EC Microbiology

The 2014-2016 Ebola virus disease epidemic exposed major weaknesses in global preparedness for emerging infectious diseases, revealing critical gaps in outbreak response, coordination, and clinical management. The COVID-19 pandemic subsequently accelerated advances in diagnostics, therapeutics, vaccine development, and public health preparedness, thereby improving the management of high-consequence viral infections. Despite these advances, Orthoebolaviruses continue to cause recurrent outbreaks in Africa, with occasional international spread. Ebola disease (EBOD) is a severe viral haemorrhagic disease caused principally by Ebola virus, Sudan virus, or Bundibugyo virus, with an average case fatality rate of approximately 50%, although rates have ranged from 25% to 90% in previous outbreaks. Early intensive supportive care, including prompt rehydration, correction of electrolyte abnormalities, and symptomatic treatment, remains the cornerstone of management and significantly improves survival. Licensed vaccines and targeted monoclonal antibody therapies are currently available only for Ebola virus disease caused by Ebola virus, whereas effective countermeasures against Sudan virus disease and Bundibugyo virus disease remain under development. Successful outbreak control depends on rapid case detection, laboratory confirmation, infection prevention and control, surveillance and contact tracing, safe and dignified burials, vaccination where appropriate, and sustained community engagement. This review summarizes current evidence on the virology, pathogenesis, transmission, diagnosis, clinical management, prevention, and evolving epidemiology of Ebola disease, with particular emphasis on the ongoing Bundibugyo virus disease outbreak.

Keywords: Ebola Disease; Bundibugyo Virus; Filoviridae; Viral Haemorrhagic Fever; Pathogenesis; Diagnosis; Therapeutics; Vaccination

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