Travel ban as eight die of incurable virus and risk of spread is 'high'

The World Health Organisation is tracing 300 people who had contact with infected people - including one who left the country

The World Health Organisation has warned the risk of a fatal, incurable disease spreading is 'high' after 26 cases and eight deaths. Health chiefs are trying to trace 300 people who may have come into contact with those who contracted Marburg Virus Disease.

The Rwanda Ministry of Health has confirmed the country's first outbreak of the disease after finding cases in seven of 30 districts. Among the confirmed cases, over 70% are healthcare workers from two health facilities in Kigali.

The patients are being cared for in hospitals. The Government of Rwanda is coordinating the response with support from WHO and partners. There is currently no available treatment or vaccine for MVD.

A WHO spokesman said: "This is why it is important for people showing Marburg-like symptoms to seek care early for supportive treatment which can improve patient survival. WHO assesses the risk of this outbreak as very high at the national level, high at the regional level, and low at the global level."

One contact travelled internationally. They remained healthy, completed the monitoring period and did not present with any symptoms. The source of the infection is still under investigation.

MVD is a highly virulent disease that can cause haemorrhagic fever and is clinically similar to Ebola diseases. Marburg and Ebola viruses are both members of the Filoviridae family (filovirus). People are initially infected with Marburg virus when they come into close contact with Rousettus bats, a type of fruit bat, that can carry the Marburg virus and are often found in mines or caves.

Marburg virus spreads between people via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with fluids. Healthcare workers have previously been infected while treating patients with suspected or confirmed MVD. Burial ceremonies that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg virus.

The incubation period varies from two to 21 days. Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Although not all cases present with haemorrhagic signs, severe haemorrhagic manifestations may appear between five and seven days from symptoms onset, and fatal cases usually have some form of bleeding, often from multiple areas. In fatal cases, death occurs most often between eight and nine days after symptom onset, usually preceded by severe blood loss and shock. There is currently no available treatment or vaccine for MVD. Some candidate vaccines are currently under development.

Several outbreaks of MVD have previously been reported from countries neighbouring Rwanda, including the Democratic Republic of the Congo, Uganda and the United Republic of Tanzania. The most recent outbreaks were reported in Equatorial Guinea and the United Republic of Tanzania between February and June 2023. Other countries that previously reported outbreaks of MVD in the African Region included Angola, Ghana, Guinea, Kenya, and South Africa.

There is a risk of the outbreak spreading to neighbouring countries since cases have been reported in districts located at the borders with the Democratic Republic of the Congo, the United Republic of Tanzania, and Uganda. Further risk of international spread is also high as confirmed cases have been reported in the capital city with an international airport and road networks to several cities in East Africa.

Based on the current risk assessment, WHO advises against any travel and trade restrictions with Rwanda.