East Africa is facing a growing threat from the Marburg virus, a highly contagious and often fatal disease related to Ebola. The recent suspected outbreak in Tanzania’s Kagera region, which has already claimed eight lives, has raised concerns about the region’s preparedness to handle such deadly viruses. This marks the second outbreak in the same region within less than a year, with a previous outbreak in March 2023 resulting in six deaths. The current situation highlights significant gaps in the healthcare systems of East Africa, which remain underprepared to effectively manage such outbreaks.
Marburg virus has a history of high mortality rates, with cases ranging from 23% to 88% fatality. The virus was first discovered in 1967 in Marburg, Germany, but it has since caused numerous outbreaks in African nations. Modern outbreaks often see mortality rates that are much higher than those recorded in the early cases, underscoring the disparity in healthcare capabilities between regions. The latest outbreak in Tanzania has already infected nine people across two districts, and health experts are concerned that the region is not adequately equipped to handle a larger-scale outbreak.
Despite the growing threat, public health experts argue that East African countries are still too reactive when it comes to managing outbreaks. Surveillance systems, infection control measures, and risk communication strategies are often activated only after an outbreak has already occurred. Experts like Dr. Joseph Kariuki Gichui, a public health specialist, warn that this approach is insufficient. He emphasizes the need for continuous and consistent surveillance, as these diseases are not going away and will continue to pose a threat in the future. Health systems need to be prepared for sporadic outbreaks, rather than being caught off guard each time a new case emerges.
In contrast to Tanzania’s struggles, Rwanda’s experience with Marburg provides a more hopeful example. In December 2024, Rwanda declared its Marburg outbreak over after infecting 66 people and causing 15 deaths, with a remarkably low fatality rate of 23%. This success is attributed to the country’s strong pandemic preparedness, rapid deployment of specialized treatment facilities, and early access to experimental drugs and vaccines. Rwanda’s approach to Marburg highlights the importance of proactive measures, including early detection, rapid response, and adequate healthcare infrastructure.
The challenge of containing Marburg is complicated by its initial symptoms, which are often mistaken for common illnesses like malaria. In the early stages, patients may experience fever, joint pain, and other non-specific symptoms, making it difficult to diagnose the virus. In malaria-endemic areas, this can lead to misdiagnosis and delayed treatment, increasing the risk of household transmission. Additionally, Marburg causes internal bleeding and organ failure rather than dramatic external bleeding, making it harder to detect in its later stages. Timely intervention, including intravenous fluids and drugs to stop coagulation, can improve survival rates, but this requires well-equipped healthcare facilities and trained personnel, which are often lacking in primary healthcare settings.
Kenya’s healthcare system is particularly vulnerable, with recurring strikes by healthcare workers and under-resourced primary health facilities. The country’s position as a major transit hub, especially near the Tanzanian border, increases the risk of cross-border transmission. The Kagera outbreak’s proximity to Kenya has prompted heightened vigilance, but experts question whether the current measures are sufficient to prevent the virus from spreading further.
Marburg has caused several outbreaks across Africa, with the largest recorded outbreak occurring in Angola in 2004-2005, which resulted in 374 cases and 329 deaths. The virus has also appeared in Uganda, the Democratic Republic of the Congo, and South Sudan, consistently challenging health systems in these regions. The World Health Organization (WHO) has warned that more cases may emerge in Tanzania, and health authorities are closely monitoring contacts of infected individuals, including healthcare workers.
To effectively combat Marburg, experts stress that it is not enough to rely solely on advanced surveillance systems or specialized laboratories. Strengthening basic healthcare infrastructure is key to preventing and controlling the spread of the virus. A robust healthcare system is essential for detecting, treating, and containing outbreaks, ultimately reducing the number of deaths and cases. Without such improvements, the region will remain vulnerable to the devastating impact of the Marburg virus and other emerging infectious diseases.
