Any outbreak of an epidemic is likely to cause panic in society and fear within the population – driven by a barrage of information shared across digital platforms, some of which are false, misleading or exaggerated.

It is even more so for a deadly viral haemorrhagic disease like Marburg, whose fatality rate is at 88 per cent – which means that at least 9 out of 10 people, who contract it are likely to die. An outbreak like that of Marburg is followed by an ‘infodemic’.

An infodemic refers to the release of excessive amount of information about a problem that is typically unreliable, spreads rapidly and makes a solution more difficult to achieve.

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Even before the confirmation of the presence of the Marburg virus in Rwanda, information was already circulating on social media – with messages and audio clips, allegedly shared by health workers, circulating on different platforms, especially on WhatsApp, warning people against a ‘spreading viral’ disease.

With the Covid-19 pandemic experience still on the back of the minds of many, who still reminisce the lockdown and other tough decisions the government and partners took to minimise the impact, an outbreak like the current one, can easily be a source of misinformation, disinformation, or even fearmongering.

Over the past couple of days, Dr. Sabin Nsanzimana, Minister of Health, has emphasised the need for people to not panic or even try to compare the two outbreaks, given the difference between Marburg viral disease and Covid-19 – which is airborne, unlike the former.

"People can continue with their daily activities – there is no ban on any activity as part of the Marburg prevention measures. People should not panic as we have identified all the hotspots of the disease and are taking appropriate action,” Minister Nsanzimana said, pointing out that wearing a mask is not necessary, much as it is a good practice.

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Several studies have shown that an outbreak of the magnitude of Marburg – which is in the same category as Ebola, can generate misconceptions, beliefs and practices which can in fact impede the control of the outbreak.

Dr. Claude Mambo Muvunyi, Director General, Rwanda Biomedical Agency (RBC), the government’s central health implementation agency charged with promoting quality affordable, and sustainable health care services, said people should strictly stick to what the Ministry of Health says to avoid being misled.

Dr. Muvunyi advises against things such as self-diagnosis and self-treatment, which can even be more dangerous, urging people to look out for the symptoms which have been outlined and be quick to seek medical help.

"The disease is identified by its symptoms. So, if you feel you have the aforementioned symptoms, quickly reach out to the nearest health facility or call 114 for quick support and help,” Dr. Muvunyi noted, urging people to take action rather than hold back or try to self-treat.

At the moment, there are no self-test kits- only doctors can diagnose it but the patient is also capable of identifying symptoms such as high fever, headache and others to take quick action.

Meanwhile, Rwanda has banned visits to the hospital to check on patients to avoid the spread of the virus which the Ministry of Health said has mainly affected health workers, especially those working in Intensive Care Units (ICU).

The Ministry of Health on Monday, September 30, confirmed that one more person had succumbed to the deadly Viral Haemorrhagic Fever (VHF), bringing the death toll to nine, but officials say unlike Covid-19, people should not panic, but instead pay attention to preventive measures.

Even though the Marburg virus is more deadly than any recent pandemic, current outbreaks in different countries show that it can be curbed when precautions are taken and it doesn’t kill as many people as say Covid-19 did when it broke out.

Risk of an infodemic

However, studies show that misconceptions and risk behaviours during an outbreak of a disease like Marburg can lead to false claims, such as beliefs that it can spread through air, mosquito bites, or houseflies and other unscientific claims.

Aimable Uwizeyimana, who works in the salon at Gisimenti in Kigali, says that the disease was brought by ‘foreigners’ to kill Africans en masse, maintaining that Marburg is a ‘biological weapon’ to destroy the continent, without substantiating his claims.

"How comes we never had these kinds of outbreaks before?” he says – as every client sought to chip in on the ‘trending’ conversation on Marburg. Majority of the assertions made in the busy salon were extremely bizarre.

In countries like DR Congo, Ghana, Uganda and Equatorial Guinea – which have experienced Marburg outbreak in recent years, researchers found that some locals linked the disease to witchcraft and some patients went on to seek treatment from traditional healers, putting their lives at risk.

ALSO READ: Marburg: How past outbreaks unfolded

In some rural parts, the spread of Marburg is largely blamed on ignorance, where people do not take precautions and maintain contact with infected persons, in an attempt to help them, or even touch the body unknowingly during burial practices. Many get infected in the process.

According to the World Health Organisation (WHO), Africa saw a deluge of coronavirus-related fictions online between 2020 and 2022 at the height of the pandemic, with many false claims about Covid-19 therapies and the vaccines emerging.

In some places like Tanzania and Uganda, several therapies and theories were developed, while in other countries people drank all sorts of herbs. Several theories were also circulated about the effects of vaccines.

WHO and the Africa Science Media Centre worked around the clock to spot the false claims mainly spread over social media and debunked them in time but still the false information would continue to proliferate and reach millions of unsuspecting people on the continent.

After effects

But that is not all. The consequences of Marburg virus, which is transmitted to humans through contact with blood or bodily fluids from an infected animal or patient, can be long term and far reaching.

Given the aggressiveness of the disease, it can lead to discriminatory attitudes towards survivors or their families, even when they survive it.

Like Ebola, Marburg survivors struggle to be accepted back in their communities, leading to isolation and dejection, complicating the lives of survivors further.

However, this is one of the misconceptions around Marburg, which is a result of lack of knowledge yet in reality when people have accurate knowledge about Marburg, mode of transmission, develop a good attitude, and observe correct practices for the prevention, they defeat it.

Marburg is a largely new disease to most Africans and they don’t know how to deal with it, with many less aware of how to protect themselves against being infected. Lack of knowledge can easily compound the fight.

Also worth noting is that research showed that the educational background can also be a reason for the limited knowledge, where people are told to pray or resort to witchcraft to heal, while those who are educated can also be prone to false narratives and misinformation.

In the wake of such an outbreak, experts say improving one’s knowledge is crucial to enhance positive attitudes as it can result in behavioural changes and make it easy for response efforts to pay off.

Uwizeyimana admits that he is not well informed about Marburg and more efforts are needed to address concerns, misconceptions, and myths surrounding the disease, so that people don’t spread false and alarming information, as he was doing to his clients.

Who is at risk?

The Ministry of Health says anyone who gets in contact with bodily fluids such as blood, faeces, vomit, spit, sweat, tears, breastmilk or semen from a person sick with Marburg, is at risk of being infected. If you have, report as soon as possible, to avoid infecting others.

Similarly, getting in contact with or sharing objects that have been contaminated with the bodily fluids from a person who is sick with Marburg, such as beddings, clothes or needles, is a major risk factor.

The most vulnerable people to contract the disease are families and relatives of people who are sick or who have died from Marburg, which explains why the Ministry of Health has restricted visits to hospitalised patients.

Health workers, volunteers and people, who handle dead bodies are at risk of being infected with the Marburg virus. As officials have explained, symptoms include a strong high fever, severe headache, general body weakness, feeling unwell, muscle aches and pains, a running stomach and nausea.

People who experience these symptoms, including a rash, bruising under the skin and bleeding from the nose, private parts, gums or blood in vomit and excreta, should report immediately to get help.

It is also encouraged that people diagnosed with Marburg engage in protected sex for at least 12 months after a diagnosis until tests return negative results at least twice.

Regular updates to citizens by authorities and officials are also important to ensure that people do not consume rumours and false information, all of which can complicate an already concerning situation and sow fear.