After mpox outbreak, Africa is under the threat of yet another virus outbreak, this is the Marburg virus outbreak in Rwanda. So far, six people have died from the outbreak, confirmed the health minister. Most victims were the healthcare workers in the hospital's intensive care unit. As per reports, 20 cases have been identified since the outbreak was confirmed on Friday.

What Is Marbug Virus?

With the fatality rate of 8% it is the same virus family as Ebola. The main carrier is from fruit bats which spreads to humans then through the contact of bodily fluids of infected individuals, it spreads to others.

Common Signs And Symptoms

The common signs and symptoms of the Marburg virus include fever, pain, diarrhoea, vomiting and in the case of extreme blood loss, death too can happen.

So far, there is no specific treatment or vaccine for the virus. However, treatments like drugs and immune therapy are being developed as per the World Health Organisation (WHO).

Call Of Action

Rwanda says that it has intensified its contact tracing, surveillance and testing to contain the spread. It has also tracked about 300 people who had come into contact with individuals affected by the Marburg virus.

The health minister has urged people to stay vigilant and avoid any physical contact and to wash their hands with clean water, soap or sanitiser and report any suspected case.

As of now, most of the cases have spread to the capital in Kigali. In light of this, the US Embassy in the city has advised its employees to work remotely for the next week.

This is the first time Rwanda has confirmed for Marburg cases, before this, in 2023, Tanzania confirmed the outbreak, whereas three people had died of this in Uganda in 2017.

History Of Marburg

As per WHO, this virus kills half of the people it infects. In the previous outbreaks, it has killed between 24% to 88% of the patients.

The virus was first detected in 1976 after 31 people were infected, out of which 7 died in simultaneous outbreak in Marburg and Frankfurt in Germany, and Belgrade in Serbia.

The source was traced to African green monkeys who were imported from Uganda. However, other animals too are linked to the virus spread, including bats.

In the past, the virus outbreaks have happened in countries like Equatorial Guinea, Ghana, the Democratic Republic of the Congo, Kenya, South Africa, Uganda, and Zimbabwe. In 2005, this virus killed 300 people in Angola.

However, for the rest of the world, only two people have died from the virus in the rest of the world, with one of them being in Europe, and the other in the US. These both have been on expeditions to caves in Uganda.

Alex Hughes, the son of former Wales and Manchester United footballer Mark Hughes, has died at the age of 38 from Sudden Arrhythmic Death Syndrome (SADS), also known as Sudden Adult Death Syndrome.

Alex Hughes, who served as Grimsby Town's Head of Player Recruitment, was found collapsed on the bedroom floor of his Cheshire home by his two sons at around 7 a.m. on June 19, an inquest at Cheshire Coroner's Court heard.

According to the hearing, Alex's eldest son immediately began CPR before paramedics arrived. Despite prolonged resuscitation efforts, emergency responders were unable to revive him.

Area Coroner Victoria Davies concluded that Hughes died from Sudden Arrhythmic Death Syndrome (SADS), a condition in which a fatal heart rhythm abnormality causes sudden cardiac arrest even though the heart appears structurally normal during a post-mortem examination.

Following his death, Mark Hughes and his wife, Jill, said they were "totally heartbroken by the sudden and unexpected loss of our beloved son."

What Is Sudden Arrhythmic Death Syndrome (SADS)?

SADS refers to a sudden, unexpected death caused by an abnormal heart rhythm in people whose hearts appear structurally normal after death. The condition is most commonly linked to inherited disorders that affect the heart's electrical system, triggering life-threatening irregular heart rhythms (arrhythmias) that can lead to sudden cardiac arrest.

According to the British Heart Foundation, around 500 people die from SADS each year in the UK, with young adults—particularly men—being most commonly affected.

What Causes SADS?

Most cases of SADS are caused by inherited genetic conditions that interfere with the heart's electrical signals. Because these disorders often cause few or no symptoms, many people remain unaware they have them until a cardiac arrest occurs.

Early diagnosis through cardiac evaluation and family screening can help identify those at risk and prevent sudden deaths.

