Maladie à virus Ebola (souche Bundibugyo)

Les fièvres hémorragiques virales (FHV) retenues dans ce document sont la maladie Ebola, la maladie à virus de Marburg, la fièvre hémorragique de Crimée-Congo et la fièvre de Lassa. Ces recommandations pourraient également être utilisées pour d’autres FHV transmissibles entre humains, telles que les FHV d’Amérique du Sud (virus Chapare, Guanarito, Junin, Machupo et Sabia), la fièvre hémorragique de Lujo et le syndrome de fièvre sévère avec thrombocytopénie. Bien que l’hantavirus des Andes et le virus Nipah n’entraînent pas de fièvre hémorragique, les mesures décrites dans ce document pourraient également s’appliquer étant donné leurs modes de transmission et la sévérité potentielle des maladies qu’ils causent. Des adaptations pourraient toutefois être acceptables, notamment au niveau des spécimens de laboratoire ou de la gestion des dépouilles, pour autant que les directives spécifiques émises par les autorités reconnues au Québec soient suivies.Il est peu probable de recevoir des cas de FHV au Québec dans le contexte actuel. Néanmoins, dans d’autres régions du monde, certaines de ces FHV sont endémiques ou des éclosions localisées surviennent sur une base régulière. Étant donné la sévérité de ces infections, tous les milieux de soins doivent être préparés à prendre en charge adéquatement et sans délai un usager dans l’attente de son transfert dans un centre hospitalier de soins généraux et spécialisés désigné.Les membres du CINQ préconisent une approche prudente et recommandent l’application des précautions additionnelles aériennes-contact avec protection oculaire (avec blouse et double paire de gants) en présence de cas suspects, probables ou confirmés de FHV. De plus, lorsque l’usager présente des pertes importantes de liquides biologiques, des équipements de protection individuelle (ÉPI) supplémentaires devraient être portés. Une pièce à pression négative est requise lors de la réalisation d’interventions médicales générant des aérosols (IMGA) qui augmentent le risque de transmission.L’usager ayant été en contact avec un cas confirmé doit être hébergé en chambre privée avec toilette réservée. Des précautions additionnelles aériennes-contact avec protection oculaire doivent être appliquées si l’exposition est jugée à risque élevé. Les travailleuses et travailleurs de la santé (TdeS) ayant eu une exposition à risque faible […]

In the context of prioritization of therapeutics to be included in clinical research for Bundibugyo virus disease (BVD) the Technical Advisory Group on Therapeutics Prioritization (TAG-TP) has begun examining the landscape of immunomodulatory and host-directed new or repurposed agents. Currently, there are no studies in patients characterizing the downstream pathogenesis that follows infection with Bundibugyo virus (BDBV). The available evidence derives mainly from data collected with Ebola virus, specifically Zaire ebolavirus (EBOV) that provides relevant information from animal models and patients, but not sufficient to allow a proper assessment for the selection of immunomodulatory and host-directed candidates for clinical trials in BVD. In addition, it is noted that even corticosteroids have never been tested in a stringent filovirus animal model. For other infectious diseases leading to sepsis or other severe disease evolutions, it is also noted that immunomodulators can be beneficial or detrimental depending on the timing of the administration.To allow for a proper scientific evaluation of the different potential interventions, the appropriate timing of administration and the appropriate patient selection for inclusion in large clinical trials, it is imperative to generate quality data on the natural history of BVD from people infected with BDBV. This would likely need to occur at select clinical sites that are adequately equipped to collect and analyze samples from patients with BVD. Suggested data for collection include immune makers associated with inflammation and innate/adaptive immunity, correlative viral load and clinical features, markers of coagulation perturbation and organ/tissue damage. This will help identify biomarkers pertaining to a pro-inflammatory status with co-relation to clinical phenotypes and organ dysfunction. Only in this way will it be possible to identify and/or confirm potential pharmacological targets and related potential interventions. Collecting further evidence is paramount to minimizing risks to participants in clinical trials, as, depending on individual patient phenotypes and the status of disease evolution, the administration of some immunomodulatory agents may result in detrimental effects (e.g. on viral replication).In addition, some of these clinical investigations may have to be tailored to specific immune phenotypes based on the pharmacological activity of the investigational candidate, but sophisticated […]

