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Tanzania - Outbreak of suspected Marburg Virus Disease in Kagera region - 10 cases including 10 deaths (WHO, January 14, 2025) - MOH: laboratory results negative for Marburg - Outbreak confirmed January 20 - declared over March 13, 2025
Tanzania - Outbreak of suspected Marburg Virus Disease in Kagera region - 10 cases including 10 deaths (WHO, January 14, 2025) - MOH: laboratory results negative for Marburg - Outbreak confirmed January 20 - declared over March 13, 2025
Outbreak of suspected Marburg Virus Disease - United Republic of Tanzania
14 January 2025
Description of the situation
Introduction
On 13 January 2025, WHO informed its Member States and IHR State Parties of an outbreak of suspected Marburg Virus Disease (MVD) in the Kagera region of the United Republic of Tanzania using our secure web-based platform—the Event Information Site (EIS). Under the International Health Regulations, the EIS is used to issue rapid alerts to Member States of acute and rapidly developing public health risks and events with possible international implications. Summary of the situation
On 10 January 2025, WHO received reliable reports from in-country sources regarding suspected cases of MVD in the Kagera region of the United Republic of Tanzania. Six people were reported to have been affected, five of whom had died. The cases presented with similar symptoms of headache, high fever, back pain, diarrhoea, haematemesis (vomiting with blood), malaise (body weakness) and, at a later stage of disease, external haemorrhage (bleeding from orifices).
As of 11 January 2025, nine suspected cases were reported including eight deaths (case fatality ratio (CFR) of 89%) across two districts – Biharamulo and Muleba. Samples from two patients have been collected and tested by the National Public Health Laboratory. Results are pending official confirmation. Contacts, including healthcare workers, are reported to have been identified and under follow-up in both districts.
The Bukoba district in Kagera region experienced its first MVD outbreak in March 2023, and zoonotic reservoirs, such as fruit bats, remain endemic to the area. The outbreak in March 2023 lasted for nearly two months with nine cases including six deaths.
Public health response
National rapid response teams have been deployed to support outbreak investigation and response; surveillance activities have been intensified with contact tracing ongoing; laboratory samples from recent cases have been sent for confirmation at the National Public Health Laboratory. A mobile laboratory is located in Kagera region and treatment units have reportedly been established.
WHO risk assessment
The risk of this suspected MVD outbreak is assessed as high at the national level due to several concerning factors. The suspected outbreak thus far involves at least nine suspected cases, including eight deaths, resulting in a high CFR of 89%. Healthcare workers are included among the suspected cases affected, highlighting the risk of nosocomial transmission. The source of the outbreak is currently unknown.
The reporting of suspected MVD cases from two districts suggests geographic spread. The delayed detection and isolation of cases, coupled with ongoing contact tracing, indicates lack of a full information of the current outbreak. More cases are expected to be identified.
The regional risk is considered high due to Kagera region's strategic location as a transit hub, with significant cross-border movement of the population to Rwanda, Uganda, Burundi and the Democratic Republic of the Congo. Reportedly, some of the suspected cases are in districts near international borders, highlighting the potential for spread into neighbouring countries. MVD is not easily transmissible (i.e. in most instances, it requires contact with the body fluids of a sick patient presenting with symptoms or with surfaces contaminated with these fluids). However, it cannot be excluded that a person exposed to the virus may be travelling.
The global risk is currently assessed as low. There is no confirmed international spread at this stage, although there are concerns about potential risks. Kagera region, while not close to Tanzania's capital or major international airports, is well-connected through transportation networks, and has an airport that connects to Dar es Salaam for onward travel outside Tanzania by air. This highlights the need for enhanced surveillance and case management capacities at relevant points of entry and borders, and close coordination with neighbouring countries to strengthen readiness capacities.
WHO advice
Human-to-human transmission of Marburg virus is primarily associated with direct contact with the blood and/or other bodily fluids of infected people. WHO advises the following risk reduction measures be taken as an effective way to reduce MVD transmission and control an outbreak. Prevention: Protective measures individuals should take to reduce human exposure to the virus include:
Reduce the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their body fluids. Close physical contact with MVD patients should be avoided.
People suspected or confirmed for MVD should immediately seek care in health facilities and be isolated in a designated treatment centre for early care and to avoid transmission at home.
