April 10, 2020 |website=Médecins Sans Frontières Access Campaign |language=en |quote=In vaccine development, access to know how is important. Knowledge and expertise including but not limited to purification techniques, cell lines, materials, software codes and their transfer of this to alternative manufacturers in the event the awardee discontinues development of a promising vaccine is critically important. The recent example of Merck abandoning the development of rVSV vaccines for Marburg (rVSV-MARV) and for Sudan-Ebola (rVSV-SUDV) is a case in point. Merck continues to retain vital know-how on the rVSV platform as it developed the rVSV vaccine for Zaire-Ebola (rVSV-ZEBOV) with funding support from GAVI. While it has transferred the rights on these vaccines back to Public Health Agency of Canada, there is no mechanism to share know how on the rVSV platform with other vaccine developers who would like to also use rVSV as a vector against other pathogens.}}{{Cite news |date=4 October 2024 |title=Why It's So Difficult to Develop a Shot for Ebola-like Marburg Virus |url=https://www.bloomberg.com/news/newsletters/2024-10-04/is-there-a-vaccine-for-marburg-virus |work=Bloomberg UK}}{{Cite news |date=4 October 2024 |title=An Ebola-like virus is spreading in Rwanda. Why isn't there an approved vaccine for Marburg? |url=https://www.vox.com/future-perfect/375819/marburg-outbreak-rwanda-vaccine-trial |work=Vox}}

The index case for the outbreak is believed to be a 27-year-old man who was being treated at King Faisal Hospital in Kigali after being exposed to the virus from contact with bats.

On 28 September 2024, the World Health Organization was informed of a first ever Marburg virus disease outbreak in Rwanda.{{Cite journal |last=Volkmer |first=Anna |date=2 October 2024 |title=Marburg virus: First cases in Rwanda spark international alarm |url=https://www.bmj.com/content/387/bmj.q2155.full |journal=British Medical Journal |language=en |volume=387 |pages=q2155 |doi=10.1136/bmj.q2155 |issn=1756-1833 |pmid=39357913|url-access=subscription }} On that day, there were already 26 known cases, mostly in healthcare workers, eight of which had been fatal.{{Cite web |date=29 September 2024 |title=Rwanda reports first-ever Marburg virus disease outbreak, with 26 cases confirmed |url=https://reliefweb.int/report/rwanda/rwanda-reports-first-ever-marburg-virus-disease-outbreak-26-cases-confirmed |access-date=29 September 2024 |website=ReliefWeb |language=en}}{{Cite web |last=Nair |first=Devika |last2=Girinema |first2=Philbert |date=28 September 2024 |editor-last=Wallis |editor-first=Daniel |title=Six people died of Marburg virus in Rwanda, health minister says |url=https://www.reuters.com/business/healthcare-pharmaceuticals/six-people-died-marburg-virus-rwanda-health-minister-says-2024-09-28/ |access-date=29 September 2024 |website=Reuters}}{{Cite news |last=Ssuuna |first=Ignatius |date=October 1, 2024 |title=Rwanda reports 8 deaths linked to Ebola-like Marburg virus days after it declared an outbreak |url=https://apnews.com/article/rwanda-marburg-virus-c9728160abef2ca94395ec3ba4dfdc49 |access-date=October 2, 2024 |work=Associated Press |language=en}}{{excessive citations inline|date=October 2024}}

As of 3 October 2024, there were 36 confirmed cases, at least 19 of whom were healthcare workers, most of them working in intensive care units, and 11 people reportedly died of the infection,{{Cite news |date=3 October 2024 |title=Marburg virus death toll in Rwanda rises to 11 as travellers in Germany test negative |url=https://www.euronews.com/health/2024/10/03/marburg-virus-death-toll-in-rwanda-rises-to-11-as-travellers-in-germany-test-negative |work=Euronews |quote=Eleven people have died in Rwanda as the African country continues to fight an outbreak of Marburg virus. The Rwandan government said there were 36 confirmed cases of the virus in its latest update, with 25 people in isolation.}}

On 6 October 2024, there were 49 confirmed cases and 12 deaths,{{Cite web |last=Rwanda Biomedical Centre |date=2024-10-06 |title=Marburg Virus Update |url=https://rbc.gov.rw/fileadmin/user_upload/logo/Update_Virusi_ya_Marburg_-_06.10.2024.jpg}} and on October 7, 56 cases out of 2387 tests carried out.{{Cite web |last=Rwanda Biomedical Centre |date=2024-10-07 |title=Marburg virus update |url=https://rbc.gov.rw/marburg/}} As of 10 October 2024, there were 58 confirmed cases and 13 dead.{{Cite journal |last=Sidik |first=Saima |date=2024-10-08 |title=Lethal Marburg virus is on the rise in Rwanda: why scientists are worried |url=https://www.nature.com/articles/d41586-024-03275-8 |journal=Nature |language=en |volume=634 |issue=8034 |pages=522–523 |bibcode=2024Natur.634..522S |doi=10.1038/d41586-024-03275-8 |pmid=39384913|url-access=subscription }}

