About a month after the World Health Organization (WHO) confirmed an outbreak of Marburg virus in Ghana, the University of Abuja Teaching Hospital (UATH), Gwagwalada, has notified the hospital community “of an outbreak” of the virus. In a leaked internal memo on August 12, 2022, which was signed by the Deputy Director of UATH’s information unit, Sani Suleiman, the hospital notified of the virus and called for caution. The memo was addressed to the staff and heads of various departments in the health facility. Mr. Suleiman confirmed the authenticity of the memo titled, “Outbreak of Marburg Disease and COVID-19 Infections,” in a phone interview with the press but said that there was no cause for alarm.
The memo reads in part, “The Management wishes to notify the entire hospital community of an outbreak of Marburg disease and upsurge in COVID-19 infection. Consequently, the attention of all Heads of Department and members of staff is hereby drawn to ensure adequate surveillance and hygiene by observing all protocols of prevention.” Marburg is a highly infectious disease that is said to be in the same family as the virus that causes Ebola, both of which are members of the Filoviridae family (filovirus). It causes a rare, highly infectious viral hemorrhagic fever. The non-airborne disease is transmitted to people from fruit bats as a result of prolonged exposure to mines and caves that have Rousettus bat colonies. It spreads through human-to-human transmission via direct contact with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials contaminated with these fluids.
The hospital management clarifies the memo to avert panic.
The Nigeria Centre for Disease Control (NCDC) said, “The initial symptoms of the disease include sudden onset of high fever, chills, headache, body aches which may be accompanied by a rash, most prominent on the chest, back and stomach, nausea/vomiting, chest pain, sore throat, abdominal pain by the fifth day of illness. Increase in severity of the illness can be heralded by the appearance of severe watery diarrhea, jaundice, inflammation of the pancreas, severe weight loss, bleeding from multiple areas, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction and/or failure. In fatal cases, death occurs often between 8 and 9 days after symptom onset. The case fatality rate for MVD is estimated to be 24 to 88 percent.”
When he was speaking to the press on August 14, 2022, Mr. Suleiman advised Nigerians not to panic and insisted that the cases are still being investigated. He said the memo was a cautionary one, which was addressed to the hospital’s workers and not for public consumption. He urged the media to report it responsibly to avoid unnecessary panic. “This is supposed to be an internal memo meant only for the management and staff but released to the public. It was simply meant to caution the workers against abandoning the protocols. I wrote that memo from one committee’s report to sensitize the people in the hospital further measures will be explained further for people to understand. So, it is not like there is an outbreak in Nigeria or in the FCT,” he said.
The history of the virus outbreak and NCDC’s guidelines.
The Ghana Health Service (GHS) confirmed the first two cases of the virus in July. This came after a preliminary finding of the cases from the Ashanti Region earlier in July by the country’s Noguchi Memorial Institute for Medical Research. The results were reportedly sent to the Institut Pasteur de Dakar (IPD), Senegal, with support from WHO, where they were confirmed to be the Marburg virus. “The two patients from the southern Ashanti region – both deceased and unrelated – showed symptoms including diarrhea, fever, nausea and vomiting. They had been taken to a district hospital in Ashanti region,” the WHO disclosed in the preliminary report. The GHS head, Patrick Kuma-Aboagye, said 98 people identified as contact cases were then placed under quarantine, adding that “this is the first time Ghana has confirmed Marburg virus disease.”
Although the NCDC is yet to react to the latest discovery of cases and its investigation, it had issued some guidelines in July aimed at guiding the public on preventive measures. The agency said it was on a high alert following the Ghanaian experience. Its Director-General, Mr. Ifedayo Adetifa, said in the statement that no case of Marburg virus has been reported in Nigeria but that several measures were being put in place to prevent its outbreak. Mr. Adetifa said following the proximity of Ghana to Nigeria as well as the WHO alert, the NCDC led multisectoral National Emerging Viral Hemorrhagic Diseases Working Group (EVHDWG) has conducted a rapid risk assessment to guide in country preparedness activities.
The NCDC highlights preventive measures for Nigerians.
The NCDC has highlighted measures to which Nigerians should adhere to prevent the outbreak of the virus in Nigeria. The agency urged Nigerians to avoid non-essential travel to locations where the outbreak is reported, and avoid direct contact with blood, saliva, vomit, urine, and other bodily fluids of people suspected or confirmed to have the virus. Other measures announced by the NCDC read: “Ensure all persons with the symptoms described above are promptly taken to healthcare facilities for diagnosis and initiation of supportive treatment. In suspected and/or confirmed MVD cases, direct physical contact should be avoided by ensuring strict isolation, the use of protective gowns, masks, gloves and safe disposal of needles, bedding, and other contaminated materials. Strict practice of infection prevention control in the healthcare setting for all suspected patients.”