African health chief criticizes U.S. travel advice

Top African health official Jean Kasea said it was “unfair” for U.S. officials to advise against non-essential travel to Rwanda due to an outbreak of the deadly Marburg virus.

The head of the Africa Centers for Disease Control and Prevention (Africa CDC) added that this was “not the treatment Rwanda and Africa deserve”.

In just two weeks, 13 people have died from the disease in Rwanda, most of them health care workers, according to a statement from Rwanda’s health minister.

But authorities said the epidemic was under control.

Still, those on the front lines dealing with its consequences are nervous.

“What scares you most? [is] “When you see people in the same profession die,” said Maria (pseudonym), an intensive care nurse at a hospital in Rwanda’s capital, Kigali.

Maria spoke on condition of anonymity because she feared she would lose her job if she spoke publicly.

“I kept telling myself that I might be next, that maybe I tested positive but didn’t have any symptoms yet,” said the 46-year-old nurse and mother.

She told the BBC that several of her colleagues had fallen ill and were being treated in isolation, and that more than one colleague had died from the virus. She described the intense pressure workers at the facility face every day.

According to the World Health Organization (WHO), on average half of people infected with Marburg virus die. Fruit bats are reservoirs for the virus, which is spread from person to person through contact with infected body fluids such as sweat, urine and blood.

While a Marburg virus vaccine has not yet been approved, Rwanda has begun trials using a vaccine provided by the U.S. non-profit Sabin Institute.

It has vaccinated 200 people, prioritizing health care workers and contacts of confirmed cases, and plans to expand vaccinations as more doses arrive.

The Africa Centers for Disease Control and Prevention also provided 5,000 Marburg virus detection kits to Rwanda and neighboring countries to strengthen cross-border surveillance.

Maria has not yet been vaccinated but is determined to continue working.

“I’m a nurse, I’m on the front lines and we have to fight this, but the fear is always there,” she said.

German authorities closed parts of Hamburg Central Station amid concerns about the spread of the virus to Europe, days after a medical student and his companion fell ill after a visit to Rwanda. Both eventually tested negative for Marburg virus.

The U.S. Centers for Disease Control and Prevention has issued its second-highest level travel advisory to Rwanda, advising people to avoid non-essential travel to Rwanda due to the outbreak.

Rwanda’s neighbors, Tanzania, Uganda and the Democratic Republic of Congo, have all had cases in Marburg in the past and have stepped up border surveillance to prevent the spread of the disease.

Burundi went a step further and established emergency treatment and isolation centers to prepare for an outbreak.

The Africa Centers for Disease Control and Prevention says it is improving public health emergency training to help staff respond more effectively to the Marburg outbreak.

Rwandan authorities have taken steps to limit attendance at funerals of virus victims to 50 people to help curb the spread of the disease.

In addition, they have implemented passenger questionnaires, hand washing stations at departure points and temperature checks at entry and exit points across the country.

Rwanda’s health minister said the outbreak was mainly concentrated in a cluster of cases in the capital.

“In different departments, you will find that there are very few staff working on shifts,” said a second nurse, Claire, who also asked not to be named. She works at another hospital in Kigali.

“I lost someone I knew; I lost a dear colleague at another hospital,” she said.

Rwandan authorities say early identification of Marburg virus cases is particularly challenging because it initially displays similar symptoms to malaria, which is very common in the region.

Health Minister Sabin Nsanzimana said the country was exercising an abundance of caution and was conducting mass testing of anyone with high fever, headache, vomiting and muscle aches. All facilities where health workers have tested positive for the virus have stopped visiting.

Marburg virus is closely related to Ebola, which killed more than 11,000 people in West Africa between 2014 and 2016, according to the World Health Organization.

Based on what it has learned from the outbreak and in partnership with the World Health Organization and the Africa Centers for Disease Control and Prevention, Rwanda said it is responding quickly with strict health measures, raising public awareness and providing health workers with protective equipment. and isolate confirmed cases.

Rwanda received 5,100 vials of remdesivir, an antiviral drug made by Gilead Sciences that was used against Ebola in the past, to help fight the virus.

While trial vaccinations are underway, a second nurse the BBC spoke to has also not yet received the vaccine.

“I hope things will get better soon… some vaccines have arrived, which gives us some hope,” she said.