WHO issues first comprehensive guidelines for Ebola and Marburg care amid ongoing outbreak in Africa

As the Democratic Republic of the Congo battles an outbreak of Ebola disease caused by the Bundibugyo virus, the World Health Organization (WHO) has released its first comprehensive guidelines for the clinical management of filovirus diseases, covering all known forms of Ebola and Marburg virus infections.

The new guidelines come at a crucial time. The current outbreak in the Democratic Republic of the Congo and neighbouring Uganda involves the Bundibugyo strain of Ebola, for which there is currently no licensed vaccine or specific treatment.

What are filovirus diseases?

Filoviruses are a family of highly infectious viruses that include Ebola virus, Sudan virus, Bundibugyo virus, Taï Forest virus and Marburg virus. These diseases can cause severe haemorrhagic fever and have historically recorded fatality rates ranging from 25 per cent to as high as 90 per cent during some outbreaks. Since Marburg virus was first identified in 1967, Africa has reported 72 outbreaks involving Ebola and Marburg viruses.

More from Health

What do WHO's new guidelines recommend?

The WHO's recommendations focus on practical interventions that can be implemented even when advanced treatments are unavailable. As mentioned on the official website, the recommendations include:

-Using prioritised clinical laboratory tests to monitor patients with filovirus disease, to identify and manage treatable problems (such as hypoglycaemia, metabolic disruptions)

-Quickly and accurately treating dehydration in patients with filovirus disease using oral and intravenous rehydration

-Promoting early and precise use of intravenous fluids and vasoactive medications to treat shock in patients with filovirus disease (low blood pressure caused by the infection, which if not properly addressed leads to organ failure), guided by serial monitoring of vital signs and markers of perfusion

-Ensuring that if other bacterial infections, including bacterial sepsis, are present in patients with filovirus disease, appropriate treatment with antibiotics is initiated

-Providing structured after-care to patients who have survived filovirus disease to promote well-being, and to prevent further infections linked to viral persistence in people who recovered from the disease.

The guidelines also emphasise that supportive care forms the foundation for any future antiviral treatments and clinical research efforts.

Why the new guidelines were introduced

The WHO says the recommendations are designed to help doctors, nurses and health systems provide better care during outbreaks, especially in settings with limited resources. Rather than focusing solely on medicines, the guidelines stress the importance of early supportive care, which has been shown to significantly improve survival rates.

“These new guidelines are a perfect example of how WHO leverages science to better protect and care for people during outbreaks and health emergencies,” WHO Director-General Tedros Adhanom Ghebreyesus said while announcing the recommendations. He added that the current Bundibugyo outbreak highlights the need for “diligent, holistic and person-focused medical care” to save lives and preserve dignity.

Lessons from past outbreaks

The recommendations were developed through consultations with global experts and draw on lessons learned from recent Ebola and Marburg outbreaks. WHO said the aim is to standardise patient care across different outbreaks while helping governments and healthcare facilities prepare more effectively through better planning, staffing and medical supplies.

Why this is important

The current outbreak has renewed concerns because the Bundibugyo strain lacks approved vaccines and treatments. Health authorities therefore view early diagnosis, rapid referral and high-quality supportive care as the most effective tools currently available to reduce deaths and improve outcomes.

While Ebola and Marburg outbreaks remain largely concentrated in Africa, it can be noted that stronger clinical guidance can help countries respond more effectively, reduce mortality and improve preparedness for future health emergencies.