WHO Issues First Unified Clinical Guidelines for All Ebola and Marburg Virus Strains

The World Health Organization has issued its first unified, evidence-based clinical management guidelines for all filovirus diseases, including the various Ebola virus species and Marburg virus, as the Democratic Republic of the Congo battles an active Bundibugyo virus outbreak.

The guidelines, released on Wednesday, June 17, 2026, provide standardised protocols for supportive care in resource-limited settings, where these high-mortality diseases continue to pose significant threats. They were developed using the GRADE methodology and draw on data from 72 recorded filovirus outbreaks since 1967.

“These new guidelines are a perfect example of how WHO leverages science to better protect and care for people during outbreaks and health emergencies,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. He noted that the current Bundibugyo outbreak in the DRC underscores the need for improved, person-centred medical care.

Filovirus infections, which cause severe haemorrhagic fevers, have historically recorded case fatality rates ranging from 25% to 90%. Prior WHO guidance focused mainly on Zaire ebolavirus (the species responsible for most major outbreaks), but the new document harmonises recommendations across Bundibugyo, Ebola, Sudan, Taï Forest, and Marburg viruses.

The 86-page guidelines contain 16 key recommendations centred on optimised supportive care widely regarded as the most effective intervention currently available, given the lack of approved vaccines or specific therapies for most filovirus species.

The guidelines stress practical interventions suitable for frontline health facilities in affected regions.

These include:

• Systematic monitoring of patients for complications such as hypoglycaemia, electrolyte imbalances, and organ dysfunction.
• Rapid oral and intravenous fluid management to address dehydration.
• Early recognition and treatment of shock using guided intravenous fluids and vasopressors.
• Prompt use of antibiotics for suspected bacterial co-infections.
• Targeted management of haemorrhagic complications, including postpartum bleeding.
• Structured follow-up care for survivors, addressing long-term sequelae, viral persistence in body fluids, and psychosocial support.

The recommendations integrate closely with infection prevention and control measures to protect both patients and health workers.

The timing of the guidelines is particularly relevant as the DRC continues to respond to an outbreak of Bundibugyo virus disease, declared a Public Health Emergency of International Concern. The outbreak has spread across parts of Ituri, North Kivu, and South Kivu provinces, with some cross-border transmission reported into Uganda. No approved vaccine or specific antiviral exists for this virus strain, making high-quality supportive care critical.

Health authorities in the region face challenges including insecurity, limited supplies, and overstretched facilities. WHO officials said the new guidelines will help standardise care and support ongoing clinical research by providing consistent platforms for future therapeutic trials.

The document builds on lessons from previous major outbreaks, particularly the 2014-2016 West Africa Ebola epidemic, and reflects evolving clinical understanding of these diseases. It addresses equity, feasibility, and resource constraints common in affected African countries while promoting integration with wider humanitarian response efforts.

By offering a single, harmonised framework, WHO aims to reduce inconsistencies in care quality and improve survival rates in future outbreaks. The guidelines are expected to serve as a key reference for health ministries, frontline clinicians, and international partners working in filovirus preparedness and response.

The full guidelines and an executive summary are now available on the WHO website for immediate use by countries and health organisations.