infectious diseases
Marburg and Ebola Virus Infections
Prevention of Marburg and Ebola Virus Infections
Several Ebola Vaccine are in clinical trials. rVSV-ZEBOV was used successfully on a limited scale at the end of the 2016 Ebola outbreak in West Africa and on a greater scale in the 2018 outbreak in the DRC and was approved by the FDA in December 2019 for prevention of disease caused by Zaire ebolavirus in people 18 years of age and older. In 2020, the European Medicines Agency granted marketing authorization to a second new vaccine delivered in 2 doses, one each of Ad26.ZEBOV and MVA-BN-Filo, for prevention of disease caused by Ebola virus (Zaire ebolavirus species) in individuals 1 year of age and older. The Zaire Ebola vaccines do not provide cross-protection against the Sudan Ebola virus disease. For the Sudan ebolavirus, there were 3 candidate vaccines recommended for the trial during the Uganda outbreak by an independent WHO expert panel. The outbreak ended before the ring vaccination (vaccinating a ring of people around cases, rather than vaccinating an entire population) vaccine trials could be done. To prevent spread, symptomatic patients with possible Ebola or Marburg virus infection must be isolated in dedicated containment facilities. Standard intensive care units (ICUs) in public hospitals are not suitable. Special containment facilities provide for total control of fluid effluent and respiratory products. Staff members in contact with patients must be completely covered in protective suits with internal containment of respiratory gases. Trained staff members must be available to help those in contact with patients remove the protective clothing. Protocols for donning and removing mask, goggles or face shields, gown, and gloves must be followed (see the Centers for Disease Control and Prevention:Sequence for Donning Personal Protective Equipment). Thorough equipment sterilization, hospital closures, and community education have shortened previous epidemics. All suspected cases, including the cadavers, require strict isolation and special handling. Because Marburg and Ebola viruses can persist in semen and be sexually transmitted, the World Health Organization (WHO) recommends that patients who have had either infection and their sex partners should abstain from all types of sex or use condoms correctly and consistently until one of the following occurs: Until 2 tests for the virus are negative If testing is unavailable, until ≥ 12 months have passed since symptom onset For more information, see theWHO: Interim recommendations for infection prevention and control,WHO: Marburg virus disease, andWHO: Interim advice on the sexual transmission of the Ebola virus disease. 