Marburg Disease: Understanding the Threat and the Situation in Tanzania

Introduction

Marburg disease, a severe and often fatal illness caused by the Marburg virus, poses a significant public health threat globally. Belonging to the same family as the Ebola virus, Marburg disease is known for its high mortality rate and potential for rapid spread. Recently, Tanzania has been at the forefront of attention due to a suspected outbreak in the Kagera region, highlighting the need for vigilance and preparedness.

First identified in 1967 during outbreaks in Germany and Serbia, Marburg disease is transmitted through direct contact with infected bodily fluids or contaminated surfaces. The disease has a incubation period of 2 to 21 days, with symptoms ranging from fever and muscle pain to severe hemorrhaging and multi-organ dysfunction. The mortality rate varies widely, from 24% to 88%, depending on the outbreak and medical care available.

Historically, significant outbreaks have occurred in the Democratic Republic of Congo, Angola, Uganda, and more recently, Equatorial Guinea. These outbreaks have underscored the importance of early detection, quarantine, and public health education.

Kagera experienced its first Marburg outbreak in March 2023, which lasted nearly two months and resulted in nine cases and six deaths. The region remains endemic to zoonotic reservoirs like fruit bats, the natural hosts of the virus.

As of January 18, 2025, the Kagera region in Tanzania is facing a suspected outbreak of Marburg virus disease (MVD), a severe and often fatal illness caused by the Marburg virus. The situation has prompted significant local and international response efforts to contain the outbreak and prevent further spread.

Current Situation

1.?????? Cases and Fatalities:

·???????? Nine suspected cases have been reported, with eight deaths, resulting in a case fatality rate (CFR) of 89%. The cases are concentrated in the districts of Biharamulo and Muleba.

·???????? Symptoms include high fever, headache, muscle pain, diarrhea, vomiting blood (haematemesis), and external bleeding in later stages.

2.?????? Laboratory Testing:

·???????? Samples from two patients have been sent to the National Public Health Laboratory for testing, but results are still pending official confirmation. 1 and 12

·???????? The Tanzanian government has denied the outbreak, stating that all tested samples were negative for Marburg virus. However, this has not been independently verified.

On-Ground Support and Response

1.?????? Local and National Efforts:

·???????? National rapid response teams have been deployed to Kagera to investigate the outbreak, conduct contact tracing, and intensify surveillance activities.

·???????? A mobile laboratory has been set up in the region, and treatment units have been established to isolate and manage suspected cases.

2.?????? International Support:

·???????? The World Health Organization (WHO) has mobilized technical expertise and logistical supplies to support Tanzania’s response. WHO has also emphasized the need for enhanced surveillance and cross-border coordination to prevent regional spread.

·???????? The Africa Centres for Disease Control and Prevention (Africa CDC) has provided 200 test kits and is preparing to deploy healthcare experts to assist in the response.

3.?????? Risk Assessment:

·???????? WHO has assessed the risk as high at the national and regional levels due to Kagera’s role as a transit hub with significant cross-border movement to Rwanda, Uganda, Burundi, and the Democratic Republic of the Congo. The global risk is currently considered low.

Challenges and Concerns

1.?????? Delayed Detection and Isolation:

·???????? The delayed identification and isolation of cases, coupled with ongoing contact tracing, suggest that the full extent of the outbreak is not yet known. More cases are expected to be identified as surveillance improves.

2.?????? Healthcare Worker Infections:

·???????? Healthcare workers are among the suspected cases, highlighting the risk of nosocomial transmission and the need for strict infection prevention and control (IPC) measures.

3.?????? Community Engagement:

·???????? There is a critical need for risk communication and community engagement to raise awareness about symptoms, protective measures, and the importance of seeking immediate medical care. Misinformation and rumors must also be addressed to foster trust.

Preventive Measures and Recommendations

1.?????? Infection Prevention:

·???????? WHO advises reducing the risk of human-to-human transmission by avoiding direct contact with infected individuals or their bodily fluids. Safe and dignified burials are also recommended to minimize community exposure.

2.?????? Surveillance and Border Health:

·???????? Surveillance capacities at points of entry and border regions should be strengthened to prevent international spread. Collaboration with neighboring countries is essential for harmonizing reporting mechanisms and conducting joint investigations.

3.?????? Research and Medical Countermeasures:

·???????? There are currently no licensed vaccines or treatments for Marburg virus disease. However, several candidate vaccines are in development, and outbreaks provide opportunities to assess their efficacy and safety.

Global Implications and the Need for Collaboration

The global health community is increasingly interconnected, making the management of infectious diseases like Marburg a collective responsibility. Outbreaks in one region can have far-reaching consequences, emphasizing the need for international cooperation.

Organizations like the WHO and Africa CDC play pivotal roles in coordinating responses, providing resources, and sharing knowledge. The Tanzanian situation serves as a reminder of the ongoing threat posed by Marburg disease and the necessity for preparedness.

A Call to Action

As the world grapples with the potential outbreak in Tanzania, it is imperative that countries and health organizations remain vigilant and prepared. Continued investment in healthcare infrastructure, disease surveillance, and global collaboration is essential to mitigate the impact of Marburg and similar diseases.

References for Further Reading

1.?????? WHO Disease Outbreak News: [Outbreak of suspected Marburg Virus Disease – United Republic of Tanzania](https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON552) .

2.?????? WHO Africa Support: [WHO support for Tanzania’s response to suspected Marburg virus disease outbreak](https://www.afro.who.int/countries/united-republic-of-tanzania/news/who-sprt-tanzanias-response-suspected-marburg-virus-disease-outbreak) .

3.?????? Forbes Article: [What Is Marburg Virus? Eight Killed In Suspected Outbreak In Tanzania](https://www.forbes.com/sites/katherinehignett/2025/01/15/what-is-marburg-virus-eight-killed-in-suspected-outbreak-in-tanzania/) .

4.?????? Healio News: [WHO: 8 dead in suspected Marburg outbreak in Tanzania](https://www.healio.com/news/infectious-disease/20250115/who-8-dead-in-suspected-marburg-outbreak-in-tanzania) .

5.?????? China Daily: [No confirmed cases of Marburg virus in Tanzania, says Africa CDC](https://www.chinadaily.com.cn/a/202501/17/WS678a5a75a310f1265a1db9c6.html) .

6.?????? SpringerOpen Research: [Assessment of risk communication and community engagement interventions during the Marburg virus disease outbreak in Kagera region, Northwestern Tanzania](https://bnrc.springeropen.com/articles/10.1186/s42269-024-01298-9) .

7.?????? Egypt Independent: [Spread of deadly Marburg virus with 88% fatality rate in Tanzania spreads fears of wider outbreak](https://www.egyptindependent.com/spread-of-deadly-marburg-virus-with-88-fatality-rate-in-tanzania-spreads-fears-of-wider-outbreak/) .

8.?????? Top African News: [Outbreak of suspected Marburg Virus Disease – United Republic of Tanzania](https://www.topafricanews.com/2025/01/15/outbreak-of-suspected-marburg-virus-disease-united-republic-of-tanzania/) .

9.?????? The Independent Uganda: [Uganda heightens border surveillance over Marburg outbreak in Tanzania](https://www.independent.co.ug/uganda-heightens-border-surveillance-over-suspected-marburg-outbreak-in-tanzania/) .

10.?? BBC News: [Tanzania denies suspected Marburg outbreak after WHO alert](https://www.bbc.com/news/articles/c62737zqn68o) .