Equatorial Guinea: Marburg Virus Disease outbreak confirmed - February 10, 2023+ - approximately 40 confirmed/probable cases (35 fatal) - Outbreak ended (June 8, 2023)

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THE REPUBLIC OF GABON
MINISTRY OF HEALTH AND SOCIAL AFFAIRS

Marburg virus epidemic in Equatorial Guinea: the Minister of Health visits the borders

Posted 11 hours ago , on 02/17/2023

As part of the preventive response against the Marburg virus disease and on the instructions of the Prime Minister, Head of Government, the Minister of Health and Social Affairs, Dr. Guy Patrick Obiang Ndong accompanied by the Resident Representative of the World Organization of Health (WHO), Dr. Magaran Monzon Bagayoko, visited the border areas of Meyo-Kyé and Mébo'o in the department of Ntem, province of Woleu-Ntem.

It was a question for the Minister and his delegation to realize the health surveillance system in these two (02) different borders on the one hand and on the other hand, to strengthen the operational and interventional capacities of the local teams in case alert. The Minister also brought a large batch of medical consumables and other health products to strengthen the logistical capacities of the surveillance teams. These are mainly personal protective equipment, hydro-alcoholic gel, thermoflash and swabs for sampling and analysis.

For Dr. Guy Patrick Obiang Ndong “we came on site to gauge the health system put in place in the border areas. With the Experts of the Operational Epidemic Response Unit (CORE) and the WHO, we again briefed the medical staff on the need to have a well-secured device. We also discussed with the politico-administrative authorities of the Department of Ntem so that they take ownership of this preventive response and become more involved in raising awareness at the community level by setting up information and community engagement mechanisms. for the people"

Opportunity for the Resident Representative of the WHO to appreciate the prevention strategy put in place by the Gabonese authorities which, according to him, has the merit of having respected the right timing: "the fact that the Gabonese authorities are very quickly on the ground , is noted insurance for the population and this further demonstrates their desire not to leave this virus on Gabonese soil” not without recalling the role of the WHO in such circumstances with the Government.

It should be recalled that the preventive response consists of epidemiological surveillance at the gateways, risk communication, community engagement and capacity building of local teams by experts from the Epidemic Response Operational Unit.

https://www.sante.gouv.ga/9-actualites/1072-epidemie-a-virus-marburg-en-guinee-equatoriale-le-ministre-de-la-sante-visite-les-frontieres/

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Translation Google

Nguema Obiang Mangue donates his salary for the management of the Marburg virus

The members of the Political Committee for Health Emergencies led by Vice President Nguema Obiang Mangue have presented the strategic plan for the 45-day quarantine of the Kie-Ntem province and part of the Wele-Nzas district.

By Constantina Nchama February 16, 2023 in Politics

The Vice President of the Republic, Nguema Obiang Mangue, donates his salary to efforts to contain the Marburg virus in the Kie-Ntem province. He has been in the work session that he has held this Wednesday with the members of the Political Committee on Health Emergencies of the country, who have presented the action plan to manage the health alert caused by hemorrhagic fever.

In addition to instructing in detail each sector represented at the dialogue table of this meeting,Nguema Obiang Mangue has reiterated the importance of a third shipment of samples to confirm the result of the laboratory in Dakar, Senegal; since there are other results made in a certified laboratory in Gabon, they came out negative; a situation that, due to the seriousness of the virus, must be treated with the greatest possible certainty.

In response to the needs of the moment, the Vice President of the Republic together with the Minister of Health and Social Welfare, Dámaso Mitoha Ondó Ayecaba, have detailed the schedule to follow and the concrete actions to be taken to safeguard the lives of more than 1,512 inhabitants of the towns. affected spread between Ebibeyin, Nsok-Nsomo and Mongomo, which are currently restricted in movement.

In this context, the Government's priority is to contain the virus and supply the population that is affected by the 45-day quarantine, providing food, drinking water, health care and fuel for the duration of this period. Likewise, evaluate the epidemiological situation to raise the health alert, if conditions improve. Since, from Saturday to date, according to the Ministry of Health and Social Welfare (Minsabs), no death or seriousness of any confirmed suspected case has been registered.

The challenge of this alert lies, according to the WHO expert at the meeting, in two aspects: the extreme care of the health workers in the red zones during the exercise of their work and cutting the chain of infections among the sick.

The contingency plan includes the ministries of Security, Social Affairs, Information, Press and Radio, Finance, Justice, Interior and Local Corporations, Minsabs, among others; and so far, subregional and international organizations such as the WHO, the Red Cross, the Cuban Medical Brigade or UNICEF have shown their support for the country, formulating their availability to help, in case it is needed.

Health currently estimates that there are more than 210 families that will be under this state of quarantine, and it is of the utmost importance to prevent the spread of the disease to the rest of the country.

The period between infection and the appearance of the first symptoms of the Marburg virus ranges from 2 to 21 days. Symptoms include high fever, severe headache, risk of fainting, abdominal cramps, nausea, vomiting, severe hemorrhagic manifestations in vomit, stool, or regular nosebleeds. Its average fatality rate is 88%.

https://ahoraeg.com/politica/2023/02/16/guinea-ecuatorial-traza-el-plan-de-accion-respecto-al-brote-del-virus-de-marburgo/

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The Government authorizes the purchase of basic necessities for the inhabitants of the quarantined areas due to the Marburg virus
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By Belgium Nvó Acaba February 21, 2023in Politics

Equatorial Guinea unlocks millions of dollars to provide humanitarian assistance to its citizens in the Kie-Ntem province and the Mongomo district isolated by the Marburg virus outbreak.

