Rwanda Declares Victory Over Marburg Virus Outbreak

The Government of Rwanda, through the Ministry of Health, on Friday, December 20, 2024, officially declared the end of the Marburg Virus Disease (MVD) outbreak in the country. This declaration comes after 42 consecutive days with no new cases, following the discharge of the last confirmed patient, in line with the World Health Organization (WHO) guidelines.

The outbreak, which began in mid-September 2024, saw 66 confirmed cases, with 15 lives lost and 51 patients recovering. Also, two patients were successfully extubated after intensive care, marking a significant step in clinical management of the disease.

Dr. Sabin NSANZIMANA, Rwanda’s Minister of Health, reflected on the nation’s response to this recent viral outbreak, emphasizing the importance of rapid action, collaboration, and scientific rigor. “This was a day no one wants to have,” he said, referring to the initial discovery of the virus, which posed critical challenges: saving lives, halting transmission, and tracing the outbreak’s origins.

The early weeks were particularly severe, with 50 of the 66 total cases and 80% of the deaths recorded within the first two weeks. Health workers bore the brunt, with many infected during the initial outbreak in hospital settings.

“This is an important milestone for Rwanda’s public health system. While we mourn the lives lost, we are encouraged by the progress made. We have reached this point because of the dedication of our healthcare workers, the government, and our partners whose seamless collaboration and swift, coordinated action made it possible to contain the outbreak effectively. We have successfully identified the virus’s zoonotic origin and we continue to strengthen our surveillance systems,” the Minister stated.

Through extensive investigations, including reviewing 120 patient files, the team identified the index case—a miner infected by bats in a nearby cave. This breakthrough enabled targeted surveillance of 50 caves and mining sites to mitigate further risk. “Now we have mapped all the sites,” Dr. Nsanzimana said, highlighting plans for ongoing monitoring, especially during February and August, when bats shed more viruses.

The outbreak response was marked by resilience and innovation. Health workers achieved a 22.7% case fatality rate—lower than global averages—through dedicated care, enhanced diagnostics, and the use of vaccines. “This didn’t happen by chance,” Dr. Nsanzimana noted, crediting their tireless efforts under grueling conditions.

Looking forward, Rwanda aims to strengthen surveillance, laboratory capacities, and public health systems while using GPS technology to track bat movements. Dr. Nsanzimana underscored the need to balance ecological preservation with human health, stating, “Bats are not just a threat; they are part of our ecosystem and protect us in many ways.”

The Minister concluded with a call for global collaboration, urging that lessons learned in Rwanda be shared widely to prevent similar outbreaks elsewhere. “Preparedness is key,” he emphasized.

Dr. Brian Chirombo, the World Health Organization (WHO) country representative, praised Rwanda’s leadership and robust health system for effectively containing the country’s first Marburg virus outbreak.

“Your decisive actions and rapid response were instrumental in safeguarding lives,” he noted, commending the Ministry of Health’s collaboration with WHO and development partners.

Dr. Chirombo described declaration of the end of the outbreak as a testament to the resilience of the Rwandan people, the bravery of healthcare workers, and the power of partnerships. He highlighted the rapid detection, isolation, and containment measures that limited the case fatality rate to 22.7%, a significant achievement compared to global averages of 24%-88%.

WHO deployed 20 viral hemorrhagic fever experts and 39 AVOC SAGE specialists from Uganda, Liberia, and Sierra Leone to fill critical gaps in emergency care. The effort showcased regional solidarity and underscored the importance of the One Health approach, integrating human, animal, and environmental health.

Dr. Chirombo emphasized the need for strengthened international health regulations and ongoing preparedness. He extended gratitude to all partners, community leaders, and health workers, calling them “the true heroes” whose sacrifices will shape a stronger health system. He concluded with a call to reflect on lessons learned and prepare for future challenges.

From the onset of the outbreak, Rwanda swiftly activated its pandemic response. A 24/7 command post was established to coordinate all aspects of the response, including surveillance, testing, case management, vaccination, risk communication, and community engagement. The coordinated efforts of government, healthcare workers, and partners ensured an efficient and evidence based process that brought the outbreak under control in a timely manner.

The successful end of the MVD outbreak underscores Rwanda’s commitment to building resilient health systems and ensuring the country’s preparedness to respond rapidly to future health emergencies.