From Zoonotic Spillover to Hemorrhagic Crisis: Molecular Insights and Epidemiology of Ethiopia’s 2025 Marburg Outbreak Amid Preparedness Gaps and Historical Lethality

Ethiopia confirmed its first Marburg virus disease (MVD) outbreak on 14 November 2025 in Jinka (Omo Valley area), where a single spillover from Rousettus aegyptiacus resulted in nine laboratory-confirmed cases and eight deaths (CFR 89%). Transmission occurred in the context of concurrent cholera and large-scale population displacement. Despite these pressures, case confirmation was achieved within 48 hours, >90% of contacts were traced, and same-day L-gene sequencing placed the isolate within the East African lineage associated with the 2024 Rwanda outbreak. This review summarizes key molecular determinants of MARV virulence including GP–NPC1 mediated entry, VP24-driven interferon antagonism, and GP-associated endothelial dysfunction and examines Ethiopia’s contrasting strengths in genomic capacity and PHEOC coordination versus persistent constraints in diagnostics, clinical readiness, and countermeasure access. We outline a feasible seven-day containment framework integrating low-cost molecular testing, remdesivir therapy, and VSV-MARV ring vaccination to prevent further spread in resource-limited settings.