Marburg Virus Spreads in Rwanda: WHO Issues Global Alert as Cases Spirale Up

Cases of the deadly Marburg virus that have surged alarmingly in Rwanda over the past few weeks have sent shockwaves around the world. It is against this alarming surge that the WHO has issued a global alert, calling on all other countries to heighten their vigilance and take measures to prevent this highly infectious virus from spreading further. Already, many lives have been lost, and intense pressure mounted on Rwanda's healthcare system due to Marburg virus, which can have a mortality rate as high as 88%. In fact, with rising mobility, the very concern is that it will start to spread to countries beyond Rwanda's borders, much more to US,Zimbabwe,Namibia,Eswatini,Lesotho & Botswana.

Let's start by giving some details about what the Marburg virus is, how it spreads, what its symptoms are, and what is being done at this time to control this outbreak.

What Is the Marburg Virus?

The Marburg virus is a highly infectious pathogen from the family of viruses known as Filoviridae. And one that includes the Ebola virus, one of the most notorious viruses on earth. It was first identified in 1967, when its first appearance happened in Marburg and Frankfurt, Germany, and Belgrade, Serbia, as this had simultaneous outbreaks in those places. The origin of the virus was attributed to the importing of African green monkeys from Uganda for medical research. These were the first recorded victims of the Marburg virus, laboratory workers handling tissues, blood, and organs of the imported monkeys without any protective attire.

Marburg Virus in 2023:

Fast-forwarding to 2023, headlines from outbreaks of the virus in several African countries have again brought it back into public attention. The very virus that had remained quite dormant for decades without much public notice suddenly erupted into Rwanda again to regain the world's attention once more with this deadly disease. MVD or Marburg Virus Disease causes severe hemorrhagic fever and is one of the deadliest pathogens known to mankind, with a very high case fatality rate.

How Does the Marburg Virus Spread?

The Marburg virus is mainly known to be zoonotic, which means transmission from animals to humans. One of the major hosts bringing the virus is the Rousettus aegyptiacus, which includes Egyptian fruit bats. These bats do contain the virus but do not display the actual signs of the disease. Humans generally contract the virus when they get closer to the infected bats within caves and mines. After the virus makes its jump from animal to human beings, it then keeps transferring from human to human.

Human-to-human transmission is possible through direct contact with the blood, secretions, or other body fluids of an infected individual. It may also be surfaces or materials that come in contact with such fluids, such as bedding and clothing. The virus is mainly contagious in the later stages of the disease when patients have acute symptoms like vomiting, diarrhea, and bleeding.

What Is Marburg Virus Symptom?

The symptoms of Marburg virus infection seem to progress from quite mild to much more severe within several days. Symptoms generally start between 2 and 21 days after exposure, with an initial onset much like the flu. During the early days of illness, patients commonly begin developing symptoms, which may include:

Fever
Headache
Muscle and joint pain
Fatigue

Patients will often subsequently begin to develop worse symptoms as the illness progresses, including:

Nausea
Vomiting
Diarrhea (often watery and profuse)
Abdominal pain

Within a couple of days, hemorrhagic manifestations may appear due to bleeding from the nose, gums, eyes, and other openings. In extreme cases, there may be widespread internal bleeding, and blood can appear in the vomit or stool. Neurological symptoms such as confusion, irritability, and aggression have also been exhibited by the patient, where the central nervous system is affected.

According to WHO officials, the affected will often have an almost ghost-like look; they have deep-set eyes and pale skin with a lazy look. If left untreated, it can lead to multi-organ failure and cause death.

What Does the Marburg Virus Look Like?

The Marburg virus is long, thread-like, and filamentous in its shape, such as the others from the family of filoviruses. Viewed under a microscope, it would resemble a spaghetti string turned into various shapes. Despite this simple shape, the virus is very deadly once it has entered the human body, wreaking havoc in most organs.

