The Marburg virus can and will be contained, if everyone continues to play their part. That is the message from both the Rwanda Ministry of health, and the World Health Organisation (WHO).
Ten days after the first ever outbreak of the Marburg virus disease (MVD), in Rwanda, confidence is high that the disease will be contained in the shortest time possible. This is in large measure thanks to a response and preparation that are as robust as the virus is aggressive.
As of last night, 5th October, there are fourty-six confirmed cases infected with MVD, including five since last night; twenty-nine people are in isolation undergoing treatement, there are sadly twelve fatalities, but promisingly, five have so far recovered. 1,748 have been traced and tested. The five recoveries show that the medical interventions, which improve day by day, as medical personnel learn more, are proving effective.
A Shared responsibility
Ask any Rwandan randomly, and the expected anxiety about the MVD outbreak, is allayed by complete confidence that the government is doing all that should be done to protect them. At today’s media briefing however, while thanking community, civil society organisations, and the media, for their part in raising awareness, the Minister of Health, Dr Sabin Nsanzimana, reiterated the message that containing the virus was a shared responsibility.
The virulence of MVD cannot be overstated, researchers have even suggested that in some ways, it might be more insidious than Ebola, with which it is almost identical. Listening to Dr Nsanzimana explain the manner in which the virus attacks the body, it is difficult not to imagine an especially accomplished, deadly military, identifying the enemy’s strongest and weakest points, before systematically degrading the former and concentrating its attack on the latter.
No time to lose, don’t be fooled by Malarial symptoms
The disease fatality rate has been put at between 24-88 percent, depending on several factors, but primarily, how quickly it is detected. People who feel any of the MVD symptoms, or who think they have come in contact with an infected person, are urged to immediately inform the health authorities, by calling the Rwanda Biomedical Centre, number 114.
The difficulty of detecting MVD is exacerbated by its apparent ability to camouflage its symptoms as any number of diseases, especially those of Malaria. Anyone who thinks they have Malaria symptoms, is strongly recommended to immediately inform the health authorities on 114. The sooner MVD is detected, the better the chances of survival for the infected person.
The message is the same, for anyone who thinks they have come in any contact with an infected person. The virus’s incubation period is 2-21 days, before an infected person shows symptoms. And when they come, they do so suddenly, there is no time to lose. If the health authorities have been made aware that a person may be infected, they can test and monitor, and treat them, if it turns out that the test is positive for MVD. Monitoring is crucial. Some individuals have tested negative, only to test positive when tested again.
Treatment and vaccines
Since last night, Rwanda has secured 700 doses of vaccines, by today, the necessary checks for vaccines had been done, and vaccinations started. More are needed, in the thousands rather than in the hundreds that are available, but the minister was keen to express deep gratitude to the Sabin Vaccine Institute, which shared the vaccines. He is especially thankful for the speed with which the vaccines have arrived in Rwanda, within a week, where they can normally take weeks, or even longer.
The first to be vaccinated will be the healthcare workers, who are on the frontline in the fight to contain the virus. Next will be people who have come in contact with an infected person. Should more vaccines become available, the “vaccination ring” will be widened.
For those under treatment, among the drugs available, remdesivir, first introduced to the general public during the Sars-Cov-2 pandemic, has proven to be effective. The minister was also keen to thank partners who have made monoclonal antibodies available, to be used as part of an array of still experimental treatment for MVD. Monoclonal antibodies are laboratory made proteins, which essentially alert the body’s immune system to be better prepared for an attack.
Heroes to be sung
Healthcare workers are literally on the frontline of the fight agaist MVD, as they are in any emergency. Most of the fatalities were among healthcare workers, as are the majority of those under treatment. Yet, they still go forward to treat others, despite knowledge of the risk to their own lives.
“It is sad that it is those who help others, who are also the ones at the greatest risk” said Rwanda World Health Organisation (WHO) country director, Dr Brian Chilombo, as he offered his condolences for the careworkers who lost their lives.
While such dangers for healthcare workers are ever present, both the minister and Dr Chilombo, noted that everything that can be done to support and protect the medical personnel is being done. The support is wraparound, and includes their families.
Staying Safe
There is much that everyone can do to help healthcare workers as they battle to contain the virus. For all its virulence, MVD is not as contagious as was Covid-19. Heightened awareness of hygiene, can go along way in protecting against infection. You can only be infected by touching secretions from an infected person. That includes bed sheets or clothing, or surfaces an infected person may have left the virus.
Partners And Friends In need
As soon MVD was detected, and Rwanda alerted WHO and others, as required under the International Health Regulation, the organisation has been on hand to support Rwanda, in almost every aspect of the fight against the virus.
A complex set of “pillars,” established by the government, divides responsibilities in combating the virus. These include everything from detection of the disease, tracing it, supplies, including any medicines and needed equipment, like Personal Protection Equipment (PPE), for instance, treatment, budget requirements, in short, everything that is necessary to ensure containment of the disease. In all this, WHO and its own partners, have worked side by side with the government of Rwanda.
The organisation and its partners are integrated within the government’s own framework, coordinating both with each other and the government. Once the government identifies a need, or a gap to be filled, WHO and the partners coordinate and determine who among them is best placed to privide the need or fill the gap.
A number of specialists arrived last week to support Rwandan researchers for instance, and others are expected. Other help include testing equipment, PPE, to name just a couple of essential needs.
Responsibility Is National, Regional And Global
In containing the disease, Rwanda is protecting not just itself, but also the region and beyond. An example is two individuals who travelled to Germany and Belgium. The Rwanda authorities alerted both their German and Belgian counterparts, tests were conducted and thankfully both individualls tested negative for MVD.
Rwanda has further put in place procedures at points of entry, to ensure that no one who might be infected, or who has been at risk of infection, enters or leaves the country undetected.
Rumours Aid The Virus
A new, somewhat unlovely word, has entered the English lexicon, Infodemic. This particular virus is usually spread through social media. There was evidence of it in the MVD outbreak, when social media was abuzz with rumours of “a mysterious disease” in Rwanda.
Some of those spreading the misinformation were anti Rwanda groups and individuals, who gleefully wanted to spread any bad news about country. Their malice is amplified by those who spread any rumour, especially if it seems alarming.
“Cross and double check any information you hear” urged Dr Chilombo, “call the government information service, check the government and WHO websites, the information is there.”
“A lie can travel half way round the world, while the truth is still putting on its boots” so, the writer and satirist Mark Twain is reputed to have observed.
As Rwandan researchers noticed that some healthworkers were complaining of an unidentified illness, and begun to investigate, social media seemed to believe it already had the answers.
It has been claimed that by the laws of probability, given a sufficient number of keyboards, and time, a group of monkeys, can bash out the entire works of shakespeare. If that were to be proven, it would be more than social media is cable of in any attempt to accurately identify any outbreak.
In short, social media is not where you find information which could mean life or death, when you most need that information.
Reassuringly, irrespective of what social media may or may not have said or predicted, the Rwanda Ministry of Health, and WHO, are certain that the MVD can and will be “beaten.”
