Health experts have advised that all candidate treatments and vaccines for Ebola disease caused by the Bundibugyo virus should be used exclusively within clinical trials to ensure safe, ethical, and effective research.

A statement made available on Thursday said that the experts were convened by the World Health Organisation (WHO).

According to it, the recommendation comes in response to the current outbreak in the Democratic Republic of the Congo, with additional cases reported in Uganda, and follows assessments by multiple WHO experts and advisory groups.

“WHO convened meetings with its Research and Development (R&D) Blueprint technical advisory groups on candidate vaccines and therapeutics for Bundibugyo Virus Disease (BVD) to evaluate options for both prevention and treatment.

“In parallel, the Strategic Advisory Group of Experts on Immunisation and its Ebola vaccine working group reviewed the potential role of licensed Ebola vaccines during BVD outbreaks,” it said.

The statement said that there are currently no licensed therapeutics or vaccines specifically approved for the prevention and treatment of BVD, though several candidate products were identified as promising enough to prioritise for clinical trial evaluation.

It noted that for treatment of confirmed BVD cases, independent experts recommended prioritising three candidates: the monoclonal antibodies MBP134 and Maftivimab®, and the antiviral remdesivir.

“Combination therapy using a monoclonal antibody and remdesivir was also recommended for evaluation in research settings.

“For prevention, the oral antiviral obeldesivir was identified as a priority candidate for post-exposure prophylaxis among contacts of confirmed and probable cases,” it said.

According to it, experts noted that post-exposure prophylaxis with obeldesivir depends on effective contact tracing, which remains operationally challenging in some affected areas of the DRC.

It said the most promising vaccine candidate is the single-dose rVSV Bundibugyo vaccine being developed by the International AIDS Vaccine Initiative, though it is expected to require 7–9 months before it is ready for clinical trial assessment.

It said that another candidate, ChAdOx1 Bundibugyo from Oxford University and the Serum Institute of India, could potentially be available within two to three months for efficacy testing, pending additional animal data.

“Experts suggested a single-dose approach for contacts of cases, while a two-dose strategy might be considered for high-risk but unexposed populations such as health-care workers and frontline responders.

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“The groups also reviewed Ervebo, the only licensed Ebola vaccine, which is approved for outbreaks caused by the most common Ebola virus in Africa but is not licensed for BVD and lacks conclusive evidence of cross-protection,” it said.

The statement said that the WHO recommended that Ervebo should not be used outside carefully designed research settings to allow its performance against BVD to be properly assessed.

“WHO, the governments of the DRC and Uganda, Africa CDC, ANRS Emerging Infectious Diseases, and other partners are now working to develop protocols for clinical field trials.

“While continuing to rely on established Ebola response measures like surveillance, contact tracing, isolation, testing, community engagement, and safe burials to stop transmission,” it said. (NAN)

The Nigeria Centre for Disease Control and Prevention (NCDC) has warned healthcare workers nationwide to heighten surveillance and preparedness for Ebola Virus Disease (EVD), citing a “high” risk of importation into Nigeria due to ongoing outbreaks in the Democratic Republic of the Congo (DRC) and Uganda.

The agency, however, said Nigeria has not recorded any confirmed Ebola case linked to the current regional outbreak as of 28 May.

In a public health advisory issued on Thursday, the NCDC said the World Health Organisation’s (WHO) declaration of the outbreak as a Public Health Emergency of International Concern (PHEIC), rising infections in neighbouring African countries, and increased cross-border movement have raised concerns about Nigeria’s vulnerability.

The advisory highlights concerns over delayed detection, healthcare-associated transmission, and the vulnerability of frontline health workers if the virus enters Nigeria.

“This assessment estimated the risk of Ebola importation into Nigeria as high due to the ongoing transmission in the DRC and Uganda, international travel and population movement, uncertainty regarding the full magnitude of the outbreak, and the potential for delayed recognition because symptoms may overlap with endemic diseases such as malaria and Lassa fever,” the agency stated.

