South Africa
Update on marburg virus disease outbreak in Ethiopia (beyond our borders)
Overview
On 14 November 2025, the Ethiopian Ministry of Health (MoH) officially confirmed the country’s first Marburg Virus Disease (MVD) outbreak, following laboratory confirmation of the detection of Marburg virus (MARV) from specimens collected from viral haemorrhagic fever (VHF) suspected cases by the Ethiopian Public Health Institute (EPHI) National Reference Laboratory. The outbreak occurred in the South Ethiopia Regional State, Jinka town in the South Omo Zone, near the border with South Sudan.
As of 15 December 2025, the Ethiopian MoH reported 14 laboratory-confirmed cases of MVD and nine (9) deaths in the South and Sidama region. The first MVD case in Hawassa, Sidama region, was reported on 27 November 2025, in an individual with a travel history to Jinka town. Six (6) of the deaths are amongst the laboratory-confirmed cases, while the other three deaths were reported among three epidemiologically linked cases, from whom laboratory tests were not conducted.
The MVD is a severe and often fatal viral haemorrhagic fever caused by the MARV, a member of the filovirus family that also includes the Ebola virus. The natural reservoir of the MARV is believed to be fruit bats of the genus
Rousettus, which can carry the virus without showing symptoms. Human infection can occur through contact with infected bats or their environments, such as caves or mines. Once a human is infected, the virus spreads through direct contact with blood, bodily fluids, or tissues of infected individuals, as well as through indirect contact with contaminated surfaces or equipment.
The MVD is a severe and often fatal viral haemorrhagic fever caused by the MARV, a member of the filovirus family that also includes the Ebola virus. The natural reservoir of the MARV is believed to be fruit bats of the genus Rousettus, which can carry the virus without showing symptoms. Human infection can occur through contact with infected bats or their environments, such as caves or mines. Once a human is infected, the virus spreads through direct contact with blood, bodily fluids, or tissues of infected individuals, as well as through indirect contact with contaminated surfaces or equipment.
The illness begins after an incubation period of two to 21 days, with early symptoms such as sudden fever, severe headache, malaise, and muscle pain. In severe cases, patients may experience profuse diarrhoea, bleeding from mucous membranes and injection sites, multi-organ dysfunction, and hypovolemic shock.
Current risk assessment and travel advice
No travel or trade restrictions with Ethiopia have been recommended. Travellers are advised to take precautions such as avoiding contact with sick individuals, avoiding caves or mines inhabited by bats, and avoiding contact with bodily fluids or contaminated materials. Travellers are advised to consider obtaining travel and medical evacuation insurance. Travellers should monitor themselves for symptoms for 21 days following any potential exposure. Anyone who develops symptoms such as fever, headache, muscle pain, rash, gastrointestinal illness, or unexplained bleeding should immediately isolate, avoid travel, and contact local health authorities or a healthcare facility in advance for guidance and a safe assessment.
As of 20 November 2025, the WHO conducted a risk assessment based on available information on the MVD outbreak in Ethiopia. The risk assessment considered the public health risk to be high at national level (within Ethiopia) due to factors such as the reported number of deaths; unsupervised burials reported amongst all deaths which poses a greater risk of community transmission; the confirmed cases includes healthcare workers, which highlight possible risk of exposure in the healthcare facility while attending to patients; as well as limited information available on sources, epidemiology and geographical spread of the outbreak.
Situation in South Africa
The risk of importation of the MVD cases into South Africa exists due to international travel networks (direct flights) between the two countries. Vigilance is vital given emerging outbreaks in the region. Healthcare workers should consider MVD in any patient presenting with unexplained acute febrile illness who has recently travelled to an affected area or had potential exposure. Rapid action is essential: isolate suspected cases, collect specimens safely, and report immediately to the relevant public health authority to initiate rapid response and to the National Institute for Communicable Diseases (NICD) for laboratory testing at the Centre for Emerging Zoonotic and Parasitic Diseases (CEZPD).
The NICD serves as the national reference centre for viral haemorrhagic fever testing, providing diagnostic capacity and expert guidance. Strict IPC measures, including the use of appropriate personal protective equipment (PPE), dedicated equipment, effective waste management, and environmental decontamination, are required when handling suspected or confirmed cases. Safe burial practices are also critical due to the high risk of transmission from deceased individuals.
Clinicians identifying a suspected case of MVD should contact the NICD Clinical Hotline (0800 212 552), a 24-hour service for healthcare professionals, to discuss laboratory testing and provide a detailed clinical, travel, and exposure history. Viral haemorrhagic fever (VHF) diseases, including MVD, are classified as Category 1 notifiable medical conditions (NMCs) in South Africa, and must be reported within 24 hours of clinical suspicion through the NMC notification system.
READ THE FULL UPDATE HERE
https://www.nicd.ac.za/update-on-marburg-virus-disease-outbreak-in-ethiopia-beyond-our-borders/
