An unknown virus in Burundi’s North Western Region: Editorial

Dear Editor,

While the regions of Africa were coping with the high case fatalities of Marburg virus, Burundi’s North Western Region, West Africa, is experiencing the ramparts of an unknown virus. The initial presentation of the viral infection includes vomiting, nausea, abdominal cramps, high-grade fever, acute headache, and worsening nose bleeds that accentuate after death^1,2. The symptoms appear to point toward some sort of viral hemorrhagic fever, which damages the walls of tiny blood vessels, making them leak. It is reported that individuals have a rapid progression leading to death even within 24 h; three fatalities have been detected so far, which has further raised the need for urgent intervention. This has forced a huge number of people to quarantine, especially in the Baziro area³.

Among the three reported deaths, two were reported from the same health center, whereas one was an 18-year-old boy who presented with similar complaints and died on the same day. These deaths were suspected due to the recent outbreak of the Marburg virus and Ebola virus in Equatorial Guinea and Tanzania, which manifest similar symptoms (Fig. 1)^4,5. Also, in view of the similarity of symptoms caused by any hemorrhagic virus predominant in this particular region, these diseases were always the differential diagnosis. However, both viral diseases tested negative. The governor and provincial doctor of Kirundo are awaiting the results of samples collected by experts from the National Institute of Public Health (INSP) to know the nature of the virus³. Similar attacks were seen in Tanzania last July. Healthcare professionals have already been sent to the Kirundo and Muyinga provinces to conduct a proper investigation; however, exact reports on this virus are unknown².

Figure 1.

Geographic distribution of recent outbreak of Marburg virus in adjoining areas to Burundi.

Management involves a multifaceted approach that includes prevention, surveillance, and response activities. To control the spread of infection and decrease mortality rates, the following actions could be implemented:

1. Early detection and isolation of cases: Early detection and isolation of cases are crucial to containing the outbreak. This can be achieved through active surveillance and contact tracing, which involves identifying and monitoring people who have come in contact with infected individuals.

2. Contact tracing and monitoring: This involves identifying and monitoring individuals who have had close contact with virus-infected individuals. This will help to prevent further transmission of the virus.

3. Treatment and supportive care: Treatment and supportive care are critical components of virus outbreak management. Treatment may include antiviral drugs (once the nature is identified), fluid and electrolyte replacement, and other supportive measures.

4. Infection prevention and control: Effective infection prevention and control measures are essential in preventing the spread of the virus. This includes using personal protective equipment (PPE), proper hand hygiene, safe burial practices, and decontamination of surfaces and equipment. Proper hand washing has to be practiced, and individuals are strictly prohibited from greeting each other with their hands. The ministry has also issued an advisory to avoid unprotected contact with bodily fluids, consuming wild animals, and touching a corpse with an unknown cause of death as measures to protect themselves.

5. Community engagement: Community engagement is a critical component of outbreak management. Engaging with affected communities can help to build trust and improve the acceptance of interventions.

6. International cooperation: International cooperation is necessary to address an outbreak that crosses borders. This includes sharing of information, resources, and expertise to ensure a coordinated response.

Overall, the management of this unknown virus outbreak requires a coordinated, multi-sectoral approach that involves the government, health workers, communities, and international partners. Due to its similar nature to other viral hemorrhagic fevers like Marburg and Ebola, targeted therapy research might be conducted for early management. Nevertheless, individuals should remain cautious at all points of the risk of infection.

Ethical approval

Not applicable. Exempted/waived at our institution.

Consent

Written informed consent is not required for this manuscript.

Funding

No funding received.

Author contribution

N.D. and V.J.: designed and draw the original draft; S.S., A.M., and R.S.: reviewed the literature and critically edited the manuscript. All authors read and approved the final manuscript.

Conflicts of interest disclosure

There are no conflicts of interest.

Research registration unique identifying number (UIN)

Not applicable.

Guarantor

Ranjit Sah.

Provenance and peer review

Not commissioned, externally peer-reviewed.

Data availability statement

Not applicable.