Marburg outbreak in Tanzania: a public health concern

Résumé fourni par la source

Marburg virus disease (MVD) is a severe hemorrhagic fever affecting humans and non-human primates. The Marburg virus causes it, a member of the RNA family of viruses known as Filoviridae, of which Ebola is also a known member1. The natural host of MVD is the fruit bat (Rousettus bat), and it spreads through human-to-human transmission through direct contact with the blood or other body secretions and fluids of infected or deceased people. On March 21, 2023, the Ministry of Health of the United Republic of Tanzania declared an outbreak of the MVD in 2 villages in Bukoba district, Kagera region, and 8 cases were reported, and 5 have died. The remaining 3 patients are still in intensive care and treatment. Reported symptoms were fever, diarrhea, vomiting, bleeding from various sites, and kidney failure2. This is the first-ever outbreak of MVD in Tanzania3. The first major outbreaks that led to the discovery of MVD occurred in Germany and Serbia on August 1967, which marked the initial reports of two large-scale outbreaks. Subsequently, various African nations have documented additional occurrences and disease outbreaks, including Angola, South Africa, Kenya, Uganda, and the Democratic Republic of Congo4. Furthermore, in 2022, Ghana also reported its first-ever outbreak, and in February 2023, Equatorial Guinea also reported its first-ever outbreak5. In response to the recent outbreak, epidemiological investigations were conducted, including enhanced surveillance and follow-up of contacts. Measures were taken to intensify surveillance and trace and monitor contacts closely to prevent the further spread of the disease5. The Tanzanian government and health care workers have already adapted to the interventions recommended by the WHO; this includes epidemiological investigations to prevent the further spread of disease in the community and outside neighboring countries, using biocontainment measures and sensitization activities to enhance infection prevention control3. The general public should be aware of the outbreak and acquire enough information about the transmission, symptoms, and prevention of MVD by getting valid information from reliable sources, such as the Ministry of Health or the WHO6. As the natural hosts of MVD are the fruit bats of the Pteropodidae family (Rousettus aegyptiacus)7,8, the communities should ensure no contact between the bats and humans or the habitats of humans. Caves and mines inhabited by Rousettus bat colonies should be avoided; if needed, gloves and masks should be used to minimize exposure to the virus. Pigs are known to be susceptible to filovirus infection, and they shed the virus, hence, named amplifier hosts7. Therefore, a risk assessment should be conducted to determine whether pig farms are near the outbreak, and confirmed Marburg infections in pig populations should be contained. In health care settings, basic hand hygiene, respiratory hygiene, safe injection practices, personal protective equipment, like face shields or medical masks, and clean long-sleeved gowns and gloves should be highly emphasized. In addition, good laboratory services should be highly adhered to whereby all the biological specimens should be handled by trained staff and packaged in a triple packaging system when transported. The Ministry of Health should conduct appropriate surveillance and contact tracing. In addition, outbreak containment measures should be taken whereby the suspected contacts should be quarantined and monitored for 21 days. Ethical approval Not applicable. Sources of funding We have not received any financial support for this letter. Author contributions M.K.B., J.N., Z.J.K., M.K., and K.J.Z.: writing the original manuscript. I.K.P.: conceptualization, reviewing, and editing of the manuscript. S.B.S.: reviewing and editing the manuscript. G.N.: reviewing the last draft. Conflict of interest disclosures The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) Not applicable. Guarantor Matilda K. Basinda.

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