Health

The Marburg virus outbreak in Rwanda in late 2024 underscores the importance of community-driven and adaptive public health strategies. A detailed brief highlights key lessons, including the vital role of leveraging decentralized systems for effective community engagement, addressing local perceptions through qualitative assessments, and safeguarding healthcare workers with enhanced protective measures. With vaccination efforts targeting high-risk groups, Rwanda’s approach offers valuable insights into managing outbreaks while respecting cultural practices and mitigating misinformation.

Community Engagement: Leveraging Rwanda's decentralized administrative system, which includes elected village leaders and Community Health Workers, is vital for disseminating public health messages. Engaging trusted local channels such as religious leaders, women's and youth organizations, and trade cooperatives can enhance the adoption of preventive measures. Utilizing media platforms like radio and social media, along with community meetings, further strengthens outreach efforts. Involving community members in adapting Safe and Dignified Burial protocols ensures cultural practices are respected.

Rapid Qualitative Assessments: Understanding community perceptions, behaviors, and concerns is crucial. Conducting assessments to explore fears related to quarantine, healthcare facilities, and vaccine safety, as well as addressing rumors or misinformation, allows for culturally sensitive adjustments in risk communication and intervention strategies.

Healthcare Worker Protection: With over 70% of reported cases among health workers, enhancing protection and rigorous infection prevention control practices are imperative. Importing personal protective equipment (PPE) to support healthcare workers and volunteers is essential to mitigate nosocomial transmission risks.

Vaccination Efforts: Prioritizing healthcare workers in high-risk districts for vaccination is a key strategy. The ChAd3-MARV vaccine, though still in its trial phase with uncertain protective effects, has been secured with 700 doses, and vaccinations have commenced for health workers.

Read more here from Key considerations: Outbreak of Marburg virus disease in Rwanda, October 2024 by Social Science in Humanitarian Action Platform. 

Mobilizes international support for containment efforts

Tanzania's President, Samia Suluhu Hassan, confirmed an outbreak of the deadly Marburg virus in the Kagera Region of northwestern Tanzania on January 20, 2025. The country has reported one confirmed case and 25 suspected cases, following laboratory tests that identified the infection. This outbreak marks Tanzania’s second encounter with the virus, following a previous outbreak in Bukoba District of Kagera in March 2023, which resulted in nine cases and six deaths.

The Marburg virus is a highly infectious disease, with a fatality rate as high as 88%. It is from the same family as the Ebola virus and is transmitted to humans primarily through fruit bats and monkeys. Victims present with symptoms typical of viral hemorrhagic fevers, including fever, headache, back pain, muscle weakness, diarrhea, vomiting blood, and external bleeding.

In response to the outbreak, the government initiated a rapid response plan, dispatching a team of public health experts to the area to monitor suspected cases and contain the spread. While 25 suspected cases have tested negative for the virus, the government has increased surveillance and response efforts to prevent further transmission.

The World Health Organization (WHO) has pledged $3 million from its contingency fund to support Tanzania’s efforts in containing the outbreak. WHO Director-General, Tedros Adhanom Ghebreyesus, emphasized the importance of continued investment in response capacity, which has been bolstered by Tanzania’s experience in managing the 2023 outbreak.

Simultaneously, the Africa Centers for Disease Control and Prevention (Africa CDC) is mobilizing immediate support, committing $2 million to help Tanzania manage the outbreak. A team of twelve public health experts, including epidemiologists, risk communication specialists, and infection prevention and control (IPC) experts, will be deployed to the region in the next 24 hours. Africa CDC’s support also includes the provision of diagnostic kits, genomic sequencing reagents, and technical assistance to enhance case detection and improve treatment protocols.

Dr. Jean Kaseya, Director-General of Africa CDC, expressed solidarity with Tanzania, highlighting the importance of swift action and coordinated efforts. “Building on Tanzania’s response capabilities from the 2023 outbreak, we are confident that, with our combined support, this outbreak will be controlled quickly,” he said.

This coordinated response effort, involving both international organizations like WHO and Africa CDC, as well as the Tanzanian government, underscores the urgent need for collaboration in managing the spread of the Marburg virus in the region. 

For more information:

Tanzania President Press Conference on MVD

Marburg Key Facts, Transmission, Symptoms, Diagnosis, Treatment

Tanzania Travel Advisory

MoH Press Release on Marburg

New undiagnosed disease in DR Congo: urgent action needed - Lancet

The outbreak of an undiagnosed disease in DR Congo, reported by WHO on Dec 8, 2024,1 is a pressing global health concern that demands swift and coordinated action. As of Dec 5, 406 cases and 31 deaths have been reported in the Panzi health zone in Kwango province, with influenza-like symptoms and anaemia. Most affected individuals are children aged younger than 5 years, many of whom are severely malnourished.

The remoteness of the region and poor infrastructure complicate the identification of the pathogen, with suspicions that multiple diseases could be contributing to these cases. Furthermore, the outbreak has the potential to transcend regional boundaries, particularly as DR Congo shares porous borders with Angola, where provinces such as Uige are vulnerable to cross-border transmission. Mobility between these regions could facilitate the spread of the disease to neighbouring African countries, raising the potential for a Public Health Emergency of International Concern.

