African health chief criticizes US travel advisory

Africa's top health official, Jean Kaseya, said the US's official recommendation against non-essential travel to Rwanda was “unfair” given the outbreak of the deadly Marburg virus.

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

In just two weeks, Rwanda has recorded 13 deaths from the disease, most of them health workers, according to a statement from the country's health minister.

But authorities say the outbreak is under control.

Nevertheless, those on the front lines dealing with its effects remain nervous.

“What you're most afraid of is [is] When I saw people in my profession dying,'' said Maria (not her real name), an intensive care nurse at a hospital in Rwanda's capital Kigali.

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

“I can't help but tell myself that I could be next, that I could be positive but not have symptoms yet,” said the 46-year-old nurse and mother.

She told the BBC that several colleagues had fallen ill and were being treated in isolation, and that several had already died from the virus. She described the tremendous strain that facility staff face every day.

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

A vaccine for Marburg disease has not yet been approved, but Rwanda has begun trials using supplies sent from the U.S.-based nonprofit Sabin Institute.

The government is currently vaccinating 200 people, prioritizing medical workers and people who have come into contact with infected people, and plans to expand vaccinations as more vaccines arrive.

Africa CDC also provided 5,000 Marburg test kits to Rwanda and neighboring countries to strengthen cross-border surveillance.

Although Maria has not yet been vaccinated, she remains determined to continue working.

“I'm a nurse and I'm on the front lines. We have to fight it, but the fear continues,” she said.

A few days ago, German authorities closed part of Hamburg Central Station after a medical student and his companion fell ill after visiting Rwanda amid fears of the virus spreading in Europe. Ultimately, both tested negative for Marburg virus.

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

Rwanda's neighbors Tanzania, Uganda and the Democratic Republic of Congo have all recorded cases of Marburg disease in the past and have increased border surveillance to prevent the spread of the disease.

Meanwhile, Burundi has gone a step further and set up emergency treatment and isolation centers in case of an outbreak.

Africa's CDC said it is improving public health emergency training to help staff more effectively respond to Marburg disease outbreaks.

Rwandan authorities have taken steps to limit the number of attendees at the funerals of virus victims to 50 people in a bid to curb the spread of infection.

In addition, we are conducting passenger surveys, installing hand sanitizing stations at departure points, and conducting body temperature checks at entry and exit points across the country.

Rwanda's health minister said the outbreak was centered on an outbreak in the capital.

“In other departments, very few staff are working shifts,” said Claire, another nurse who also requested anonymity. She works at another hospital in Kigali.

“I lost people I knew. I lost a colleague who was important to me in another hospital,” she says.

Rwandan authorities said early detection of Marburg disease patients is particularly difficult because they initially present with symptoms similar to malaria, which is very common throughout the region.

Health Minister Sabin Nsanzimana said the country was on high alert and mass testing people with high fever, headache, vomiting and muscle pain. Visits to hospitals have been suspended in facilities where health care workers have tested positive for the virus.

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

Based on information from this outbreak, Rwanda is working with the WHO and Africa CDC to take immediate action, including strict hygiene measures, public awareness, providing protective equipment to healthcare workers, and isolating confirmed cases. He said that it corresponds to

Rwanda has received 5,100 vials of Gilead Sciences' antiviral drug remdesivir, previously used in the fight against Ebola, to help fight the virus.

Trials of the vaccine are ongoing, but a second nurse the BBC spoke to has not yet received the vaccine.

“We hope that the situation will get better soon… some vaccines have arrived and this is what gives us hope,” she said.