This decision was made this Monday at the session that brought together the Political Committee for Emergencies led by the Vice President of the Republic, Nguema Obiang Mangue.

During the meeting, held at the Palacio del Pueblo in Malabo, the Health and Social Affairs departments presented the invoices for essential products, logistics and material that is expected to be acquired to respond, on the one hand, to the emergency. And, on the other hand, supply basic necessities and hygienic products to citizens during the period that this precautionary measure of confinement lasts.

In the proposals presented to the Vice President of the Republic, the acquisition of medicines, imported and national consumer products such as rice, olive oil, bologna, sardines, sugar, soap, pasta, toothbrushes, bananas, cassava, stand out. taro, vegetables, smoked fish, among others.

Some food kits that will be delivered three times to some 240 families in the province of Kie-Ntem and the district of Mongomo during the duration of this enlistment.

Nguema Obiang Mangue, who wishes to protect his fellow citizens in the face of any social emergency, in addition to authorizing the purchase of these food products, has also instructed the inter-ministerial commission to ensure that the products reach those affected.

On the other hand, the president of this committee wants a good communication campaign to be put together through the massive distribution of posters and pamphlets, which contain messages to raise awareness about the measures to be followed to prevent this viral disease from spreading throughout the world. country.

https://ahoraeg.com/politica/2023/02/21/el-gobierno-autoriza-la-compra-de-productos-de-primera-necesidad-para-los-habitantes-de-las-zonas-en-cuarentena-por-el-virus-de-marburgo/

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Translation Google

The government is preparing a contingency plan for zero spread of the Marburg virus in Gabon

Editor February 21, 2023

Gabonese Prime Minister Alain Claude Bilie-by-Nze instructed the Minister of Health and his Minister Delegate to prepare a contingency plan to prevent the spread of the Marburg virus in Gabon. Minister Guy Patrick Obiang Ndong then brought together experts in epidemiological issues around the issue. The country will also be able to benefit from the support of the WHO for the implementation of the various measures.

The objective of the Gabonese government is zero spread of the virus on Gabonese territory. A system has already been put in place in the province of Woleu-Ntem. "To date, we have not had any notification of cases or symptoms in favor of Marburg hemorrhagic fever," said Gabon's Minister of Health, Guy Patrick Obiang Ndong.

Marburg virus disease has been detected and reported in Equatorial Guinea. A country with which Gabon shares borders at the level of the northern province. To date, no cases have been detected in Gabon.

https://www.gabonnationalnews.com/le-gouvernement-prepare-un-plan-de-contingence-pour-zero-propagation-du-virus-marburg-au-gabon/

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Chad: measures taken against Marburg disease

APA - N'Djamena (Chad)By APA - N'DJAMENA (CHAD) 02/20/2023

After the detection of suspected cases of Marburg disease in Cameroon, Chad is taking preventive health measures. In a press release, the Ministry of Public Health announced the establishment of a joint team to assess the country's capacities in the response and control of this disease.

He also announced a strengthening of case-by-case surveillance at the country's entry points, the strengthening of the surveillance system at N'Djamena airport for all passengers from Cameroon, Equatorial Guinea and the other countries in the Cemac zone. The toll-free number, 1313, which is used for suspected cases of Covid-19 will also be used for Marburg disease.

The Minister of Health invites health personnel to isolate any suspected case, respecting the rules of prevention, control and care. Marburg disease, considered highly contagious and virulent, has already caused several deaths in Equatorial Guinea, which shares its border with Cameroon.

It is transmitted through saliva, sexual intercourse, breastfeeding and contact with an infected person. To avoid contracting it, the health authorities invite you to wash your hands regularly with soap, to avoid all contact with an infected person, including sexual intercourse.

CA/cgd/APA

https://fr.apanews.net/health/tchad-des-mesures-prises-contre-la-maladie-de-marburg/

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Marburg virus: South Cameroon says no

Abena Jonas
Posted by
Abena Jonas
February 21, 2023

The response to the Marburg virus is organized in the South Region through the permanent monitoring committee activated on February 17, 2023 by the Governor of the South Region Félix Nguélé Nguélé.

The South Region fears an importation of the deadly Marburg virus epidemic which is knocking insistently at the gates of Cameroon. From Kye-Ossi to Ebolowa via Ambam everyone is on the alert. Cameroon, on high alert, has already deployed an important system on the ground which makes it possible to collect more data and above all to provide an effective response to this Marburg virus. For Félix Nguélé Nguélé the Governor of the South Region “it should be remembered that we have no cases yet in the South region. The health facilities are ready in case we move on to the therapeutic phase. The situation is under control”.

Situation under control

The Regional Coordination for the surveillance of the epidemic is activated. The joint Ministry of Public Health-WHO teams are on the ground for epidemiological surveillance. Permanent contact with the health authorities of the province of Kye-Ntem in Equatorial Guinea, home of the fever, has already been established.

Stayed vigilant

The Regional Coordination also indicates that the two suspected cases turned out to be negative. Highest vigilance is recommended. Raising awareness and preventing populations through barrier measures remains essential. According to Félix Nguélé Nguélé “it is good for people to know how to protect themselves from contamination. The advice is given at the level of the health areas”.
The Marburg virus would like to disturb the tranquility and serenity found after the control of covid-19. Arrangements are therefore made for everyone.

