Marburg: Rwanda discharges last virus patient, set to declare end of outbreak

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Rwanda has discharged the last Marburg virus disease patient, kicking off the mandatory 42-day countdown to declare the end of the outbreak. The country has reported no new confirmed cases since 30 October 2024.

The last patient was discharged on 8 November 2024. Contacts of the last patient, along with those of previously discharged patients, will continue to be followed up until the end of their 21-day observation period. The outbreak can only be declared over if no new infections arise 42 days after the last confirmed case tests negative.

Despite no new cases being reported for over a week, health authorities remain vigilant. During this period of enhanced surveillance, the Ministry of Health will intensify efforts, leveraging the country’s extensive network of almost 60 000 community health workers to conduct active case finding and test any suspected cases, ensuring that no chain of transmission has been missed.

To date, a total of 66 cases and 15 deaths have been recorded during the outbreak, which was declared on 27 September. Health workers, who constitute almost 80% of the cases, were primarily becoming infected while providing emergency care to their colleagues and patients.

Though the outbreak initially spread quickly in the country’s two leading hospitals in Kigali and among the family of one of the first cases, the rapid, robust response resulted in no community transmission to date.

National health authorities, supported by World Health Organization (WHO) and partners, immediately activated the outbreak response to halt further spread and save lives. The rapid deployment of rapid response teams, close monitoring of contacts, and implementation of infection prevention and control measures significantly reduced confirmed case numbers, which were halved between weeks two and three, and decreased by around 90% thereafter.

“This outbreak demonstrates that with the best available treatment, recovery is possible, and contributions to science can be made,” said Dr Sabin Nsanzimana, Rwanda’s Minister of Health. “The evidence generated from this outbreak is going to help shape surveillance activities going forward and prevent future outbreaks.”

Marburg is a highly virulent virus causing haemorrhagic fever, with a fatality ratio of up to 88%. The virus belongs to the same family as the Ebola virus. Illness begins abruptly with high fever, severe headache, and malaise, and many patients develop severe haemorrhagic symptoms within seven days.

The virus is transmitted to people from fruit bats and spreads through direct contact with the bodily fluids of infected people, surfaces, and materials. Supportive care, including rehydration with oral or intravenous fluids and treatment of specific symptoms, improves survival rates.

“Thanks to the concerted efforts of all involved, Rwanda is successfully emerging from a highly challenging outbreak, effectively mitigating its potentially devastating impacts. I commend the Government of Rwanda for the significant progress achieved. WHO remains committed to supporting these ongoing collaborative efforts until the outbreak is officially declared over,” said Dr Brian Chirombo, WHO Representative in Rwanda.

 

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