Rwandan National Reference Laboratory Championing Biosafety and Biosecurity While Leading the Response to Marburg Virus Outbreak in the Country

The Marburg virus (MARV) is an extremely contagious zoonotic virus that leads to severe hemorrhagic fever in humans, with a fatality rate as high as 90%. It is known for causing nosocomial outbreaks in hospitals and laboratories globally. The recent outbreak of MARV in Rwanda highlighted significant challenges to infection prevention and control (IPC) protocols in two major hospitals, leading to outbreaks in intensive care units (ICUs) where the majority of infections occurred among healthcare providers. In contrast, the Rwandan National Reference Laboratory (NRL) demonstrated remarkable preparedness and resilience due to systematic investments and capacity building, which resulted in zero contamination, exposure, or infection, despite handling thousands of samples from across the country. This stark difference in infection dynamics between laboratory personnel at the NRL and healthcare providers underscores the effectiveness of the strict biosafety and biosecurity measures in place. Consequently, this situation underscores the urgent need for cross-facility training, the sharing of best practices, and the role of the NRL in reinforcing IPC measures throughout the country. This report delves into the preparedness and resilience of the NRL by examining its exemplary laboratory biosafety and biosecurity practices, emphasizing the crucial need for ongoing training, supervision, adherence to safety protocols, and improvements in the structure and operations of healthcare settings to prevent future outbreaks.