The World Health Organization (WHO) has released its first comprehensive guidelines for the clinical management of filovirus diseases, covering all types of Ebola and Marburg viruses, as the Democratic Republic of the Congo continues to battle an Ebola outbreak caused by the Bundibugyo virus.

The new guidance highlights the critical role of early supportive care in improving survival and health outcomes for patients affected by Ebola and Marburg diseases. WHO outlined 16 evidence-based recommendations designed to strengthen patient care during outbreaks.

Ebola and Marburg diseases are serious illnesses that can be fatal, with case fatality rates ranging from 25% to 90% in the most severe outbreaks. Since the discovery of the Marburg virus in 1967, Africa has recorded 72 outbreaks of Ebola and Marburg diseases, often causing significant social, economic and psychological impacts on affected communities.

WHO noted that in the absence of licensed vaccines and treatments for Marburg virus disease, Bundibugyo virus disease and Sudan virus disease, early supportive care remains a key factor in improving patient survival.

“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 Dr. Tedros Adhanom Ghebreyesus said.

“The current Bundibugyo virus outbreak is a stark reminder of the need for diligent, holistic and person-focused medical care, to save lives and preserve human dignity. We encourage governments and authorities to integrate these new recommendations into preparedness and outbreak response, to ensure high-quality care for everyone,” he added.

According to WHO, the guidelines were developed through consultations with global experts and are based on the latest scientific evidence and clinical knowledge. They aim to help healthcare workers provide standardized and effective care while supporting health facility administrators and policymakers in preparing for and responding to filovirus disease outbreaks.

The recommendations are intended to help frontline health workers identify clinical deterioration, manage dehydration and shock, improve patient monitoring, safely deliver critical supportive interventions, and provide structured follow-up care for survivors.

Among the key recommendations are the use of prioritized clinical laboratory tests to identify and manage treatable conditions such as hypoglycaemia and metabolic disruptions. WHO also recommends the quick and accurate treatment of dehydration through oral and intravenous rehydration.

The guidance further emphasizes the early and appropriate 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. In cases where bacterial infections, including bacterial sepsis, are present alongside filovirus disease, WHO recommends prompt treatment with appropriate antibiotics.

The guidelines also call for structured after-care for survivors of Ebola and Marburg diseases to support recovery and help prevent further infections associated with viral persistence.

WHO stressed that for Bundibugyo virus disease, as with other filovirus diseases, early recognition, rapid referral and optimized supportive care remain fundamental components of patient management. The organization said optimized supportive care can reduce complications and provides the foundation for all other clinical interventions, including research evaluating potential antiviral treatments.

The new clinical management guidelines complement existing WHO guidance and operational tools aimed at supporting safe and effective care during filovirus disease outbreaks.