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Roula Khalaf, editor of the FT, picks her favorite stories in this weekly newsletter.

The author is a science commentator

The 31 patients had one thing in common: they had all reported contact with African green monkeys that had previously been imported from Uganda. Some were laboratory workers who used the animals’ tissue to create a live polio vaccine.

At first they complained of fever, headache and muscle pain. Some worsened and suffered from vomiting and diarrhea. For a few unfortunate people, this resulted in organ failure and death. Two of the 1967 outbreaks occurred in Frankfurt and Belgrade, but it was the third location – Marburg, Germany – that would forever be associated with this new disease.

The Marburg virus is not as well known as the Ebola virus, which has caused devastating epidemics in West Africa. But Marburg’s same dark approach is neither as rare nor as reserved as it used to be. It is mainly found in only a few countries in sub-Saharan Africa, particularly Uganda, and appeared for the first time in Equatorial Guinea and Tanzania last year. Last month, the deadly virus reached Rwanda.

With 56 confirmed cases on Monday, most of them in the capital Kigali, it is the third largest outbreak recorded. There are fears it could spread to neighboring Democratic Republic of Congo, where there are 7 million internally displaced people. But there is hopeful news: Rwanda has procured hundreds of doses of a promising experimental vaccine and immunization of health workers and close contacts of confirmed cases has reportedly begun.

There are clearly some lessons being learned from the post-pandemic era: the importance of continuing research against potential epidemic diseases and the need to rigorously test vaccine and treatment candidates in the heat of an outbreak. However, some important details remain secret, including the genetic sequence of the current virus and how it spreads.

Craig Spencer, an emergency physician at Brown University who has cared for Ebola patients (and survived the disease himself), praised the response to -cases a little over a week has passed.” before primary care providers were vaccinated today.” Interestingly, Rwanda’s Health Minister Sabin Nsanzimana is a doctor and epidemiologist. According to his department’s posts on X, Monday’s 56 confirmed cases included 12 deaths and eight recoveries.

“Outbreaks of (Marburg and Ebola) infections appear to be becoming more frequent and expanding their range,” says Jimmy Whitworth, emeritus professor of epidemiology at the London School of Hygiene and Tropical Medicine, who has worked in outbreak response. Humans are increasingly encroaching on bat habitats, he explains, increasing the likelihood of zoonotic spread. Due to the ease of air and land transport and an incubation period of around five to ten days, there is always a risk of spread to further areas.

Accordingly, precautionary measures are being tightened. On Monday, the U.S. Centers for Disease Control and Prevention advised against non-essential travel to Rwanda, and starting Oct. 14, U.S. travelers returning home will be subject to a public health screening if they have been in the past were in the country for three weeks.

Marburg and Ebola belong to a family of viruses known as filoviruses. Confusingly, Marburg virus disease, as the disease is technically called, can be caused by two slightly different viruses: the similarly named Marburg virus and the closely related Ravn virus, which was first identified in 1987.

Like Ebola, Marburg is transmitted to humans and non-human primates through flying foxes; The viruses can then be transmitted from person to person through close personal contact and body fluids. The risk of transmission between strangers is therefore low – but higher for close family members and hospital staff. Symptoms include bleeding from the nose, gums, and sometimes eyes, as well as internal bleeding. Unlike Ebola, there is no approved vaccine, treatment or cure.

Last year, a World Health Organization advisory committee identified a Marburg vaccine being developed by the Sabin Vaccine Institute, a nonprofit in Washington, with funding from the U.S. biomedical research agency Barda, as the front-runner. The institute, which is conducting phase 2 trials in Uganda and Kenya, has now delivered 700 doses to Rwanda. Gilead Sciences is also donating 5,000 doses of remdesivir for emergency use. The antiviral, originally developed to treat Ebola and used to fight Covid, is untested against Marburg.

The Rwandan response appears to be quick and well-organized, although scientists are waiting for more information. Time will tell whether it will be enough to turn the tide.