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PANDEMIC ALERT: Deadly ‘No-Cure’ Marburg Virus Strikes Tanzania and Equatorial Guinea

The Marburg Virus Disease (MVD) has been spreading since February 12, 2023, when it was first confirmed in the northeastern rural province of Kié-Ntem of the West African country of Equatorial Guinea. As of the last week of March, the virus had reached the coastal city and economic center of Bata, with four confirmed cases detected. Equatorial Guinea’s Ministry of Health and Social Welfare has so far reported 13 cases with nine confirmed deaths, while 20 suspected but unconfirmed cases have all ended in death.

Equatorial Guinea, located on the Atlantic coast of Central Africa, just north of Gabon. [Photo by JRC, EC / CC BY 4.0]

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In Tanzania, on March 21, 2023, almost 3,000 kilometers east of Equatorial Guinea, the first-ever cases of MVD in the country’s northwest Kagera region were confirmed. Five of the eight confirmed cases have died, including a health care worker, while the other three are under treatment. The World Health Organization (WHO) has identified 161 contacts who are being monitored.

The WHO is initiating “ring vaccination” trials in Equatorial Guinea with three experimental vaccines similar to Ebola Zaire vaccines but specifically developed for use against Marburg virus. However, there are currently no approved treatments or vaccines available to protect the people of the affected countries. The International AIDS Vaccine Initiative (IAVI) has been awarded $35.7 million from the Defense Threat Reduction Agency, an arm of the US Department of Defense, in 2019, but currently has no available doses.

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Marburg virus is a highly fatal disease, with a fatality rate for infection at 88 percent. The two largest outbreaks to date occurred in the Democratic Republic of Congo (1998-2000) with 154 cases and 128 deaths (83 percent fatality rate) and Angola (2005) with 374 cases and 329 deaths (88 percent fatality rate). The current outbreak in Equatorial Guinea could be construed as the third largest, depending on the ability for public health officials in the field to contain its spread.

Electron Microscope of the Marburg virus. [Photo: Dr. Erskine Palmer, Russell Regnery, Ph.D., Centers for Disease Control and Prevention’s Public Health Image Library ]

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The spread of the virus into a heavily populated city like Bata is alarming, and as Teresa Lambe, Professor of Vaccinology and Immunology at Oxford’s Pandemic Sciences Institute, said, “Although Marburg virus has recently been detected in rural Tanzania and Equatorial Guinea, the spread of this deadly virus into a heavily populated city is very concerning.” The WHO is working closely with the affected governments to control the outbreaks and contain the virus.

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