MAGLOIRE ESSONO

https://afrikinfo.net/virus-marburg-le-sud-cameroun-dit-non/

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Cameroon -

20 FEB

MARBURG VIRUS DISEASE ALERT

1. SUMMARY OF THE SITUATION

02/08/2023 : Several deaths occurred in a clinical picture of bleeding and fever in several villages in the province of KieNtem (in Equatorial Guinea) bordering the South Region by the districts of Kye-Ossi, Ambam and Olamze.
02/09/2023 : Alerting of the Public Health Emergency Operations Coordination Center (CCOUSP) at the central level and in the South region.
02/13/2023 : Confirmation of the first case of Marburg Virus Disease (MVM) in Equatorial Guinea
02/14/2023 : Activation of the Marburg disease SGI in the South region
02/15/2023 : Of the 07 suspected cases investigated and sampled to date in the Olamze (02) and Efoulan (05) Health Districts, all are negative (Centre Pasteur du Cameroun)
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https://www.ccousp.cm/2023/02/20/ale...us-de-marburg/

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MARBURG VIRUS DISEASE (MVM) SITUATION REPORT NO. 1



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https://www.ccousp.cm/download/rappo...us-marburgmvm/

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Thailand to screen for Marburg Virus at points of entry for certain travelers
By Pattaya Mail
February 22, 2023....

The Department of Disease Control (DDC) has instructed international disease control checkpoints to screen all arrivals from countries with confirmed cases of Marburg Virus Disease (MVD) as a precautionary measure.....

.DDC Director-General Dr Tares Krassanairawiwong said 200 people who are considered to be at high-risk in Equatorial Guinea have been quarantined. In addition, two confirmed cases and 42 likely cases have been reported in Cameroon, which shares a border with Equatorial Guinea....https://www.pattayamail.com/thailand...��

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U.S. Department of State


Secretary Blinken’s Call with Equatoguinean President Obiang

READOUT
OFFICE OF THE SPOKESPERSON

FEBRUARY 23, 2023

The below is attributable to Spokesperson Ned Price:

Secretary of State Antony J. Blinken spoke today with Equatoguinean President Teodoro Obiang Nguema Mbasogo. Secretary Blinken called President Obiang to offer support and partnership as Equatorial Guinea responds to an outbreak of Marburg virus disease. The Secretary and the President agreed cooperation is essential to a successful response to this outbreak.

https://www.state.gov/secretary-blinkens-call-with-equatoguinean-president-obiang/

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U.S. Embassy in Equatorial Guinea

Health Alert: U.S. Embassy Malabo

Health Alert: U.S. Embassy Malabo (February 23, 2023)

Location: Equatorial Guinea

Event: As of the afternoon of February 22, there have been no new reports of confirmed or suspected cases of Marburg virus disease (MVD) in Equatorial Guinea (EG) or the surrounding countries. The last death of an individual infected with the Marburg virus occurred on February 10.

As was mentioned in a previous alert, the virus has an incubation period of up to 21 days. The World Health Organization (WHO) and the EG Ministry of Health and Social Welfare (MINSABS) will continue to monitor for potential cases in the Kie-Ntem province and surrounding areas for at least double that time period (42 days) from the last known case.

Epidemiological experts from the U.S. Centers for Disease Control and Prevention (CDC) will arrive to EG this week to assist the WHO and MINSABS in responding to the outbreak.

The Kie-Ntem province in the mainland region of EG remains under a general quarantine, and travel out of the province is not allowed, except by medical workers.

The U.S. Embassy will continue to send out regular updates to U.S. citizens living in or traveling to EG until health officials declare an end to the crisis. These alerts will also be posted to the Embassy’s website here. More information on MVD can be found on the CDC’s website.

Actions to Take:

• Immediately report to a qualified medical professional if you experience fever, muscle soreness, weakness, abdominal pain, diarrhea, nausea, vomiting, or hemorrhaging.
• Avoid contact with any individuals experiencing these symptoms or any people who have had contact with individuals displaying those symptoms.
• Do not eat or handle bushmeat, especially monkeys and other primates. Avoid contact animal cadavers for any reason.
• Avoid caves or other areas where fruit bat populations reside.
• Practice good hygiene, including regular hand washing.
• Avoid large gatherings and wear a mask when in enclosed spaces.
• Do not attend wakes or funerals.
• Do not attempt to travel to the Kie-Ntem province or surrounding areas until MINSABS and the WHO advise it is safe to do so.
• If you reside in the Kie-Ntem province and/or are subject to the quarantine, alert the U.S. Embassy and follow instructions given by WHO and MINSABS officials.
• Do not attempt to cross the land border between Equatorial Guinea and Cameroon.
• Monitor news programs and websites to stay abreast of new health announcements from the government.
• Check your email regularly for additional updates from U.S. Embassy Malabo.

For Assistance and Information:

U.S. Embassy Malabo, Equatorial Guinea

+(240) 333-095-741 or +(240) 555-516-008 (after hours)

MalaboConsular@state.gov

https://gq.usembassy.gov/

State Department – Consular Affairs

888-407-4747 or 202-501-4444

Equatorial Guinea Country Information

Enroll in the Smart Traveler Enrollment Program (STEP) to receive security and health updates.

Follow us on Twitter and Facebook.

