Kisoro on high alert as Marburg kills 11 in Rwanda

The Kisoro District Task Force (DTF) on disease outbreaks is on high alert following the outbreak of the Marburg hemorrhagic fever virus in Rwanda.

Rwanda’s Ministry of Health on Wednesday confirmed more cases of the Marburg Virus Disease (MVD), with seven more cases reported and one more fatality, bringing the total cases to 36 and the death toll to 11, while 25 patients remain in isolation and on treatment, as of  October 2.

Seven is the highest number of cases reported in 24 hours, pushing the number of confirmed cases from 29 to 36, mainly discovered in health workers in different hospitals in the country, particularly those working in intensive care units.

The same day, the country’s Ministry of Education announced that it had temporarily suspended monthly visits to students in boarding schools as part of measures to prevent the spread of the deadly haemorrhagic fever, which was confirmed to be in the country last week.

Rwanda borders Uganda in the South Western part, including Kisoro district with frequent movement of people between the two countries, posing a risk of spread of the disease.

The Kisoro district taskforce held an emergency meeting on Tuesday to lay strategies on surveillance and prevention. Chaired by Kisoro Resident District Commissioner, Hajji Badru Sebyaala, the meeting was also attended by Dr. Allan Muruta, the commissioner of epidemiology and disease surveillance in the ministry health, security officers, the health department and implementing partners.

The Kisoro district Health officer, Dr. Steven Nsabiyunva regretted that the Marburg threat coincides with the Mpox outbreak in the neighbouring Democratic Republic of Congo.

He expressed commitment of his staff to frustrate the spread of the two deadly outbreaks, calling for support from implementing partners.

“The official Uganda – Rwanda border at Cyanika now needs emergency attention by staging a screening point. It is however regrettable that as a department and as a district, we are resource-constrained,” said Dr Nsabiyumva.

The other official border points of Bunagana and Mupaka to DRC have equipped screening points for the mpox disease, according to him.

The district acting Health Educator (DHE), Mubangizi Valentino noted that daily uncontrolled movements of Rwandans within areas of Murora and Chahafi pose a high risk to the entire community, calling for an immediate risk communication to increase vigilance in these areas.

Dr. Allan Muruta is however confident that the country can avert the Marburg cross-border threat. He told the meeting that the ministry of health has already started mobilizing for international aid to fund prevention and control efforts.

He emphasized that the task force must relay the information about Marburg to all facilities so that health workers can be protected.

“The key actions we propose is to communicate. Communicate to all facilities to make sure that they are on alert and active surveillance of any acute febrile illness or hemorrhagic manifestation…those are bleeding tendencies. Make sure that all those are investigated fully in view of the current outbreaks in the region, and this should be immediate.”

Dr Muruta emphasized that, “anyone presenting with fever at the entry point should be handled as a suspect.”

Taskforce resolutions

The meeting resolved to alert all schools, health facilities and community participation in averting a possible outbreak.

1. DHO to write a circular to all the Health facilities to be alert, take precautions and report any Marburg suspected cases.
2. DEO to write a circular to all head teachers to be alert, emphasising precautions and report any Marburg suspected cases among the students, teaching and non-teaching staff.
3. DHO to widely share the preparedness and response plan with the Implementing Partners and Ministry of Health for possible funding.
4. DHO to support the Police with some Personal Protection Equipment (PPEs) and other IPCs commodities.
5. The secretary DIY to invite the border point stakeholders especially the OC and Immigration officers of Chanika.
6. The DHO to activate all the pillars of the District Task force

About Marburg Virus Disease

MVD, according to scientists, begins abruptly, with high fever, severe headache and severe body weakness. Many patients develop severe haemorrhagic (bleeding) symptoms within seven days. The virus is transmitted to people from fruit bats and spreads from one infected person to another.

Marburg can spread through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (such as bedding, clothing) contaminated with these fluids, according to the WHO.

According to details from the World Health Organisation (WHO), on March 21, 2023, Tanzania’s Ministry of Health of Tanzania officially declared the first MVD outbreak in the country and eight laboratory-confirmed cases were reported. Tanzania managed to contain the outbreak with its end declared on July 23, 2023.

However, Uganda has also had an outbreak of MVD in the past. Information from the WHO indicates that on October 17, 2017, the Ugandan Ministry of Health notified WHO of a confirmed outbreak of MVD in Kween District, Eastern Uganda. The Health ministry officially declared the outbreak on October 19, 2017, and by October 24, 2017, five cases had been reported, but the country contained the outbreak.