On 10 January 2025, WHO received reliable reports from in-country sources regarding suspected cases of Marburg virus disease in the Biharamulo and Muleba Kagera region of the United Republic of Tanzania. As of 11 January 2025, nine suspected cases were reported including eight deaths (case fatality ratio (CFR) of 89%) across two districts. The cases presented with similar symptoms of headache, high fever, back pain, diarrhoea, haematemesis (vomiting with blood), malaise (body weakness) and, at a later stage of disease, external haemorrhage (bleeding from orifices).
Samples from two patients have been collected and tested by the National Public Health Laboratory. Results are pending official confirmation. Contacts, including healthcare workers, are reported to have been identified and under follow-up in both districts.
The Bukoba district in Kagera region experienced its first MVD outbreak in March 2023, and zoonotic reservoirs, such as fruit bats, remain endemic to the area. The outbreak in March 2023 lasted for nearly two months with nine cases including six deaths.
Kagera region in Tanzania with possible Marburg virus disease outbreak:
Follow media and official reports!
Travellers should be made aware of the ongoing outbreak. The risk for travellers is assessed as low, but it is high for family members and caregivers who have contact with sick people.
Preventive measures:
- Wash your hands regularly and carefully using soap and water (or alcohol gel if soap is unavailable).
- Avoid contact with sick people who have symptoms, such as fever, muscle pain, and rash.
- Avoid contact with blood and other body fluids.
- Avoid visiting healthcare facilities in the MVD-affected areas for nonurgent medical care or non-medical reasons.
- Avoid contact with dead bodies or items that have been in contact with dead bodies, participating in funeral or burial rituals, or attending a funeral or burial.
- Avoid handling, cooking, or eating bush/wild meat (meat of wild/feral mammals killed for food).
- Wash and peel fruit and vegetables before consumption.
- Avoid visiting mines or bat caves and contact with all wild animals, alive or dead, particularly bats.
- If you decide to visit mines or caves inhabited by fruit bat colonies, wear gloves and other appropriate protective clothing, including masks and eye protection.
- Practice safer sex.
Upon return:
- Watch your health for symptoms of Marburg while in the outbreak area and for 21 days after leaving the outbreak area (no quarantine is required if there are no symptoms).
In case of symptoms
If you develop fever and nonspecific symptoms such as chills, headache, muscle pain or abdominal pain:
- you should separate yourself from others (isolate) immediately and
- directly contact the in-country hotline by phone or contact a tropical institute or university hospital infectious disease unit.
- alert the healthcare providers of your recent travel to an area with a Marburg outbreak.
For clinicians:
- Consider Marburg as a possible diagnosis in patients with epidemiologic risks factors, especially in people with possible exposure of Marburg cases in Rwanda.
- Further information on evaluation and diagnosis: see LINK and ECDC risk assessment.