Inherited Conditions Linked to SADS

Several inherited heart rhythm disorders are associated with SADS, including:

• Brugada syndrome: Causes dangerous abnormal rhythms in the heart's lower chambers (ventricles).
• Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT): Triggers dangerously fast heart rhythms during exercise or emotional stress.
• Long QT syndrome (LQTS): Delays the heart's electrical recovery between beats, increasing the risk of life-threatening arrhythmias.
• Short QT syndrome (SQTS): Causes the heart to recharge too quickly, raising the risk of atrial fibrillation and ventricular arrhythmias.
• Timothy syndrome: A rare form of Long QT syndrome associated with severe heart rhythm abnormalities.
• Wolff-Parkinson-White (WPW) syndrome: An extra electrical pathway in the heart causes episodes of rapid heartbeat.

Symptoms That May Signal SADS

Many people with inherited heart rhythm disorders experience no warning signs. However, symptoms that warrant medical evaluation include:

• Fainting or seizures, particularly during exercise, excitement or emotional stress.
• Chest pain during physical activity.
• Shortness of breath while exercising.
• Episodes of rapid or irregular heartbeat (palpitations).
• A family history of unexplained sudden cardiac death.

The Ebola outbreak in the Democratic Republic of Congo (DRC) has crossed 4,000 cases, making it the second-largest Ebola epidemic ever recorded after the 2014-2016 West Africa outbreak.

According to the latest Health Ministry situation report, the DRC has recorded 4,053 cases and 1,850 deaths since the outbreak was officially declared in mid-May. Health officials believe transmission may have begun as early as January.

The outbreak is caused by the Bundibugyo strain of the Ebola virus, which has neither a vaccination nor any antiviral. However, two vaccine candidates by Oxford-SII and Moderna have entered clinical trials.

Africa CDC Calls for Intensified Response

Africa's public health agency has said the current response needs to be significantly expanded, announcing plans to shift from traditional contact tracing to an active, community-wide search for cases.

Dr. Wessam Mankoula, Acting Head of Emergency Preparedness and Response at the Africa Centres for Disease Control and Prevention (Africa CDC), said response teams will begin door-to-door case finding.

"I think the time for incremental action is over and we're starting now the phase for scaling up," he said.

He explained that community health workers would move from house to house to identify people showing Ebola symptoms rather than relying solely on contact tracing.

Africa CDC Director General Dr. Jean Kaseya also outlined plans for a village-centered response, with greater community involvement, expanded use of digital surveillance tools, and stronger interventions in camps housing people displaced by conflict.

Second-Largest Ebola Outbreak on Record

The outbreak has spread across 53 health zones in the provinces of Ituri, North Kivu, South Kivu, Haut-Uele and Tshopo.

Ituri, the epicentre of the outbreak, accounts for 86.9% of confirmed cases.

Africa CDC noted that, 11 weeks into the outbreak, the DRC has reported eight times more cases and six times more deaths than were recorded at the same stage of the 2014 West Africa Ebola epidemic, which ultimately infected more than 28,000 people and killed at least 11,000.

Is The Bundibugyo Virus Mutating?

Health officials are now examining whether changes in the virus could be contributing to the unusually severe outbreak.

Speaking at a press briefing, Dr. Jean Kaseya said he had discussed the situation with World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus.

"We plan studies to check if there is no additional issue, or maybe if the virus is not mutating, because the level of severity of this Bundibugyo outbreak is unprecedented," Kaseya said.

He cautioned against assuming scientists fully understand the virus.

"After many Ebola outbreaks, we cannot assume we know everything. In the DRC, we must listen to communities, act on what they tell us and build the trust needed to stop transmission."

Outbreak Shows No Signs Of Slowing

Medical charity Médecins Sans Frontières (MSF) said the response is expanding but is still not reaching communities quickly enough to interrupt transmission, The Guardian reported.

Philippa Boulle, MSF's Deputy Medical Director, warned that the outbreak continues to spread into new areas.

