Marburg virus disease in Rwanda

Original publication date: October 4, 2024

Updated: October 10, 2024

Current situation

On September 27, 2024, the Ministry of Health of Rwanda reported an outbreak of Marburg virus disease. Cases have been reported in several districts in the country. The majority of cases and deaths have been among health care workers from two health care facilities in Kigali.

The Government of Rwanda is coordinating a response to the local outbreak, with support from World Health Organization and partners, including case finding, contact tracing, and implementation of infection prevention and control measures at health care facilities. While these measures are being put into place, working or receiving care at health facilities could present a health risk. Travellers who think they may need to visit health care facilities while in the country may wish to postpone travel until adequate infection control measures are widely implemented.

Be aware that you may be subject to Rwanda’s infection prevention and control measures while visiting the country, including exit health screening at the airport upon departure. 

Learn more:

Rwanda - Entry and Exit Requirements
Government of Rwanda - Marburg virus disease information

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.

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:

• providing health care to people with Marburg virus disease (e.g., hospital staff or caring for sick family members)
• working in a laboratory or quarantine facility where the virus is present
• receiving care at  health facilities
• participating in burials that involve direct unprotected contact with the bodies of people who have died from Marburg virus disease or an unknown illness
• coming into contact with wild animals (alive, sick, or dead), particularly fruit bats 

There is no risk of getting Marburg virus disease through casual interaction with people showing no symptoms of the disease. 

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.

Learn more: 

Marburg virus disease 
Marburg virus disease - Symptoms

Recommendations

Before your trip

Consult a health care provider or visit a travel health clinic preferably at least 6 weeks before you travel to get personalized health advice and recommendations for your trip. 

Visit the Rwanda Travel Advice and Advisories page.

Rwanda - travel advice and advisories

During your trip

• Avoid contact with people who have symptoms of Marburg virus disease (fever, rash, muscle pain), especially contact with their blood and other body fluids. This includes avoiding:
  
  • contact with anything that may have come in contact with the sick person’s body fluids (e.g. linens, clothing, toilet, toiletries)
  • contact with the bodies of people who have died of Marburg virus disease or an unknown illnesses during funerals and burials
  • unprotected sexual activity, particularly with a person who has or is recovering from Marburg virus disease or an unknown illness   
• Avoid close contact with live, sick, or dead animals, as both can spread the virus. Animals such as fruit bats, chimpanzees, gorillas, monkeys, pigs and duikers may be carriers.
• Avoid visiting healthcare facilities for nonurgent medical care or for nonmedical reasons.
• Wash your hands often with soap and water for at least 20 seconds, or use a hand sanitizer containing at least 60% alcohol.
  • Keep a bottle of hand sanitizer with you when you travel.
  • If your hands look dirty, you should wash them with soap and water instead of using hand sanitizer.
• Isolate from others and seek medical care immediately if you develop symptoms of Marburg virus disease.

Returning to Canada

• Do not travel if you have symptoms of Marburg virus disease.
• Monitor your health for symptoms of Marburg virus disease while in Rwanda and for 21 days after leaving.
• 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.

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)

Learn more:

If you become sick or injured while travelling outside Canada or after your return

Information for health care professionals

The viruses that causes Marburg virus disease and Ebola disease both belong to the filoviridae family of viruses. Similar infection, prevention and control guidance can be used to prevent the spread of both viruses. As such, the following Ebola disease guidance documents could be leveraged for Marburg virus disease.

• The Ebola Virus Disease Prevention, Monitoring and Surveillance Recommendations, developed by the Committee to Advise on Tropical Medicine and Travel (CATMAT), provides recommendations for preventive measures, monitoring and surveillance of travellers, including healthcare and other humanitarian workers, returning from outbreak areas.

Ebola disease prevention, monitoring and surveillance recommendations

• National infection prevention and control guidance available for Ebola disease to assist healthcare organizations and complement provincial/territorial public health efforts in establishing appropriate precautions for the management of Marburg virus disease  in healthcare settings.

Infection prevention and control measures for Ebola disease in acute care settings

• The Public health management of cases and contacts of Ebola disease in the community setting in Canada (2024) to support response efforts in the event that a suspected or confirmed case or contact of Marburg virus disease is identified in Canada.

Public health management of cases and contacts of Ebola disease in the community setting in Canada (2024)

Learn more:

Marburg virus disease – Health professionals
Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings

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. 

Learn more:

Registration of Canadians Abroad