Ebola Bundibugyo lacks licensed vaccine

The World Health Organization said on May 16 that Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constituted a public health emergency of international concern. WHO said the event was known to be occurring in both countries, elevating an outbreak involving a strain for which there is no licensed vaccine or approved treatment. The Bundibugyo strain is unusual because the vaccines and antibody treatments that shaped recent Ebola responses were developed for Zaire ebolavirus, not for Bundibugyo virus. The U.S. Centers for Disease Control and Prevention said Bundibugyo virus was first identified in Uganda in 2007 and that previous outbreaks have had mortality rates of about 25% to 50%, though severe disease and death can still occur. (who.int) ### Why are health officials saying this outbreak is different from recent Ebola responses? Infection Control Today reported on May 20 that infection prevention teams are confronting a “blank page” because hospitals cannot rely on a licensed Bundibugyo-specific vaccine or an approved treatment. The publication said facilities are being pushed to reopen and test high-consequence infectious disease plans that in some cases have not been updated since 2015. (cdc.gov) The London School of Hygiene & Tropical Medicine said current Ebola vaccines would provide no protection against this strain. The school said a strain-specific vaccine could potentially be moved into Phase 1 trials within six to 12 months, but large efficacy trials during an active outbreak would be difficult. ### What does care look like when there is no approved Bundibugyo vaccine or treatment? (infectioncontroltoday.com) The London School of Hygiene & Tropical Medicine said supportive care remains the current standard for Bundibugyo Ebola, alongside research into broadly neutralising antibodies. That means treatment centers are relying on early diagnosis, hydration, monitoring, infection prevention and supportive clinical management rather than a licensed strain-matched product. (lshtm.ac.uk) The Pan American Health Organization said in a May 21 epidemiological alert that it was circulating updated guidance on laboratory diagnosis, infection prevention and control, and clinical management to member states. The alert was framed as technical support for preparedness as the situation in DRC and Uganda evolved. ### How far has the response spread beyond DRC and Uganda? (lshtm.ac.uk) Africa CDC said on May 15 that it was monitoring the confirmed outbreak in Ituri province in DRC and an imported Ebola Bundibugyo case reported by Uganda. The agency called for urgent regional coordination with national authorities and partners. (paho.org) Zambia said on May 21 that it was strengthening readiness through investments in surveillance, digital tools and pandemic planning as neighboring countries responded to ongoing Ebola outbreaks. The WHO Regional Office for Africa said Zambia was taking proactive steps to build preparedness and response capacity. (africacdc.org) ### What are hospitals and governments being told to do now? NETEC, a U.S.-based special pathogens network, said on May 18 that WHO’s emergency declaration reflected concern about the scale and complexity of the outbreak. Its guidance for healthcare professionals focused on preparedness, infection control and readiness for high-consequence pathogens. (afro.who.int) WHO’s disease outbreak notice and the regional guidance issued afterward point to the same immediate tasks: case detection, laboratory readiness, infection prevention, clinical management and cross-border coordination. Zambia’s measures and Africa CDC’s regional call show that neighboring health systems are treating the outbreak as a preparedness test as well as a response operation. (netec.org) WHO’s outbreak notice remained the central international reference on May 22, and Zambia’s May 21 preparedness update was the latest named regional step tied to neighboring countries’ response. Any next milestone is likely to come through additional WHO outbreak notices, health ministry updates from Kinshasa and Kampala, or new guidance from Africa CDC. (who.int)