Marburg Virus Disease in Rwanda: Key Facts, Risks, and Prevention

What is Marburg Virus Disease:

Marburg Virus Disease (MVD) is a viral hemorrhagic fever caused by the Marburg virus, which belongs to the Filoviridae family, the same family as the Ebola virus. The disease is known for severe internal and external bleeding, organ failure, and high mortality rates, making it a public health emergency whenever outbreaks occur.

The Marburg virus was first identified in 1967 during laboratory outbreaks in Germany and Serbia, where workers who had been in contact with infected African green monkeys became ill. Since then, outbreaks have been reported sporadically in Africa, with high concentrations in Uganda, the Democratic Republic of Congo, and Angola. While the disease remains relatively rare, its fatality rate ranges between 23% and 90%, depending on the outbreak’s location and healthcare infrastructure.

Currently, the natural host of the virus is the Egyptian fruit bat (Rousettus aegyptiacus). These bats can carry the virus without showing symptoms, making them a primary source of transmission to humans through direct contact or environmental contamination.

How Does Marburg Virus Spread:

The transmission of Marburg Virus Disease occurs through multiple routes, most notably:

1. Direct Contact with Infected Bodily Fluids:
   Marburg virus spreads through contact with blood, saliva, vomit, or other excretions from infected individuals. Healthcare workers and caregivers are particularly vulnerable when treating patients without adequate protective gear.
2. Human-to-Human Transmission:
   Once infected, an individual can transmit the virus to others through physical interaction or contaminated surfaces. Secondary infections often occur within healthcare settings or households.
3. Transmission from Animals to Humans:
   The virus is transmitted to humans primarily through exposure to fruit bats, either by visiting caves where these bats reside or through consumption of bat-contaminated fruits. Certain regions in Africa also report transmission through direct handling of infected primates, such as monkeys.
4. Contaminated Burial Practices:
   Cultural burial practices that involve touching or washing the deceased’s body can contribute to spreading the virus. Special precautions must be taken during funerals to prevent transmission from infected corpses.

Given Rwanda’s close trade and tourism links with neighboring regions, cross-border transmission is a concern. The government has implemented strict screening and quarantine protocols to prevent imported cases from spreading locally.

What are the Symptoms of Marburg Virus Disease:

The incubation period for Marburg Virus Disease ranges from 2 to 21 days, and symptoms appear suddenly. The illness progresses rapidly, with initial symptoms resembling common flu or malaria, making early detection difficult. Here is a breakdown of the disease’s progression.

Stage 1: Early Symptoms (Days 1-5)

• High fever
• Severe headache
• Muscle pain and body aches
• Chills and general malaise

Stage 2: Gastrointestinal Symptoms (Days 5-10)

• Nausea and vomiting
• Severe diarrhea
• Abdominal pain and cramps
• Dehydration

Stage 3: Hemorrhagic Symptoms (Days 10+)

• Bleeding from the gums, nose, or eyes
• Bruising and rash development
• Blood in vomit or stool
• Organ dysfunction (especially liver and kidneys)

As the disease progresses, patients may go into shock or develop multi-organ failure, leading to death in severe cases. Survivors may face long-term health complications such as joint pain, vision problems, or chronic fatigue. Immediate medical care is essential to improve survival chances, though no specific treatment currently exists.