Rwanda Deals With a Deadly Outbreak of Marburg Virus Disease as it Becomes a Testing Ground for Vaccines

Marburg virus is transmitted via bodily fluids including saliva, blood, urine, and feces (Flickr).

Rwanda declared an outbreak of the deadly Marburg Virus Disease (MVD) on September 27. This is the first reported outbreak of MVD in Rwanda.

The disease transmits to humans by contact with the virus’ host, the Egyptian fruit bat The first transmissions often occur in caves, and outbreaks usually originate with miners. The virus spreads between humans via bodily fluids including saliva, blood, urine, and feces, making healthcare workers extremely vulnerable to infection. Because the Egyptian fruit bat is the only known vector for the disease, previous outbreaks have been limited to its range in Angola, Equatorial Guinea, the Democratic Republic of the Congo, Ghana, Guinea, Kenya, South Africa, Tanzania, and Uganda. Outbreaks have generally been small, and there have only been two outbreaks with over 100 fatalities: one in the Democratic Republic of the Congo from 1998-2000, and another in 2005 in Angola. The last recent major outbreak was in 2023 in Equatorial Guinea, where 40 people contracted the virus and 35 died. 

MVD is similar to ebola, and while caused by a different virus, it can be equally as dangerous. It has a fatality rate of about 50 percent, but the fatality rate has varied from 24 to 88 percent in past outbreaks. 

Rwanda has identified many cases among frontline healthcare workers, who come into regular contact with highly contagious infected patients. As of October 11, there are 61 reported cases, 14 deaths, 16 recovered patients, and 31 patients still undergoing treatment. The number of new cases has been decreasing, with the three newest ones all reported among healthcare workers working in Kigali, the capital of Rwanda. Thanks to assistance from the WHO, the Rwandan government was able to orchestrate an effective response to the outbreak.

In an effort to contain the spread of MVD, the U.S. Department of State has instituted a travel advisory, warning U.S. citizens not to travel to Rwanda unless necessary. American airports are also requiring passengers arriving from Rwanda to undergo screening upon arrival. Additionally, Rwanda is requiring people leaving the nation to undergo screening for symptoms in an attempt to curb the spread of the virus to other African nations.

Unfortunately, the disease does not have a licensed and effective vaccine. However, the Sabin Vaccine donated 700 doses of an experimental vaccine for frontline healthcare workers and followed with a second donation of an additional 1000 vaccines. While there have been no reports on the effectiveness of the vaccine, 501 people have received the vaccine, and have not reported any negative side effects. Additionally, American biopharma company Gilead donated 5,000 doses of Remdesivir, an antiviral medication that has also been used to treat patients infected with COVID-19.

Currently, 700 people who were in contact with infected people are undergoing monitoring for symptoms of MVD, but it appears that the outbreak is subsiding thanks to Rwanda’s response and additional private and international assistance.