The government plans to make a decision on classifying Marburg as a socially dangerous disease tomorrow morning at an extra government meeting, says Forssmed at a press conference on Thursday.
In the current situation, the virus is classified as generally dangerous. A reclassification enables so-called extraordinary infection control measures. This means, among other things, that an area can be cordoned off, for example parts of Arlanda or a train station, and that patients can be kept isolated.
In Rwanda, the alarm was raised about an outbreak on September 27, and the country's authorities report 36 confirmed cases, including 11 deaths. The majority of those infected are healthcare personnel.
German case negative
A suspected case in Germany, the only one in Europe so far, has turned out to be negative.
It is very reassuring, but no reason to relax. Marburg is a disease with high mortality that can cause what is called bleeding fever, says Forssmed and emphasizes that there are no reported or suspected cases in Sweden.
The government has no figures on how many Swedes are currently in Rwanda, but estimates that between 3,000 and 5,000 Swedes travel to the country each year.
This means that there is a risk that this disease can come to Sweden, says Jakob Forssmed.
Those who come from Rwanda and experience symptoms are advised not to go to the healthcare system but to call 1177.
Low risk globally
State epidemiologist Magnus Gisslén also participated in the press conference, stating that entry controls do not have any effect. Exit controls with temperature measurements, such as those currently in place in Rwanda's capital Kigali, do make people who feel sick more likely to refrain from traveling, he says.
The World Health Organization (WHO) assesses the risk of a global outbreak as low. However, the risk is assessed as very high in Rwanda and high in the surrounding region.
The virus got its name after the German university town of Marburg, where the first outbreak was noted in 1967. Since then, there have been about a dozen outbreaks, mainly in southern and eastern Africa.
The infection spreads to humans through bats.
Marburg virus is an RNA virus belonging to the filovirus family, which causes bleeding fever (hemorrhagic fever).
The virus was first discovered in 1967, with simultaneous outbreaks in Marburg and Frankfurt, Germany, and in Belgrade. Laboratory personnel working with organs from experimental apes imported from Uganda became infected, and seven people died.
Today, it is assumed that Marburg spreads from fruit bats (a family in the order of bats) to humans, and then from human to human through blood or other bodily fluids.
The incubation period lasts from two days to three weeks. Around one week after the first symptoms, the virus often develops into bleeding fever, which means that the blood vessel walls are damaged and the infected person begins to bleed both internally and externally. The mortality rate in previous outbreaks has ranged from 24 to 88 percent.
The disease belongs to the group of viral hemorrhagic fevers, along with, for example, Ebola fever, dengue fever, Lassa fever, and yellow fever. In Europe, viral hemorrhagic fevers are rare, although hantavirus formally belongs to the group.
Since 1967, about a dozen major outbreaks of Marburg virus have been reported in southern and eastern Africa. In the worst outbreak so far, in Angola in 2004-2005, 227 of 252 infected people died.
Sources: World Health Organization and Public Health Agency
