Ebola and filovirus disease: Challenges and prospects for 2030

Ebola virus is one of the major species of the family Filoviridae in the order of Mono-negavirales and is one of the four species of the genus Ebolavirus that have been identified and which are epizootic in West or Equatorial Africa. They are pathogens associated with an acute, severe, potentially fatal, systemic disease in man and great apes. Once the more virulent forms enter the human population, transmission occurs primarily through contact with infected body fluids or excreta and can result in major epidemics in under-resourced settings. Ebola and Mar-burg viruses are pathogens that represent an important local public health hazard in Africa, with a potential worldwide impact through imported infections. Ebola and Marburg virus diseases are characterized by major fluid and electrolyte losses, with immune suppression, immune -mediated cell damage and a dysregulated systemic inflammatory response that causes damage to the vasculature, impaired coagulation, and immune dysfunction, leading to multiple organ failure and shock, and high mortality. Following the devastating Ebola virus disease outbreaks in West Africa (2013-2016) and in the eastern Democratic Republic of the Congo (2018-2020), that were classified by World Health Organisation as public health emergencies of international concern, substantial progress has been made in diagnosis, treatment, and vaccine prophylaxis of filovirus infection. Nonetheless, many uncertainties remain regarding the prevention and management of these deadly disorders that occur in the setting of limited health resources and challenging geopolitical settings, particularly given the uptick in conflict and the massive displacements of affected populations.& COPY; 2023 l'Academie nationale de medecine. Published by Elsevier Masson SAS. All rights reserved.