East Africa is once again grappling with a potential public health disaster as the Marburg virus threatens the region. Recent reports from Tanzania’s Kagera region have heightened concerns, as a suspected outbreak of viral hemorrhagic fever has already claimed the lives of eight individuals, with nine others infected. This marks the region’s second Marburg outbreak in less than a year, following a similar event in March 2023. Health experts are now sounding the alarm over the region’s ability to handle such deadly viruses.
Marburg, a highly contagious and often fatal virus related to Ebola, has a terrifying track record. Since its discovery in 1967 in Marburg, Germany, the disease has caused numerous outbreaks across Africa, with fatality rates ranging from 23 to 88 percent. The virus’s symptoms often mimic those of common illnesses like malaria, which complicates early diagnosis and containment. Health systems in the region, however, remain woefully underprepared to handle large-scale outbreaks.
Dr. Joseph Kariuki Gichui, a public health expert specializing in infectious diseases, stresses the dire situation. “We are not anywhere close to being prepared if it were to become an outbreak of large proportions,” he says, expressing concern about the high mortality rates seen in recent outbreaks. While the virus initially presents with fever and joint pain, its progression leads to severe internal bleeding and organ failure, making it a major health threat. The critical phase requires intensive medical care, including intravenous fluids and specialized drugs, which are often unavailable in resource-limited areas.
In Kenya, where the border with Tanzania lies just a few hours away, the government has ramped up its surveillance efforts following the Kagera outbreak. Kenya’s Director General of Health, Dr. Patrick Amoth, reassured the public, saying that systems for surveillance, infection prevention, and risk communication had been reactivated. However, Dr. Gichui is skeptical. He believes that Kenya’s response remains reactive rather than proactive. “We need continuous and consistent surveillance,” he argues. “We cannot afford to be caught off guard every time a new outbreak emerges.”
Tanzania’s health crisis is not an isolated incident. Marburg has made appearances in several other African nations, including Uganda, the Democratic Republic of the Congo, and South Sudan, causing significant mortality rates. Despite these recurring outbreaks, the region’s healthcare systems have struggled to meet the challenge of managing such viruses. The outbreak in Kagera, for example, has already spread across two districts, Biharamulo and Muleba, and there is growing concern that more cases will surface as contacts are traced and tested.
Despite the challenges, Rwanda offers a hopeful example of how swift action and preparation can make a difference. The country recently contained its Marburg outbreak, which began in 2024, with only 66 cases and 15 deaths an impressive 23 percent fatality rate. Rwanda’s success is attributed to rapid response, strong healthcare infrastructure, and early access to experimental drugs and vaccines. This has set a standard for the region, demonstrating that with the right resources and preparedness, Marburg outbreaks can be managed effectively.
The key lesson for East Africa is clear: Marburg outbreaks are not going away, and health systems need to be equipped to deal with sporadic, unpredictable threats. In addition to enhancing surveillance systems, experts advocate for a broader focus on strengthening the entire healthcare infrastructure, especially at the primary care level. This includes investing in healthcare worker training, providing adequate medical supplies, and ensuring that hospitals are equipped to handle emergency cases.
Dr. Gichui sums up the urgency of the situation, emphasizing that “if the health systems don’t work, these viruses can, with concerted effort, be prevented, and the number of deaths can be controlled.” For East Africa to truly fight back against Marburg and other emerging viruses, it must build stronger healthcare systems from the ground up systems that are capable of detecting and responding to outbreaks before they spiral out of control.
