A narrative review of filovirus outbreaks in East Africa: lessons for strengthening regional disease surveillance

Abstract

The recent outbreaks of Marburg virus disease (MVD) in Tanzania and Sudan virus disease (SVD) in Uganda reveal the growing threat of filoviruses in East Africa. These highly lethal viruses, with case fatality rates exceeding 50%, continue to challenge regional health systems due to delayed detection, weak surveillance networks, and limited cross-border coordination. The outbreak in Tanzania's Kagera region, a major transit hub, highlights the risk of international spread, while Uganda's struggle with Sudan virus further emphasizes the urgent need for regional infectious disease surveillance. This review paper explores the epidemiological trends, challenges in outbreak response, and the role of regional cooperation in mitigating future filovirus threats. It summarizes key epidemiological features, transmission dynamics, and response timelines associated with both outbreaks to provide data-driven context to the current regional public health threat. By analyzing past and ongoing outbreaks, we propose strategies to strengthen disease surveillance, enhance cross-border coordination, and improve rapid response mechanisms. A unified regional approach is critical to preventing filovirus epidemics from escalating into global public health crises.