### Controversy Over US Travel Advisory Amid Marburg Virus Outbreak in Rwanda

Amid an outbreak of the deadly Marburg virus in Rwanda, a US travel advisory recommending against non-essential travel has been deemed "unfair" by Africa's top health official, Jean Kaseya. The head of the Africa Centres for Disease Control and Prevention (Africa CDC) criticized the advisory, stating that it does not reflect a balanced treatment of Rwanda and Africa.

Rwanda's health crisis has resulted in 13 deaths over the past two weeks, mostly affecting healthcare workers. Despite this, local authorities insist that the outbreak is under control. However, healthcare workers on the front lines are deeply concerned. Maria, an intensive-care nurse in Kigali who requested anonymity out of fear of losing her job, described her persistent anxiety about contracting the virus. She noted that multiple colleagues are currently isolated and undergoing treatment, with some already having succumbed to the disease.

The World Health Organization (WHO) estimates that the Marburg virus has an average fatality rate of 50%. Transmitted by fruit bats, the virus spreads from person to person through contact with bodily fluids. There are no approved vaccines for Marburg, but Rwanda has initiated trials with supplies from the US-based Sabin Institute, prioritizing healthcare workers and close contacts of confirmed cases. Africa CDC has also contributed by providing 5,000 test kits to Rwanda and its neighboring countries.

Despite not being vaccinated yet, Maria remains committed to her role. Her situation reflects broader fears, recently underscored when German authorities temporarily shut down part of Hamburg’s central station after two travelers from Rwanda fell ill; they tested negative for Marburg in the end. Meanwhile, the US Centers for Disease Control and Prevention has issued a travel advisory, recommending against non-essential travel to Rwanda due to the outbreak.

Rwanda’s neighboring countries—Tanzania, Uganda, and the Democratic Republic of Congo—have heightened border surveillance. Burundi has taken an extra step by establishing an emergency treatment and isolation center in preparation for a possible outbreak. Africa CDC is also enhancing public health emergency training to equip staff for managing Marburg cases more effectively.

In Rwanda, the government has limited funerals for virus victims to a maximum of 50 attendees and implemented health measures such as hand-sanitizing stations and temperature checks at travel points. Despite these efforts, the situation remains grim, particularly in Kigali, where most cases are concentrated. Another nurse, Claire, revealed that the virus has led to staff shortages and the loss of several colleagues.

Identifying Marburg cases has proven difficult as the initial symptoms closely resemble malaria, which is prevalent in the region. Rwanda's Health Minister Sabin Nsanzimana emphasized caution and the necessity of mass testing for anyone exhibiting symptoms like high fever, headache, and vomiting. Hospital visitation is currently restricted where health workers have tested positive.

Drawing lessons from past outbreaks like the Ebola crisis, Rwanda is responding rigorously with WHO and Africa CDC support. The country's efforts include stringent hygiene protocols, widespread public awareness campaigns, provision of protective gear, and quarantine for confirmed cases. To combat the outbreak, Rwanda has also received 5,100 vials of remdesivir, an antiviral drug previously used against Ebola.