Ethiopia: First Reported Marburg Virus Disease Outbreak

On November 14, 2025, the Ethiopian Ministry of Health declared the country’s first-ever Marburg virus disease (MVD) outbreak in the South Ethiopia and Sidama regions. According to the World Health Organization (WHO) and U.S. Centers for Disease Control and Prevention (CDC), as of December 3, 2025, Ethiopia has reported 13 laboratory-confirmed cases, eight of which were fatal (62% case fatality rate). Additional cases may be retrospectively identified as the outbreak investigation progresses. Genomic sequencing suggests this is the same Marburg virus strain reported in previous East African outbreaks. No cases related to this outbreak have been reported outside of Ethiopia as of December 3, 2025, and the risk of spread to the United States and other countries is considered low.

Affected regions:

South Ethiopia Regional State
Sidama Region

Current status:

13 confirmed cases
8 deaths (62% mortality rate)
No secondary cases reported outside Ethiopia
Active investigations ongoing to determine timeline, transmission chains, and outbreak source

Keep in Mind:

MVD is caused by Marburg virus or Ravn virus (both in the Filoviridae family, which also includes Ebola virus). The virus is zoonotic, with Egyptian rousette bats (Rousettus aegyptiacus) being the natural reservoir. Previous MVD outbreaks have occurred in other African countries including Uganda, Kenya, Angola, Democratic Republic of Congo, and Ghana. This is the first recorded outbreak in Ethiopia.

Marburg virus disease (MVD) is a rare but highly fatal viral hemorrhagic fever with mortality rates of 23-90%, depending on virus strain and level of case management
The actual number of infections may be higher than confirmed cases, as investigations are ongoing
A person infected with Marburg virus is not contagious until after symptoms appear
Incubation period ranges from 2-21 days after exposure
Early intensive supportive care and fluid replacement can lower mortality rates
Marburg virus is NOT spread through airborne transmission—it requires direct contact with body fluids of infected persons or animals
There are currently no FDA-approved vaccines or treatments for MVD, though investigational vaccines and treatments are in development

Symptoms and Transmission

Early “dry” symptoms (first 2-5 days):

Sudden onset of high fever
Severe headache
Muscle aches and pains
Chest pains
Severe fatigue

Later “wet” symptoms (days 5-7 onward):

Vomiting
Diarrhea
Unexplained bleeding or bruising (from nose, gums, injection sites, or in vomit/stool)
Rash may appear
Severe weight loss
Multi-organ dysfunction

Transmission occurs through:

Direct contact (through broken skin or mucous membranes) with body fluids of infected persons: blood, urine, saliva, sweat, feces, vomit, breast milk, amniotic fluid, or semen
Contact with objects contaminated with body fluids (needles, medical equipment, bedding)
Contact with infected animals, particularly bats or non-human primates
Handling or eating bushmeat
Entering caves or mines where bats live

NOT transmitted through:

Casual contact (sitting near someone)
Airborne transmission
Contact with asymptomatic persons

Travel Recommendations

CDC Travel Health Notice:

On November 17, 2025, CDC issued a Level 1 Travel Health Notice (Practice Usual Precautions) for Ethiopia. The risk to travelers is low, but travelers should be aware of MVD and take preventive measures.

Prevention measures for travelers to Ethiopia:

Avoid contact with blood and body fluids of people who are sick
Avoid contact with semen from a person who recovered from MVD until testing shows virus is no longer present
Do not touch the body of someone who died from suspected or confirmed MVD, including during funeral or burial practices
Avoid contact with cave-dwelling bats, bat urine or droppings, forest antelopes, non-human primates (monkeys, chimpanzees, gorillas)
Do not eat or handle blood, fluids, or raw meat from these or unknown animals (bushmeat)
Do not enter areas known to be inhabited by bats, such as mines or caves
Practice good hand hygiene

Healthcare workers traveling to Ethiopia:

Be aware of increased risk of MVD exposure in clinical settings
Follow strict infection prevention and control precautions
Use appropriate personal protective equipment (PPE)
Monitor yourself for symptoms for 21 days after returning to your home country

While in outbreak areas:

Monitor your health daily
Check for signs or symptoms of MVD while in affected regions and for 21 days after leaving
If you develop symptoms:
- Isolate immediately from others
- Do not travel
- Contact local health authorities or healthcare facility for guidance
- Alert healthcare providers of your recent presence in MVD-affected area BEFORE entering facility

If symptoms develop after returning home:

Seek immediate medical attention
Call ahead before visiting healthcare facility
Inform healthcare providers of your travel to Ethiopia
Isolate from others until assessed by medical professionals

Ethiopian national response:

Ethiopian authorities are implementing comprehensive response measures including screening, isolation of cases, contact tracing, airport exit screening, and public awareness campaigns. As of December 3, 2025, CDC is not recommending additional assessments or monitoring of travelers arriving from Ethiopia by U.S. health departments.