By U.S. Embassy Malabo | 23 February, 2023 | Topics: Alert


https://gq.usembassy.gov/health-alert-u-s-embassy-malabo/

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Translation Google

Guinean Health@GuineaSalud

The Minister of #MINSABS receives the Ambassador of@USEmbassyEG, to express concrete actions of support from your Government to the country in the epidemiological fight against the #Virus of #Malburgo .


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3:38 AM · Feb 23, 2023

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Guinean Health@GuineaSalud

🗓️First Coordination Meeting of the Minister of Health@MitohaOndo with its work team for the coordination of the concrete actions to be carried out in the field work in the points affected by the #Marburgo Virus . #MINSABS




4:34 AM · Feb 23, 2023

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Guinean Health@GuineaSalud

The Minister of #MINSABS @MitohaOndo has thanked the "EVITA GROUP" for the donation of 2️⃣4️⃣0️⃣drums for confined families, which comes to support the Containment Plan approved by the Political Committee for Health Emergency @HonoratoOma



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7:10 AM · Feb 23, 2023

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Guinean Health@GuineaSalud

🗓The Minister of #MINSABS arrives at Ebibeyin and is received by the Governor and representatives of @OMS
Y@UNICEF, the first contact for the coordination of the works in the capital of the Kie Ntem Province. #Marburg

More information soon.....


...
2:11 PM · Feb 23, 2023

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Nigeria -

NCDC on Alert Following the Announcement of the Marburg Virus Disease Outbreak in Equatorial Guinea

Friday, February 24, 2023

24 February 2023 | Abuja - NCDC on Alert Following the Announcement of the Marburg Virus Disease Outbreak in Equatorial Guinea

The Nigeria Centre for Disease Control and Prevention (NCDC) is aware of the first-ever outbreak of Marburg virus disease (MVD) announced in Equatorial Guinea on 13th February 2023. The death of nine people prompted laboratory testing on samples of individuals experiencing symptoms of fever, fatigue, blood-stained vomit, and diarrhoea in two communities of the country’s western Kie Ntem province. So far, one confirmed case, nine deaths and 16 suspected cases of MVD have been reported in Equatorial Guinea.

MVD is a viral haemorrhagic fever (VHF) caused by a virus from the same family as the Ebola virus disease. The primary route of transmission is from fruit bats to humans. Human-to-human transmission is possible through contact with the body fluids of an infected person. Currently, there are no available vaccines or therapeutics for the prevention and treatment of this strain of the virus. The early initiation of supportive treatment has been shown to significantly reduce the probability of death due to MVD.

There are currently no cases of Marburg virus disease in Nigeria, however, the NCDC, relevant Ministries, Departments, Agencies, and partners have taken proactive measures to mitigate the risk of cross-border importation. The multi-sectoral National Emerging Viral Haemorrhagic Disease Technical Working Group (NEVHD TWG) led by NCDC, is responsible for coordinating the national response to all VHFs across pillars including surveillance, laboratory, case management and risk communication. The NEVHD TWG like it has always done in the past following news of MVD outbreaks conducted a dynamic risk assessment to inform Nigeria’s preparedness following this recent outbreak in Equatorial Guinea on the 17th of February 2023.

Based on available data, the overall risk of importation of the Marburg virus and the impact on the health of Nigerians has been assessed as MODERATE for the following reasons:

• The extent of the outbreak in Equatorial Guinea has not yet been ascertained.

• The likelihood of importation to Nigeria is high due to the direct flight between Nigeria and Equatorial Guinea.

• The proximity of Equatorial Guinea to Nigeria

• The likelihood of spread in Nigeria following importation is high due to the gatherings and travel associated with upcoming national elections.

• The case fatality rate of MVD ranges between 24 to 88%.

• MVD does not currently have an effective drug for treatment or a licensed vaccine for prevention.

The risk assessment also shows that Nigeria has the capacity – technical, human (health workforce), and diagnostic – required to respond effectively in the event of an outbreak. Nigeria has also responded to viral haemorrhagic fever epidemics like the Ebola Outbreak in 2014 and built up her preparedness and response capabilities over the years. We have the diagnostic capacity to test for MVD presently at the National Reference Laboratory (NRL) in Abuja and the University of Lagos Teaching Hospital laboratory Centre for Human and Zoonotic Virology (CHAZVY). However, diagnostic capacity will be scaled up to other laboratories in cities with important points of entry (POE) and others as may be required. An effective response system is in place with the availability of control capacities (trained rapid response teams, and an effective infection prevention and control programme) to limit the risk of spread in the event of a single imported case.

Several measures have been taken to strengthen preparedness for the MVD in Nigeria. These include:

• The NCDC Incident Coordination Centre (ICC) has been activated to alert mode.

• Development of an emergency incident action plan for MVD has commenced.

• A review to update case definitions for MVD if necessary.

MVD guidelines currently under development

• The NRL and CHAZVY have the capacity to promptly test and diagnoses cases of MVD if needed.

• Follow-up of persons of interest (POIs) on arrival from Equatorial Guinea has commenced.

• Point of entry surveillance has been heightened using the passenger’s pre-boarding health declaration and screening form.

• Trained Rapid Response Teams are on standby to be deployed in the event of an outbreak.

• A medical countermeasures plan is being developed.

• Amplification of risk communication and engagement with states and partners to strengthen preparedness activities which include a review of risk communication protocols, plans, and messages in the event of an outbreak.

• Nigeria has an active infection prevention and control (IPC) programme nationwide with guidelines and training packages developed for healthcare workers.

