SITUATION OVERVIEW
The Ministry of Health of Equatorial Guinea received reports of a cluster of deaths due to an unknown illness in two north-eastern districts of the continental region of Equatorial Guinea (Nsok-Nsomo and Ebebiyin). A total of nine people died from January 7 to February 6 with symptoms similar to a viral haemorrhagic fever infection.
Samples were collected from the deceased and sent for testing in Dakar, Senegal. One tested positive for Marburg virus disease (MVD). On 13 February 2023, Equatorial Guinea’s Ministry of Health officially declared the outbreak, marking the first-ever Marburg outbreak in the country. According to government information, initial alerts and deaths were traced back to public events which, according to local religious and cultural customs, brought together several dozen and sometimes hundreds of people. Untraced contacts in the community, rumors and lack of information within the communities could be important transmission levers that need to be urgently managed.
At the request of the Ministry of Health, several agencies deployed to the affected area in Equatorial Guinea to support the set-up of the response, including the Equatorial Guinea Red Cross Society (EGRCS) and IFRC, with an initial DREF allocation. This included setting up surveillance systems, case management, infection prevention and control, laboratory capacities, and risk communication and community engagement (RCCE).
Throughout the first month, despite the best efforts of the government and partners, deaths with similar symptoms continued to be reported at the community level, although not confirmed by laboratory tests. According to WHO, since the beginning of the outbreak and as of 21 March, a cumulative number of nine confirmed and 20 probable cases have been recorded in Equatorial Guinea.
In addition to the province of Kié-Ntem, where the first case was confirmed, there are now four cases in Litoral province and two in Centro Sur province, confirming wide transmission of the epidemic across the country. Contact tracing is not yet reaching all of the new areas where confirmed and probable cases exist, which poses a risk to epidemic surveillance and control.
There are four confirmed cases in Bata, the most populous city in Equatorial Guinea with approximately 300,000 people, which substantially increases the risk profile of this epidemic. National response coordination has been moved to Bata under instructions of the Ministry of Health. This includes all subcommissions.
The EGRCS and IFRC have mobilised to Bata to support the set-up of the response in the area, while 100 trained volunteers continue to conduct activities in Ebebiyin, Mongomo and Nsok-Nsomo, under the supervision of the local EGRCS branches.
MVD is a highly virulent disease that causes haemorrhagic fever, with a case fatality rate of up to 88%. It belongs to the same family of viruses that causes Ebola virus disease (EVD). Marburg begins abruptly, with a high fever, and severe headache and malaise. Many patients develop acute haemorrhagic symptoms within seven days. The virus is transmitted to humans by fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials. There is no approved vaccine or antiviral treatment for the virus. However, supportive care – rehydration with oral or intravenous fluids and treatment of specific symptoms improves chances of survival.