Thailand heightens screening as Ethiopia reports Marburg virus outbreak

Dr Montien Kanasawat, Director-General of the Department of Disease Control (DDC), provided an update on Friday (November 21) regarding several confirmed cases of Marburg virus disease in Ethiopia. 

He noted that the disease belongs to the same family as Ebola and causes fever and haemorrhagic symptoms. Fruit bats are considered the natural reservoir of the virus, which is named after the German city of Marburg, where the first outbreak was recorded.

Infection typically occurs through contact with fruit bats in mines or caves. Once transmitted from animals to humans, the virus can spread between people through direct contact with the bodily fluids of an infected person, similar to Ebola.

The Marburg virus was first identified in 1967 following outbreaks in Marburg and Frankfurt in Germany, and in Belgrade, Serbia, linked to laboratory contamination involving African green monkeys imported from Uganda. 

Sporadic cases have since been recorded. Most outbreaks occur in East and Central Africa, including Uganda, Kenya, the Democratic Republic of the Congo, Angola, Ghana, Guinea and Tanzania.

Outside Africa, imported cases have been reported, such as one fatal case in Europe following exposure in a Ugandan cave, and another non-fatal case in the United States after travel to the same area.

As of November 17, 2025, the World Health Organisation (WHO) and the Africa Centres for Disease Control and Prevention have deployed teams to assist Ethiopia’s outbreak response. The Ethiopian government has reported 17 suspected cases, nine laboratory-confirmed cases and three deaths. 

Patients have presented with fever, fatigue, bloody vomiting and diarrhoea. The outbreak has been detected in the Omo region in southern Ethiopia, near the border with South Sudan.

Thailand classifies Marburg virus disease as one of 13 dangerous communicable diseases under the Communicable Disease Act BE 2558 (2015). It is considered highly severe, although no cases have ever been reported in Thailand.

The disease has an incubation period of 2–21 days following exposure to the bodily fluids of infected individuals or reservoir animals. Early symptoms include fever, headache, fatigue, nausea, vomiting, abdominal pain and diarrhoea. 

Patients may develop a non-itchy rash and later haemorrhagic symptoms, including blood-stained vomit, black or bloody stools, and bleeding from the nose, mouth or vagina. Some cases progress to liver failure, multi-organ failure or shock.

Many patients develop severe haemorrhaging within seven days. Fatalities typically occur 8–9 days after symptom onset, with mortality rates reported between 24% and 88%. There is currently no vaccine or specific antiviral treatment.

Although Thailand has not issued any travel bans, it has tightened screening measures for all passengers arriving from Ethiopia. International disease control checkpoints have been instructed to intensify surveillance and screening, while all public health facilities nationwide have been placed on heightened alert.

Suspected cases must undergo laboratory testing, and health officials must report suspected cases within three hours. Members of the public who encounter individuals showing symptoms consistent with Marburg virus disease are urged to notify provincial public health offices or Ministry of Public Health hospitals. 

Response measures follow the same protocols used for Ebola.

The DDC recommends the following preventive measures:

• Travellers to African countries or areas with active outbreaks should avoid contact with reservoir animals, wash their hands thoroughly with soap after handling animals, meat or carcasses, and avoid direct exposure to symptomatic individuals or their bodily fluids without protective equipment.
   
• Healthcare facilities should remain vigilant for Marburg virus disease in patients with travel history to affected countries and consider laboratory testing for those with risk factors.
   
• Travellers returning from outbreak areas who develop symptoms should seek medical care immediately. For further advice, the DDC hotline is available at 1422.