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Ebola virus disease

Key sources
The following summarized guidelines for the management of ebola virus disease are prepared by our editorial team based on guidelines from the World Health Organization (WHO 2022; 2020; 2014), the Center for Disease Control (CDC 2021), and the Ebola Virus Disease Working Group (EBV-WG 2018).
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Guidelines

1.Medical management

Monoclonal antibodies
Administer either ansuvimab or atoltivimab/maftivimab/odesivimab for the treatment of patients with RT-PCR confirmed Ebola virus disease and in neonates of unconfirmed Ebola virus disease status, ≤ 7 days old, born to mothers with confirmed Ebola virus disease.
B
Avoid using ZMapp for the treatment of patients with RT-PCR confirmed Ebola virus disease.
D
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  • Remdesivir

  • Fluid therapy

  • Analgesic therapy

  • Antibiotic therapy

2.Inpatient care

Serial clinical assessment: obtain systematic monitoring and charting of vital signs and volume status in all patients with Ebola virus disease.
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  • Serial laboratory assessment

3.Specific circumstances

Pregnant patients: provide optimized supportive care in the clinical management of pregnant patients with Ebola virus disease.
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  • Breastfeeding patients

4.Patient education

Communication with relatives: consider facilitating communication with family and friends to reduce psychological distress in patients admitted to the treatment unit with suspected, probable, or confirmed Ebola virus disease.
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5.Preventative measures

Personal protective equipment: ensure that all healthcare workers follow the following precautions while providing clinical care for patients with filovirus disease in order to prevent virus exposure:
cover the mucous membranes of their eyes, mouth, and nose completely with personal protective equipment
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use either a face shield or goggles
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wear a fluid-resistant medical/surgical mask with a structured design not collapsing against the mouth, such as duckbill or cup shape
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use a fluid-resistant particulate respirator during procedures generating aerosols of body fluids
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wear double gloves, preferably with nitrile material rather than latex
B
wear protective bodywear in addition to regular on-duty clothing
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; with the choice of bodywear being either a disposable gown and apron, or a disposable coverall and apron, with the gown and the coverall made of fabric tested for resistance to penetration by blood or body fluids or to blood-borne pathogens
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; with the choice of apron being, in order of preference: disposable, waterproof apron, or heavy-duty, reusable waterproof aprons if appropriate cleaning and disinfection between patients are performed, if disposable aprons are not available
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wear waterproof boots, such as rubber/gum
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wear a head cover covering the head and neck, being separate from the gown or coverall, so that these may be removed separately.
B

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  • Immunization

6.Quality improvement

Requirements for Ebola treatment unit personnel: ensure a staffing ratio of at least 1 clinician to 4 patients in Ebola treatment units, taking into account the need for patient assessment at least TID and continuous (24 hours/day) monitoring of patients to allow prompt recognition of and reaction to acute changes in condition.
B