Introduction
On January 20, 2025, a joint statement by Her Excellency Hon. Dr. Samia Suluhu Hassan, President of the United Republic of Tanzania, and Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, confirmed an outbreak of Marburg Virus Disease (MVD) following the detection of a positive case among 26 tested samples. The confirmed cases were male from Katerela village, Ruziba ward which is one of 17 wards of, Biharamulo District in Kagera Region. The cause of earlier deaths in the community remains unconfirmed, and investigations into the source of infection are ongoing.This outbreak is centered in Biharamulo, part of Kagera region, which also saw the first MVD outbreak 21st March 2023 in Bukoba District Council in Maruku village. While the two outbreaks are in different areas, Kagera continues to be the epicenter. The 2023 outbreak was successfully controlled and declared in 74 days through strong public health measures.
Investigation and Confirmation
On 10 January 2025, the World Health Organization issued an alert about suspected MVD cases in Tanzania’s Kagera region and, by 13 January, notified its Member States and IHR State Parties through its Event Information Site (EIS). On January 15, Tanzania’s Ministry of Health announced the deployment of an expert team on January 11 to investigate the Marburg virus outbreak. As of February 12, 2025, there have been 2 confirmed deaths, 8 probable deaths, and 82 suspected cases. It marks the 14th consecutive day without new cases, as the countdown to 42 days continues. Additionally, 281 contacts have been released from isolation, though they remain under close monitoring.
Regional Context
Marburg Virus, like Ebola, is a filovirus that causes highly infectious viral hemorrhagic fever, with a fatality rate that can reach up to 88%. The virus is transmitted to humans through fruit bats and spreads through human-to-human contact, particularly via blood, bodily fluids, and secretions. The Marburg Virus Disease outbreak in Tanzania follows Rwanda’s declaration of a similar outbreak on September 27, 2024. Given their proximity, effective regional and international coordination is critical to prevent further spread. Since the 1980s, eastern, central and southern Africa has repeatedly faced outbreaks of Viral Hemorrhagic Fevers (VHF). Marburg outbreaks across Africa have exhibited varying mortality rates, with the most severe occurring in Angola (2004–2005) where 374 cases resulted in 329 deaths, yielding a case fatality rate (CFR) of 88% (3). Notable outbreaks include the 1998 – 2000 epidemic in the Democratic Republic of Congo (154 cases, 128 deaths, 83% CFR) and the 2023 Marburg outbreak in Tanzania (9 cases, 6 deaths, 66.7% CFR).In 2024, Rwanda experienced an outbreak with 66 cases and 15 deaths, yielding a CFR of 22.7%.
Public Health Response and Preventative Measures
To curb Marburg virus transmission, Tanzania’s Ministry of Health has launched public awareness campaigns on MVD symptoms, enforced strict infection control measures, and discouraged contact with the deceased during burial. Efforts include early detection, reporting, outbreak investigations, isolation of cases, and 21-day follow-ups. Public Health Emergency Operations Centers (PHEOCs) are coordinating the response.
Government Response and Pillar Approach
The Tanzanian government has swiftly intensified its multi-pillar approach to managing the Marburg outbreak. Key pillars include: Coordination, ensuring effective communication and collaboration among all stakeholders, with a community-centered focus; Surveillance and Disease Intelligence, prioritizing contact tracing and monitoring of suspected and confirmed cases; WASH and Point of Entry, strengthening water, sanitation, and hygiene measures, along with enhanced screening at all eight border points; Risk Communication and Community Engagement, raising awareness with clear Kiswahili messaging and involving 191 CHWs across 17 wards and 373 hamlets in Biharamulo District; Logistics, ensuring timely distribution of health supplies and resources; Laboratory Capacity, expanding diagnostic capabilities through mobile labs and the National Public Health Laboratory for case confirmation; Case Management and Dignified Burial, strengthening healthcare facilities, ensuring PPE for workers, and upholding safety in burial practices; Mental Health and Psychosocial Support, offering mental health services and addressing stigma, trauma, and psychological impacts; and Traditional Medicine and Research, ensuring that traditional medicine practices do not contribute to the spread of MVD.
Additionally, on the 21st January, the Government issued Travel Advisory No. 15, which includes a requirement for all travelers to complete an online surveillance form at https://afyamsafiri.moh.go.tz. Travelers will also receive essential information via the toll-free number 199.
Collaboration and Research
International partnerships, especially with WHO, Africa CDC, the US CDC, MSF and UNICEF are vital for providing technical expertise, collaborative Filovirus research, and resources to support Tanzania’s efforts.
The global health community can learn from Tanzania’s response that effective political leadership, multi-sectoral engagement, strong coordination mechanisms, and timely reporting are essential for the successful containment of Marburg Virus Disease.
Conclusion and Call to Action
Immediate, coordinated actions are crucial to contain the Marburg virus outbreak in Tanzania. The collective efforts of the government, international partners, healthcare workers, and the public are key to preventing further spread.
Author: Dr. Ntuli Angyelile Kapologwe MD, PhD is the Director of Preventive Health Services, Tanzania Ministry of Health. He is a health systems leader with 20 years of experience in policy formulation and implementation at Tanzania’s Ministry of Health and the President’s Office Regional Administration and Local Government. He has led preparedness and response efforts for the COVID-19 vaccination campaign and the 2023 Marburg Virus Disease outbreak.
Competing Interest: Author is a Director of Preventive Health Services at the Ministry of Health
Handling Editor: Neha Faruqui