Rwanda confirms further Marburg cases and plans vaccine trial

As Rwanda grapples with its first outbreak of the Marburg virus, the country’s Ministry of Health reported seven more cases and one more death yesterday. At briefings today, the country’s health minister shared more details about the outbreak, including that a vaccine trial will begin soon.

In other developments, German officials reported negative results in two travelers returning from Rwanda who were isolated in Hamburg because of past contact at a Rwandan hospital where patients were being treated in Marburg.

29 health workers among the confirmed cases

The new disease confirmations and deaths bring the total number of Marburg virus cases in Rwanda to 36, 11 of them fatal, making it one of the world’s largest outbreaks of the virus.

At a media briefing at the Africa Centers for Disease Control and Prevention (Africa CDC) today, Rwanda’s Minister of Health Sabin Nsanzimana, MD, PhD, said 29 (80%) of the patients were healthcare workers. 25 people are currently being treated in isolation. Health officials have identified 323 contacts for monitoring.

Like previous Marburg outbreaks in other countries, Rwanda came to the attention of health authorities when health workers became ill. The virus is known to be transmitted through contact with infected body fluids. He noted that the first two patients did not respond to usual treatment for other diseases such as malaria, which initially has a similar clinical presentation.

Many of the patients belong to a group of people who had close contact in the intensive care unit (ICU) of a hospital where the likely index patient was being treated.

Brian Chirombo, MD, MPH, told a World Health Organization (WHO) briefing today that the index patient died on September 8 and that the outbreak affected patients at two hospitals in Kigale, King Faisal and University Teaching Hospital.

Nsanzimana said the ministry expects to receive about 5,000 doses of remdesivir to provide Marburg patients with advanced treatment.

He also said officials expect to launch a vaccine trial in the coming days, and details about the vaccine and the official launch date will be announced soon. There are currently no approved specific treatments or vaccines for Marburg virus.

The epidemiological investigation and genetic sequencing are still ongoing. He described the outbreak as “controlled but not contained.”

Negative tests for German passengers, CDC alert for healthcare providers

Yesterday, German health authorities transported two train passengers to a hospital in Hamburg for testing after their past exposure at a Rwandan medical facility treating Marburg patients.

The European Center for Disease Prevention and Control (ECDC) announced today that it was in close contact with German health authorities, who reported today that the tests were negative.

It said the risk of Marburg disease among European residents traveling to or living in affected parts of Rwanda is still considered low, but the risk of infection in healthcare settings there is considered moderate. Travelers are urged to avoid contact with symptomatic people and the bodies of infected people.

Meanwhile, the U.S. Centers for Disease Control and Prevention (CDC) today issued a Health Alert Network notice to healthcare providers informing them of the outbreak and urging them to be alert to the possibility of imported cases.

Although most cases in Rwanda involve health care workers, the CDC noted that there are also cases that are not linked to known chains of transmission, suggesting that additional cases may have gone undetected or unreported.

Although cases were reported in seven districts of Rwanda, three in Kigali reported the most cases.