Marburg virus disease in Equatorial Guinea

Original publication date: March 30, 2023

Updated: April 14, 2023

Current situation

On February 13, 2023, the Ministry of Health of Equatorial Guinea declared an outbreak of Marburg virus disease in the western Kié-Ntem province. Since this time, cases have also been reported in Litoral, Centro Sur, and Wele-Nzas provinces. Investigations are ongoing to determine the full scope of the outbreak.

Due to the outbreak, movement restrictions have been put in place in and around Kié-Ntem province. In Ebebiyín district, Kié-Ntem province, the borders between Equatorial Guinea and Cameroon, and Equatorial Guinea and Gabon are closed. Be aware that should you become ill while abroad, you may be subject to the country’s outbreak response procedures, such as isolation, and you may have limited access to timely and appropriate health care. 

The Government of Canada is recommending that travellers practise health precautions when visiting Equatorial Guinea.

About Marburg Virus Disease

Marburg virus disease is caused by a virus that is spread through contact with infected bodily fluids from people or animals. Although it is rare, it is very serious and often fatal.

Symptoms of Marburg virus disease can begin 2 to 21 days after exposure. Initial symptoms include:

• fever
• chills
• headache
• muscle pain

The disease progresses to include symptoms such as:

• rash on chest, back and stomach
• nausea, vomiting and diarrhea
• chest and abdominal pain
• jaundice (yellowing of the skin and whites of the eyes)
• swelling and pain in the stomach area
• severe weight loss
• delirium and shock
• haemorrhaging (bleeding from inside and outside the body)

There are no approved vaccines or specific treatments available for Marburg virus disease. Early supportive treatment is important to prevent severe disease and death.

Recommendations

As long as precautions are taken, travellers are at low risk of becoming ill with Marburg virus disease.

Travellers are at higher risk of contracting Marburg virus disease if they will be:

• working in a laboratory or quarantine facility where the virus is present
• providing health care to people with Marburg virus disease (e.g. hospital staff or those caring for sick family members)
• participating in burials that involve direct unprotected contact with the body of the deceased
• coming into contact with wild animals, particularly fruit bats 

Canadian travellers participating in usual tourist or business activities are unlikely to encounter these exposures. There is no risk of getting Marburg virus disease through casual interaction with people showing no symptoms of the disease. 

Before your trip:

Consult a health care professional or visit a travel health clinic preferably 6 weeks before you travel. Make sure your routine vaccinations are up to date.

Visit the Equatorial Guinea Travel Advice and Advisories page.

During your trip

• Wash your hands often with soap under warm running water for at least 20 seconds.
  • Use alcohol-based hand sanitizer (containing at least 60% alcohol) if soap and water are not available. It's a good idea to always keep some with you when you travel.
• Take measures to prevent other infectious diseases (like those transmitted through food, water or insects) that may be mistaken for the early signs of Marburg virus disease. 
• Avoid contact with people with Marburg virus disease or an unknown illness and their body fluids. 
  • Avoid participating in burials and contact with the bodies of people who have died of Marburg virus disease or unknown illnesses.
• Avoid unprotected sexual activity, particularly with a person who has or is recovering from Marburg virus disease or an unknown illness. 
  • The virus can persist for an extended period of time in the semen of recovered males and possibly in the vaginal secretions of recovered females.
• Avoid close contact with live or dead animals, as both can spread the virus. Animals such as fruit bats, chimpanzees, gorillas, monkeys, pigs and duikers may be carriers.
• Avoid exposure to mines or caves inhabited by fruit bat colonies.
• Avoid handling raw or undercooked meat and avoid eating wild game (meat from animals caught in the wild). 

Humanitarian aid workers and health professionals should follow the guidance provided by their organization, and practise strict infection control measures, including the appropriate use of personal protective equipment (e.g., gowns, masks, goggles and gloves) when providing care for people suspected or confirmed of having Marburg virus disease.

• Avoid contact with medical equipment, such as needles, and personal belongings that may have been contaminated with body fluids of people with Marburg virus disease or unknown illnesses.

Travellers should isolate immediately and seek medical care if they develop symptoms of Marburg virus disease.

Returning to Canada

Monitor your health. Do not travel if you have symptoms of Marburg virus disease. If you feel sick or experience any symptoms of Marburg virus disease during the flight or upon arrival, tell the flight attendant before you land or the border services officer as you enter Canada. They will notify a quarantine officer who can assess your symptoms. 

If you were exposed to someone with Marburg virus disease, you must report this information to a Canada Border Services Agent on arrival in Canada. This is required under the Quarantine Act. The Canada Border Services Agent will give you instructions to follow.

What to do if you become ill after returning to Canada

Before visiting a doctor or a hospital, immediately call your appropriate public health authority if you have or if anyone in your household has:

• any of the symptoms listed above, and;
• has travelled in a Marburg virus disease-affected area in the last 21 days

Describe your symptoms over the phone, tell them where you have been travelling or living and mention any possible exposure risks. The public health authority will make appropriate arrangements for your medical assessment.

Follow the instructions provided to you by your public health authority and:

• if not already isolated, immediately separate yourself from those around you and do not have physical contact with people, household pets or other animals
• wash your hands frequently, especially after vomiting or using the toilet
• ensure that others do not come into contact with your body fluids (including blood, urine, feces, vomit, saliva, sweat, breast milk and semen) or anything that may have come in contact with your body fluids (e.g. linens, clothing, toilet, toiletries)

Registration of Canadians Abroad

Sign up with the Registration of Canadians Abroad service to stay connected with the Government of Canada in case of an emergency abroad or an emergency at home.