Guideline: Prevention and Control guideline for Marburg and Ebola diseases.

During the major Ebola outbreak in West Africa from 2014 to 2016, rapid IPC guidance was urgently needed to support health ministries, healthcare providers, and non-governmental organizations (NGOs). In response, the World Health Organization (WHO) produced several IPC-related documents based on expert opinion. Key resources included:

1. Guidelines on personal protective equipment (PPE) for filovirus outbreaks (2016),
2. Guidelines on hand hygiene in the context of filovirus outbreaks (2014), and
3. Interim IPC guidance for managing suspected or confirmed cases of hemorrhagic fevers like Ebola in healthcare settings (2014).

These guidelines were widely adopted, and IPC practices became standardized. However, recurring outbreaks highlighted a need to reassess these IPC protocols. In 2021, the WHO Health Emergencies (WHE) IPC team reviewed existing documents and identified areas for improvement. This led to the establishment of a Guideline Development Group (GDG) in mid-2021, tasked with updating the 2014 guidance on IPC for Ebola and Marburg diseases. This new guideline follows rigorous methodology, known as GRADE (Grading of Recommendations Assessment, Development and Evaluation) and the evidence-to-decision (EtD) framework, to ensure the recommendations are grounded in the latest available evidence.

The updated WHO guideline clarifies IPC recommendations tailored to various healthcare settings that pose different levels of risk to healthcare workers. It covers critical aspects like screening, triage, and care provision for patients suspected or confirmed to have Ebola or Marburg disease. Additionally, the GDG is creating tools to facilitate guideline implementation, making it easier for healthcare facilities to apply IPC practices effectively.

This guideline distinguishes between IPC needs in specialized Treatment Centers (TCs) and other healthcare facilities (HCFs), recognizing the differences in staff training and resources available across facility types. The guideline aims to equip all types of healthcare facilities to prepare for potential Ebola or Marburg cases, ensuring safety for infected patients, healthcare workers, and any others present within these facilities.

The IPC GDG, composed of experts in the field, met virtually and in person, including a major meeting in October 2022 in Geneva, Switzerland, to finalize the updated recommendations. The guideline’s initial publication focuses on healthcare facility-specific IPC protocols and will be revised as new evidence becomes available.