Community and family members should avoid caring for symptomatic individuals at home, and avoid touching bodies of people deceased with MVD symptoms. They should avoid touching other potentially contaminated items and surfaces. They should be encouraged to go to a health facility for assessment and treatment if they have symptoms.
Reduce the risk of bat-to-human transmission arising from prolonged exposure to mines or caves inhabited by fruit bat colonies. During work or research activities or tourist visits in mines or caves inhabited by fruit bat colonies, people should wear gloves and other appropriate protective clothing (including masks). During outbreaks, all animal products (blood and meat) should be thoroughly cooked before consumption.
Coordination: Multisectoral coordination and pillar meetings at all levels and sharing of detailed situation reports is encouraged. Involvement of different stakeholders and partners in preparedness and response activities is also encouraged. To ensure an effective and sustained response, resource mobilization efforts within the government and with partners are recommended. Risk communication and community engagement: Raising public awareness and engaging with communities are important for successfully controlling MVD outbreaks. This includes raising awareness of symptoms, risk factors for infection, protective measures and the importance of seeking immediate care at a health facility. Sensitive and supportive information about safe and dignified burials is also crucial. This awareness should be increased through targeted campaigns and direct work with communities. Special attention should be given to high-risk groups, such as traditional healers, clergy, and community leaders, who may inadvertently facilitate disease spread, and who are important sources of information for the community. Misinformation and rumours should be addressed to foster trust and promote early symptom reporting. Surveillance: Active case detection, contact tracing, and alert management across affected and neighbouring regions should be intensified. Community-based surveillance systems should be strengthened to promptly identify and report new cases, particularly in high-risk areas. Close monitoring of healthcare workers, family members and individuals who have had contact with suspected cases or other high-exposure settings should be ensured. Surveillance capacities should also be intensified at relevant points of entry and borders to reduce the risk of further spread, including internationally.
Infection prevention and control (IPC) measures: critical infection prevention and control measures should be implemented and/or strengthened in all health care facilities, per WHO’s Infection prevention and control guideline for Ebola and Marburg disease, which highlighted the importance of the rapid implementation of the IPC ring approach including but not limited to IPC rapid assessment, decontamination of the health facilities and household and early detection and identification of the cases through the screening and isolation of the suspected cases to minimize the transmission risk.
Health workers caring for patients with confirmed or suspected MVD should apply transmission-based precautions in addition to: standard precautions, including appropriate use of personal protective equipment (PPE) and hand hygiene according to the WHO 5 moments to avoid contact with patient’s blood and other body fluids and with contaminated surfaces and objects. Waste generated in healthcare facilities must be safely segregated, safely collected, transported, stored, treated and finally disposed. Follow the national guidelines, rules and regulations for safe waste disposal or follow the WHO’s guidelines on safe waste management
Patient-care activities should be undertaken in a clean and hygienic environment that facilitates practices related to the prevention and control of health-care-associated infections (HAIs) as outlined in Essential environmental health standards in health care. Safe water, adequate sanitation and hygiene infrastructure and services should be provided in healthcare facilities. For details on recommendations and improvement, follow the WASH FIT implementation Package
Laboratory testing: The processing and analysis of samples should be expedited, with results promptly shared with responders and clinicians to guide patient management, containment strategies and broader response efforts. This includes genomic sequencing on positive samples. International referral of samples to a regional reference laboratory should be considered for inter-laboratory comparison. Evaluation of candidate medical countermeasures: There are no licensed vaccines or therapeutics against MVD. Several candidate vaccines are in the pipeline and outbreaks offer an opportunity to assess their efficacy and safety. There are protocols available and a network of experts in filovirus ready to support national researchers. Safe and dignified burials: Safe and dignified burial protocols should be implemented for people who have died to minimize community exposure. Additional training and equipment for healthcare workers and burial teams should be provided to ensure safe management of MVD-related fatalities. Thorough community engagement is required to ensure that affected communities are empowered to adhere to the protocol. Case management and mental health and psychosocial support: Isolation and treatment facilities should be adequately equipped to ensure the safety and efficacy of patient care, while simultaneously preventing the spread of the disease. Supportive care such as rehydration, symptom management, and psychological support for patients and their families is essential to improving survival rates and mitigating the outbreak's impact. Border health and cross-border coordination: Surveillance and response capacities should be strengthened at relevant points of entry, onboard conveyances, and in border regions to prevent further spread, including internationally. Cases, contacts and individuals in affected areas who present signs and symptoms compatible with case definitions should be advised not to travel in line with WHO’s border health and points of entry technical guidance for filovirus disease outbreaks. Collaboration with neighbouring countries should be enhanced to harmonize reporting mechanisms, conduct joint investigations, and share critical data in real-time. Surrounding countries should enhance readiness activities to enable early case detection, isolation and treatment. Preparedness and Readiness: Readiness assessments in high-risk regions should be conducted to ensure response mechanisms, such as mobile labs and isolation units, are adequately equipped to manage new cases.
