About three weeks after Rwanda declared the Marburg Virus Disease outbreak over, the World Health Organisation (WHO) on January 13 informed its member states about an outbreak of suspected Marburg Virus Disease (MVD) in the Kagera region of Tanzania using its secure web-based platform—the Event Information Site (EIS). ALSO READ: Rwanda declares Marburg virus outbreak over On 13 January 2025, @WHO informed its Member States and International Health Regulations (IHR) State Parties of an outbreak of suspected #Marburg Virus Disease in Kagera region, #Tanzania, using our secure web-based platform – the Event Information Site (EIS). Under the IHR,... pic.twitter.com/3LmCyweyxZ — Tedros Adhanom Ghebreyesus (@DrTedros) January 14, 2025 Under the International Health Regulations, the Event Information Site is used to issue rapid alerts to member states of acute and rapidly developing public health risks and events with possible international implications. On January 10, WHO received reliable reports from in-country sources regarding suspected cases of MVD in Kagera region of Tanzania. “Six people were reported to have been affected, five of whom had died. The cases presented with similar symptoms of headache, high fever, back pain, diarrhoea, haematemesis (vomiting with blood), malaise (body weakness) and, at a later stage of disease, external haemorrhage (bleeding from orifices),” reads a WHO statement. As of January 11, the statement says, nine suspected cases were reported including eight deaths (case fatality ratio (CFR) of 89%) across two districts – Biharamulo and Muleba. “Samples from two patients have been collected and tested by the National Public Health Laboratory. Results are pending official confirmation. Contacts, including healthcare workers, are reported to have been identified and under follow-up in both districts.” Bukoba district in Kagera region experienced its first MVD outbreak in March 2023, and zoonotic reservoirs, such as fruit bats, remain endemic to the area. The outbreak in March 2023 lasted for nearly two months with nine cases including six deaths. “National rapid response teams have been deployed to support outbreak investigation and response; surveillance activities have been intensified with contact tracing ongoing; laboratory samples from recent cases have been sent for confirmation at the National Public Health Laboratory. A mobile laboratory is located in Kagera region and treatment units have reportedly been established.” According to WHO, the risk of this suspected MVD outbreak is “assessed as high at the national level” due to several concerning factors. As noted, the suspected outbreak thus far involves at least nine suspected cases, including eight deaths, resulting in a high case fatality ratio of 89%. Healthcare workers are included among the suspected cases affected, highlighting the risk of nosocomial transmission. The source of the outbreak is currently unknown. “The reporting of suspected MVD cases from two districts suggests geographic spread. The delayed detection and isolation of cases, coupled with ongoing contact tracing, indicates lack of a full information of the current outbreak. More cases are expected to be identified.” According to the UN health agency, the regional risk is considered high due to Kagera region's strategic location as a transit hub, with significant cross-border movement of the population to Rwanda, Uganda, Burundi and DR Congo. Reportedly, WHO says, some of the suspected cases are in districts near international borders, highlighting the potential for spread into neighbouring countries. MVD is not easily transmissible. In most instances, it requires contact with the body fluids of a sick patient presenting with symptoms or with surfaces contaminated with these fluids. However, it cannot be excluded that a person exposed to the virus may be travelling. Global risk assessed as low The WHO statement adds: “The global risk is currently assessed as low. There is no confirmed international spread at this stage, although there are concerns about potential risks. Kagera region, while not close to Tanzania's capital or major international airports, is well-connected through transportation networks, and has an airport that connects to Dar es Salaam for onward travel outside Tanzania by air. “This highlights the need for enhanced surveillance and case management capacities at relevant points of entry and borders, and close coordination with neighbouring countries to strengthen readiness capacities.”