The NCDC advises Nigerian citizens and residents to AVOID ALL BUT ESSENTIAL TRAVELS to Equatorial Guinea at this time. Persons with recent travel history to or transit through Equatorial Guinea within the past 21 days who experience symptoms such as fever, muscle pain, sore throat, diarrhoea, weakness, vomiting, stomach pain, or unexplained bleeding or bruising should NOT go to any health facility but call 6232 or their State Ministry of Health hotline IMMEDIATELY for assessment and testing.

For further information on Marburg virus disease, visit the NCDC website at https://www.ncdc.gov.ng/diseases/factsheet/66

About NCDC

The Nigeria Centre for Disease Control and Prevention (NCDC) is the country's national public health institute, with the mandate to lead the preparedness, detection, and response to public health emergencies. The Bill for an Act to establish NCDC was signed into law in November 2018, by President Muhammadu Buhari. The mission of the NCDC is 'To protect the health of Nigerians through evidence-based prevention, integrated disease surveillance and response, using a One Health approach, guided by research and led by skilled workforce'.

Contact

NCDC Toll-free Number: 6232 | SMS: 08099555577 | WhatsApp: 07087110839 Twitter: @NCDCGov | Facebook: @NCDCgov | Instagram: @NCDCgov | NCDC Media Releases

Signed:

Dr Ifedayo Adetifa

Director General

Nigeria Centre for Disease Control and Prevention

https://ncdc.gov.ng/news/440/ncdc-on...atorial-guinea

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Marburg virus disease - Equatorial Guinea

25 February 2023

Situation at a glance

On 7 February 2023, the Ministry of Health and Social Welfare of Equatorial Guinea reported the deaths of a number of individuals with suspected hemorrhagic fever.

On 12 February 2023, one sample was confirmed positive for Marburg virus by real-time polymerase chain reaction (RT-PCR), at the Institute Pasteur in Dakar, Senegal.

Investigations are ongoing to find additional cases. WHO is supporting the response by strengthening contact tracing, case management, infection prevention and control, laboratory, risk communication and community engagement.

WHO assesses the risk posed by the outbreak as high at the national level, moderate at the regional level and low at the global level.

Description of the situation

This is the first Marburg virus disease (MVD) outbreak reported in Equatorial Guinea.

On 7 February 2023, the Ministry of Health and Social Welfare of Equatorial Guinea reported at least eight deaths that occurred between 7 January and 7 February 2023, in two villages located in the district of Nsock Nsomo, eastern province of Kie-Ntem, Río Muni Region. According to the ongoing epidemiological investigation, the cases presented with fever, followed by weakness, vomiting, and blood-stained diarrhoea; two cases also presented with skin lesions and otorrhagia (bleeding from the ear).

On 9 February 2023, eight blood samples were collected from contacts and sent to the Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF) in Gabon, where they tested negative for both Ebola and Marburg viruses by real-time polymerase chain reaction (RT-PCR).

An additional eight blood samples were collected from other contacts and sent to the Institute Pasteur in Dakar, Senegal, on 12 February 2023. One of these samples was taken from a suspected case that was confirmed positive for Marburg virus by RT-PCR. This case presented with fever, non-bloody vomiting, bloody diarrhoea, and convulsions and died on 10 February 2023 at Ebebiyin District Hospital. The case also had epidemiological links to four deceased cases from one of the villages in Nsoc-Nsomo district.

As of 21 February 2023, the cumulative number of cases is nine, including one confirmed case, four probable cases and four suspected cases. All the cases have died, one in a health facility and the other eight in the community. There are no cases among healthcare workers. Thirty-four contacts are currently under follow-up.

Epidemiology of Marburg virus disease

Marburg virus is the causative agent of Marburg virus disease (MVD), which has a case-fatality ratio of up to 88%. Marburg virus disease was initially detected in 1967 after simultaneous outbreaks in Marburg and Frankfurt in Germany, and in Belgrade, Serbia.

Rousettus aegyptiacus fruit bats are considered natural hosts for Marburg virus, from which the virus is then transmitted to people.

Marburg spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids. Healthcare workers have previously been infected while treating patients with suspected or confirmed MVD. Burial ceremonies that involve direct contact with the body of the deceased can also contribute to the transmission of Marburg.

The incubation period varies from two to 21 days. Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Severe haemorrhagic manifestations appear between five and seven days from symptoms onset, and fatal cases usually have some form of bleeding, often from multiple areas. In fatal cases, death occurs most often between eight and nine days after symptom onset, usually preceded by severe blood loss and shock.

In the early course of the disease, the clinical diagnosis of MVD is difficult to distinguish from many other tropical febrile illnesses due to the similarities in the clinical symptoms. Other viral haemorrhagic fevers need to be excluded, including Ebola virus disease, as well as malaria, typhoid fever, leptospirosis, rickettsial infections, and plague. Laboratory confirmation can be made by different tests, such as antibody-capture enzyme-linked immunosorbent assay (ELISA), antigen-capture detection tests, serum neutralization test, reverse transcriptase polymerase chain reaction (RT-PCR) assay, electron microscopy, and virus isolation by cell culture.

Although no vaccines or antiviral treatments are approved to treat the virus, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms improve survival. A range of potential treatments are being evaluated, including blood products, immune therapies, and drug therapies.

