3 min readNew DelhiOct 8, 2024 10:53 AM IST
First published on: Oct 8, 2024 at 09:30 AM IST
The deadly Marburg virus could overwhelm Rwanda’s fragile healthcare system. Since the east African country reported the first Marburg case late last month, at least 46 individuals have been infected and 12 Marburg deaths reported.
About 80% of infections are among medical workers. For a nation with only 1,500 doctors to cater to a population of over 13 million, the outbreak threatens to significantly strain the healthcare system.
What is Marburg virus?
Marburg is among the deadliest pathogens known to humans, with Marburg virus disease (MVD) case fatality rates ranging from 24% to 88% in past outbreaks, depending on virus strain and case management. The first outbreak occurred in Marburg, Germany, in 1967. Since then, subsequent outbreaks have been mostly reported across Africa.
Marburg belongs to the filovirus family, like Ebola. Both pathogens are clinically similar, and although rare, can cause outbreaks with high fatality rates.
How does MVD spread?
Initially, human MVD infections were caused by prolonged exposure to mines or caves inhabited by colonies of Rousettus bats, most notably the Egyptian fruit bat. However, according to the World Health Organization (WHO), Marburg also spreads through human-to-human transition both directly (through contact with blood and other bodily fluids of infected people) and indirectly (through surfaces and materials like bedding, clothing, etc. contaminated with these fluids).
Medical workers treating confirmed or suspected MVD cases have been frequently infected in outbreaks, especially when infection control and precautions are lax.
What are the symptoms of MVD?
The interval between infection and onset of symptoms varies from 2 to 21 days. Initial symptoms, according to the WHO, include high fever, severe headache, muscle ache, severe watery diarrhoea, abdominal pain and cramping, and vomiting.
Many patients develop haemorrhagic symptoms (bleeding), often in many places including the digestive system (faeces and vomit often come with fresh blood), the nose, gums, and vagina. Haemmorage leads to most MVD fatalities, with death in fatal cases occurring 8 to 9 days after the onset of symptoms, usually of severe blood loss and shock.
How can MVD be prevented, treated?
Currently, there are no approved vaccines or specific treatments for MVD. However, according to WHO, supportive care — rehydration with oral or intravenous fluids — and treatment of specific symptoms, improves survival.
Some treatments are currently in the works. Rwanda Health Minister Sabin Nsanzimana has said the country is seeking experimental vaccines and treatments, and hopes to address the outbreak with candidate drugs and shots — those in preclinical or clinical trial phases. The US-based Sabin Vaccine Institute has provided Rwanda with 700 doses of its experimental Marburg vaccine, which will be administered to healthcare professionals at the frontlines.
Casket of a person who died of Marburg virus in Angola in 2005. (NYT) 
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