Marburg virus disease in Tanzania

First ever outbreak of Marburg virus disease (MVD) in Tanzania confirmed

• This updates the news item of 13 April 2023

On 21 March 2023, the Ministry of Health of the Republic of Tanzania declared an outbreak of Marburg virus disease (MVD). Confirmed cases and deaths have been reported from Bukoba district, Kagera region, north-western Tanzania. A healthcare worker is among those who have died. This is the first-ever confirmed outbreak of MVD in Tanzania [1, 2].

Epidemiological investigations are being undertaken and an emergency response is underway with contact tracing and case management in affected communities [1, 2].

Updated case numbers and deaths will be reported on the Tanzania Country Information page: Outbreaks section.

The reservoir host of Marburg virus, the fruit bat, is widely distributed across Africa. MVD is a severe, often fatal haemorrhagic fever, which is clinically almost indistinguishable from Ebola virus disease [3].

There is a current outbreak of Marburg reported in Equatorial Guinea which was declared on 13 February 2023. A previous recent outbreak has also been reported in Ghana in 2022, and additionally sporadic cases have occurred in previous years in Angola, the Democratic Republic of the Congo, Guinea, Kenya, South Africa (associated with travel from Zimbabwe), and Uganda [3].

Whilst MVD is rare and very unusual in travellers, sporadic cases have been reported in travellers who spent prolonged periods in mines or caves inhabited by bat colonies [3].

Country-specific information can be found on our Country Information pages and Outbreak Surveillance section.

Advice for travellers

Before you go

Check and follow the advice from the Foreign, Commonwealth & Development Office on safety, security, and any travel restrictions at your destinations.

Check our Country Information pages to research general health risks, prevention advice and any vaccine recommendations or malaria advice for your destination and make sure you get comprehensive travel health insurance.

There is currently no licensed vaccine to protect against MVD [3].

While you are there

The risk of exposure to Marburg virus for the majority of those travelling to Tanzania is very low. If you have planned travel to Tanzania, the following measures will reduce your risk of infection:

• Wash your hands regularly and carefully using soap and water (or alcohol gel if soap is unavailable).
• Avoid visiting mines or bat caves and contact with all wild animals; alive or dead, particularly bats.
• If you decide to visit mines or caves inhabited by fruit bat colonies, wear gloves and other appropriate protective clothing, including masks.
• Avoid contact with symptomatic patients/their bodily fluids, corpses and/or bodily fluids from deceased patients.
• Avoid handling, cooking, or eating bush/wild meat (meat of wild/feral mammals killed for food).
• Wash and peel fruit and vegetables before consumption.
• Practice safer sex.

When you return

Get medical advice if you become ill within 21 days of returning home. Call NHS111 or contact your GP by phone. Although it is very unlikely you have MVD, you should mention your dates and itinerary of travel and any potential exposure to the virus.

While the risk of MVD is very low, other infectious disease like malaria are present in Tanzania. You should be aware of the signs and symptoms of malaria and should seek immediate medical attention if these occur either while you are in Tanzania or up to a year after you return to the UK.

Advice for those working in affected areas

If you are planning to visit outbreak areas for work related reasons (i.e. humanitarian, healthcare or media activities), you should follow advice from your deploying organisation.

As of 13 April 2023, organisations undertaking business in areas affected by Marburg must register with the UKHSA returning workers scheme (RWS) [4].

If you are working with infected individuals, strict barrier techniques should be implemented, and all staff provided with and trained in the use of protective equipment [5].

Advice for health professionals

Health professionals should remain alert for travellers returning from MVD affected areas who develop symptoms compatible with MVD. See UKHSA's MVD information page for symptoms and guidance.

Health professionals should practise strict universal precautions when caring for patients when MVD is suspected.

Guidance and information about high consequence infectious disease and their management in England and further information and guidance about Marburg fever is available from UK Health Security Agency. Rapid transfer to a designated High Consequence Infectious Disease Treatment Centre will be arranged [6].

UKHSA has specialised laboratory facilities to provide a definitive MVD diagnosis at the Rare and imported pathogens laboratory (RIPL).