With disease samples dispatched to Kinshasa for laboratory testing to determine the pathogen's origin, we are in a crucial window to prevent its further spread. Today, the approach must be different. The disease's unknown nature warrants containment measures at both the local and international levels. These measures should include the immediate restriction of cross-border movement in affected regions, enhanced disease surveillance, and the rapid mobilisation of health-care resources to DR Congo and neighbouring countries. Additionally, the international community must recognise that this is not solely an African challenge; it is a global health threat. Comprehensive funding and logistical support should be prioritised, enabling rapid diagnostic efforts, contact tracing, and the provision of personal protective equipment to front-line workers.

The risk of spillover into neighbouring countries underscores the urgency for Angola and other countries in the region to heighten preparedness measures. These measures should include deploying rapid response teams, establishing quarantine protocols, and intensifying public health communication to mitigate panic and misinformation. In this interconnected world, a delayed or fragmented response could allow this disease to evolve into a global health crisis. By learning from our recent past, we can change the trajectory of this outbreak and safeguard lives across continents. The experience with COVID-19 has shown that delays in responding to outbreaks can have catastrophic consequences. Therefore, it is imperative that the global community acts decisively to contain this undiagnosed disease in DR Congo, protecting not only African populations, but also global public health.

Reference

Undiagnosed disease—Democratic Republic of the Congo

https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON546

A recent outbreak of an undiagnosed illness in the Democratic Republic of the Congo is on the radar of public health professionals. Preparedness is key to mitigating the issue.

Photo: Testing for malnourishment in Democratic Republic of the Congo. Image courtesy of DFID – UK Department for International Development,

A recent outbreak of an undiagnosed illness in the Panzi health zone of the Democratic Republic of the Congo (DRC) has captured global attention, spotlighting the challenges of outbreak investigations in resource-limited settings. Since late October, over 400 cases have been reported, predominantly among children under five years old. Symptoms such as fever, cough, and body aches have resulted in 31 deaths, with severe malnutrition compounding the crisis.

This outbreak highlights the critical need for strong global public health systems to detect and respond to emerging health threats. Although the cause remains uncertain, investigators are exploring various possibilities, including endemic diseases like malaria and respiratory infections such as acute pneumonia, influenza, COVID-19, and measles. Malnutrition is thought to play a significant role in worsening disease severity. Laboratory testing is ongoing, and health officials are evaluating whether multiple diseases may be contributing to the cases and fatalities reported.

Read more here from an article in the New York Academy of Sciences: https://www.nyas.org/ideas-insights/blog/unraveling-the-mystery-in-the-drcs-disease-outbreak-is-it-disease-x/

Photo: Roger Samuel Kamba, Minister of Public Health, Hygiene and Prevention.

The Democratic Republic of the Congo (DRC) is confronting a health crisis in the remote Panzi health zone of Kwango Province, where an undiagnosed illness has infected more than 400 people and killed at least 31, predominantly malnourished children under the age of five. The mystery “Disease X”—which may or may not be a new disease—causes symptoms such as fever, headache, cough, runny nose and body aches. The World Health Organization said in a press briefing on Tuesday that 10 out of 12 samples have tested positive for malaria, but it’s possible more than one disease is involved. The outbreak has raised pressing questions about the DRC’s ability to respond effectively to health emergencies in isolated areas.

Accessing Panzi is a formidable challenge, with poor road infrastructure requiring a multi-day journey from Kinshasa, the nation’s capital. “This is really the definition of remote,” says Placide Mbala, a virologist and head of epidemiology at the DRC’s National Institute of Biomedical Research. He explains that limited connectivity and delayed sample collection have hampered diagnosis efforts. Specimens collected initially were unsuitable for analysis, but a team from the DRC’s Ministry of Public Health has now gathered higher-quality samples, says Mbala, who is part of the team. Read more from the Publication, Scientific American, here .

At least 79 people have died from an unknown disease that is causing flu-like symptoms in south-western Democratic Republic of Congo, the health ministry says.

Media reports quoting the health ministry says the majority of people who have died are between the ages of 15 and 18.

More than 300 people have been infected with patients exhibiting symptoms like fever, headaches, runny noses and coughs, breathing difficulties and anaemia.

Response teams have been sent to Kwango Province, specifically the Panzi health zone, where the disease is most common, to manage cases and investigate the nature of the disease. Symphorien Manzanza, a civil society leader, told Reuters news agency the situation was worrying as the number of infected people continues to rise.

"Panzi is a rural health zone, so there is a problem with the supply of medicines," he said.

A World Health Organisation (WHO) Africa region official told the BBC they have "dispatched a team to the remote area to collect samples for lab investigations".

Authorities have urged the population to remain calm and vigilant. They urged people to wash their hands with soap, avoid mass gatherings, and avoid touching the bodies of the deceased without qualified health personnel.