This is the first time that Equatorial Guinea has reported an outbreak of MVD. The most recently reported outbreak of MVD was in Ghana in 2022 (three confirmed cases). Other MVD outbreaks have been previously reported in Guinea (2021), Uganda (2017, 2014, 2012, 2007), Angola (2004-2005), the Democratic Republic of the Congo (1998 and 2000), Kenya (1990, 1987, 1980) and South Africa (1975).

Public health response

• In-depth epidemiological investigations are underway to determine the source of the outbreak.
• National teams have been deployed to the affected districts for active case finding, contact tracing, isolating and providing medical care to cases.
• WHO has deployed experts in epidemiology, case management, infection prevention, laboratory and risk communication to support national response efforts and ensure community engagement.
• WHO is also facilitating the shipment of tents, materials for sample collection and analysis, and a viral haemorrhagic fever kit including personal protective equipment for 500 health workers.
• WHO is supporting the transportation of samples to laboratories in Senegal and Gabon as plans are underway to set up laboratory facilities in-country.

WHO risk assessment


Equatorial Guinea is facing an outbreak of MVD for the first time and the country's capacity to manage the outbreak is insufficient.

Based on available information, all nine deceased cases were in contact with a relative with the same symptoms or participated in a burial of a person with symptoms compatible with MVD. At this stage it cannot be ruled out that all MVD cases have been identified, therefore there could be transmission chains that have not been tracked. To date, most of the contacts of the nine deceased cases have not been identified.

It should also be noted that with the exception of one case who died in a health facility, the other eight died in the community and their burial conditions are unknown.

Cross-border population movements are frequent, and the borders are very porous, between Ebebiyin and Nsock Nsomo districts (Equatorial Guinea), Cameroon and Gabon. This constitutes a risk of cross-border spread.

Considering the above described scenario, the risk is considered high at the national level, moderate at the regional level and low at the global level.

WHO advice


Marburg virus disease outbreak control relies on using a range of interventions, namely case management, surveillance including contact tracing, a good laboratory service, infection prevention and control including safe and dignified burials, and social mobilization. Community engagement is key to successfully controlling MVD outbreaks. Raising awareness of risk factors for Marburg infection and protective measures that individuals can take is an effective way to reduce human transmission.

Communities affected by Marburg should make efforts to ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures.

Outbreak containment measures include prompt, safe and dignified burial of the deceased cases, identifying people who may have been in contact with someone infected with Marburg and monitoring their health for 21 days, isolating and providing care to confirmed patients and maintaining good hygiene and a clean environment.

Healthcare workers caring for patients with or suspected of MVD should apply additional infection control measures in addition to standard precautions to avoid contact with patients’ blood and body fluids and with surfaces and objects contaminated.

WHO recommends that male survivors of MVD practice safer sex and hygiene for 12 months from onset of symptoms or until their semen twice tests negative for Marburg virus. Contact with body fluids should be avoided and washing with soap and water is recommended. WHO does not recommend isolation of male or female convalescent patients whose blood has tested negative for Marburg virus.

WHO advises against any restrictions on travel and/or trade to Equatorial Guinea based on available information for the current outbreak.

Further information

• WHO. Equatorial Guinea confirms first-ever Marburg virus disease outbreak.
• WHO. Marburg virus disease fact sheets.
• WHO. Ebola and Marburg virus disease epidemics: preparedness, alert, control, and evaluation.
• WHO. Infection prevention and control guidance for care of patients with suspected or confirmed Filovirus haemorrhagic fever in health-care settings, with focus on Ebola
• Organisation mondiale de la Santé. (2014). Flambées épidémiques de maladie à virus Ebola et Marburg : préparation, alerte, lutte et évaluation. Organisation mondiale de la Santé. https://apps.who.int/iris/handle/10665/130161

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https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON444

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Death Toll in Equatorial Guinea Marburg Outbreak Rises to 11

February 28, 2023 7:47 AM
Agence France-Presse

Two more people in Equatorial Guinea have died of Marburg hemorrhagic fever, a cousin of the Ebola virus, bringing the toll of fatalities to 11, the authorities say.

"Two days ago, the monitoring system recorded eight notifications, including the deaths of two people with symptoms of the disease," Health Minister Mitoha Ondo'o Ayekaba said in a statement issued late Tuesday.

Work is underway "to strengthen assessment of the spread of the epidemic," said the statement, read on national television.

"Forty-eight contact cases have been documented, four of whom have developed symptoms, and three who have been quarantined in hospital," it added.

...
https://www.voanews.com/a/death-toll...1/6982164.html
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Guinean Health@GuineaSalud

📊FHM Update #GE 48 contacts, 3 with mild symptoms in hospital isolation, 1 in the community.
📈2 deceased with symptoms suggestive of FHM, without laboratory confirmation, 15 samples taken from suspected cases.
ℹ️For more information:👉http://bit.ly/41H7L22




4:15 PM · Feb 27, 2023

https://twitter.com/GuineaSalud/stat...30789278695424

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Translation Google

Marburg virus: 48 contacts, 4 symptomatic, 3 in isolation and two deceased

Data provided by the Minister of Health and Social Welfare, Mitoha Ondó Ayecaba.

By Belgium Nvó Acaba February 28, 2023in Health

On February 13, 2023, at an official press conference, the Minister of Health and Social Welfare, Mitoha Ondó Ayecaba, announced for the first time the appearance of the Marburg virus in the province of Kie-Ntem. After the confirmation of a positive case of the 16 samples that were sent to two international laboratories; and complying with the provisions of the International Health Regulations (RSI).