Treatment of the Marburg Virus

There are no licensed vaccines or specific antiviral treatments available for Marburg Virus Disease (MVD). Treatment is broadly supportive care in an effort to improve the prospects of survival. This encompasses:

Rehydration: Oral and intravenous fluids could be given to prevent dehydration through the route of vomiting and diarrhea.
Control of symptoms: Analgesics and antipyretics may be administered to alleviate the symptoms, but not at the risk of using drugs that stimulate bleeding.
Blood transfusions: In some instances, blood products may be replaced to replace the lost blood and control the hemorrhagic symptoms.

Researchers are working on possible vaccines, but so far, none of those have been approved for widespread use. The WHO has recommended strict infection control measures in hospitals and other healthcare facilities to protect the medical workers as they are at a high risk of exposure. This is especially important because 80% of the cases in the current Rwanda outbreak fall into this category of healthcare workers.

US Reaction to Marburg Virus Breakout

The U.S. has been very proactive about the potential threat of the Marburg virus. According to reports from the CDC, there are no confirmed cases within the United States; however, it has taken preparedness measures against its entry. Among such steps are strengthened monitoring at major entry points, such as airports, and coordination with international partners.

The U.S. government has also dedicated more resources to researching vaccines and therapeutics for the Marburg virus. Therapeutics development is being fast-tracked in a bid to minimize the influence should this virus break out of Africa. USAID has dispatched health experts to Rwanda to bolster containment efforts and supplement the ability of local health authorities to contain the outbreak.

The quarantining measure has thus been strengthened for anybody coming from Rwanda and countries where the virus is wreaking havoc. The CDC has given advisories to medical officers at all facilities in the U.S. to be on high alert and ready to handle any potential cases, emphasizing the necessity of early detection and isolation to prevent any community transmission.

It is a holistic approach, reflecting the commitment of the United States towards both global health security and the safety of its citizens against any potential outbreak.

The Marburg Virus Outbreak in Rwanda

As late September 2024 reports and records began to show up on increased cases of the Marburg virus in Rwanda, the country reported a total of 26 active cases and 12 deaths within just days. The speed with which the virus has spread, as well as its high killing rate, has shortly overwhelmed an already weak health structure in Rwanda. With barely 1,500 doctors for a population of over 13 million, this renders it impossible to cope with such an increase effectively.

As an immediate response, the WHO has issued a global alert and has summoned nations to watch vigilantly, stepping up surveillance and infection control measures. The virus is currently confined only to Rwanda, but there is a real danger of its spreading to other countries, including India, especially with the resumption of travel in the world following the pandemic.

Global Response and Measures to Control the Spread

Countries are improving their affairs so that the spread of the Marburg virus is checked. In the United States, the Centers for Disease Control and Prevention announced it will begin screening passengers arriving from Rwanda at major airports, including Chicago O'Hare, JFK in New York, and Washington Dulles in Virginia. Travelers entering from Rwanda in the past 21 days shall be followed for symptoms of the disease, including fever, vomiting, and sore throat.

Meanwhile, in Africa, neighboring countries also strengthened their vigilance. East African countries stepped up border control measures and are highly on the lookout for potential cases. Rwanda started its vaccination trial campaigns, although no vaccine has yet been approved.

How to Protect Yourself from the Marburg Virus

There is no vaccine, but the outbreak of the disease can be prevented by various precautionary measures. These are as follows:

Avoid contact with fruit bats.
Maintain good hygiene.
Avoid contact with body fluids.
Use personal protective equipment (PPE).

Is India at Risk of a Marburg Virus Outbreak?

India has not yet reported any case of the Marburg virus, and according to health officials, this is very low risk for an outbreak. India continues to be kept on high alert following the onset of the global pandemic world. Efforts to surveil international airports have been increased to identify cases suspected at the airports and isolate them from entering the country.

Conclusion

The Marburg virus is a killer pathogen with high potential to unleash some widespread outbreaks, especially in places with deficient health care infrastructure. The crisis in Rwanda has thrown light on this killer once more and its notorious ability to trespass across borders. As countries across the world take precautions, it is essential for people to stay informed about the guidelines provided by health authorities to take care of themselves and others.

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