It said high-risk states, border communities, major transport hubs and points of entry had already been identified through its national risk assessment.

Existing outbreak response systems

The NCDC said Nigeria still retains important outbreak response structures developed after previous viral haemorrhagic fever outbreaks, including the 2014 Ebola outbreak, which was successfully contained in Lagos.

According to the agency, the country currently maintains laboratory capability, trained rapid response teams, Emergency Operations Centres (EOCs), established Viral Haemorrhagic Fever preparedness systems, and prior outbreak response experience.

However, it admitted that existing systems require constant review and strengthening.

It also warned healthcare workers that Ebola patients or suspected cases could present at health facilities anywhere in Nigeria.

“The key operational question is therefore how healthcare workers should recognise, respond to, and safely manage such situations,” it said.

The agency stressed that healthcare workers remain one of the most vulnerable groups during Ebola outbreaks because of direct exposure during patient care.

Symptoms

The agency warned that Ebola symptoms may initially resemble several common illnesses frequently seen in Nigerian hospitals, increasing the risk of delayed recognition.

It listed malaria, typhoid fever, Lassa fever, gastroenteritis, COVID-19, influenza, sepsis and other severe bacterial infections among illnesses with symptoms similar to Ebola.

According to the advisory, Ebola has an incubation period of two to 21 days.

Early symptoms may include fever, weakness, headache, muscle pain, sore throat, vomiting and diarrhoea. While severe illness may involve unexplained bleeding, organ dysfunction, confusion, shock and collapse

Patients with non-specific febrile illness could initially appear similar to people suffering from more common diseases, “potentially delaying recognition and increasing exposure risk within healthcare settings.”

No approved vaccine

The current outbreak involves the Bundibugyo strain of the Ebola virus, which differs from the Zaire strain responsible for the 2014 West African epidemic.

The Bundibugyo virus is a Risk Group 4 pathogen and one of the less common Ebola virus strains.

“Unlike the Zaire strain, there are currently no approved vaccines or specific antiviral therapies for Bundibugyo virus disease,” the agency said.

The absence of approved vaccines or targeted therapies could complicate response efforts if infections are detected in Nigeria.

Ebola not airborne

The agency clarified that Ebola is not considered an airborne disease under normal circumstances.

Transmission occurs through direct contact with infected blood, body fluids, secretions, organs, contaminated materials, or infected animals.

The advisory listed vomit, diarrhoea, urine, saliva, sweat, breast milk and semen among infectious body fluids capable of transmitting the virus.

The agency warned that transmission risk is highest when infected patients become symptomatic and actively produce infectious body fluids.

It added that healthcare-associated transmission remained a major concern during Ebola outbreaks, citing reports by the WHO of infections and deaths among healthcare workers linked to gaps in infection prevention and control measures.

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Hospital surveillance

The NCDC directed healthcare facilities to strengthen triage systems for early identification and isolation of suspected cases.

It urged workers to maintain “a high index of suspicion,” especially among persons with recent travel history to affected countries or epidemiological links to confirmed or suspected cases.

It also asked them to carefully assess patients’ travel history, exposure history, contact with sick persons, and attendance at burial or funeral activities where relevant.

It advised hospitals to minimise unnecessary exposure while ensuring safe clinical care.

It also asked the healthcare workers to strictly implement infection prevention and control measures at all times, including hand hygiene before and after patient contact, appropriate use of personal protective equipment (PPE) and safe injection practices.

Others are environmental cleaning and disinfection, safe waste segregation and disposal and safe handling of laboratory specimens.

It further asked to avoid direct contact with blood or body fluids without PPE, prevent needle-stick injuries, follow safe burial guidance, and ensure proper decontamination of equipment and surfaces.

In addition, the health workers are instructed to promptly report occupational exposure incidents and participate in refresher infection prevention and preparedness training programmes.