This led, according to the report read yesterday Monday on the public channel TVGE, to an immediate response and activation of the National Technical Committee for Health Emergencies and, in parallel, the Political Committee for Emergencies, both with the responsibility of implementing packages of concrete measures to contain the epidemic in Kie-Ntem province and Mongomo district.

“It should be noted that at the same time we began to receive immediate support from the different partners of the United Nations agencies (WHO and UNICEF), the Cuban Medical Brigade, Africa CDC, the Red Cross, CDC Atlanta and USAID, who have been in the accompaniment technical and logistical in the affected areas", stressed the minister.

Mitoha Ondó Ayecaba has also reported that the National Emergency Political Committee, chaired by the Vice President of the Republic, summoned all the departments involved to guarantee integrity in the response, and preserve the well-being of the affected population, not only in the area public health, but also psychosocial, with food, water and personal hygiene provisions that will be distributed in the affected towns every 2 weeks, during the isolation period.

The regular supply to wholesale warehouses, the supply of gas and fuel to pumps, the supply to banks that operate in confined areas, and the necessary coordination to guarantee the commercialization of local products have been guaranteed, thanks to the establishment of a strict protocol that offers all the security guarantees to prevent any spread of the disease beyond the affected areas. All the aforementioned measures have been adopted, under the protection of the principles of “no regret policy and none behind”.

The work in the field, according to the report read by the minister, has been gaining in problem-solving capacity with the experience of the experts who have been joining the work teams, especially in the field of epidemiology; and that has allowed to expand the depth of the epidemiological investigations still in progress.

Health has had the experience of Dr. Pavlin Boris, head of epidemiological surveillance in the emergency program, as well as Dr. Pierre Formenty, head of the hemorrhagic fever program, Dr. Janet Díaz, head of the case management unit, all from WHO headquarters in Geneva. At the same time, Health relies on the vast experience of Dr. Marie Roseline Damycka Belizaire, a community medicine specialist, epidemiologist and public health expert, with 17 years of experience coordinating responses to major public health emergencies, currently responsible for emergency preparedness and RSI in the Central African Republic; Dr. Julienne Anoko, anthropologist and regional head of risk communication at WHO AFRO, as well as an important group of epidemiologists from CDC Atlanta and Africa CDC.

"These actions have resulted in the reinforcement of epidemiological surveillance, 15 samples of suspected cases have been taken in the country, and one suspected case identified in Spain, whose result was negative on the first examination, despite handling information that the The patient had no link here in Equatorial Guinea with the area in isolation, even so, we have had constant exchanges with the National Center for Microbiology of the Carlos III Health Institute, to take immediate action in accordance with the International Health Regulations. Therefore, we thank the authorities of the National Center for Microbiology of the Carlos III Institute of Spain, the fluid communication that has allowed the clarification of this case until its elimination as a possible suspicious case.

In this epidemic, a suspected case is considered to be any living or dead person who presents three (3) of the symptoms under surveillance and who is in the risk area, or contact with probable or confirmed cases who presents a single symptom, all the natural deaths that occur suddenly and unexplained in the community, and anyone with unexplained bleeding.

Currently, according to Health, there are 48 contacts of which four (4) have developed symptoms under surveillance; three (3) are in hospital isolation with a favorable evolution and one (1) in the community that has been reported between yesterday and today, in the course of evaluation for transfer to the hospital.

The alert system has been activated three days ago and has received eight (8) notifications, among which two (2) died with symptoms consistent with those of the disease, from which samples were taken, which shows the work in progress , which will allow a better dimensioning of the extent of the epidemic.

"We trust that in the next few days the confined towns that have not registered suspicious cases will be able to lift the mobility restrictions and return to normality without even lifting the restrictions placed in each district."

The National Technical Committee for Health Emergencies traveled to the Province of Kie-Ntem headed by the Minister of Health and Social Welfare, to coordinate and reinforce the epidemic management system with the creation and implementation of a Multisectoral Command Center with international organizations.

Solid integrated interventions are being carried out in the field of epidemiological surveillance, case management, infection prevention and control, risk communication and social mobilization, and health logistics.

Teams with qualified human resources have been strengthened at the level of institutional and community isolations; suits and 2 provisional treatment centers have been set up within the hospital structure itself; prevention material and medicines have been guaranteed in the quantities necessary for the response.

Structural rearrangement actions are carried out in institutional isolations with the aim of ensuring compliance with the flowchart and the epidemiological criteria established for these services; without affecting the normal operation of essential services.

A field laboratory is in the process of being implemented with the help of the CDC Atlanta, which will allow rapid analysis of the samples and be able to act more promptly, and have more elements to assess the scope of the crisis. Today, with the collaboration of CDC Africa experts, it is planned to begin in Malabo the calibration of the equipment for the analysis of samples of viral hemorrhagic fevers in one of the units of the national public health laboratory of Baney, located in the city of Sipopo.

« The cases mentioned also inform us that the MARBURG virus is not a virus from Equatorial Guinea, nor even from Africa, as certain international and sensationalist media have tried to convey . We therefore appeal to the restraint, ethics and professionalism of the media when it comes to giving media coverage to this type of crisis, as it is a disease with a high impact at the international public health level.

Our Government, together with the Health System, have acted in a balanced manner, in accordance with the parameters set forth in Annex 2 of the IHR, and at the height of the risk represented by the presence of the Marburg Virus in our country, due to the high lethality of this disease. which oscillates between 24 and 88%, the non-existence of a vaccine for immunization, and related specific treatments.

