WHO warning as Marburg cases rise in Equatorial Guinea

Equatorial Guinea’s outbreak of the deadly Marburg virus has grown significantly and health officials may not be fully tracking its spread, the World Health Organization (WHO) has said.

The first update in weeks from the outbreak in West Africa reported there have been nine-laboratory confirmed cases and 20 suspected cases, with all but two of the patients now reported dead.

The update makes the outbreak of the Ebola-like disease the fourth largest ever recorded.

Cases have been spread across three different provinces over a range of nearly 100 miles, “suggesting wider transmission of the virus,” the health body said.

The cases are also in provinces bordering neighbouring Gabon and Cameroon, meaning that “the risk of international spread cannot be ruled out”, a statement said.

The announcement came soon after Tanzania announced its own first outbreak, in which it said eight people had developed symptoms and five of them had died.

Genetic sequences from the two outbreaks, which are around 2,000 miles apart, would be tested to see if they were linked, said Dr Ahmed Ogwell Ouma, acting director of the Africa Centres for Disease Control and Prevention.

He told the Telegraph: “We are going to sequence both and see if there is a relationship between the current two outbreaks. At the moment we have not done that genomic analysis.”

Potential for undetected spread

Of the eight new confirmed cases in Equatorial Guinea, two were reported from the country’s Kie-Ntem province, four from the Litoral province and two from Centre-Sur province.

The WHO said: “The wide geographic distribution of cases and uncertain epidemiological links in Centre Sur province suggests the potential for undetected community spread of the virus.”

Until the update, the most recent reports from late February had said there had been one confirmed case in Equatorial Guinea and eight probable or suspected cases.

Earlier this week, Tanzania also said it had identified its first ever cases. Eight people developed symptoms including fever, vomiting, bleeding and kidney failure. Five of them died, the WHO said.

The Marburg virus is in the same filovirus family as Ebola and causes similar symptoms.

Infections start with fever, headaches and fatigue. They can then go on to haemorrhage and bleed from bodily orifices. In some outbreaks as many as nine-out-of-10 who are infected have died.

There are no approved vaccines or antiviral treatments, but good quality medical care greatly improves survival rates.

Dr Matshidiso Moeti, WHO Africa director, said: “The confirmation of these new cases is a critical signal to scale up response efforts to quickly stop the chain of transmission and avert a potential large-scale outbreak and loss of life.

“Marburg is highly virulent but can be effectively controlled and halted by promptly deploying a broad range of outbreak response measures.”

Marburg was first recognised in 1967, when outbreaks of haemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, then in Yugoslavia.

The infections were traced back to three laboratories which received a shared shipment of infected African green monkeys.

Thirty-one people became ill, initially laboratory workers followed by several medical personnel and family members who had cared for them. Seven deaths were reported.

The first people infected had been exposed to Ugandan imported African green monkeys or their tissues while conducting research.

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