Following the announcement of an outbreak of Marburg virus in Equatorial Guinea in February 2023, WHO has issued a situation update from the limited information available. This includes advice to the country itself and other countries about the risk posed by travel to and from the region.  

What WHO knows so far 

The situation summary states that on 7th February 2023, the Ministry of Health and Social Welfare of Equatorial Guinea reported the deaths of a “number of individuals” with suspected haemorrhagic fever. 5 days later, a sample was confirmed positive for Marburg virus by a real-time polymerase chain reaction (RT-PCR) at the Institut Pasteur in Senegal. Current investigations continue to identify additional cases. 

“WHO is supporting the response by strengthening contact tracing, case management, infection prevention and control, laboratory, risk communication, and community engagement.”  

As this is Equatorial Guinea’s first reported Marburg outbreak, WHO describes the “country’s capacity to manage the outbreak” as “insufficient”.  

Risk level 

WHO describes the outbreak risk as “high at the national level”, but “moderate” on a regional level and “low” at a global level. These risk assessments were made using “available information”, such as the possibility of “transmission chains that have not been tracked” and unidentified contacts of the 9 deceased cases.  

WHO also notes that “with the exception of one case”, who died in a health facility, the remaining 8 died “in the community” with “unknown” burial conditions. Furthermore, “cross-border population movements are frequent”, and the borders between districts and other countries are “very porous”. Thus, there is a risk of cross-border spread.  

Public health response 

WHO identifies the following measures comprising a public health response on the ground: 

  • In-depth epidemiological investigations are underway to determine the source of the outbreak. 
  • National teams have been deployed to the affected districts for active case finding, contact tracing, isolating and providing medical care to cases. 
  • WHO has deployed experts in epidemiology, case management, infection prevention, laboratory and risk communication to support national response efforts and ensure community engagement. 
  • WHO is also facilitating the shipment of tents, materials for sample collection and analysis, and a viral haemorrhagic fever kit including personal protective equipment for 500 health workers. 
  • WHO is supporting the transportation of samples to laboratories in Senegal and Gabon as plans are underway to set up laboratory facilities in-country. 
Advice from WHO 

The current advice from WHO to other countries is that travel or trade restrictions are unnecessary “based on available information for the current outbreak”. However, it provides further guidance for the communities that are currently affected, or at risk of becoming affected. Interventions include “case management, surveillance including contact tracing, a good laboratory service, infection prevention and control including safe and dignified burials, and social mobilisation”.  

“Community engagement is key to successfully controlling MVD outbreaks.” 

As part of this engagement, WHO recommends “raising awareness of risk factors” and protective measures.  

Research continues into safe and effective vaccine candidates, and we hope to hear more on this front at the World Vaccine Congress in Washington.