Background:

Marburg virus outbreaks are relatively rare but have occurred sporadically in Africa. The most recent outbreak was reported in Guinea in 2021, where four cases of Marburg virus disease were confirmed, and all four patients died. This outbreak was the first time Marburg virus was reported in West Africa.

The Marburg virus is believed to originate from fruit bats, which are considered to be the natural hosts of the virus. Outbreaks have occurred in Uganda, the Democratic Republic of the Congo, Angola, and South Africa, among other countries.

The first recorded outbreak of Marburg virus occurred in 1967 in Germany, where laboratory workers were infected with the virus after handling imported African green monkeys. Since then, several other outbreaks have occurred, with varying numbers of cases and fatalities.

It is important to note that while Marburg virus outbreaks can be serious, they are relatively rare, and the risk of transmission to the general population is low. It is crucial to follow proper infection control measures and seek medical attention immediately if you develop symptoms of Marburg virus disease, such as fever, headache, muscle aches, and bleeding.

The Centers for Disease Control and Prevention (CDC) has recently reissued a travel advisory for Equatorial Guinea due to an ongoing outbreak of Marburg Virus Disease (MVD). The outbreak was first declared on February 13, 2023, and as of May 1, a total of 17 laboratory-confirmed cases and 23 probable cases of MVD have been reported, with a case fatality rate of 75% among confirmed cases. All probable cases have resulted in fatalities.

The outbreak has been reported in five districts across four of the country’s eight provinces. The most affected district is Bata in Litoral province, where 11 laboratory-confirmed MVD cases have been reported. The presence of Marburg cases across multiple districts may indicate undetected spread of the virus.

Given the risk of MVD transmission, the CDC recommends that travelers reconsider non-essential travel to mainland Equatorial Guinea. If travel is necessary, travelers should take precautions to avoid contact with sick people, blood and other body fluids, dead bodies or items that have been in contact with dead bodies, healthcare facilities in the outbreak area, traditional healers, fruit bats and the caves and mines where they live, and nonhuman primates such as chimpanzees and gorillas.

Travelers should also watch for symptoms of Marburg virus while in the outbreak area and for 21 days after leaving. If they develop symptoms such as fever, chills, muscle pain, rash, sore throat, diarrhea, weakness, vomiting, stomach pain, or unexplained bleeding or bruising, they should isolate themselves and seek medical attention immediately.

Healthcare or emergency response workers traveling to Equatorial Guinea should follow special recommendations from the CDC for organizations sending workers to the outbreak area. It is important to follow proper infection control measures and seek medical attention immediately if symptoms develop.

The ongoing outbreak of Marburg virus disease (MVD) in the Republic of Equatorial Guinea has prompted the U.S. Centers for Disease Control and Prevention (CDC) to reissue its Alert-Level 2, Practice Enhanced Precautions notice. As of May 12, 2023, the CDC recommends reconsidering non-essential travel to mainland Equatorial Guinea.

For those who do travel to the affected area, the CDC recommends taking precautions to avoid contact with sick people who have symptoms of fever, muscle pain, and rash. It is also advised to avoid contact with blood and other body fluids, dead bodies, and items that have been in contact with dead bodies. Visitors are advised against participating in funeral or burial rituals, visiting healthcare facilities for non-urgent medical care or non-medical reasons, and contacting traditional healers. In addition, it is recommended to avoid contact with fruit bats, nonhuman primates, and the caves and mines where they live.

Visitors are also advised to monitor their health for symptoms of Marburg, a viral hemorrhagic fever, while in the outbreak area and for 21 days after leaving. Unfortunately, there are currently no available Marburg vaccines.

Other Marburg outbreak alerts have also been issued for Africa as of May 14, 2023.

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