Situation Report: Marburg Virus Disease in Tanzania

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Marburg Virus Disease in Tanzania: Key Insights for Healthcare Professionals

On January 20, 2025, Tanzania confirmed a case of Marburg Virus Disease (MVD) in Kagera, a regional transportation hub and one of the most populous regions in Tanzania. Kagera shares borders with Rwanda, Burundi, and Uganda, and lies close to the Democratic Republic of Congo (DRC). Although the World Health Organization (WHO) has classified the risk of national and regional spread as high, the global risk remains low.

This marks Tanzania’s second recorded MVD outbreak, following the 2023 outbreak that resulted in nine cases (eight confirmed and one probable) and six deaths. Other African nations, including Angola, the DRC, Ghana, Kenya, Equatorial Guinea, Rwanda, South Africa, Uganda, and Zimbabwe have also reported previous MVD outbreaks or sporadic cases.

What is Marburg Virus Disease?

MVD is a rare but severe viral hemorrhagic fever caused by the Marburg virus, a close relative of the Ebola virus. It spreads through direct contact with the bodily fluids of infected individuals or contaminated surfaces.

Diagnosing MVD can be challenging due to its similar signs and symptoms as other viral hemorrhagic fevers (Lassa Fever, Ebola) and more common infectious diseases (malaria, typhoid fever, dengue). Early detection and supportive care are essential for improving patient outcomes.

Symptoms and Progression

The incubation period for MVD is 2–21 days, with symptoms often appearing between 5–10 days after exposure. Early symptoms may include fever, chills, headache, and myalgia, and can have a sudden onset. Around the fifth day, a maculopapular rash may appear, typically on the chest, back, or stomach. Other symptoms can include nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhea.

As the disease progresses, symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction. These symptoms can escalate quickly, emphasizing the importance of early detection and supportive care.

MVD has a high fatality rate, ranging from 23% to 88%, with most fatalities occurring within the second week of illness.

Treatment and Care

Currently, there are no approved therapeutics or vaccines for MVD, though investigational treatments are under development. Supportive care, including hydration, symptom management, and monitoring vital signs, plays a critical role in improving patient outcomes.

Healthcare professionals should stay updated on research and development of vaccines or treatments that may be deployed in outbreak scenarios. Read “Marburg virus disease: A summary for clinicians,” written by the NETEC Special Pathogens Research Network (SPRN).

Guidance for U.S. Healthcare Workers

Although the risk of MVD in the U.S. is low, health care professionals should be aware of international outbreaks, especially in regions with travel connections to the U.S. Healthcare professionals should follow the Identify-Isolate-Inform algorithm to manage suspected cases of high-consequence infectious diseases like MVD:

1. Identify: Recognize symptoms in patients with recent travel to affected regions.
2. Isolate: Implement strict infection control measures immediately.
3. Inform: Notify public health authorities to initiate response protocols.

U.S. healthcare facilities should review and update their protocols for handling viral hemorrhagic fevers. Resources such as the CDC guidelines, WHO recommendations, and tools from NETEC, including the Viral Hemorrhagic Fever Preparedness Checklist and the customizable Marburg FAQ template, are valuable for preparedness.

EMS and Facility Preparedness

Emergency Medical Services (EMS) personnel are unlikely to encounter MVD cases during routine operations. However, the risk increases with international travel from affected areas. EMS and healthcare facilities should adopt robust infection control practices and ensure their teams are trained in the identify, isolate, and inform strategy. See Guidance for EMS Personnel.

For more detailed guidance, explore NETEC’s resources, including the “Health Care Facility Viral Hemorrhagic Fever Preparedness Checklist” and the “Identify, Isolate, and Inform Tip Sheet.”