WHO Confirms Marburg Outbreak in Rwanda
An outbreak of Marburg disease has been reported by WHO in Rwanda. Fifty-eight cases and 13 deaths have been reported up to October 10, 2024. The outbreak was first notified by the Ministry of Health in late September. The source of the outbreak is currently unknown. Most of the cases have been reported in Kigali.
Marburg is a serious viral haemorrhagic disease. It is in the same family as Ebola and has a high fatality rate (24% to 88%). Human to human transmission occurs through exposure to secretions, organs or bodily fluids of infected individuals. Health workers have been implicated in the current outbreak.
More than 700 contacts are currently being monitored. Two cases have involved international travel (Germany, Belgium). The disease has been excluded in both cases after a monitoring period.
Recent outbreaks have occurred in Tanzania (9 cases) and Equatorial Guinea (40 cases) in 2023. The largest outbreak on record occurred in Angola in 2005 (374 cases and 329 deaths). WHO provides in country support when outbreaks do occur.
Should you be concerned about Marburg disease if travelling to Rwanda?
The risk to travellers is very low.
Human infection occurs with exposure to bats. This exposure may become the index case of an outbreak.
Travellers to an area of risk should understand how the disease is transmitted. Those most at risk are health care workers and family members of an infected person. Certain burial practices can increase the risk of exposure.
Occupations like veterinarians who might handle non-human primates may be at increased risk.
Contact with bats in caves and mines might increase the risk to travellers.
Raw meat from unknown sources should always be avoided.
2009 Marburg Case in Colorado
A case of Marburg disease was reported in Colorado in 2009. The 44-year-old woman was hospitalised with an unexplained febrile illness in January 2008. She had previously visited a cave in Uganda.
Early testing did not implicate Marburg disease but after a further case was identified in a Dutch tourist, the original case was retested again a few months later and found to be positive. The cave had already been closed because of the Dutch case.
Are we prepared in Australia?
One major concern is with contacts travelling to overseas destinations. This has already happened.
Are we prepared at a health interface should this happen in Australia?
The basic skill of good history taking is often overlooked when there is access to various modern technologies. It is very possible for a contact to enter the medical system at a very basic level. It can be seen as just a fever of unknown origin.
