Since this article was published, Politico has reported that the previously suspected cases in Hamburg tested negative for Marburg virus with a PCR test and will be monitored throughout the incubation period of up to 21 days.
“There was no danger to fellow passengers on the train or in the plane at any time.”
After the announcement of an outbreak of Marburg virus in Rwanda in September 2024 and the initiation of response efforts, reports of suspected cases on a train at Hamburg Central Station have increased concerns. The situation in Rwanda is developing, with the latest figures suggesting 36 (+7) cases and 11 (+1) deaths. Although public health agencies are emphasising that contact tracing and containment measures are in place, the possibility of cases in Germany brings this into question.
Rwanda’s response
In a statement from Africa CDC, the organisation recognised that the Rwandan Ministry of Health is “working tirelessly” with relevant partners to “contain the deadly virus through enhanced preventive measures”. Contact tracing and case isolation are ongoing. The Ministry of Health is stepping up public health communication with a focus on preventive measures. Africa CDC also stated that it dispatched a team of experts to Rwanda on 29th September and is collaborating with the Ministry of Health and neighbouring countries to ensure cross-border responses are secure.
Weighing in on the situation on social media, emergency medicine doctor Dr Craig Spencer recognised the Ministry of Health’s “excellent epidemiological work”. Although “some reporting makes it seem like this outbreak exploded immediately”, Dr Spencer suggests that it has “likely been going on for weeks”. Detection is hard, particularly in countries that have not had an outbreak before. However, he is “hopeful” that the “strong health system” and “appropriate support from the international community” will limit the outbreak.
“The Rwanda health care system is very very strong, especially on bread-and-butter public health.”
This praise was echoed by Dr Mark Feinberg, Chief Executive of IAVI, who described the Rwandan health authorities as “exceptionally capable”.
“I hope that they will be able to rapidly contain this outbreak. The risks of extension of the outbreak to adjacent countries is not insignificant and the consequences of this could be severe.”
Suspected spread
In October 2024, the media picked up reports of a suspected case in Germany. The BBC described “fears that a train passenger may have arrived” to Hamburg Central Station with an infection. A spokesperson from the fire department told the press that a man, believed to be a medical student, and his girlfriend, had developed flu-like symptoms on a high-speed train from Frankfurt.
German media outlets suggest that the couple had travelled from Rwanda, where they had been in contact with a man who developed an infectious disease. The couple were taken to a specialist clinic after a team of police and firefighters attended the station, closing the platform. The nature of their illness is unconfirmed, but the man was reported to not have a fever.
Vaccine urgency
As there are no approved vaccines or treatments for Marburg, health services will need to focus on “supportive care”. Meanwhile, pressure mounts on various candidate vaccines, including Sabin Vaccine Institute’s ChAd3-based vaccine, which is currently in trial in Uganda and Kenya. Oxford’s ChAdOx1 vaccine candidate also recently progressed to a first-in-human trial.
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