African Health Chief Critiques US Travel Advisory Amid Marburg Outbreak

Jean Kaseya, the head of the Africa Centres for Disease Control and Prevention (Africa CDC), has criticized the United States for issuing travel warnings against Rwanda due to the ongoing Marburg virus outbreak. Kaseya described the advisory as “not fair” and argued that it does not reflect the treatment Rwanda and the broader African continent deserve.

In a short span of two weeks, Rwanda has reported 13 deaths attributed to the Marburg virus, with a significant number of fatalities among healthcare workers. Despite the alarming numbers, Rwandan authorities maintain that the outbreak is under control, although the emotional toll on frontline medical professionals remains high.

Maria, an intensive-care nurse at a hospital in Kigali who spoke to the BBC under a pseudonym for fear of losing her job, expressed her concerns. “What scares you the most is when you see people of the same profession dying,” she said, highlighting the pervasive anxiety among healthcare workers. “I can’t stop telling myself that I might be the next, that maybe I am positive but without symptoms yet,” she added.

Although no vaccines for the Marburg virus have been officially approved, Rwanda has initiated trials using supplies provided by the Sabin Institute, a US-based non-profit organization. So far, 200 individuals—primarily healthcare workers and contacts of confirmed cases—have been vaccinated, with plans for further distribution as more doses become available.

The Africa CDC has stepped up its support, providing Rwanda and neighboring countries with 5,000 Marburg test kits to enhance cross-border surveillance efforts. Maria, however, has not yet received the vaccine but remains committed to her role. “I am a nurse, I am on the front line; we have to fight it, but the fear is constant,” she said.

In Europe, concerns about the virus have escalated, prompting authorities in Germany to shut down part of Hamburg’s central station after a medical student and his companion reported illness following a visit to Rwanda. Both individuals tested negative for the Marburg virus, but the incident raised alarms.

In response to the outbreak, the US Centers for Disease Control and Prevention (CDC) has issued its second-highest travel notice for Rwanda, advising against non-essential travel. Rwanda’s neighbors—Tanzania, Uganda, and the Democratic Republic of Congo—have ramped up border surveillance in light of past Marburg cases, while Burundi has established an emergency treatment and isolation center.

The Africa CDC has indicated that it is enhancing public health emergency training to better equip staff for potential Marburg outbreaks. Rwandan authorities have also taken significant measures to mitigate the virus’s spread, including limiting funerals for victims to 50 attendees and implementing passenger questionnaires, hand-sanitizing stations, and temperature checks at key transit points.

The emotional impact of the outbreak is profound among healthcare workers. Claire, another nurse in Kigali who requested anonymity, shared her grief: “I have lost people I knew; I lost a colleague who was dear to me at another hospital.” The situation has led to staffing shortages, with fewer personnel available to handle cases.

Health Minister Sabin Nsanzimana has emphasized the difficulty of identifying Marburg cases early due to its symptoms mirroring those of malaria, which is prevalent in the region. As a result, mass testing is being conducted for individuals presenting high fevers, headaches, vomiting, and muscle aches. Visits to healthcare facilities where staff tested positive for the virus have been halted to contain the outbreak.

The Marburg virus is closely related to Ebola, which claimed over 11,000 lives during the West African outbreak from 2014 to 2016, according to the World Health Organization (WHO). Drawing lessons from that crisis, Rwanda is collaborating with the WHO and the Africa CDC to implement stringent hygiene protocols, raise public awareness, provide protective gear for healthcare workers, and isolate confirmed cases.

To bolster its response, Rwanda has received 5,100 vials of remdesivir, an antiviral medication previously used to combat Ebola. As trial vaccinations continue, healthcare professionals like Claire express cautious optimism. “I hope that things will soon get better… some vaccines have arrived, and this is what is giving us some hope,” she remarked, highlighting the resilience of those on the front lines.

As Rwanda navigates this crisis, the focus remains on controlling the outbreak while ensuring the safety and well-being of its healthcare workers and the general public.