Marburg Viral Disease Outbreak in the Adansi North of Ashanti Region, Ghana: A Case Report

On July 7, 2022, a blood sample from a resident of Adansi North District, Ashanti region of Ghana, tested positive for Marburg virus disease. Within 24 hours of confirmation, a rapid outbreak response was initiated. This report presents results of response activities conducted to adequately response to the outbreak. A regional rapid response team was activated consisting of specialized teams to conduct case finding, case management and isolation, contact listing and follow up, sample collection and testing, and community engagement. Support from the National Surveillance Department and WHO were provided. An investigation was also carried out to identify the potential source of infection. Laboratory virus isolation and sequencing were performed by the NMIMR and corroborated by the Institute Pasteur in Dakar to identify the strain of Marburg virus. One hundred and ninety-eight closed contacts were epidemiologically investigated, with blood samples of sixteen (16) randomly selected tested for MVD. Standard case definition of MVD was used to screen all. No case was suspected based on the case definition used. Two closed contacts were confirmed as MVD after the follow- up. Of the three confirmed MVD cases, two died, yielding a case fatality rate of 67.0%. All three cases form a single nuclear family and 50% (2/3) of the MVD cases were male. The cases had clinical symptoms of fever, chills, general malaise, and bleeding from the nose and mouth. Genetic sequencing results indicated that the Marburg virus genomes were related to the sequence from the 2021 outbreak and overall, group with sequences obtained from bats in Sierra Leone and an outbreak that occurred in Angola in 2004-2005. This outbreak of MVD occurred as a family cluster with no additional transmission outside of the three related cases. Rapid case detection, prompt laboratory testing at the NMIMR and presence of pre-trained, well-prepared national and district rapid response teams facilitated the containment and control of this outbreak.