Marburg
The Marburg virus disease outbreaks (as of 14th April) have reached 38 cases (15 confirmed) and claimed 11 lives (79% CFR of confirmed cases) in Equatorial Guinea along with 8 cases and 5 deaths in Tanzania (63% CFR). This CFR is typical of past outbreaks, but the occurrence of two simultaneous epicentres is unusual.
Recently WHO advised 26 countries had implemented measures to impede the spread of the virus. Note that the WHO statement on Marburg advises against travel or trade restrictions with Equatorial Guinea or Tanzania. See recent updates: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON451
https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON459
The update for Equatorial Guinea notes: “The country surveillance system remains suboptimal with few alerts reported and investigated… Several epidemiological links and transmission chains have not been detected, thus there might be contacts not identified.” The outbreak includes several recent cases in the city of Bata, with WHO noting: “The presence of confirmed cases in Bata increases the risk of disease spread, as it is the most populated city and economic hub of Equatorial Guinea, with an international airport and port….Bata has also reported the highest number of confirmed cases and confirmed deaths.”
WHO assesses risk posed by the Equatorial Guinea outbreak as very high at the national level. Both Marburg outbreaks are assessed also as high at sub-regional level, moderate at the regional level and low at the global level.
COVID and other
It was reported that in view of the rise in number of Covid-19 cases across the state, the Uttar Pradesh government has issued a 'high-priority' directive, instructing officials concerned to ensure that international passengers are screened at all airports.
In terms of variants, the growth of XBB.1.5 seems to have “stalled” at around 55% globally; second is XBB.1.9 (1.9.1 and 1.9.2) at 20%, and then XBB.1.16 which has now reached 10% globally, is more infectious than XBB.1.5 but apparently no more pathogenic, based on available data and the experience in India. In Australia the fastest growing is XBC.1.6 “Deltacron” at a third of recent cases but only 4% internationally. Similarly XBB.2.3 is 30% in Singapore but only 2% globally (Airfinity).
In Niger, there are high numbers of cases of meningitis (mostly meningococcal caused by Neisseria meningitidis Type C) with 831 cases and 41 deaths in the first three months of this year.
The outbreak of mpox in non-endemic countries continues to slow, with only four deaths in as many weeks globally.
There is a WHO EPI-WIN Webinar on Plague, “Managing Plague in the Field: Launch of the WHO plague manual” at 13:00-14:00 CEST (Geneva time) on Wednesday, 19 April, 2023. The webinar can be viewed post-event on the EPI-WIN YouTube channel.
David Powell
IATA Medical Advisor