Ethiopia Confirms Three Marburg Deaths, Sparks Regional Alarm

Ethiopia has officially confirmed three deaths from the Marburg virus in its southern Omo region, bordering South Sudan, triggering a regional health alert. Health Minister Mekdes Daba announced the fatalities on Monday, November 17, following the government's declaration of an outbreak just three days prior, as reported by Al Jazeera.

Ethiopian health authorities are now in a race against time to contain the deadly hemorrhagic disease, actively isolating over 100 contacts of confirmed cases. The rapid response includes monitoring these individuals closely to prevent further spread, Al Jazeera reported on November 17.

The UN health agency has issued a stark warning regarding the high infection risk for healthcare workers involved in the response. This vulnerability arises particularly when stringent infection control precautions are not consistently practiced, according to the World Health Organization (WHO) and Al Jazeera.

The outbreak was first detected in the Jinka area of the Omo region after alerts about a suspected hemorrhagic illness, with officials testing 17 individuals and identifying at least nine infections before confirming the initial deaths, Al Jazeera stated on November 17. The Africa Centres for Disease Control and Prevention (Africa CDC) also confirmed nine cases by November 14.

Neighboring South Sudan has been placed on high alert, with its National Ministry of Health issuing public health advisories urging residents in border counties to avoid contact with bodily fluids. South Sudan's Health Minister Sarah Kleto Hassen confirmed on Monday, November 17, that her country is taking all necessary steps to prevent importation of the virus, Radio Tamazuj reported.

Marburg virus, a pathogen related to Ebola, spreads through direct contact with infected bodily fluids or contaminated materials. The World Health Organization (WHO) indicates that the virus kills roughly half of those infected on average, though fatality rates can climb significantly higher in some outbreaks.

This Ethiopian outbreak extends a concerning pattern of hemorrhagic fever emergencies across East Africa, following recent Marburg incidents in Tanzania and Rwanda. The bmj reported on November 18 that the Ethiopian strain closely matches those identified in previous regional outbreaks, suggesting a potential expansion of the virus's geographical reach.

• Background of Marburg Virus Disease: Marburg virus disease (MVD) is a severe, often fatal illness in humans, caused by the Marburg virus (MARV) or Ravn virus (RAVV), both members of the Filoviridae family, which also includes Ebola. The disease was first identified in 1967 in Marburg and Frankfurt, Germany, and Belgrade, Serbia, linked to African green monkeys from Uganda. Rousettus aegyptiacus fruit bats are considered the natural hosts, transmitting the virus to humans through prolonged exposure in caves or mines.

• Symptoms and Clinical Progression: MVD begins abruptly with symptoms such as high fever, severe headache, and malaise, often accompanied by muscle aches, severe watery diarrhea, abdominal pain, and vomiting, according to the WHO. A non-itchy rash may appear after 5-7 days. In severe cases, patients develop hemorrhagic manifestations, including bleeding from the nose, gums, and internal organs, with death typically occurring 8-9 days after symptom onset due to severe blood loss and shock.

• Transmission and Prevention: Marburg virus spreads among humans through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals, or with surfaces and materials contaminated with these fluids, as stated by the WHO. Public health control measures focus on early detection, rapid isolation of cases, timely contact tracing, proper personal protective equipment, safe burials, and community awareness campaigns to interrupt human-to-human transmission.

• Vulnerability of Healthcare Workers: Healthcare workers are particularly susceptible to Marburg infection due to close contact with patients, especially when infection control precautions are not strictly followed, the WHO warns. Previous outbreaks, such as in Rwanda in 2024, saw over 70% of confirmed cases among healthcare professionals, highlighting critical gaps in infection prevention and control practices and the immense risks faced by frontline workers.

• Regional Context and Previous Outbreaks: The Ethiopian outbreak is not an isolated incident, following a series of Marburg cases in East Africa. Tanzania experienced an outbreak claiming 10 lives between January and March 2025, while Rwanda ended its first recorded Marburg outbreak in December 2024 with 15 fatalities, according to Al Jazeera and The Guardian. Genetic analysis by the Ethiopia Public Health Institute indicates the current strain is similar to those previously identified in the region.

• International and National Response: The World Health Organization (WHO) and the Africa CDC are actively supporting Ethiopia's response efforts, deploying technical teams and essential supplies, including personal protective equipment and isolation tents, as reported by The Washington Post on November 15. Ethiopia's government has activated emergency response centers at multiple levels, deployed rapid response teams, and launched public awareness campaigns to curb the virus's spread.

• South Sudan's Proactive Measures: In response to the outbreak in neighboring Ethiopia, South Sudan's Ministry of Health has intensified surveillance and preparedness measures, including reactivating its Public Health Emergency Operations Centre (PHEOC) and deploying rapid response teams to high-risk border counties like Kapoeta East and Akobo. Health Minister Sarah Cleto Rial emphasized the need for vigilance, especially given South Sudan's fragile healthcare infrastructure, Xinhua reported on November 18.

• Treatment and Vaccine Development: Currently, there are no approved vaccines or specific antiviral treatments for Marburg virus disease. Treatment is primarily supportive, focusing on rehydration with oral or intravenous fluids and managing specific symptoms, which can significantly improve survival rates, according to the WHO. However, several promising candidate monoclonal antibodies, antivirals, and vaccines are under development and undergoing clinical trials.