In a major international effort to evaluate potential treatments for Ebola disease due to Bundibugyo virus (BVD), the PARTNERS clinical trial has opened enrolment today for patients in the Democratic Republic of the Congo.  The PARTNERS (Platform Adaptive Randomised Trial for New and Repurposed Filovirus TreatmentS) trial will assess whether two antiviral therapies – a monoclonal antibody (MBP134) and remdesivir – can improve survival among people diagnosed with BVD. It will also evaluate whether combining the two antivirals provides additional benefits.The trial, sponsored by the World Health Organization (WHO), has been coordinated by the Institut National de Recherche Biomédicale (INRB) in the Democratic Republic of the Congo, the Institute of Tropical Medicine in Belgium, and the University of Oxford in the United Kingdom, in collaboration with international research, clinical and humanitarian partners, and supported by Africa CDC.Since the start of the outbreak, over 1400 people have been diagnosed with BVD, nearly 210 people have recovered and nearly 440 people have died of the disease in the Democratic Republic of the Congo. While effective treatments have been developed for Ebola virus disease, none are currently approved for Bundibugyo virus disease, and no treatment has been shown to work across all virus types that cause Ebola diseases.These treatments were selected for the trial by the WHO Technical Advisory Group after a thorough review of scientific evidence, including preclinical research and safety data, and evidence from previous outbreak responses. People enrolled in the clinical trial will be provided with close support and follow-up for at least 28 days after enrolment.“Even without approved therapeutics, people are recovering from this disease, but of course, we could save many more lives with safe and effective therapeutics in our toolkit," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The PARTNERS trial, established with national authorities and scientific partners in record time, offers real hope that we can deliver concrete results for – and with – the communities at the heart of the outbreak.”The trial has been established as a platform trial, which allows for additional treatments to be added as they become available following assessment by the WHO Technical Advisory Group."We urgently need treatments that can help people affected by Bundibugyo virus disease. One of the key lessons from recent […]

Today, the World Health Organization (WHO) has added the first molecular diagnostic test for Bundibugyo virus (BDBV) to its Emergency Use Listing (EUL). The test detects the virus by identifying its genetic material in blood samples, helping confirm infection rapidly and accurately.WHO’s EUL procedure assesses the quality, safety and performance of essential health products based on the available evidence, while ensuring they meet minimum international standards and address the needs of low- and middle-income countries.Through this mechanism, WHO aims to accelerate access to reliable diagnostic tools for early case detection, timely clinical care, disease surveillance and effective outbreak response. The EUL also supports United Nations procurement agencies and governments in making informed decisions about the procurement and use of these products in public health emergency settings."Public health emergencies require not only speed, but also confidence that the health products being used meet standards for quality, safety and performance," said Dr Yukiko Nakatani, WHO Assistant Director-General for Health Systems, Access and Data. "During a fast-moving outbreak, timely access to quality-assured diagnostic tests can make a critical difference in containing transmission. Through this Emergency Use Listing, WHO is helping countries access trusted diagnostic tools more rapidly so that they can respond more effectively.”On 17 May 2026, WHO Director-General Dr Tedros Adhanom Ghebreyesus declared a public health emergency of international concern over the outbreak of Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo, with cases in Uganda. Less than two weeks later, WHO launched a call for manufacturers of IVDs for Bundibugyo virus to submit Expressions of Interest for Emergency Use Listing.The listing comes at a critical time as countries respond to the largest recorded outbreak of Ebola disease caused by BDBV, which continues to expand. As of today, 1406 laboratory-confirmed cases and 438 deaths had been reported in the Democratic Republic of the Congo alone.With support from WHO and the Africa Centres for Disease Control and Prevention (Africa CDC), laboratory testing capacity has expanded from a limited number of sites – primarily Institut National de Recherche Biomédicale in Kinshasa and Goma, with an estimated combined capacity of approximately 200–400 tests per day – to a broader network of 10 laboratories across […]

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Rapid diagnosis of Ebola disease (EBOD) and Marburg virus disease (MVD) is critical to provide timely and appropriate care and stop transmission. These diseases can be difficult to clinically distinguish from other infectious diseases such as malaria, and countermeasures, including vaccines and therapeutics, are available specifically for some species of orthoebolaviruses and orthomarburgviruses, meaning that laboratory confirmation is very important. Handling of samples from patients with suspected EBOD or MVD requires appropriate biosafety measures.  This document constitutes an update to the Diagnostic testing for Ebola and Marburg virus diseases: interim guidance, 20 December 2024. It provides interim guidance to laboratory personnel, clinicians, health workers, public health officials, outbreak response teams, and other stakeholders involved in the diagnosis and care of patients with suspected or confirmed EBOD or MVD, from specimen collection through to diagnostic analysis and reporting.

Nouvelles mesures frontalières temporaires en réponse à l’éclosion de la maladie Ebola