Kagera Region, Tanzania
The World Health Organization (WHO) has issued an urgent alert to its Member States and International Health Regulations (IHR) State Parties following reports of Marburg Virus Disease (MVD) outbreak in Tanzania’s Kagera region.
This alarming development comes after the country previously grappled with an MVD outbreak in March 2023.
The WHO disseminated the alert via its secure Event Information Site (EIS), a critical platform for issuing rapid warnings about acute public health risks with potential international ramifications.
“We would expect further cases in coming days as disease surveillance improves,” WHO Chief-Tedros Adhanom Ghebreyesus said in his X message.
WHO officials say they received credible reports on January 10, 2025, indicating that nine individuals in Kagera region had developed symptoms consistent with MVD, including headache, high fever, severe back pain, diarrhoea, vomiting blood (haematemesis), body weakness (malaise), and external bleeding in advanced stages.
Tragically, eight of these cases have resulted in fatalities, marking a grim case fatality ratio (CFR) of 89%.
The affected areas include Biharamulo and Muleba districts, where healthcare workers are among the suspected cases.
Laboratory testing of samples from two patients is underway at the National Public Health Laboratory, with results pending official confirmation.
Contact tracing efforts are ongoing, with health authorities closely monitoring those exposed to suspected cases.
Previous Outbreak
This suspected outbreak follows a similar crisis in March 2023, when nine cases, including six deaths, were reported in Bukoba district of Kagera region.
Experts have long noted that the region’s endemic fruit bat population, known reservoirs of the Marburg virus, presents a persistent risk of zoonotic transmission.
However, Tanzania’s Ministry of Health, in collaboration with WHO and local partners, has intensified its response to contain the outbreak:
Deployment of rapid response teams: National teams are assisting with outbreak investigation, contact tracing, and surveillance.
Establishment of treatment units: Mobile laboratories and treatment centres have been set up in affected districts.
Enhanced surveillance: Efforts to detect and isolate new cases are underway, especially in high-risk areas near international borders.
Risk to Neighbouring Countries
Given Kagera region’s strategic location and its shared borders with Uganda, Rwanda, and Burundi, neighbouring countries are on high alert. As a result, significant cross-border movement of people increases the likelihood of the virus spreading beyond Tanzania.
Uganda, which shares a porous border with Kagera, is particularly at risk. Health authorities in Uganda have intensified surveillance in border districts and set up isolation units to handle suspected cases.
Rwanda, Burundi, and the Democratic Republic of the Congo are also enhancing readiness by mobilizing rapid response teams and strengthening border health checks.
Public health experts advise neighbouring countries to watch for early symptoms of MVD, including high fever, severe headache, muscle pain, vomiting, and unexplained bleeding. Prompt reporting and isolation of suspected cases will be crucial in preventing further spread.
Risk Assessment
According to WHO’s assessment, the national risk level remains high due to the following factors:
High mortality rate: With eight out of nine suspected cases resulting in death, the outbreak’s severity is evident.
Involvement of healthcare workers: This raises concerns about transmission within healthcare settings.
Geographic spread: Cases have been reported in multiple districts, increasing the likelihood of further spread.
At the regional level, the risk is also high. Kagera region serves as a key transit hub, with significant cross-border movement to Rwanda, Uganda, Burundi, and the Democratic Republic of the Congo. This mobility heightens the potential for international transmission.
Globally, the risk is currently assessed as low. While no international cases have been confirmed, the region’s connectivity via Dar es Salaam’s international airport underscores the importance of vigilance.
WHO Recommendations
The WHO has advised several key measures to curb the outbreak and prevent further spread:
Prevention and Control
Avoid direct contact: Individuals should refrain from close physical contact with suspected or confirmed MVD patients, especially their bodily fluids.
Isolation of patients: Suspected cases should immediately seek care at designated treatment centres.
Safe burial practices: Communities must adhere to safe and dignified burial protocols to prevent exposure.
Protective gear: Healthcare workers should wear appropriate personal protective equipment (PPE) and practice stringent hand hygiene.
Community Engagement
Public awareness campaigns are crucial for educating communities about symptoms, prevention measures, and the importance of early medical intervention. Engaging local leaders, traditional healers, and clergy is essential for fostering trust and dispelling misinformation.
Cross-border Coordination
Given the risk of cross-border transmission, WHO has urged Tanzania and its neighbours to enhance coordination, harmonize reporting systems, and conduct joint investigations. Border health capacities should be strengthened to detect and manage potential cases.
Laboratory and Research Efforts
WHO has emphasized the need for rapid laboratory testing and genomic sequencing of positive samples to understand the virus better. Additionally, the outbreak offers an opportunity to evaluate candidate vaccines and therapeutics, with protocols and research networks ready to support national efforts.
Outlook and Preparedness
While no travel or trade restrictions have been recommended at this time, WHO stresses the importance of preparedness. High-risk regions should ensure that isolation units, mobile labs, and healthcare facilities are equipped to handle new cases.
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