Global health authorities are working to find medical solutions to control an Ebola outbreak in eastern Democratic Republic of Congo caused by the Bundibugyo strain. No approved vaccines or treatments exist for this strain, unlike the more common Zaire strain. The current outbreak has recorded around 363 confirmed cases and 62 deaths. Bundibugyo ebolavirus carries a fatality rate of up to 40 percent. A limited number of experimental vaccines and therapies are under review, and officials are checking if existing Ebola treatments could provide protection based on preliminary animal studies. Most of these options have not been tested in humans and would need emergency authorization for use in Congo. The World Health Organization has advised focusing on several experimental antibodies, antivirals and vaccines for managing and preventing Bundibugyo infections. For vaccines, the WHO highlighted a single-dose rVSV Bundibugyo candidate from the International AIDS Vaccine Initiative as the leading option. This vaccine uses similar technology to Merck’s approved Ervebo and showed benefits in primate studies from 2023. Development is expected to take seven to nine months before clinical trials. The initiative is preparing for trials and manufacturing with support from the Coalition for Epidemic Preparedness Innovations, which provided initial funding of $3.2 million. Another candidate, ChAdOx1 Bundibugyo from Oxford University and the Serum Institute of India, is also prioritized. It uses the same platform as the Oxford-AstraZeneca COVID-19 vaccine. Production began under an emergency framework, with CEPI committing up to $8.6 million. Doses may be available in two to three months for trial assessment, though further animal studies are needed. Experts suggest a single dose for contacts of cases and a two-dose schedule for high-risk groups like healthcare workers. Moderna is advancing an mRNA-based candidate with CEPI support of up to $50 million for preclinical and early clinical work. For antibody therapies, the WHO recommends prioritizing Mapp Biopharmaceutical’s MBP134, a combination of two monoclonal antibodies. It was studied for Sudan ebolavirus and backed by BARDA. The drug shows activity against multiple ebolaviruses. Regeneron’s maftivimab is also under consideration after lab tests showed activity against Bundibugyo. The company is preparing supply for trials. Its approved Inmazeb combination treats Zaire ebolavirus, and 500 doses were recently donated to the WHO.