On 20 October, authorities said that there was no community transmission of disease after no new cases were recorded in the preceding six days.{{Cite news |date=20 October 2024 |title=Rwanda says no community transmission of Marburg virus, with zero new infections in recent days |url=https://apnews.com/article/rwanda-marburg-outbreak-e84410d7a216543a1f6252b3c568ec7e |work=Associated Press}}

As of 30 October 2024, Rwanda has recorded 66 illnesses and 15 deaths from Marburg while 75 percent of patients with Marburg had recovered.{{Cite web |last=CDC |date=2024-10-31 |title=Marburg Outbreak in Rwanda Situation Summary |url=https://www.cdc.gov/marburg/situation-summary/index.html |access-date=2024-11-01 |website=Marburg Virus Disease |language=en-us}}

On 8 November 2024, the last patient to be treated for Marburg was released from hospital. On 20 December 2024, the WHO and the Rwandan government declared an end to the outbreak after no new cases were reported in the preceding 42 days.{{Cite web |date=20 December 2024 |title=Rwanda and WHO declare end of Marburg outbreak after no new cases reported |url=https://apnews.com/article/rwanda-marburg-outbreak-6975a9f1edca2970ccca0f14b957799e |access-date=20 December 2024 |website=Associated Press |language=en}}

As of October 3, cases had been reported in seven of the 30 districts in Rwanda. Three districts in Kigali Province reported the highest number of cases, namely Gasabo District, Kicukiro District and Nyarugenge District. Other districts included Nyagatare District and Gatsibo District in the Northeast, which border Tanzania, site of the 2023 Tanzania Marburg virus disease outbreak as well as Rubavu District in the Northwest bordering Democratic Republic of the Congo and Kamonyi District, which is adjacent to Kigali in the center.{{Cite web |last=Health Alert Network (HAN) |date=2024-10-03 |title=First Marburg Virus Disease Outbreak in the Republic of Rwanda |url=https://emergency.cdc.gov/han/2024/han00517.asp |access-date=2024-10-04 |website=emergency.cdc.gov |language=en-us}}

The U.S. embassy in Rwanda issued an alert on the matter on 29 September 2024{{Cite web |date=28 September 2024 |title=Health Alert – U.S. Embassy Kigali |url=https://rw.usembassy.gov/health-alert-u-s-embassy-kigali-5/ |access-date=29 September 2024 |website=U.S. Embassy in Rwanda}} and advised staff to work remotely.{{Cite web |date=11 October 2024 |title=Rwanda's Marburg outbreak is under control, Africa's health chief says |url=https://apnews.com/article/rwanda-marburg-outbreak-510489da891108bdf5b277ef1d24a60b |access-date=11 October 2024 |website=Associated Press}}

Contact tracing was started, and as of 3 October, 3,000 people were being monitored because they came in contact with the infected individuals.

The WHO advised against travel and for trade restrictions with Rwanda.{{Cite news |date=3 October 2024 |title=Travel warning as eight die from incurable Marburg virus |url=https://www.independent.co.uk/travel/news-and-advice/marburg-virus-travel-ban-symptoms-b2623220.html |work=The Independent |quote=Based on the current risk assessment, WHO advises against any travel and trade restrictions with Rwanda.}}{{Cite news |date=2 October 2024 |title=UK tourists warned 'do not travel' over incurable virus which has killed nine |url=https://www.birminghammail.co.uk/travel/uk-tourists-warned-do-not-30051921 |work=Birmingham Live |quote=A "do not travel" warning has been issued to UK tourists after nine died of an incurable virus. The World Health Organisation has warned people are being advised not to visit the country and to watch out for symptoms amid a "high risk".}}{{Cite news |date=1 October 2024 |title=Travellers given warning as incurable disease spreads after eight die |url=https://www.dailyrecord.co.uk/news/uk-world-news/travellers-given-warning-incurable-disease-33792513 |work=Daily Record |quote=The World Health Organisation has issued a 'high' risk warning after 26 cases and eight fatalities were linked to the spread of the deadly and incurable Marburg Virus Disease. Efforts are under way to trace 300 individuals who may have been in contact with those infected.}} The Centers for Disease Control issued a travel alert,{{Cite web |title=Marburg in Rwanda - Level 2 - Practice Enhanced Precautions |url=https://wwwnc.cdc.gov/travel/notices/level2/marburg-rwanda |access-date=2024-10-05 |website=Travelers' Health |publisher=CDC}} which was criticised as "unnecessary" and made without input from local authorities by Africa Centres for Disease Control and Prevention director-general Jean Kaseya, citing the Rwandan government's rapid response to the outbreak.{{Cite news |date=October 11, 2024 |title=Travel bans unnecessary as Rwanda's Marburg fever situation improves |url=https://www.africanews.com/2024/10/11/travel-bans-unnecessary-as-rwandas-marburg-fever-situation-improves/ |access-date=October 14, 2024 |work=Africanews}}

