10/05/2024
Understanding the Marburg Virus Outbreak in Rwanda: Reflections, Facts, Key Methods, and Symptoms
As many of you are aware, Rwanda is currently facing an outbreak of the Marburg virus, a highly infectious disease in the same family as Ebola. Given the nature of the virus and its potential impact, I want to share some brief reflections, along with key facts and principles, to help clarify the situation and avoid unnecessary panic or misinformation.
As you may know, I have a fondness and connection with Rwanda. I have traveled there many times to collaborate on capacity building in transplant surgery and increasingly in hepatobiliary (HPB) surgery (liver surgery). I have made friends there, and whenever something happens in Rwanda, especially in Kigali, the capital where I have spent a lot of time, my thoughts immediately go to them.
My heart goes out to those who have lost loved ones and colleagues thus far. I have personally worked with the amazing healthcare staff at King Faisal Hospital and the University Teaching Hospital of Kigali (CHUK), and I can only imagine the pain they must feel at the sudden loss of their dedicated, selfless, and courageous colleagues who have succumbed to this disease while serving others.
With them in mind, I would like to ensure no misinformation is put forth. I know that Rwanda has a robust, well-organized healthcare sector, and the Ministry of Health, its ministers, and staff are quite capable. I look forward to the full resolution of this outbreak and to returning many more times to the ‘Land of a Thousand Hills’ and its beautiful people in the future.
Known Facts:
• Marburg virus disease (MVD) is a severe viral hemorrhagic fever with a fatality rate ranging from 24% to 88%, depending on the virus strain and case management.
• As of October 4th, 2024, Rwanda has reported 41 confirmed cases and 12 deaths.
• The Rwandan government, in collaboration with WHO and CDC, has been swift in implementing isolation and decontamination measures to contain the outbreak. Daily updates are provided on their websites and social media.
• The virus has an incubation period of 2-21 days, meaning it can take up to 21 days for an exposed person to show symptoms.
• No licensed treatment is currently available to neutralize the virus, but experimental treatments and vaccines are in development.
Epidemiological Principles: What Is Being Done
1. Containment: The primary focus is isolating infected individuals and conducting thorough contact tracing to find anyone exposed to the virus. Rwanda is actively applying these methods, and there has been no confirmed international spread as of now.
2. Case Fatality Rate (CFR): Marburg’s CFR can range between 50-90%, making it one of the more lethal viruses. It is crucial to focus on reducing the spread rather than assuming all exposed individuals will be infected.
3. R0 (Reproduction Number): This represents how many people, on average, one infected person can pass the virus to. If the R0 is greater than 1, the outbreak can grow. Reducing the R0 through isolation and quarantine is key to stopping the spread.
Symptoms of Marburg Virus Disease (Source: WHO):
• Initial symptoms: High fever, severe headache, severe malaise, muscle aches, and pains.
• Day 3 symptoms: Severe watery diarrhea, abdominal pain, cramping, nausea, and vomiting. Diarrhea can last for a week.
• Between Days 5 and 7: Many patients develop severe hemorrhagic symptoms, with bleeding from multiple areas, such as the nose, gums, and even venepuncture sites.
• Severe cases: Central nervous system involvement can lead to confusion, irritability, and aggression.
• Fatal cases: Death usually occurs between 8 and 9 days after the onset of symptoms, often due to severe blood loss and shock.
For more details on Marburg symptoms and general information, you can check the WHO fact sheet here: https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease.
Caution Against Speculation:
It’s important to avoid speculating on the spread of the virus without factual evidence. As we learned early in the COVID-19 pandemic, misinformation can cause more harm than good. In addition there is always opportunists who will render biased opinions without merit.
Current data from Rwandan authorities, WHO, and CDC show that containment efforts are underway. We should focus on supporting these measures and staying informed through trusted sources.
Follow more updates here:
• WHO: https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease
• CDC: https://www.cdc.gov/vhf/marburg/index.html
• Rwandan Ministry of Health: http://www.rbc.gov.rw
Mini Glossary:
• Incubation Period: The time from exposure to the virus to the onset of symptoms (2-21 days for Marburg).
• Case Fatality Rate (CFR): The percentage of people who die after becoming infected.
• R0 (Reproduction Number): A measure of how many people one infected person can spread the virus to.
Facebook links:
• WHO Facebook: https://www.facebook.com/WHO/
• CDC Facebook: https://www.facebook.com/CDC/
Poll:
1. Do you feel more informed about the current Marburg virus outbreak in Rwanda?
• Yes
• No
This is the World Health Organization (WHO) official page. Join the conversation!
