Rwanda’s first recorded infections of the Marburg virus, an Ebola-like hemorrhagic fever, is another sign that outbreaks of dangerous animal-borne diseases will become more frequent in an increasingly connected world, according to the US government’s main health ambassador.
Rwanda’s health ministry says at least 11 people have died from the disease, which is carried by Egyptian rousette bats, and 25 are in isolation since the spread started in an intensive care unit in Kigali, the capital. Cases have now been found in about eight of Rwanda’s 30 districts, according to the Africa Centres for Disease Control and Prevention.
Increased frequency of outbreaks of so-called zoonotic diseases — pathogens harbored by animals that from time-to-time cross into the human population — have been forecast for decades as populations grow and transportation improves.
“It’s ecological disequilibrium, where essentially we are moving into areas where before we were not,” John Nkengasong, the US senior bureau official for global health security and diplomacy, said in an interview in South Africa’s capital, Pretoria, on Wednesday. This “will drive the emergence of diseases and now we are seeing how those diseases are emerging.”
Nkengasong cited the growing frequency of Ebola outbreaks since its discovery in 1976 in the Democratic Republic of Congo as well as the recent emergence of a sub-variant of mpox in the east of that country and in neighboring Burundi as examples of the spread. The Rwandan outbreak is the 14th of the disease recorded ever.
A Dozen Governments Have Recorded Marburg Since 1967
Disease first recognized after outbreaks in Germany, Serbia
Sources: US CDC; Africa CDC
Marburg, which also infects primates other than humans, causes symptoms including fevers, rashes and severe bleeding. Fatality rates from infection can exceed 80%.
Marburg deaths have been fairly limited and dwarfed by Ebola, which killed more than 11,000 people in West Africa in an outbreak between 2013 and 2016.
The disease was first identified in 1967 when there were simultaneous outbreaks in the German town of Marburg and in Belgrade in the country now known as Serbia among laboratory workers handling green monkeys imported from Uganda.
Since then, human infections have been recorded in several African countries as well as in Russia and the Netherlands. Egyptian fruit bats found throughout southern Africa harbor the virus and the disease occasionally infects humans who encounter them.
Diseases such as Marburg “seem to be occurring with greater frequency as well as in locations where they haven’t happened before,” said Mark Feinberg, chief executive officer of IAVI, a nonprofit vaccine and antibody drug developer working on a potential Marburg shot.
No Treatment
While experimental vaccines are being developed, there are no licensed treatments for the disease, according to the US Centers for Disease Control and Prevention. Gilead Sciences Inc. has donated 5,000 doses of its Remdesivir antiviral in a bid to combat the disease, Sabin Nsanzimana, Rwanda’s health minister, said on an Africa CDC conference call on Thursday. An experimental vaccine will also be trialled, he said, declining to identify the manufacturer.
“It is very unfortunate that we still have these gaps in research and development,” he said. “This should be a call to action.”
A lockdown to prevent the further spread is currently not considered necessary, Nsanzimana said on Rwandan television earlier. The head of the Africa CDC, Jean Kaseya cautioned against the potential imposition of travel restrictions on Rwanda.
“We are going to stop this outbreak before it affects other regions, countries and even beyond,” Nsanzimana said. “Its a very aggressive disease that affects the immune system and destroys organs.”
Burundi, which borders Rwanda, has started a preparedness campaign, asking people to alert medical authorities to any suspected cases, and will discuss a potential response with the World Health Organization.
“We must be prepared because there are contacts between Burundi and Rwanda through people’s movements between the two countries,” Liduine Baradahana, Burundi’s health minister, told reporters in Bujumbura on Thursday.
While Rwanda is relatively well equipped to fight the disease, its poorer neighbors are not, according to Feinberg. Burundi and Congo are among the world’s poorest nations.
Rwanda is “an exceptionally capable country in terms of their public health system,” he said. “If the outbreak extends to the DRC or maybe even came from the DRC, the situation could change significantly in the coming days and weeks.”
