Genomic and transmission dynamics of the 2024 Marburg virus outbreak in Rwanda
Yvan Butera, Léon Mutesa, Edyth Parker, Raissa Muvunyi, Espérance Umumararungu, Alisen Ayitewala, Jean Pierre Musabyimana, Alhaji Olono, Placide Sesonga, Olusola Ogunsanya, Emmanuel Kabalisa, Oluwatobi Adedokun, Nelson Gahima, Laetitia Irankunda, Chantal Mutezemariya, Richard Niyonkuru, Arlene Uwituze, Ithiel Uwizera, James Kagame, Arlette Umugwaneza, John Rwabuhihi, Fidele Umwanankabandi, Valens Mbonitegeka, Edouard Ntagwabira, Etienne Kayigi, Gerard Izuwayo, Herve Murenzi, Therese Mukankwiro, Nasson Tuyiringire, Jean Marie Uwimana, Agnes Gasengayire, Reuben Sindayiheba, Glory-Ugochi Onyeugo, Merawi Aragaw Tegegne, Lenny Gitundu, Radjabu Bigirimana, Mosoka Fallah, Adaora Ejikeme, Senga Sembuche, Alice Kabanda, Jean Claude Mugisha, Emmanuel Edwar Siddig Francis, Pierre Gashema, Jerome Ndayisenga, Alexis Rugamba, Faustin Kanyabwisha, Gad Murenzi, Anise N. Happi, Jean Claude Semuto Ngabonziza, Misbah Gashegu, Ayman Ahmed, Noella Bigirimana, Edson Rwagasore, Muhammed Semakula, Jean Paul Rwabihama, Clarisse Musanabaganwa, Eric Seruyange, Menelas Nkeshimana, Théogène Twagirumugabe, David Turatsinze, Eric Remera, Noël Gahamanyi, Sofonias Kifle Tessema, Isabelle Mukagatare, Sabin Nsanzimana, Christian Happi, Claude Mambo Muvunyi
Abstract
The ongoing outbreak of Marburg virus disease in Rwanda marks the third largest historically, although it has shown the lowest fatality rate. Genomic analysis of samples from 18 cases identified a lineage with limited internal diversity, closely related to a 2014 Ugandan case. Our findings suggest that the Rwandan lineage diverged decades ago from a common ancestor shared with diversity sampled from bats in Uganda. Our genomic data reveal limited genetic variation, consistent with a single zoonotic transmission event and limited human-to-human transmission. Investigations including contact tracing, clinical assessments, sequencing and serology, linked the index case to a mining cave inhabited by Rousettus aegyptiacus. Serology tests identified three individuals seropositive for immunoglobulin G and immunoglobulin M, further supporting the zoonotic origin of the outbreak through human-animal interactions.