A local MP told Top Congo Radio that about 67 people had fallen sick and died between 10 and 26 November. "It should be noted that Panzi hospital is short of medicines to cope with this epidemic. We really need assistance," said the MP.

For the first time, the East African Community (EAC) is operationalising its Rapidly Deployable Expert (RDE) Pool in response to an international public health emergency due to the spreading Mpox virus disease outbreak. EAC Partner States such as the Democratic Republic of the Congo (DRC) and the Republic of Burundi are particularly affected, with the DRC reporting over 7,000 confirmed cases by end of October 2024, around 40% of them among children under 15.

The Rapidly Deployable Expert (RDE) Pool is a specialized team of trained health professionals and other experts within the East African Community (EAC) that can be quickly mobilized to assist member states in managing public health emergencies. The RDE Pool brings together experts in fields like epidemiology, environment, IT, laboratory science, logistics, risk communication, and clinical management, providing immediate, hands-on support in disease surveillance, response coordination, and healthcare provision during outbreaks. By deploying the RDE Pool, EAC enhances regional preparedness and strengthens each member state's capacity to address complex health crises effectively and efficiently. Read more on this link .

In March 2023, Tanzania faced a Marburg virus disease (MVD) outbreak in the Kagera region, impacting nine confirmed cases and resulting in six deaths. Through swift response actions, led by the Government of Tanzania and supported by Africa CDC and other health partners, the outbreak was contained within 78 days. Key factors in this success included strong political leadership, robust partnerships across sectors, and efficient use of existing health programs and resources. Regular coordination, multi-sectoral collaboration, and transparent communication were also pivotal in managing the crisis effectively, setting a benchmark for handling future outbreaks.

More details in an article by Africa CDC on this link .

The Democratic Republic of the Congo (DRC) continues to face a significant Mpox outbreak, with 23 of its 26 provinces reporting confirmed cases. According to a recent UNICEF Mpox situational report, as of October 2024, over 31,350 suspected cases and 992 deaths have been recorded, with a case fatality rate of 3.1%. In response, the report indicates, UNICEF has launched a vaccination campaign in eight health zones across three provinces, reaching 14,180 people, mostly frontline workers. However, testing challenges and limited resources hinder the ability to fully control the outbreak, particularly in hard-to-reach areas.

Eastern provinces, such as South Kivu and North Kivu, are witnessing a rise in case fatality rates, exacerbated by overcrowding, inadequate WASH infrastructure, and frequent cross-border movement. Vulnerable children, particularly those facing malnutrition or undiagnosed HIV, are at heightened risk of severe Mpox outcomes. Meanwhile, new hotspots continue to emerge in provinces like Haut Uele and Ituri.

In Tshopo province, where 79 deaths have been reported, UNICEF, in collaboration with local partners, has established nine treatment centers to curb the outbreak. Despite these efforts, the province still struggles with a high case fatality rate of 4.9%. UNICEF’s efforts to disseminate preventive messages have reached over 43 million people nationwide, raising awareness through various media channels.

The Mpox outbreak in the Democratic Republic of the Congo (DRC) prompted swift action, with the arrival of 99,100 doses of the JYNNEOS vaccine in early September 2024. This critical shipment, facilitated by Africa CDC and UNICEF, marked the beginning of a large-scale vaccination campaign aimed at curbing the spread of the virus. The DRC’s Minister of Health, Samuel Roger Kamba, alongside key officials from Africa CDC and UNICEF, emphasized the importance of this milestone in protecting vulnerable populations, especially frontline health workers. The vaccines are seen as a crucial tool in the fight against the escalating epidemic, which has already resulted in thousands of cases and hundreds of deaths this year.

The JYNNEOS vaccine rollout follows Africa CDC's declaration of Mpox as a Public Health Emergency of Continental Security (PHECS) in August 2024. The vaccination campaign is part of a broader effort by the DRC Ministry of Health and international partners to mitigate the crisis, with a focus on protecting children and high-risk groups. By mid-September, the DRC is expected to have received a total of 200,000 vaccine doses. These actions underscore the commitment of African and international health organizations to control the outbreak and safeguard the health of communities across the country.

Read more from UNICEF Democratic Republic of the Congo Humanitarian Situation Report No. 2 (Mpox) of September - October 2024 on this link .
 

In the past 24 hours, Uganda has confirmed 11 new Mpox cases, bringing the total to 164 cases since the outbreak began, with a case fatality ratio (CFR) of 0.6%. Among the confirmed cases, 13 patients are being moved to treatment units across districts including Nakaseke, Nakasongola, Kasese, and Wakiso. Tragically, one death has been recorded. Several districts, such as Adjumani, Kabale, and Mbarara, continue to host active admissions as health authorities ramp up efforts to control the outbreak. For further details, refer to the WHO Mpox Outbreak Situation Update from October 21, 2024.

Read more from WHO Mpox Outbreak in Uganda situation update of 21 October 2024 on this link . 

Read EAC calls for heightened public awareness to combat spread of Mpox on this link .