Uganda has officially informed the World Health Organization (WHO) about a Marburg disease outbreak in the western region of the country, according to a spokesperson from the Geneva-based health organization. This new development could further complicate efforts to manage the existing Ebola outbreak in Central Africa, which is the third-largest on record. Both Ebola and Marburg are viral hemorrhagic fevers.
Although the Ugandan government has not made a public announcement regarding the Marburg outbreak, the U.S. embassy in Kampala issued a health alert on Monday. The alert mentioned awareness of a possible Marburg case in Uganda and advised Americans against traveling to the country, issuing a level 4 advisory.
Initially, Uganda reported a single Marburg case to the WHO. However, a well-informed source, who requested anonymity, told STAT that two cases had been confirmed as of Monday. The source indicated that the outbreak appears localized at this time.
The same source noted that the WHO had informed other countries about the two confirmed cases through a secure disease news-sharing network governed by the International Health Regulations, a treaty signed by most nations, including the United States.
The WHO stated, “We continue to request further information, and once this is received from Ugandan health authorities, we will continue to update Member States, and the wider public,” according to a statement provided to STAT.
STAT has sought comments from Uganda’s health ministry but has not yet received a response.
Nahid Bhadelia, director of Boston University’s Center on Emerging Infectious Diseases, suggested that the U.S. embassy’s alert might have been intended to prompt Uganda to publicly acknowledge the situation, which may have been known internally for several days.
“The embassy releasing this does make me feel like this is something that is a bit more confirmed,” she stated.
Marburg is caused by a filovirus, which is the same family of viruses as Ebola. These viruses cause similar diseases and are transmitted through contact with the bodily fluids of an infected person or during the preparation of an infected body for traditional burials.
Since the virus was first identified in 1967, about 20 Marburg outbreaks have been confirmed, with five occurring in Uganda. Two involved tourists who were infected in Uganda but diagnosed after returning home, and one involved lab workers infected by monkeys from Uganda.
Currently, there are no approved vaccines available to prevent Marburg infection, although several candidates are at various stages of testing. Vaccine development for Marburg is more advanced than for the Bundibugyo species of Ebola, responsible for the ongoing outbreak in the Democratic Republic of the Congo. However, entities developing these vaccines do not yet have doses ready for clinical trials, which are still several months away.
While Uganda is known for effectively managing Ebola and Marburg outbreaks, it tends to be hesitant in releasing information, possibly due to the significant role of tourism in its economy. The Marburg outbreak emerges as the Ugandan government seeks to have countries, including the United States, lift entry restrictions on Ugandan nationals or travelers who have been in Uganda in the past 21 days, the incubation period for Ebola and Marburg.
“There is a need to review these restrictions,” Uganda’s health minister, Chris Baryomunsi, said at a recent press conference, as reported by NBS Television in Uganda.
Baryomunsi argued that with effective public health measures, including rigorous airport screening, the risk of Ebola spreading from Uganda is minimal. He did not address the Marburg outbreak in his comments.
Baryomunsi also emphasized that Uganda’s Bundibugyo Ebola outbreak was under control. The country has recorded 20 Ebola cases in the current outbreak, with 15 involving Congolese nationals who traveled to Uganda; some cases involved Ugandan health workers infected by these travelers. No new Ebola cases have been detected in Uganda for over two weeks.
This story has been updated with a statement from the WHO.
Correction: An earlier version of this story incorrectly identified Ugandan Health Minister Chris Baryomunsi.
