WHO issues comprehensive guidelines on filovirus disease, including Ebola and Marburg disease

As the Democratic Republic of Congo grapples with 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 disease, which include all types of Ebola and Marburg viruses. The new guidelines emphasize the importance of early supportive care to improve patient survival and health outcomes, highlighting 16 evidence-based recommendations.

Ebola and Marburg diseases are serious and often fatal, with fatality rates ranging from 25% to 90% in the most severe outbreaks. There have been 72 outbreaks of Ebola and Marburg disease in Africa since 1967, when the Marburg virus was first discovered. These epidemics often have a significant socio-economic and psychological impact on the affected communities. In the absence of licensed vaccines and treatments for Marburg virus disease, Bundibugyo and Sudan virus disease, early supportive care significantly improves survival.

“These new guidelines are a perfect example of how WHO is using science to better protect and care for people during outbreaks and health emergencies,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “The current Bundibugyo outbreak is a powerful reminder of the need for diligent, holistic, person-centered medical care to save lives and preserve human dignity. We encourage governments and authorities to integrate these new recommendations into outbreak preparedness and response to ensure high-quality care for all.”

Developed through global expert consultation and based on the latest scientific evidence and clinical knowledge, the guidelines translate lessons learned from the recent Ebola and Marburg disease outbreaks into practical recommendations for improved patient care. WHO has previously issued several guidelines on clinical care and therapy specific to Ebola virus disease.

The new guidelines were developed primarily to guide healthcare professionals when caring for patients, to harmonize clinical approaches and enable healthcare administrators and policymakers to better plan, prepare, and respond to filovirus disease outbreaks through appropriate procurement of medical supplies, biomedical equipment, laboratory support, and human resources.

The practical recommendations aim to support first-line health workers in recognizing clinical deterioration, managing dehydration and shock, improving patient follow-up, safely providing critical supportive interventions, and providing structured follow-up for patients who have recovered from Ebola and Marburg disease. Some of the key recommendations include:

• Usage priority clinical laboratory tests to monitor patients with filovirus disease, to identify and manage treatable problems (such as hypoglycemia, metabolic disorders);
• Fast and precise treatment of dehydration in patients with filovirus disease using oral and intravenous rehydration;
• Promotion of early and accurate use of intravenous fluids and vasoactive drugs for treat shock in patients with filovirus disease (low blood pressure caused by infection, which if not treated properly leads to organ failure), guided by serial monitoring of vital signs and perfusion markers;
• Ensuring that if other bacterial infections, including bacterial sepsis, are present in patients with filovirus disease, appropriate treatment with antibiotics is started;
• Providing structured follow-up care to patients who have survived filovirus disease to promote well-being and prevent further infections associated with virus persistence in people who have recovered from the disease.

For Bundibugyo virus disease, as for other filovirus diseases, early recognition, rapid referral and optimized supportive care remain fundamental components of patient care. Optimized supportive care can reduce complications and provide the foundation on which all other clinical interventions are implemented. It is also a prerequisite for clinical trials evaluating antiviral treatments. These clinical guidelines complement existing WHO guidelines and operational tools designed to support safe and effective care delivery.

ABOUT WHO

Committed to the well-being of all people and guided by science, the World Health Organization leads and supports global efforts to give everyone, everywhere, an equal opportunity to live a safe and healthy life.

We are the UN health agency that connects nations, partners and people on the front lines in more than 150 locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health problems and expanding access to medicines and healthcare. Our mission is to promote health, keep the world safe and serve the vulnerable.

“Together for health. Let’s stand by science”, is the theme World Health Day 2026 marks a year-long campaign to highlight science as the foundation for protecting health and well-being around the world.