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Rwanda successfully controlled its first Marburg virus disease (MVD) outbreak in record time, achieving the lowest fatality rate ever recorded for the virus, according to a new study published in the New England Journal of Medicine (NEJM). The research, released on September 10, highlights how early identification and a well-coordinated response helped limit the spread and reduce fatalities. ALSO READ: Rwanda declares Marburg virus outbreak over Health Minister Dr. Sabin Nsanzimana shared these results on his X account, stating, “One year later, our study shows how science-based detection and quick action stopped Rwanda’s first Marburg outbreak within weeks, achieving the lowest recorded fatality.” ALSO READ: How Rwanda identified the first cases of the Marburg virus Summary of the findings The outbreak was identified in September 2024 when groups of patients with severe fever were admitted to two specialized hospitals in Kigali. Within days, more than 20 healthcare workers became infected, highlighting the risk of transmission in hospitals. Investigations traced the source to a miner who likely contracted the virus from Egyptian fruit bats, with further spread occurring through hospital contacts. By the time the outbreak was declared over in December, Rwanda had confirmed 66 cases among more than 6,000 tested individuals. Health workers accounted for 77 percent of infections. Despite the high potential for transmission, the fatality rate was 23 percent, significantly lower than previous Marburg outbreaks in Africa, where death rates often exceeded 50 percent. Rwanda’s swift response was crucial as authorities established a national treatment center within days, expanded laboratory capabilities, and deployed rapid response and contact-tracing teams. The country’s network of community health workers was used to screen nearly 4.8 million people. Surveillance was strengthened through mandatory mortality testing and regular household visits, which kept the outbreak confined to three clusters. Advanced medical care also played a role, as patients received dialysis, transfusions, and mechanical ventilation—treatments rarely available during earlier filovirus outbreaks (a group of highly deadly hemorrhagic fever viruses). Emergency measures allowed the use of experimental therapies, with 52 patients receiving remdesivir (an antiviral drug) and 10 treated with the monoclonal antibody MBP091 (an experimental antibody targeting the Marburg virus). The study suggests that these treatments, along with advanced supportive care, contributed to better patient outcomes. The report marks Rwanda’s first use of a vaccine during an active Marburg outbreak. The ChAd3-MARV vaccine was administered 13 days after the outbreak was declared, reaching over 1,700 healthcare workers and other high-risk individuals. At the same time, a phase 2 clinical trial was initiated to assess the vaccine’s effectiveness.

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