Suspected outbreak of Marburg reported in transit hub in Tanzania

There’s a suspected outbreak of Marburg in Tanzania’s Kagera region that borders Rwanda, Uganda, Burundi, and Lake Victoria. This comes less than a month after an outbreak of the disease was declared over in Rwanda. According to the World Health Organization, there are currently nine suspected cases and eight deaths across two of Tanzania’s districts: Biharamulo and Muleba. Samples from two patients are being tested by the country’s National Public Health Laboratory — with results pending confirmation. Symptoms of the suspected cases have included vomiting with blood, bleeding from orifices, headaches, and high fevers. If confirmed, this would be Tanzania’s second Marburg outbreak. The East African country experienced its first Marburg outbreak in the Bukoba district in the Kagera region in March 2023, which lasted nearly two months with nine cases and six deaths. Whenever a Marburg outbreak emerges, it’s alarming because it’s one of the deadliest pathogens to infect humans. The disease, which is similar to Ebola, infects people exposed to bat colonies. It can then spread between humans through bodily fluids and can lead to hemorrhaging and death. Concern about regional spillover is heightened in this case because Kagera is a transit hub with significant cross-border movement of people between Tanzania, Rwanda, Uganda, Burundi, and the Democratic Republic of Congo. Some of the suspected cases are in districts near international borders. “It cannot be excluded that a person exposed to the virus may be travelling,” WHO wrote. “The delayed detection and isolation of cases, coupled with ongoing contact tracing, indicates lack of a full information of the current outbreak. More cases are expected to be identified.” There have been 18 recorded outbreaks of Marburg since its discovery in 1967. In some outbreaks, the case fatality ratio has spiraled to as high as 88%. In Rwanda, the outbreak lasted less than three months late last year with a case-fatality ratio of 22.7%, which is one of the lowest recorded rates in the history of viral hemorrhagic fevers. Sixty-six people were reported infected — the majority of which were health workers exposed to infected patients, and 15 people died. The disease doesn’t have licensed vaccines nor therapeutics, but patients can receive supportive care. During the Rwanda outbreak, there was experimental use of Sabin Vaccine Institute’s vaccine candidate and Gilead Sciences antiviral medicine remdesivir. Contact tracing and rapid testing are crucial in managing a Marburg response. WHO reports that contacts of cases, including health workers have reportedly been identified. Health care workers are also included among suspected cases. The source of the suspected outbreak in Tanzania is unknown and the presence of suspected cases in two districts suggests geographic spread, according to WHO. But the agency has also deemed that there’s currently a low risk of international spread. “We do not recommend travel or trade restrictions with Tanzania at this time,” WHO Director-General Tedros Adhanom Ghebreyesus wrote.