Ethiopia's first Marburg virus outbreak — Implications for emerging hemorrhagic fevers in Africa

Ethiopia's first Marburg virus outbreak -Implications for emerging hemorrhagic fevers in Africa Marburg virus (MARV), belonging to the Filoviridae family, causes Marburg virus disease (MVD), a severe and frequently fatal viral hemorrhagic fever first identified in 1967 during laboratory-associated outbreaks in Germany and former Yugoslavia [1].The natural reservoir is the Egyptian fruit bat (Rousettus aegyptiacus), and initial spillover to humans occurs through exposure to bat-inhabited caves or mines [2].Subsequent human-to-human transmission occurs through direct contact with infected bodily fluids, contaminated fomites, or via unsafe burial practices (Fig. 1) [3].Clinical illness begins abruptly with high fever, headache, and malaise.Within several days, patients develop profuse diarrhea, vomiting, abdominal pain, and in many cases hemorrhagic manifestations and shock [4].Case-fatality rates range from 24 % to 88 % depending on viral strain and quality of supportive care [5].There are currently no licensed treatments or vaccines for MVD, although multiple investigational countermeasures-including vesicular stomatitis virus (VSV)-based vaccine expressing the MARV glycoprotein (VSV-MARV) the chimpanzee adenovirus type 3-vectored Marburg virus (cAd3-Marburg) vaccine candidates, are undergoing evaluation [6,7].Historically, outbreaks have been documented in Angola, Uganda, Kenya, Democratic Republic of the Congo, Guinea, Ghana, and Europe among travelers exposed in Africa, thus showing the pathogen's East and Central African ecology [8][9][10].On November 14, 2025, Ethiopia confirmed its first-ever MVD outbreak in the Omo region [11].The Ethiopia Public Health Institute, supported by the World Health Organization (WHO) and Africa Centers for Disease Control (CDC), initiated case isolation, contact tracing, community risk communication, and laboratory diagnostics scale-up.Whole genome sequencing identified the virus as belonging to a lineage similar to strains previously circulating in East Africa.This represents a major public-health event: the first known introduction of MVD into Ethiopia, a country not previously associated with filovirus outbreaks.The recent Ethiopia Marburg virus outbreak poses significant regional and cross-border public health risks due to its high fatality rate and potential for rapid transmission.Key challenges include controlling the spread in hard-to-reach communities, strengthening healthcare capacity, and ensuring swift detection and case management to prevent wider outbreaks.Surveillance and diagnostics systems are central to this outbreak: rapid laboratory confirmation demonstrates strengthened capacity to detect high-risk pathogens, yet the emergence of Marburg virus in a previously unaffected country points to either recent introduction or missed historical spillover events.Sustained sentinel surveillance, especially in bat-dense ecological zones, is therefore essential to detect new cases early and prevent wider spread.