Based on the current risk assessment, WHO advises against any travel and trade restrictions with the United Republic of Tanzania.,,
On 13 January 2025, @WHO informed its Member States and International Health Regulations (IHR) State Parties of an outbreak of suspected #Marburg Virus Disease in Kagera region, #Tanzania, using our secure web-based platform – the Event Information Site (EIS).
Under the IHR, the EIS Platform is used by WHO to issue rapid alerts to Member States of acute and rapidly developing public health risks and events with possible international implications.
We are aware of 9 cases so far, including 8 people who have died. We would expect further cases in coming days as disease surveillance improves.
WHO has offered its full assistance to the government of Tanzania, and to affected communities.
Marburg virus disease is an infectious, severe and often fatal disease caused by a filovirus. Rapid action saves lives, including ensuring people with symptoms receive prompt care.
We recommend neighboring countries be on alert and prepared to manage potential cases. We do not recommend travel or trade restrictions with Tanzania at this time.
On 09/01/2025, the regional EOC received an alert from Biharamulo DC following occurrence of unusual illness which had affected about 6 cases among which 5 are deaths. These cases exhibited similar signs of headache, high fever, back pain, diarrhea, vomiting blood, body weakness and at the later stage before death they exhibited bleeding from open areas. • The index case named EE, with age 27yrs, Female G2P1L1 at 24 weeks of pregnancy from Chankende Hamlet of Katerera village Ruziba in biharamulo who developed headache,fever, body pain, abdominal pain and per vaginal bleeding. She was managed at Rukaragata Health center where she had a miscarriage. She later worsened and later referred to Biharamulo CDH and on 16th December 2024 the patient died, no sample had been taken and unsupervised burial service.
Description
On January 9, 2025, the Regional Emergency Operations Center (EOC) in Kagera Region reported an outbreak of an unknown illness originating in Biharamulo District. To date, nine cases have been identified, resulting in eight fatalities (Case Fatality Rate: 88.9%). The illness is characterized by symptoms such as high fever, headache, back pain, diarrhea, vomiting blood, and bleeding from open areas at advanced stages. Key Details: Index Case: A 27-year-old pregnant woman from Chankende Hamlet in Katerera village, who succumbed after a miscarriage. Transmission Chain: The disease has affected close family members, traditional healers, healthcare workers, and others who came into contact with the deceased. Geographical Spread: Cases are concentrated in Biharamulo District, with recent suspected deaths reported in Muleba. Current Cases: One patient remains in isolation at Biharamulo District Hospital and is reportedly stable. Two additional deaths were reported in Muleba following a burial event linked to the outbreak.
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Home / World / Africa
No confirmed cases of Marburg virus in Tanzania, says Africa CDC
By Geoffrey Mburu in Nairobi, Kenya | chinadaily.com.cn | Updated: 2025-01-17 21:26
The Africa Centres for Disease Control and Prevention said on Thursday that there are no confirmed cases of Marburg virus in Tanzania, despite reports on Tuesday by the World Health Organization indicating that suspected cases of the virus had been identified in the Kagera region.
The official communication from the government of Tanzania on Wednesday, according to the Africa CDC, said that there were no confirmed cases of Marburg virus based on the testing conducted by the government.
"We have already provided 200 test kits to Tanzania when we had the Marburg virus in Rwanda. We are going to provide a number of healthcare experts who are ready to be deployed in Tanzania," said Jean Kaseya, director general of Africa CDC...
Special Briefing on Mpox and other Health Emergencies | Jan. 16, 2025
Excerpts form the video:
3:29
... Transcript:
Question:
...from New York Times
Priwanka Runwal...
