In light of the ongoing Marburg Virus Disease (MVD) outbreak in Rwanda, the U.S. Centers for Disease Control and Prevention (CDC) has released interim recommendations aimed at protecting the health and safety of U.S.-based healthcare personnel who have recently returned from the region. The first known cases of MVD in Rwanda were confirmed on September 27, 2024, prompting the CDC to adopt a cautious approach in managing returning healthcare workers.
Marburg Virus Disease, a severe and often fatal illness caused by the Marburg virus, poses significant risks, especially to healthcare workers in direct contact with infected individuals. Given the potential exposure risk due to inadequate infection prevention measures in Rwanda’s healthcare facilities, the CDC has implemented updated protocols to ensure the safety of returning healthcare workers and to mitigate the risk of transmission in U.S. healthcare environments.
The CDC’s updated guidelines emphasize several critical measures for U.S.-based healthcare personnel who have recently worked in Rwandan healthcare facilities:
21-Day Work Exclusion: Healthcare personnel who have been present in any healthcare setting in Rwanda—including outpatient clinics and traditional healers—must be excluded from all clinical and non-clinical duties in U.S. healthcare facilities for 21 days following their last presence in a Rwandan healthcare facility.
Self-Monitoring: Once the 21-day exclusion period is over, personnel should continue self-monitoring for the remaining days if there is any time left in the 21-day window since they departed Rwanda.
Avoid Nonessential Visits: Healthcare personnel are advised to avoid nonessential visits to U.S. healthcare facilities, such as elective surgeries, during the 21-day monitoring period after leaving Rwanda.
Pre-Departure Risk Assessment: Before leaving Rwanda, healthcare personnel should undergo a thorough risk assessment by an occupational health professional. If any high-risk exposures or symptoms suggestive of MVD are detected, the CDC must be consulted before authorizing travel back to the United States.
Coordination with U.S. Health Departments: Health departments across the U.S. are encouraged to conduct exposure risk assessments for returning personnel and to monitor them daily for 21 days. Monitoring may be conducted through electronic means or in-person evaluations, as deemed appropriate by local health authorities.
The CDC has also clarified that while the current recommendations apply to all returning healthcare workers from Rwanda, they may evolve based on new developments in the outbreak and as the risk of exposure becomes better understood.
Healthcare personnel working in affected areas are particularly at risk, given their close proximity to patients. As such, rigorous infection prevention and control measures are essential to protect both healthcare workers and the wider population.
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