Guideline

WHO guidelines for the clinical management of filovirus disease

Year of Publication

2026

Issuing Institution

World Health Organization

Links

WHO IRIS

Recommendations

15 included recommendations

WHO recommends that for patients with suspected or confirmed filovirus disease, systematic laboratory monitoring be performed based on clinical assessment, rather than on routine testing.

Status

New

Recommended in favor

Strong

Certainty of evidence

Low

WHO recommends patients with suspected or confirmed filovirus disease with ongoing gastrointestinal fluid losses and some dehydrationa be treated with a protocolized oral rehydration regimen (e.g. WHO Plan B).

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

WHO suggests patients with suspected or confirmed filovirus disease with ongoing gastrointestinal fluid losses and severe dehydrationa be treated with a protocolized intravenous fluid regimenb compared with no protocolized intravenous fluid regimen

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO recommends balanced crystalloids (such as Ringer’s lactate) rather than 0.9% sodium chloride for acute intravenous fluid resuscitation in patients with suspected or confirmed filovirus disease.

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

WHO suggests for patients with suspected or confirmed filovirus disease and clinical signs of shock or circulatory impairment, the serial measurement of lactate as part of the assessment of perfusion to guide further intravenous fluid management.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests for patients with suspected or confirmed filovirus disease and clinical signs of shock or circulatory impairment, capillary refill time should be used as part of the assessment of perfusion to guide intravenous fluid management

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests that for patients with suspected or confirmed filovirus disease with shock who are being resuscitated with intravenous fluids, vasopressor treatment be initiated early rather than later.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO recommends that patients with suspected or confirmed filovirus disease requiring a vasopressor be treated with norepinephrine rather than dopamine.

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

WHO suggests that patients with suspected or confirmed filovirus disease requiring a vasopressor be treated with norepinephrine rather than epinephrine.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO suggests that for patients with suspected or confirmed filovirus disease requiring initiation of vasopressors, peripheral intravenous catheters be used rather than central venous catheters.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

WHO recommends that for patients with suspected or confirmed filovirus disease requiring central venous access, ultrasound guided placement be used rather than non-ultrasound guided placement.

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate

WHO suggests for the use of presumptive broad-spectrum antibiotics in patients with confirmed filovirus disease in the presence of suspected sepsis or bacterial co-infection.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO suggests against the use of tranexamic acid in patients with confirmed filovirus disease and haemorrhage.

Status

New

Recommended against

Conditional

Certainty of evidence

Very low

WHO suggests for the use of tranexamic acid in patients with confirmed filovirus disease and postpartum haemorrhage.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Low

WHO recommends that persons who have survived/recovered from filovirus disease be offered structured follow-up after discharge.

Status

New

Recommended in favor

Strong

Certainty of evidence

Moderate