33:59
...please help me understand in case I'm getting this wrong but the five samples that were tested from Tanzania for Marburg weren't positive for Marburg in the lab but it's suspected that it's Marburg because of the symptoms that have been detected ...
Answer:
36:00
We need first to share the agreement based on some international regulations that we have. In Africa when we have an outbreak at country level, as it was the case in Rwanda, it is firstly the responsibility of the government to declare the outbreak and then the CDC and other partners will come to support because nothing can be without the leadership of the government and ownership of the government. If now we have more than one country affected, it would become now the mandate of the Africa CDC to lead the response. That could be at multycountry level, at regional level or at Continental level. When we had the Marburg outbreak in Rwanda, it was the government of Rwanda declaring the outbreak and then putting in place all mechanism and Africa CDC came to support, ...UNICEF and all other partners including the US government. In case of Tanzania, we were proactive. Not only in Tanzania but in all other countries around neighboring countries of Rwanda, we talk about Burundi, we talk about Uganda, we talk about Tanzania and others and DRC. Africa CDC provided test kits to all of these countries and even we supported training for rapid detection of cases if we could have cases. We did the same in Tanzania. We are following the leadership of the government as I said in my presentation. Yesterday there was an official communication from the government of Tanzania saying that there is no confirmation of Marburg based on the result they got. We are consistent with what we are saying. We are supporting Tanzania. We remain committed for any kind of support Tanzania will need . I have my director of the laboratory here, Dr Yenew and all other colleagues who are working surveillance and IPC and all other sectors to provide support to Tanzania. For now, this is the comment we can make, and we saw the communique talking about the rumor on suspected marburg cases. We don't want to comment more, we are working with the government and we know when the government will request, will need our support, they will request and Africa CDC will remain available to provide the support.
Tanzania confirms outbreak of Marburg virus disease
20 January 2025
Dodoma – Tanzania today confirmed an outbreak of Marburg virus disease in the northwestern Kagera region after one case tested positive for the virus following investigations and laboratory analysis of suspected cases of the disease.
President of the Republic of Tanzania, Her Excellency Samia Suluhu Hassan, made the announcement during a press briefing alongside World Health Organization (WHO) Director-General, Dr Tedros Adhanom Ghebreyesus, in the country’s administrative capital Dodoma.
“Laboratory tests conducted at Kabaile Mobile Laboratory in Kagera and later confirmed in Dar es Salaam identified one patient as being infected with the Marburg virus. Fortunately, the remaining suspected patients tested negative,” the president said. “We have demonstrated in the past our ability to contain a similar outbreak and are determined to do the same this time around.”
A total of 25 suspected cases have been reported as of 20 January 2025, all of whom have tested negative and are currently under close follow-up, the president said. The cases have been reported in Biharamulo and Muleba districts in Kagera.
“We have resolved to reassure the general public in Tanzania and the international community as a whole of our collective determination to address the global health challenges, including the Marburg virus disease,” said H.E President Hassan.
WHO is supporting Tanzanian health authorities to enhance key outbreak control measures including disease surveillance, testing, treatment, infection prevention and control, case management, as well as increasing public awareness among communities to prevent further spread of the virus.
“WHO, working with its partners, is committed to supporting the government of Tanzania to bring the outbreak under control as soon as possible, and to build a healthier, safer, fairer future for all the people of Tanzania,” said Dr Tedros. “Now is a time for collaboration, and commitment, to protecting the health of all people in Tanzania, and the region, from the risks posed by this disease.”
Marburg virus disease is highly virulent and causes haemorrhagic fever. It belongs to the same family as the virus that causes Ebola virus disease. Illness caused by Marburg virus begins abruptly. Patients present with high fever, severe headache and severe malaise. They may develop severe haemorrhagic symptoms within seven days.
“The declaration by the president and the measures being taken by the government are crucial in addressing the threat of this disease at the local and national levels as well as preventing potential cross-border spread,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Our priority is to support the government to rapidly scale up measures to effectively respond to this outbreak and safeguard the health of the population,”
Tanzania previously reported an outbreak of Marburg in March 2023 – the country’s first – in Kagera region, in which a total of nine cases (eight confirmed and one probable) and six deaths were reported, with a case fatality ratio of 67%.
In the African region, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Ghana, Kenya, Equatorial Guinea, Rwanda, South Africa and Uganda.
