On October 2, 2024, the Republic of Rwanda confirmed its first outbreak of Marburg virus disease (MVD) with 36 laboratory-confirmed cases and 11 deaths (31 percent case fatality rate), including 19 cases in healthcare workers largely working in intensive care units or ICUs.
Currently, there is no FDA-approved vaccine or treatment for MVD, which has a high mortality rate of up to 90 percent in certain cases.
On October 3, 2024 at 12:15 pm ET, the Centers for Disease Control and Prevention (CDC) issued a Health Alert Network Health Advisory about the outbreak for clinicians and US health departments to stay vigilant of potential imported cases of MVD. The CDC stated that there have been no confirmed related cases of MVD in the US, and that “the risk of MVD in the United States is low.”
The CDC Health Advisory reported that to date, several of the cases have no link to known chains of transmission, suggesting that there may be additional cases that have so far gone undetected or unreported as part of the outbreak. There are currently about 300 contacts to confirmed cases that are being monitored in Rwanda.
According to the Health Advisory, “Investigations are ongoing to determine timeline, transmission chains, and potential source of the outbreak.” On October 3, 2024, the CDC issued interim recommendations for public health management of US-based HCPs who were present in a healthcare facility in Rwanda in the previous 21 days.
The CDC summarized its recommendations for public health departments and clinicians in the US on case identification and testing and clinical laboratory biosafety considerations.
CDC recommendations for clinical laboratory biosafety |
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CDC recommendations for public health departments |
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- Follow your established jurisdictional protocols regarding patient assessment to determine if testing for Marburg virus is warranted for a patient with concerning clinical and epidemiologic history for MVD is identified in your jurisdiction.
- Coordinate patient management, sample referral, and Marburg virus testing with State, Territorial, Local and Tribal health departments, CDC, and the clinical team.
- Contact CDC’s Viral Special Pathogens Branch (VSPB) 24/7 for consultations about Marburg virus disease or other viral hemorrhagic fevers. Call CDC Emergency Operations Center at 770-488-7100 and request VSPB’s on-call epidemiologist. For non-emergency inquiries, email spather@cdc.gov.
- For suspect cases, request testing for Marburg virus and other viral hemorrhagic fevers from CDC (Atlanta, Georgia) or the Laboratory Response Network (LRN).
- To date, 37 geographically diverse LRN laboratories and 13 Regional Emerging Special Pathogen Treatment Centers can test using the Biofire FilmArray NGDS Warrior Panel, with several more LRN laboratories working toward building testing capability.
- The Warrior Panel can detect orthomarburgviruses (Marburg and Ravn viruses) and orthoebolaviruses (Ebola, Sudan, Tai Forest, Bundibugyo, and Reston viruses) in addition to other high-consequence pathogens.
- Per manufacturers’ recommendations, results from the Biofire FilmArray NGDS Warrior Panel are presumptive, and results require confirmatory testing which can be performed in CDC laboratories.
- Follow CDC travel guidance for Rwanda and consider engaging travel health clinics or other clinical and public health partners to increase awareness on MVD.
- Review CDC’s new interim recommendations for public health management of US-based healthcare personnel who were present in a healthcare facility in Rwanda during the previous 21 days.
- These interim recommendations include post-arrival monitoring by health departments and exclusion from work duties in a U.S. healthcare facility until 21 days after their last presence in a healthcare facility in Rwanda.
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