WHO Releases New Clinical Management Guidelines for Ebola and Marburg Diseases

The World Health Organization (WHO) has released its first comprehensive guidelines for the clinical management of filovirus disease, including Ebola and Marburg viruses, as the Democratic Republic of the Congo (DRC) grapples with an outbreak caused by the Bundibugyo virus. The guidelines, developed through global expert consultations and based on the latest scientific evidence, outline 16 evidence-based recommendations to improve patient outcomes through early supportive care.

Ebola and Marburg diseases, which have a case fatality rate ranging from 25% to 90% in severe outbreaks, have caused 72 reported outbreaks in Africa since 1967. The DRC’s current Bundibugyo virus outbreak underscores the critical need for standardized clinical approaches, particularly as there are no licensed vaccines or treatments for Marburg virus disease or certain Ebola strains. WHO Director-General Dr. Tedros Adhanom Ghebreyesus emphasized that the guidelines “leverage science to better protect and care for people during outbreaks,” calling for governments to integrate the recommendations into preparedness and response strategies.

Key Recommendations for Clinical Care

The guidelines prioritize early supportive care to address complications such as dehydration, shock, and secondary infections. Key recommendations include:

• Using prioritized clinical laboratory tests to monitor patients and manage treatable issues like hypoglycemia and metabolic disruptions.
• Administering oral and intravenous rehydration to quickly treat dehydration in filovirus patients.
• Employing intravenous fluids and vasoactive medications to manage shock, guided by serial monitoring of vital signs.
• Initiating appropriate antibiotic treatment for bacterial infections, including sepsis, in co-infected patients.
• Providing structured after-care for survivors to address long-term health needs and prevent viral persistence.

These measures aim to stabilize patients, reduce complications, and create a foundation for evaluating antiviral treatments. For Bundibugyo virus disease, early recognition and optimized supportive care remain critical, according to the WHO.

Global Collaboration and Implementation

The guidelines were developed through consultations with global experts and translate lessons from recent outbreaks into actionable protocols. They are designed to harmonize clinical practices, ensure adequate medical supplies, and support health workers in high-risk areas. WHO noted that the recommendations complement existing guidance and operational tools, reinforcing a unified approach to filovirus management.

“Optimized supportive care can reduce complications and provide the foundation on which all other clinical interventions are delivered,” the WHO stated. The organization also highlighted the importance of these guidelines in enabling clinical research, as they establish standardized care protocols that can be used to evaluate new therapies.

Context of the DRC Outbreak

The DRC’s ongoing Bundibugyo virus outbreak has intensified the urgency for these guidelines. While the country has experience managing Ebola outbreaks, the Bundibugyo strain presents unique challenges, including its potential for rapid transmission and severe clinical manifestations. WHO’s emphasis on holistic, person-focused care aligns with efforts to address both the medical and socio-economic impacts of the outbreak on affected communities.

“The current Bundibugyo virus outbreak is a stark reminder of the need for diligent, holistic and person-focused medical care,” Dr. Tedros said. He urged governments to prioritize the implementation of the guidelines to ensure high-quality care for all patients.

About the World Health Organization

The WHO, a United Nations agency, is dedicated to promoting health, keeping the world safe, and serving the vulnerable. Its work includes responding to health emergencies, preventing disease, and expanding access to medicines and healthcare. The organization’s 2026 World Health Day campaign, “Together for health. Stand with science,” emphasizes the role of science in protecting global health.