"New suspected cases are being reported almost daily in new locations, outside already identified transmission chains. To prevent further loss of life, the response must outpace the current rate of transmission," Boulle said.

Kaseya also highlighted shortcomings in surveillance, noting that only 10 contacts are being identified per Ebola patient, compared with the approximately 40 contacts typically expected during effective contact tracing.

The US Food and Drug Administration (FDA) has granted accelerated approval to Replimune's Tudriqev for the treatment of advanced refractory melanoma—a deadly form of skin cancer that continues to grow or spread despite treatment with standard immunotherapy drugs such as PD-1 inhibitors.

The approval comes after the FDA rejected the therapy twice over concerns related to the quality of clinical data.

The latest decision was supported by clinical trial results showing that 24% of patients responded to treatment, with responses lasting a median of 14.1 months. The FDA also considered input from clinical experts and patient advocates, who highlighted the urgent need for new treatment options for patients with refractory melanoma.

What Is Tudriqev?

Tudriqev is an oncolytic viral immunotherapy based on a genetically modified herpes simplex virus type 1 (HSV-1). The virus is engineered to selectively infect and destroy cancer cells while stimulating the body's immune system to recognize and attack the tumour.

The therapy is approved in combination with nivolumab for adults with unresectable melanoma that:

• Has spread or cannot be safely removed through surgery.
• Has progressed after treatment with a PD-1-blocking antibody-based regimen.

"For patients with advanced melanoma that has stopped responding to PD-1 blocking therapy, the prognosis is often devastating, and options have been far too limited. Clinicians managing these patients know this urgency firsthand," said Karim Mikhail, Acting Director of the FDA's Center for Biologics Evaluation and Research (CBER).

Also read: Narcolepsy: US FDA Approves First-Ever Pill That Targets Root Cause of Rare Sleep Disorder

How Does Tudriqev Work?

Tudriqev is injected directly into tumours, where the modified virus replicates inside cancer cells, causing them to rupture. At the same time, it activates the immune system to identify and attack cancer cells throughout the body.

When combined with nivolumab, an anti-PD-1 immunotherapy, Tudriqev may help restore an anti-tumour immune response in patients whose melanoma no longer responds to checkpoint inhibitor therapy.

How Is The Treatment Given?

Tudriqev is administered once every two weeks for eight consecutive doses.

• The dose is determined by tumour size.
• A lower concentration is used for the first injection, followed by a higher concentration for the remaining doses.
• Nivolumab is administered intravenously starting in week three of treatment.

Replimune has announced a list price of $450,000 per course of therapy, before rebates and discounts.

Clinical trial results

The FDA based its approval on an open-label, multiregional, single-arm trial involving 140 adults with Stage IIIB, IIIC, or IV unresectable melanoma whose disease progressed after at least eight consecutive weeks of prior anti-PD-1 therapy.

Among the 91 evaluable patients:

• 24% achieved an objective response.
• The median duration of response was 14.1 months.

A confirmatory Phase III study is currently underway to verify the drug's clinical benefit. Replimune expects results in 2030.

Safety and Side Effects

The most common side effects reported in more than 10% of patients included:

• Fatigue
• Fever (pyrexia)
• Infections
• Chills
• Musculoskeletal pain
• Nausea and Vomiting
• Diarrhoea
• Injection-site reactions
• Headache
• Cough
• Influenza-like illness
• Rash
• Shortness of breath (dyspnoea)
• Bleeding (haemorrhage)
• Oedema
• Abdominal pain

The FDA also warned of:

• The risk of accidental transmission of herpes infection to close contacts.
• Development or reactivation of herpes infection in treated patients.
• Injection-related complications.

About melanoma

Melanoma is the deadliest form of skin cancer and the fifth most common cancer in the United States. An estimated 105,000 new cases are expected to be diagnosed in the US in 2025, with the disease causing nearly 8,500 deaths each year.

Immune checkpoint inhibitors are the current standard treatment for advanced melanoma, but about half of patients either do not respond or eventually develop resistance, underscoring the need for new treatment options such as Tudriqev.