Marburg virus kills 9 out of 10 infected, possibly contained

The Centers for Disease Control and Prevention (CDC) is recommending that people reconsider nonessential travel to Rwanda in light of a Marburg virus disease (MVD) outbreak. The deadly disease has a high death rate, killing 90% of patients. Recently officials out of Rwanda said the disease was showing signs of containment. ^[][][]

The CDC recently tightened these travel recommendations, having issued, at the beginning of October, a Level 2 travel warning suggesting that people “practice enhanced precautions” when visiting the country.^[] The current recommendation for reconsidering nonessential travel is considered a Level 3 travel warning, just behind Level 4, which recommends that people avoid all travel

Experts at Johns Hopkins University have raised concerns about Rwanda’s outbreak, particularly due to its impact on healthcare workers. 

“As you can imagine, if health care workers are getting infected, it weakens the area’s overall health infrastructure, which is a major problem,” Kari Debbink, PhD, MEd, a virologist at Johns Hopkins University, said on an episode of the “Public Health On Call” podcast earlier this October.^[]

Understanding fatality rates

Marburg virus disease is a severe and often deadly hemorrhagic fever with an average case fatality rate of around 50%.^[] In some outbreaks, case fatality rates have reached 88%, according to the World Health Organization (WHO). The virus is often compared to Ebola in terms of its symptoms and severity.

Some symptoms of MVD include:

• Fever

• Chills

• Headache

• Muscle aches

• Rash with both flat and raised bumps, often on the torso

• Chest pain

• Sore throat

• Nausea, vomiting, and diarrhea^[]

MVD transmission risks

Marburg spreads to humans from fruit bats and can be a greater risk to those who live in areas near mines or caves inhabited by fruit bat colonies, according to the WHO.^[] Once contracted by humans, the virus can spread via human-to-human contact. Some transmission routes include:

• Direct contact (through broken skin or mucous membranes) with the blood, secretions, organs, or other bodily fluids of infected people;

• Contact with contaminated surfaces or materials (eg, bedding or clothing) and;

• Direct contact with infected bodies during burial ceremonies.

Transmission through contaminated injection equipment or needles can be particularly dangerous, as it is “associated with more severe disease, rapid deterioration, and possibly a higher fatality rate,” according to the WHO.

MVD treatment

There are currently no FDA-approved treatments or vaccines for MVD; however, there are vaccines under trial.^[] One of these vaccines, created by the Sabin Vaccine Institute in Washington, DC, is currently being rolled out in Rwanda.^[] A total of about 1,700 vaccine doses have been sent to Rwanda so far, some 771 of which have been administered as of October 15, 2024.^[][]

For those who cannot get vaccinated, the CDC recommends that people with the virus focus on:

• Resting;

• Hydrating;

• Managing oxygen status;

• Managing blood pressure and;

• Getting treatment for secondary infections.^[]