We consider it appropriate to highlight that a specific area in the country has been declared an epidemic and with only 1 confirmed case, the rest of the national territory continues in total normality, without socioeconomic limitations in daily life, or restrictions on international or national flights .

As observed in the epidemiological data offered, we have control indicators, and the necessary medical and logistical resources have been made available to the response to put an end to it as soon as possible. Insisting that it is safe to leave and travel to the country, there are therefore no epidemiological reasons currently in the rest of the country, except for areas with restricted movement, that suggest otherwise," the minister concluded.

https://ahoraeg.com/ciencia-y-salud/salud/2023/02/28/virus-de-marburgo-48-contactos-4-sintomaticos-3-en-aislamiento-y-dos-fallecidos/

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Marburg Virus Disease (MVM) Situation Report No. 2

HIGHLIGHTS

• To date no confirmed cases in Cameroon

AREAS OF INTERVENTION
1. COORDINATION
• Meeting to present priority activities to technical and financial partners
• Consultation meeting on the support to be provided to Equatorial Guinea
• Daily briefing meetings

https://www.ccousp.cm/download/rappo...us-marburgmvm/

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Translation Google

Posted 13 hours ago

The Minister of Health denounces the manipulation of information from the French newspaper Le Figaro on the number of deaths from the Marburg virus in Equatorial Guinea

He has done so through a statement and has said that Equatorial Guinea appeals to informative prudence in the publication of information related to Marburg hemorrhagic fever

By
Amelia Santander Waiter
Royal EG MagazineHealth

The Minister of Health and Social Welfare Mitoha Ondo'o Ayekaba, through a statement, has denounced the misuse and manipulation of the official death figures related to the Marburg virus in Equatorial Guinea.

This complaint arises from the erroneous data recently published by the French newspaper Le Figaro regarding the number of deaths from this hemorrhagic fever that the Minister has considered an attempt to destabilize and create panic in the Equatoguinean population.

Mitoha Ondo'o Ayecaba has called on all the national and international media to make good use of the information and to fulfill their responsibility to report faithfully and objectively on the reality regarding the epidemiological situation in the country.

According to the second official update statement issued by the MINSABS of Equatorial Guinea on February 27, 2023, and which was read by the head of the branch, Equatorial Guinea reported a balance of 48 contacts, 3 with mild symptoms in isolation and with a favorable evolution, 1 in the community, and 2 deceased with symptoms suggestive of Marburg without laboratory confirmation and about 15 samples taken from possible suspected cases.

Data very contrary to those issued by this French outlet, which includes a total of 11 deaths in the country due to this hemorrhagic fever, while only nine have currently been recorded, according to the Equatorial Guinean Ministry of Health.

The head of the national health sector has responded by clarifying that the other two additional deaths to which the French newspaper Le Figaro alludes are unrelated to the Marburg virus, but to people who had their residence in areas considered to be the epicenter of this fever. hemorrhagic in the country.

https://realequatorialguinea.com/salud/el-ministro-de-sanidad-denuncia-la-manipulacion-de-informacion-del-periodico-frances-le-figaro-sobre-la-cifra-de-muertos-por-el-virus-marburgo-en-guinea-ecuatorial/

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U.S. Embassy Malabo 🇺🇸🇬🇶@USEmbassyEG

March 1, a team of @CDCgov established a mobile laboratory in #Ebibeyin that will allow understanding of the magnitude of the outbreak. Testing is like a camera that allows you to see the bigger picture of the outbreak so you can implement the most effective response. #USinGE #Marburg



3:02 AM · Mar 2, 2023

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Translation Google

Posted 5 hours ago

Equatorial Guinea already has a laboratory in Ebebiyin to process samples of hemorrhagic fevers, including Marburg

An initiative of the Ministry of Health and Social Welfare in collaboration with CDC Atlanta to strengthen the health system. This will stop depending on the results of foreign laboratories.

By
Feliciano Obiang
Royal EG MagazineHealth

The district of Ebebiyin, capital of the Province of Kie Ntem in the Continental Region of the country, already has a field laboratory that has been installed in the provincial hospital for the diagnosis of hemorrhagic fevers, including the one in Marburg. Representatives of the Ministry of Health and Social Welfare have arrived at these facilities this morning to find out their status.

The initiative to install this infrastructure comes from the Equatorial Guinea health department in collaboration with the Center for Disease Control and Prevention of Atlanta, United States.

The aim of this laboratory is not only to strengthen the national health system, but also to achieve better management of the "Marburg epidemic". The reinforcement is not only in the field of diagnosis, but also teaching, allowing the training of laboratory technicians in handling equipment, processing samples and compliance with biosafety standards for these specific processes.

This laboratory has an estimated capacity to carry out 16 daily samples and the possibility of not only diagnosing Marburg hemorrhagic fever, but also almost all hemorrhagic fevers. With these facilities, the autonomy of the diagnostic capacity of the country is achieved, something that will allow us to act more quickly and not have to depend on the results of foreign laboratories.

The Equatoguinean Government has thanked CDC Atlanta for this collaboration, which once again reaffirms the cooperation between the United States and Equatorial Guinea.

https://realequatorialguinea.com/salud/guinea-ecuatorial-ya-cuenta-en-ebebiyin-con-un-laboratorio-para-procesar-muestras-de-fiebres-hemorragicas-incluida-la-de-marburgo/