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Rwanda's Marburg virus outbreak is seeing an unusually low fatality rate

AYESHA RASCOE, HOST:

Good news now about a deadly virus. Marburg virus disease is notoriously fatal. There are no approved vaccines or medications. But in the midst of one of the largest Marburg outbreaks, Rwanda has found a way to dramatically improve outcomes for people who get sick. NPR's Gabriella Emanuel reports.

GABRIELLA EMANUEL, BYLINE: A little over a month ago, Rwandan officials announced the country's first Marburg outbreak. It's a nasty disease, a cousin to ebola, and the fatality rate can be as high as 88%. But this past week, Yvan Butera, one of Rwanda's top health officials, had better news to share.

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YVAN BUTERA: Now we are at a case fatality rate of 22.7%, probably among the lowest ever recorded.

EMANUEL: Fifteen of the 66 patients have died, but some of the recoveries have been impressive. For example, two patients were suffering from multiple organ failure and on life support. But now their breathing tubes have been removed, and they've recovered.

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BUTERA: I think it was probably the first time on the continent that we recorded two patients that were intubated that recovered from it.

EMANUEL: One of the reasons for this success is some basic but big changes. In the past few decades, Rwanda has spent far more on health care per capita than most other African countries, investing in medical training, building modern hospitals with well-equipped intensive care units.

BUTERA: Our critical care capacity had been prepared to deal with severe diseases such as Marburg.

EMANUEL: In order to understand why critical care is so important, Daniel Bausch of the London School of Hygiene and Tropical Medicine says, you have to look at past Marburg outbreaks. He cared for Marburg patients in the late-'90s in Africa.

DANIEL BAUSCH: We didn't have really anything available to us. People were lucky that they got a paracetamol or a - you know, a Tylenol.

EMANUEL: As a result, the fatality rate in that outbreak was 83%. Fast-forward a couple decades, and Rwanda is able to offer a lot more - from IV fluids, which are critical when a patient has severe vomiting and diarrhea, to life support. Craig Spencer at Brown University School of Public Health says Rwanda's health infrastructure has let the country move incredibly quickly. Officials got experimental vaccines into the country just about a week after discovering the outbreak, and they've done 6,000 Marburg tests.

CRAIG SPENCER: Absolutely, you know, remarkable in terms of the response.

EMANUEL: But the outbreak isn't over, and the country's effort to contain the Marburg virus continues. Gabriella Emanuel, NPR News. Transcript provided by NPR, Copyright NPR.

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