- This disease is quite similar to Ebola and has a mortality rate that varies between 60 and 90%.
- It is the first time in Tanzanian history that an outbreak of the Marburg virus has been reported.
- So far there is no vaccine to reduce risks.
The situation around the world is surrounded by complications. On the one hand, the Covid-19 pandemic is in a moment of relative control. In addition, the cases of MPOX (formerly monkeypox) are also on the decline. While at the opposite extreme is the outbreak caused by the Marburg virus because it remains active and has even now reached a new country.
According to what was reported by the World Health Organization (WHO), for the first time in history an outbreak was recorded in the United Republic of Tanzania. A total of eight cases have been reported so far, including five deaths (case fatality rate: 62.5%) in two villages in Bukoba district. While two of these cases were healthcare workers, one of whom has died.
As response measures, rapid response teams have been deployed to investigate and implement interventions in affected areas, including contact tracing and risk communication activities.
#Tanzania 🇹🇿 has confirmed its first-ever cases of #Marburg virus disease.
Here’s everything you need to know about what it is, its symptoms, and how it spreads 👇🏿#ViralFactsAfrica @viralfacts pic.twitter.com/qV1tDQ8to5
— WHO African Region (@WHOAFRO) March 22, 2023
WHO assesses the risk of spread as very high at the national level, high at the subregional level, and moderate at the regional level due to cross-border movements between the Kagera region and neighboring countries, including Uganda in the north, Rwanda and Burundi in the west. . Global risk is assessed as low.
Description of the situation
On March 16, 2023, the Ministry of Health of the United Republic of Tanzania announced that seven cases and five deaths from an unknown disease had been reported in two villages in Bukoba district, Kagera region. The cases were later confirmed as Marburg virus infection by reverse transcriptase-polymerase chain reaction (RT-PCR) at the Tanzania National Public Health Laboratory. On March 21, 2023, the Ministry of Health officially declared the first outbreak in the country.
As of March 22, eight cases have been reported, including five deaths in the Kagera region. The remaining three patients are currently undergoing treatment. As of March 22, no cases have been reported outside the Bukoba district of the Kagera region.
The first identified case reported a travel history from Goziba Island in Lake Victoria in Tanzania and developed symptoms after returning to his village in Bukoba. The case died in the community. Four additional cases from the same family as this index case were identified. In addition, two cases were reported among the health workers who treated them, one of whom died. No information is available on the eighth case.
The reported symptoms of the patients were fever, diarrhea, vomiting, bleeding from various sites, and renal failure. The National Public Health Laboratory took samples from living and deceased cases and confirmed them for the Marburg virus.
Epidemiology of Marburg virus disease
Marburg virus disease is an epidemic-prone disease associated with high case fatality rates (24-90%). It is caused by the same family of viruses (Filoviridae) as Ebola virus disease and is clinically similar. The current CFR for this outbreak is relatively high at 62.5%.
The infection by marburg virus often results from prolonged exposure to mines or caves inhabited by colonies of Rousettus bats. Once a person is infected with the virus, it can spread through person-to-person transmission through direct contact with the blood, secretions, or other bodily fluids of infected or deceased persons.
The incubation period varies from two to 21 days. The disease caused by marburg virus begins abruptly, with high fever, severe headache, and severe general malaise. Severe watery diarrhea, abdominal pain and cramps, nausea, and vomiting may begin around the third day.
Severe bleeding manifestations can appear 5 to 7 days from symptom onset, and fatal cases often have some type of bleeding, often from multiple areas.
The clinical diagnosis of Marburg virus is difficult in the early phase as the symptoms are similar to other febrile illnesses. The differential diagnosis may include other filovirus diseases, Lassa fever, malaria, typhoid fever, dengue fever, rickettsiosis infections, leptospirosis, and plague.
Laboratory confirmation is mainly done by RT-PCR. Other tests may be used, such as antibody capture enzyme-linked immunosorbent assay (ELISA), antigen capture screening tests, serum neutralization tests, electron microscopy, and virus isolation by cell culture.
Although there are no vaccines or antiviral treatments, supportive care, such as rehydration with oral or intravenous fluids, and treatment of specific symptoms improve survival. A variety of potential treatments are being evaluated, including blood products, immune therapies, and drug therapies.
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