In July 2024 Rwanda detected its first-ever Marburg outbreak in Kigali, which began among health workers and challenged assumptions about how epidemics start and spread. The first cases appeared in a leading referral hospital, and the health minister Sabin Nsanzimana learned of the event while at the UN General Assembly in New York. The World Health Organization describes Marburg as highly infectious and, on average, fatal for about half of those infected.
Authorities quickly revised traditional rural-to-city outbreak assumptions and set up a command post that combined health, local government and security sectors. They implemented a ten-pillar plan from the pandemic response strategy, cut bureaucracy and made fast decisions so institutions could act as a single team. International partners were ready to help within 24 hours.
Scientists carried out genomic sequencing that linked the virus to a common ancestor from a 2014 outbreak and to bats in mining areas. Researchers concluded the event was a single viral introduction, which focused the response. There are no approved vaccines or antivirals for Marburg, but the Sabin Vaccine Institute delivered about 2,700 investigational doses for two targeted clinical trials, and officials deployed two specific treatments guided by the virus’s genetic profile.
The rapid scientific and logistical response helped limit deaths: of 66 confirmed cases, 51 recovered and 15 died. No new cases appeared for 42 consecutive days, and Rwanda recorded a 23 per cent case fatality rate, the lowest ever recorded for Marburg. Officials noted the human cost was high because most of those who died were experienced doctors and nurses. The WHO representative announced the end of the outbreak in November, showing how coordinated leadership, fast science and strong institutions can contain a dangerous disease.
Difficult words
- outbreak — sudden start of many disease cases
- referral — hospital that receives patients from other hospitalsreferral hospital
- infectious — able to spread disease from person to person
- fatal — causing death in many cases
- bureaucracy — complex official procedures and paperwork
- genomic sequencing — reading the virus's genetic code
- investigational — not yet fully approved for general use
- case fatality rate — percentage of confirmed patients who died
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- Which actions described in the article do you think most helped limit deaths, and why? Give specific reasons from the text.
- How might rapid international support within 24 hours change the outcome of an urban outbreak like this?
- What are the ethical issues of using investigational doses and treatments during an outbreak? Explain your view with reasons.
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