WHO presses Uganda for update on cases of deadly Marburg virus

The Ugandan government has been silent regarding a recent Marburg virus outbreak it reported last month. The World Health Organization (WHO) has revealed that it has repeatedly sought updates on the investigation into the outbreak’s origin and extent.

“We’ve made several additional requests for information and are still awaiting specific outcomes from the investigation being conducted,” stated Chikwe Ihekweazu, executive director of the WHO’s Health Emergencies Program, during a news conference. 

Ihekweazu mentioned that the WHO has formally requested updates through the International Health Regulations, a treaty that obliges countries to inform one another, via the WHO, about disease threats that could potentially cross borders.

“We have sent frequent and repeated requests to the Ugandan government, and we are waiting for their response to the IHR request we submitted,” he emphasized.

Marburg is a viral hemorrhagic fever caused by a virus related to the Ebola virus family. It results in a disease similar to Ebola and can have a comparably high fatality rate, although Marburg outbreaks have never reached the scale of the largest Ebola epidemics. The largest recorded Marburg outbreak was in Angola from 2004 to 2005, with 252 cases and 227 fatalities.

The concurrent spread of Marburg in Central Africa, alongside a significant Ebola outbreak in the neighboring Democratic Republic of the Congo, complicates response efforts. However, Uganda has considerable experience and success in managing such diseases.

The Marburg outbreak was initially revealed in late June through unusual channels when the U.S. embassy in Kampala issued an alert about a Marburg case in Western Uganda. The Ugandan Ministry of Health later confirmed to the WHO that a case was diagnosed in a baby living in a displaced person’s camp.

A source, who requested anonymity, informed STAT that two cases had been confirmed at the outbreak’s onset. 

It is uncommon for an infant to be the first or last case in such outbreaks, as caregivers of an infected baby are at high risk of contracting the virus. 

As of now, there has been no confirmation of the second case or additional information from Uganda.

In related developments, WHO Director-General Tedros Adhanom Ghebreyesus announced that the last Ebola patient in Uganda was discharged from the hospital on Thursday, initiating the 42-day countdown to declare the country Ebola-free. An Ebola outbreak is considered over when two full 21-day incubation periods pass without new cases.

Uganda has reported 20 cases in the current outbreak, involving either infected individuals from the DRC entering the country or those they infected upon arrival. 

Conversely, efforts in the DRC are not as successful, with confirmed cases nearing 2,100 and almost 800 deaths. This outbreak, declared only two months ago, ranks as the third-largest on record and is progressing faster than previous ones.

Despite significant strides in scaling up treatment facilities, people continue to avoid seeking care. This reluctance is driven by longstanding political instability, regional violence, large numbers of displaced individuals, and deep-seated distrust within communities.

Tedros noted that two-thirds of Ebola deaths occurred in communities where individuals never sought treatment. This substantially reduces their survival chances and contributes to the virus’s spread.

“All partners are currently focused on getting patients into care as soon as possible,” Ihekweazu said. “That’s the most important message we have.”