Africa must prepare for Marburg virus disease
Africa needs to improve its surveillance and detection infrastructure following an outbreak of the deadly Marburg virus in Ghana. That’s the warning from public health officials.
Last month, Ghana recorded its first disease outbreak in Marburg virus after tests confirmed that two men died from the disease.
Patrick Kuma-Aboagye, director general of the Ghana Health Service (GHS), said the tests were carried out in Accra in Noguchi Memorial Institute for Medical Research and confirmed by the Institut Pasteur in Dakar, Senegal.
“Africa, Ghana and the DRC must collaborate on prevention. In countries where there is an outbreak, this is the best approach”
Emily Lebughe Nzimo, General Hospital
On August 2, a representative of the World Health Organization (WHO) reported that a child who had contracted the disease also died. A fourth case has also been identified.
Patrick Kuma-Aboagye said community surveillance volunteers have been deployed to detect and document cases of the Marburg virus disease which has already claimed the lives of three people in the Ashanti region of Ghana.
Franklin Asiedu-Bekoe, director of public health at the GHS explained to the press that 98 people had been placed under strict surveillance and that 39 individuals were no longer considered at risk.
At a July press conference he said, “Our approach is based on containment. So what we’re doing is making sure that we’re identifying all the contacts by involving community members who are more knowledgeable. So if a case arises, we detect and manage. »
This is the second time this zoonotic disease has been detected in West Africa. Guinea had confirmed a single case during an outbreak that was declared over on September 16, 2021, five weeks after the first case was detected.
Before making its appearance in Guinea, the disease had previously manifested itself in Central and East Africa.
According to the WHO, the Marburg virus is transmitted by fruit bats. Human-to-human transmission occurs through direct contact with the body fluids of infected people or through contaminated surfaces and materials.
Marburg virus disease is a highly contagious viral hemorrhagic fever that belongs to the same family as the better known Ebola virus disease.
During an outbreak of the disease in the Democratic Republic of Congo (DRC) between 1998 and 2000, a case fatality rate of over 83% was recorded.
Emily Lebughe Nzimo, a doctor at the general hospital in Kinshasa, DRC, can testify to the deadly danger posed by the Marburg virus, especially in a context where resources are scarce. She indicated to SciDev.Net that disease control measures should be put in place at borders.
“Faced with a lack of approved treatment and vaccine, we must develop public health mechanisms,” she added, specifying that “We must already strengthen passenger control at the border. »
The interested party explains to SciDev.Net that the management of the Congolese outbreak has proven difficult, in particular due to the lack of medicines and protective equipment for health personnel.
“The DRC had never been prepared to deal with a generalized epidemic throughout the country”, she underlined before continuing: “So, it is really not a wish that an epidemic arrives in this magnitude that we had. »
For Emily Lebughe Nzimo, the outbreak of the Marburg virus that we are witnessing must be treated as a public health problem: “Of the 154 cases of contamination that we had recorded in the DRC, there had been 128 deaths. So, even though it is a rare disease, Marburg should be considered a public health problem due to its severity. »
She believes that countries in sub-Saharan Africa should collaborate and pool their resources to fight the disease. For her, there are lessons to be learned from the way the DRC had handled the virus:
“Africa, Ghana and the DRC must collaborate on prevention. In countries where there is an outbreak, this is the best approach”.
She adds that “The fact that the DRC has already had to deal with this disease can become an asset. Now that we know how the disease manifests and how we have managed it, we can train other health professionals in the area. »
Ebola’s “big brother”
Titus Beyuo, secretary general of the Ghana Medical Association (GMA) told SciDev.Net that the Ghanaian health services have taken the necessary measures to contain the disease.
Public health agencies in other countries have also sounded the alarm.
On August 14, news of an outbreak of Marburg virus disease spread in Nigeria when a protocol from Abuja Teaching Hospital, titled Marburg virus disease: Nigeria prepares for possible outbreakhas been disclosed. The university, however, denied that there had been an outbreak of the disease in the country.
The hospital’s public relations officer, Sani Suleiman, told SciDev.Net that there had been no outbreak of Marburg virus disease in the establishment.
According to him, the protocol was an internal document sent to staff to remind them to take proactive measures in the event of an outbreak in Abuja or elsewhere in Nigeria:
“Unfortunately, one of our employees decided to pass it on to the general public, without adding the precautionary measures that we had posted on our platform. The message was intended to touch upon proactive measures in case of an outbreak in Nigeria as Ghana had just reported cases of the disease. »
The head of communications at the Nigerian Center for Disease Control, Yahya Disu, confirmed to SciDev.Net that there had been no cases of Marburg virus disease in Nigeria. He added that the country had intensified surveillance at the point of entry, to reduce the risk of importation from Ghana.
Yahya Disu clarifies that Nigeria can carry out tests for the virus: “The National Reference Laboratory in Abuja and the laboratory of the Center for Human and Zoonotic Virology at the University Hospital of Lagos have the necessary equipment to detect and identify the virus. he said.
He concludes by affirming that “at the laboratory level, we have the technical human capacity and that is necessary to recognize and manage the disease if it appears in the country. »
A call to action
Solomon Woldetsadik, Emergency Response Manager at the WHO Regional Office for Africa, told SciDev.Net that while the Ghanaian authorities had acted quickly, more needed to be done in terms of detection and surveillance systems:
“Most countries are looking to do more in the area of surveillance, especially after Ebola,” he explained, adding that “efforts are being made to identify and screen for diseases such as Marburg, but there is still work to do. work to do. »
Solomon Woldetsadik said WHO will continue to work with countries in the region to help them identify and control diseases.
For the WHO Regional Director for Africa, Matshidiso Moeti, “health service officials reacted quickly, and took the lead in preparing for a possible outbreak. This is good because without immediate and decisive action, Marburg disease can easily spiral out of control. »
Kabinet Kourouma, doctor and project manager for Amref Health Africaa non-profit organization based in Kenya, told SciDev.Net that Ghana’s neighbors should put in place border security measures, including screening at entry and exit points, monitoring passengers to see if they develop symptoms, physical distancing measures and compliance with conventions of use in case of coughing or sneezing.
“We must strengthen border measures by taking temperatures, checking symptoms,” he explained, adding that “on the other hand, African countries in general and those in West Africa in particular , all have porous borders, we do not have total control of our borders; whether official or not. It is also a challenge. »
Constantin Bashengezi, pharmacognosy researcher and general manager of Creppat Laboratories in Kinshasa, DRC, told SciDev.Net that, since there is currently no treatment or vaccine, other drugs may be suitable for the management of Marburg virus disease.
He mentions locally known antivirals, namely Ebanga, approved in December 2020 to fight Ebolavirus Zaire and the antiviral Doubase C. developed by Creppat laboratories.
For Constantin Bashengezi, “it will suffice to extend the therapeutic indication of existing antiviral drugs to other types of virus such as Marburg or Ebola, and results are possible. »
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