Gilead Sciences donated 5,000 vials of remdesivir as emergency treatment.{{Cite web |last=Ntirenganya |first=Emmanuel |date=2024-10-05 |title=What is Remdesivir, the drug Rwanda will use for Marburg virus response? |url=https://www.newtimes.co.rw/article/20682/news/health/what-is-remdesivir-the-drug-rwanda-will-use-for-marburg-virus-response |access-date=2024-10-06 |website=The New Times |language=en}}

On 6 October 2024, Rwandan health minister Sabin Nsanzimana confirmed that the country had received about 700 vaccine doses to be used in trial, which will be distributed on a priority basis starting with healthcare workers, the frontline response team and individuals who were in contact with the confirmed cases.{{Cite web |last=Umutesi |first=Alice |date=2024-10-06 |title=Rwanda gets 700 vaccine doses for Marburg virus |url=https://www.newtimes.co.rw/article/20686/news/health/rwanda-gets-700-vaccine-doses-for-marburg-virus |access-date=2024-10-07 |website=The New Times |language=en}} These trial vaccines were delivered by the Sabin Vaccine Institute as a support by the government of US and international partners.{{Cite news |date=October 5, 2024 |title=US ships Marburg vaccines to Rwanda after 11 die in outbreak |url=https://www.reuters.com/world/africa/us-ships-marburg-vaccines-rwanda-after-11-die-outbreak-2024-10-05/ |archive-url=https://archive.today/20241006045245/https://www.reuters.com/world/africa/us-ships-marburg-vaccines-rwanda-after-11-die-outbreak-2024-10-05/ |url-status=dead |archive-date=October 6, 2024 |access-date=October 5, 2024 |work=Reuters}} As of 14 October, more than 200 people have been vaccinated.{{Cite news |date=October 14, 2024 |title=Rwanda Marburg Outbreak: Health Minister says situation is under control as vaccines underway |url=https://www.africanews.com/2024/10/14/rwanda-marburg-outbreak-health-minister-says-situation-is-under-control-as-vaccines-underw/ |access-date=October 14, 2024 |work=Africanews}}

On 31 October 2024, the Sabin Vaccine Institute dispatched 1,000 additional investigational vaccine doses for a randomized clinical trial arm within an ongoing open-label study.{{Cite journal |last=Hamer |first=M. J. |last2=Houser |first2=K. V. |last3=Hofstetter |first3=A. R. |last4=Ortega-Villa |first4=A. M. |last5=Lee |first5=C. |last6=Preston |first6=A. |last7=Augustine |first7=B. |last8=Andrews |first8=C. |last9=Yamshchikov |first9=G. V. |last10=Hickman |first10=S. |last11=Schech |first11=S. |last12=Hutter |first12=J. N. |last13=Scott |first13=P. T. |last14=Waterman |first14=P. E. |last15=Amare |first15=M. F. |display-authors=1 |date=2023 |title=Safety, tolerability, and immunogenicity of the chimpanzee adenovirus type 3-vectored Marburg virus (cAd3-Marburg) vaccine in healthy adults in the USA: a first-in-human, phase 1, open-label, dose-escalation trial |journal=Lancet |volume=401 |issue=10373 |pages=294–302 |doi=10.1016/S0140-6736(22)02400-X |pmc=10127441 |pmid=36709074 |last16=Kioko |first16=V. |last17=Storme |first17=C. |last18=Modjarrad |first18=K. |last19=McCauley |first19=M. D. |last20=Robb |first20=M. L. |last21=Gaudinski |first21=M. R. |last22=Gordon |first22=I. J. |last23=Holman |first23=L. A. |last24=Widge |first24=A. T. |last25=Strom |first25=L. |last26=Happe |first26=M. |last27=Cox |first27=J. H. |last28=Vazquez |first28=S. |last29=Stanley |first29=D. A. |last30=Murray |first30=T.}} As of end of October, more than 1,500 frontline workers had been vaccinated in Rwanda with the Sabin vaccine.{{Cite web |title=Sabin Vaccine Institute: Sabin Sends More Marburg Vaccines for Rwanda's Outbreak |url=https://www.finanznachrichten.de/nachrichten-2024-10/63690013-sabin-vaccine-institute-sabin-sends-more-marburg-vaccines-for-rwanda-s-outbreak-399.htm |access-date=2024-11-01 |website=FinanzNachrichten.de |language=de}}

• List of other Filoviridae outbreaks

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{{Commons|Marburg virus}}

• [http://www.expasy.org/viralzone/all_by_species/224.html ViralZone: Marburg virus]
• World Health Organization, [https://www.who.int/csr/disease/marburg/en/ Marburg Haemorrhagic Fever].

{{Ebola}}

Category:Marburg virus outbreaks

Category:2024 disease outbreaks

Category:2024 disasters in Africa

Category:2024 in Rwanda

Category:Disease outbreaks in Rwanda