Marburg virus is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials. Although several promising candidate medical countermeasures are currently undergoing clinical trials, there is no licensed treatment or vaccine for effective management or prevention of Marburg virus disease. However, early access to treatment and supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improve survival.
Local health authorities in Tanzania are working to identify infected people and sources of transmission, conduct investigations, take action to prevent further transmission, and educate communities and the public about the risks and dangers of Marburg.
Consider getting travel insurance before you travel, including health and medical evacuation insurance, to cover yourself in case delays, injuries, or illnesses occur on your trip.
Avoid contact with sick people who have symptoms, such as fever, muscle pain, and rash.
Avoid contact with dead bodies or items that have been in contact with dead bodies, participating in funeral or burial rituals, or attending a funeral or burial.
Avoid contact with fruit bats or entering the caves and mines where they live.
Watch your health for symptoms of Marburg while in the outbreak area and for 21 days after leaving. If you develop fever, chills, headache, muscle aches, rash, chest pain, sore throat, nausea, vomiting, diarrhea, or unexplained bleeding or bruising (a late stage of illness):
Separate yourself from others (isolate) immediately.
Do not travel.
Contact local health authorities or a healthcare facility for advice. Calling ahead before going to a healthcare facility helps the facility prepare for your arrival, including contacting health authorities and taking any precautions needed to protect staff and other patients.
Region of Tanzania (Kagera) with Marburg virus disease outbreak (View larger)
What is Marburg?
Marburg virus disease (Marburg) is a rare and deadly disease that has, at times, caused outbreaks in several African countries. The disease is named after the city in Germany where it was first reported in 1967.
Marburg is a viral hemorrhagic fever. Symptoms include fever, chills, headache, muscle aches, rash, chest pain, sore throat, nausea, vomiting, diarrhea, or unexplained bleeding or bruising (a late stage of illness).
Marburg is spread by contact with blood or body fluids of a person infected with or who has died from Marburg. It is also spread by contact with contaminated objects (such as clothing, bedding, needles, and medical equipment) or by contact with animals, such as fruit bats and nonhuman primates, who are infected with Marburg virus.
Infection with Marburg virus is often fatal. There are no approved vaccines or treatments for Marburg. Page last reviewed: January 23, 2025
WHO ramps up support for Tanzania’s Marburg outbreak response
24 January 2025
Biharamulo, Tanzania – A team of public health emergency experts from World Health Organization (WHO) has deployed to Tanzania’s north-western Kagera region to support the health authorities strengthen response to an outbreak of Marburg virus disease.
The WHO experts are part of an initial 20-member inter-agency team from Médecins Sans Frontières, Tanzania Red Cross Society and UNICEF in the field working with national and local health officials to reinforce disease surveillance, diagnostic capacity, ensure effective case management, and help strengthen public awareness to prevent further transmission of the virus.
WHO has also shipped 1.4 tonnes of essential medical supplies including diagnostic kits and personal protective equipment to Tanzania from its Regional Emergency Response Hub in Nairobi. As of 23 January 2025, there were two confirmed and 29 suspected cases reported. A total of 281 contacts are being closely monitored.
“Our focus is to rapidly halt the spread of the virus and save lives by working closely with the government to ensure a coordinated and effective response,” said Dr Charles Sagoe-Moses, WHO Representative in Tanzania.
The ongoing outbreak is Tanzania’s second of Marburg virus disease, following a successful containment of the first in 2023, which occurred in the same region. Lessons learned from that experience, coupled with the government’s investments in emergency preparedness, are proving crucial in addressing the current challenge.
WHO is committed to working with Tanzanian authorities and partners to bring the outbreak under control. The Organization has allocated US$ 3 million from its Contingency Fund for Emergencies to help accelerate the outbreak control efforts.
Marburg virus disease is a highly contagious illness that causes haemorrhagic fever. It spreads through direct contact with the bodily fluids of infected individuals or contaminated materials. Although there are no approved treatments or vaccines, early supportive care can significantly improve outcomes for patients.
