Ghana’s Ministry of Health made the declaration after no new cases were reported over the past 42 days, or two incubation periods—the time between infection and the onset of symptoms. In total, three confirmed cases, including two deaths were recorded in the outbreak declared on 7 July 2022 after laboratory confirmation of the virus that affected the country’s Ashanti, Savannah and Western regions. A total of 198 contacts were identified, monitored and completed their recommended initial 21-day observation period which was then extended for another 21 days out of an abundance of caution by the Ghanaian health authorities.

The health authorities, with support from World Health Organization (WHO) and other health partners, swiftly rolled out outbreak control measures, stepping up disease surveillance, testing, contact-tracing, clinical care as well as raising public awareness and working with communities to support disease prevention efforts. Marburg is a highly infectious disease in the same family as Ebola and has a high fatality rate of between 24% and 88%.

“Marburg is a frightening disease as it is highly infectious and lethal. There are no vaccines or antiviral treatments. Any outbreak of Marburg is a major concern,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Despite having no previous experience with the disease, Ghana’s response has been rapid and robust. Lives have been saved and people’s health protected thanks to an effective disease detection system that helped to quickly identify the virus and enabled prompt response to curb the spread of infection.”

The Marburg outbreak in Ghana was the second of its kind in West Africa. Guinea reported a single case in an outbreak that was declared over in September 2021. In Africa, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda.

Genomic sequence analyses of the Marburg virus by Senegal’s Institut Pasteur and the Noguchi Memorial Institute for Medical Research in Ghana suggest that this latest outbreak is related to the case reported in Guinea in 2021. However, further investigations are needed to fully understand the origin of the outbreak, which may be due to a shared animal reservoir or to population movements between the two countries. WHO is supporting the health authorities to carry out ecological studies to increase understanding of the disease and help anticipate and prevent future outbreaks.

Resurgence of Marburg can occur and WHO is working with Ghana’s health authorities to maintain surveillance and improve detection and response to potential flare-up of the virus. Marburg is transmitted to people from fruit bats and spreads among humans through direct contact with the bodily fluids of infected people, surfaces and materials. Illness begins abruptly, with high fever, severe headache and malaise. Many patients develop severe haemorrhagic signs within seven days.