Marburg Outbreaks 2005-2014

2014: Marburg Hemorrhagic Fever Outbreak in Uganda

On Nov. 13, 2014, the Ministry of Health of Uganda declared Uganda free of Marburg virus related to the case first reported in early October. Overall, one case was confirmed (fatal) and a total of 197 contacts were followed for 3 weeks. Out of these 197 contacts, 8 developed symptoms similar to Marburg, but all tested negative at the Uganda Virus Research Institute with support from CDC.

Latest CDC Outbreak Information

Updated November 13, 2014

2012: Marburg Hemorrhagic Fever Outbreak in Uganda

As of November 29, 2012, the Ugandan Ministry of Health reported 15 confirmed and 8 probable cases of Marburg virus infection, including 15 deaths, in the Kabale, Ibanda, Mbarara, and Kampala Districts of Uganda. Testing of samples by CDC's Viral Special Pathogens Branch is ongoing at the Uganda Virus Research Institute in Entebbe. Working with the Ministry's National Task Force, a CDC team is assisting in the diagnostic and epidemiologic aspects of the outbreak. Note that Kabale District, on the border with neighboring Rwanda, is distinct from Kibaale District, the site of the recently-ended Ebola outbreak; both districts are in Uganda's Western Region.

A recent history of Marburg cases and outbreaks in Uganda includes:

• a fatal case in 2008 of a Dutch tourist who visited the Python Cave, a bat cave in Queen Elizabeth National Park (QENP);
• a non-fatal case in 2008 of an American tourist who visited the same cave in QENP; and,
• a 2007 small outbreak of Marburg HF among miners working in the Kitaka lead and gold mine in Kamwenge District.

2008: Marburg Hemorrhagic Fever, Imported Case – United States

On January 22, 2009, CDC's Viral Special Pathogens Branch retrospectively diagnosed a case of Marburg hemorrhagic fever in a U.S. traveler, who was hospitalized, discharged, and fully recovered. Initial testing of samples collected during the patient's acute illness in January, 2008 did not initially show evidence of Marburg virus infection. Testing of a convalescent sample indicated a possible previous infection, and more detailed testing of both samples at CDC confirmed that the patient's illness was due to Marburg hemorrhagic fever.

The recovered patient had visited the "python cave" in Maramagambo Forest, Queen Elizabeth Park, western Uganda. This is a popular destination among tourists to see a cave inhabited by thousands of bats; a fatal case of Marburg hemorrhagic fever occurred in a Dutch tourist in July 2008 who had entered this cave. Both patients likely acquired their infections as a result of contact with cave-dwelling fruit bats, which are capable of harboring Marburg virus. Marburg virus is a zoonotic virus that occurs in tropical areas of Africa, and causes a severe, often fatal, hemorrhagic fever in humans and nonhuman primates. It can also be transmitted through direct contact with a symptomatic patient or materials contaminated with infectious body fluids. The Ugandan Ministry of Health officially closed the cave to visitors in August 2008, after the Dutch case.

The state and local health departments are working with CDC's Viral Special Pathogens Branch and Traveler's Health and Animal Importation Branch to further investigate the circumstances of this patient's case. This includes an assessment of any persons who may have been at risk of exposure at the time the patient was ill, and an investigation of travelers potentially exposed when visiting this or other caves in Africa. There is no evidence of apparent transmission as a result of this case.

Travelers should be aware of the risk of acquiring Marburg hemorrhagic fever and other potentially fatal diseases such as rabies after contact with bats. Healthcare providers should be aware of the risk of viral hemorrhagic fever among travelers returning from endemic countries, and should report any suspected cases immediately to their health department and to CDC's Viral Special Pathogens Branch (Tel. (404) 639-1115; (404) 639-2888 after hours) for diagnostic testing and further guidance.

2008: Marburg Hemorrhagic Fever, Imported Case – Netherlands ex Uganda, July

On July 10, 2008 CDC was notified by the European Centre for Disease Control (ECDC) about a case of Marburg Hemorrhagic Fever in a woman from The Netherlands. The woman had recently returned from traveling in Uganda. On one occasion the woman had contact with a bat in a cave in the Maramagambo forest in Western Uganda (at the southern edge of Queen Elizabeth National Park), and became ill after returning to The Netherlands. Laboratory testing at the Bernhard Nocht Institute in Hamburg, Germany revealed evidence of Marburg virus infection by polymerase chain reaction (PCR). The patient died on Thursday July 11, 2008 in the morning.

ECDC is working with health authorities in The Netherlands and the World Health Organization (WHO) to respond to the situation.

For more information, see:

• WHO information about the imported case of Marburg in The Netherlands

2007: Marburg Hemorrhagic Fever Outbreak in Uganda

On July 27, 2007, CDC was notified of a suspect case of Marburg Hemorrhagic Fever in Uganda by the Uganda Virus Research Institute (UVRI). A blood specimen taken from the only fatal patient, a miner at a local lead and gold mine, was received by CDC on Friday, July 27, 2007. The specimen tested positive for Marburg virus.

A 6-person CDC team consisting of three medical officers, a mammologist, and two microbiologists arrived in Uganda on August 10, traveling to the town of Ibanda in Kamwenge province, near the site of the mine where the exposures are believed to have occurred. WHO, the Ugandan Minsistry of Health, and other collaborators have also deployed personnel. The team has initiated an investigation by capturing bats and other animals at the site of the mine in an effort to further identify the animal host of the Marburg virus, and by tracing human contacts in communities near the mine.

2005: Marburg Hemorrhagic Fever Outbreak in Angola

On March 25, 2005, CDC's Viral Special Pathogens Branch reported that testing conducted by its laboratory had identified the presence of Marburg Hemorrhagic Fever in 9 of 12 specimens from patients who had died during an outbreak of suspected hemorrhagic fever in Angola. The testing, which was performed using a combination of RT-PCR, antigen-detection ELISAs and virus isolation, was carried out by CDC. The Viral Special Pathogens Branch is a World Health Organization (WHO) Collaborating Center on Viral Hemorrhagic Fevers.

CDC is working closely with WHO and other international partners to assist the Ministry of Health in Angola with the outbreak investigation and response. A CDC emergency response team consisting of experts in viral hemorrhagic fevers is expected to be deployed to the affected region in the next few days. CDC also has shipped preventive gear and supplies to officials in Angola. An outbreak notice was posted on CDC travelers' health website on March 25.