New recommendations represent an advance but also highlight need for more evidence to inform effective infection measures, say experts
Ten years on from the West African Ebola outbreak, the World Health Organization (WHO) updated its infection prevention and control guidelines for Ebola and Marburg disease.
The key recommendations are summarized in The BMJ today with an infographic and the full guideline is available on both the WHO website and the web-based MAGICapp platform.
Case fatality rates for both Ebola and Marburg disease are high, averaging about 50% (and can range from 24% to 90%). Up-to-date, evidence-based infection prevention and control (IPC) guidelines are thus critical to ensuring a safe, systematic, and standardized approach during outbreaks.
The new guideline was developed by a group of experts and a patient representative supported by the WHO secretariat and reflects the knowledge and experience garnered from multiple outbreaks of Ebola and Marburg disease since 2014.
The updated guideline includes 11 new recommendations, 10 new good practice statements, and nine recommendations from previous guidelines to assist health and care workers implement effective IPC measures and reduce the risk of Ebola and Marburg virus transmission.
The guideline development group prioritized 13 key questions and five background questions, and WHO commissioned systematic reviews to inform the formulation of the recommendations.
The group also carefully considered the balance between desirable and undesirable effects of interventions, the certainty of evidence, the evaluation of outcomes, resource use, the acceptability and feasibility of interventions to affected populations, and the impact of interventions on equity.
Although the recommendations pertain to all healthcare settings, some are also relevant to community settings for example, when interacting in the homes of individuals suspected or confirmed to have had Ebola or Marburg disease.
