Neighbors on alert as Equatorial Guinea and Tanzania battle Marburg

With Equatorial Guinea and Tanzania striving to stem the spread of their respective first outbreaks of Marburg virus, neighboring countries are now on high alert as they ramp up surveillance and preparedness measures. On Feb. 13, Equatorial Guinea confirmed its first outbreak of Marburg virus — a hemorrhagic fever similar to Ebola. At the time of publication, the country had a total of 13 confirmed cases and nine deaths. Just over a month later on March 21, health authorities in Tanzania confirmed their first outbreak of the disease. So far eight cases, including five deaths, have been reported. As regional health authorities work with both governments to scale up control measures and end the outbreaks, neighboring countries are now on high alert and are sensitizing citizens, especially those living in border regions, on the disease and how to notify health authorities. In Uganda, the government through the ministry of health has already commenced compulsory testing for Marburg virus at all its borders. It has also assessed preparedness and readiness in the high-risk district of Kyotera. In Kenya, the government has also heightened surveillance and warned citizens to report any unusual increase in individuals presenting with a high fever. Patrick Amoth, the acting director general at the Ministry of Health in Kenya, said his office has activated enhanced surveillance mechanisms at all border points between Kenya, Tanzania, and Uganda as there is a lot of human traffic between the three countries with some of the passengers originating from the epicenter of the current outbreaks. Equatorial Guinea shares borders with Cameroon and Gabon. Both countries have also heightened their surveillance and introduced travel restrictions. But media reports noted that people, including students that attend schools in Cameroon, are still able to cross borders, raising fears that the outbreak could spread. Vaccine, testing, and treatment The Africa Centres for Disease Control and Prevention and the World Health Organization Regional Office for Africa said the current testing capacity for the disease is still being improved in both affected countries. The agencies are currently training workers on testing, configuring laboratories for Marburg testing, and supporting countries with the reagents necessary for testing. When this is completed, the turnaround time for test results is expected to further reduce from five days in Equatorial Guinea to a few hours, thus improving the countries’ ability to quickly detect and isolate cases. While there are no approved vaccines or treatments for Marburg virus disease, a race to conduct clinical trials for the few that are in development is already underway. Two vaccine candidates have phase 1 clinical trial data — while three others are still to reach the completion of phase 1 clinical trials. WHO AFRO said any decision regarding trials of vaccines and therapeutics will be made by national authorities and researchers in the two countries. The agency is also discussing access to experimental therapeutics as part of a clinical trial with health ministries in both countries. Update, March 30, 2023: This article has been updated with the latest number of cases from Equatorial Guinea.