On 27 th September 2024 a young man, with a history of being bitten by a bat in a cave, presented to a hospital in Kigali, Rwanda and was later diagnosed with Marburg virus. This was the first index case of Marburg ever reported in Rwanda. Thereafter, several health care providers working in hospitals in Kigali also contracted the virus. To date 66 cases have been confirmed, all traced back to a known contact. Over 6,000 tests were conducted as contacts were carefully traced. As of 1 st November, 15 deaths were reported with two active cases. The case fatality rate was 22.7%, lower than usual in a Marburg outbreak. A vaccine was piloted, mostly administered to health care providers.

During a visit to Rwanda in mid October World Health Organisation Director, Dr Tedros Adanom Ghebreyesus, congratulated Rwanda on the proactive approach it has taken. Rwanda’s success in managing the outbreak mirrors the high coverage rates in the Covid 19 vaccination campaign. Rwanda was the only country in Sub- Saharan Africa that attained the World Health Organisation targets. A political analysis of the vaccine campaign indicated the fully functional and flexible systems that existed in Rwanda were a key contributing factor to its success. (link here to presentation). The lessons learned provide a strong message to other African countries on the importance of investment in routine health systems and multi-sectoral co-operation with strong community involvement to manage future outbreaks and pandemics. We are interested to hear your views.

As explained in a briefing on Marburg Virus, the disease “is not easily transmissible (i.e. in most instances it requires contact with the body fluids of a sick patient presenting with symptoms or with surfaces contaminated with these fluids)”. Rwanda has However, 82% cases were among health care providers in two hospitals in Kigali. Rwanda has Infection Prevention and Control guidelines in place. These include the need for handwashing before and after physical contact with patients and routine disinfection of contaminated surfaces. During this outbreak a new guideline for Infection Prevention and control, specifically for the Marburg virus was developed. However, we ask…how can a culture of using simple, prescribed infection prevention and control measures be institutionalised into African health care settings to prevent a recurrence of the high burden of cases among health care providers? We look forward to hearing your experiences and suggestions.