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 05: 27 January to 02 February 2025
Data as reported by: 17:00; 02 February 2025
... United Republic of Tanzania Marburg Virus Disease
10 cases
10 Death
100.0% CFR
EVENT DESCRIPTION
On 20 January 2025, the Government of Tanzania
officially declared an outbreak of Marburg virus disease
(MV D) following post-mortem laboratory confirmation
of a deceased patient in Kagera Region, northwestern
Tanzania. This marks the country’s second reported
Marburg virus outbreak, the first of which occurred in
March 2023 in the same region, involving nine cases and
six deaths (case fatality ratio: 67.0%).
The index case is a 27-year-old female from Biharamulo
District, Kagera Region, who died on 19 January
2025 after presenting with signs and symptoms
typical of Marburg virus disease. Confirmation of this
outbreak followed earlier reports of suspected cases
received by WHO from credible sources on 10 January
2025. A retrospective investigation established an
epidemiological link between the index case and a
cluster of eight deaths that occurred between December
2024 and early January 2025 in Biharamulo and Muleba
districts. The deceased individuals reportedly exhibited
Marburg-like symptoms before their deaths but were not
sampled or tested prior to burial. The first case in this
cluster was reported to have developed symptoms on 9
December 2024.
A second confirmed case was reported on 20 January
2025, following positive laboratory test results for
Marburg virus obtained at the Kabaile Mobile Laboratory
in Kagera Region. The diagnosis was subsequently
confirmed by RT-PCR at the National Reference
Laboratory in Dar es Salaam. The case died on 28
January 2025 while undergoing care.
As of 31 January 2025, a total of 10 cases, all dead
(CFR 100.0%), have been reported in Kagera Region.
Of these, two are laboratory-confirmed, while the
remaining eight are classified as probable cases with
epidemiological links to the index case. The reported
cases range in age from 1 to 75 years, with a median age
of 30 years. Females account for 70.0% (n=7) of the total
cases.
No new cases have been reported since 20 January
2025. A total of 281 contacts have been identified for
follow-up, of whom 241 have reportedly completed the
21-day follow-up period as of 02 February 2025.
PUBLIC HEALTH ACTIONS
A national task force was set up to coordinate the response
to the event. At the subnational level, regular coordination
meetings are being held in Kagera Region, including joint
pillar meetings at the Biharamulo District command post.
The Ministry of Health developed a national response
plan to guide response activities. Additionally, a national
rapid response team was deployed to the affected region
to enhance outbreak investigation and response, with
technical and operational support from WHO and health
partners.
Surveillance activities continue with active case finding
and contact tracing across affected areas. Suspected
cases meeting the outbreak case definition are routinely
sampled and tested for Marburg virus disease. As of 2
February 2025, 79 suspected cases have been tested,
all of which returned negative results.
Contact tracing is ongoing, with 281 contacts identified
and followed daily as of 2 February 2025. Of these, 241
have completed the 21-day follow-up period. Screening
of travellers departing from Kagera Region is in progress
at key points of entry and exit, including Lusahunga
and Arusha airports. So far, 7,975 travellers have been
screened across 15 screening points.
Healthcare worker sensitization sessions on infection
prevention and control are ongoing across Kagera
and other regions. The Katoke Marburg Treatment Unit
has been upgraded with enhanced decontamination
and doffing areas, and the facility has been fully
decontaminated. Daily decontamination of ambulances,
treatment units, and affected locations is being conducted
to minimize the risk of further transmission.
Public awareness campaigns, including health education,
door-to-door outreach by community health workers, and
public announcements in high-risk areas, are ongoing.
The national Afya call center remains active and available
to the public for reporting rumours or seeking other public
health inquiries.
SITUATION INTERPRETATION
The confirmation of a second MVD outbreak in Tanzania
within two years, particularly in the same region, raises
concerns about persistent transmission risks. The virus
may have an established ecological niche in the region,
particularly among fruit bats that typically inhabit mines
or caves, creating the possibility for zoonotic spillovers
during visits to these areas or when conditions are
favorable. The high case fatality ratio underscores the
severity of the outbreak, resulting from the late detection. Delayed recognition of unusual deaths without timely
sampling and testing indicates missed opportunities for
early intervention, possibly due to gaps in community-
based surveillance, leading to further exposure and transmission before control measures were implemented. In the
current outbreak, national authorities need to continue implementing enhanced surveillance, risk communication,
and infection prevention and control measures. Preparedness efforts, including targeted risk communication and
community engagement activities, are needed to mitigate the potential for future outbreaks.
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