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Viral Infections and Outbreaks Research / Zoonotic Diseases and Public Health · Journal article
The Egyptian Journal of Internal Medicine · August 6, 2026
Early or partial results. Treat as a signal, not a conclusion.
This scoping review synthesizes evidence on recent EVD outbreaks, zoonotic transmission dynamics, and therapeutic developments from 50 recent sources (predominantly 2018–2026). It documents CFRs ranging from 25% to over 90% across outbreaks, describes monoclonal antibody efficacy improvements (Inmazeb and Ebanga at ~33–35% 28-day mortality versus 49.7% for ZMapp), and identifies integrated One Health surveillance and equitable vaccine access as essential future strategies.
Scoping review. Literature on recent EVD outbreaks, zoonotic transmission, genomic epidemiology, therapeutics, vaccines, and sociocultural and ecological drivers (2018–2026 focus).. Intervention: Recent EVD outbreak investigations, monoclonal antibody (Inmazeb, Ebanga, ZMapp) and vaccine (rVSV-ZEBOV) developments, and ring-vaccination trials. Compared with: Historical comparators (ZMapp) and vaccine efficacy by ebolavirus species (Zaire versus Sudan). n = 50. Global; recent outbreaks in Democratic Republic of the Congo (2018–2020, 2025), Guinea (2021), Uganda (2022, 2025), and Bundibugyo (2026).
DRC 10th outbreak (2018–2020): 3,470 cases with CFR 66.2%, exacerbated by armed conflict and nosocomial transmission 2021 Guinea resurgence genetically linked to 2014–2016 survivor, revealing viral persistence in immune-privileged tissues 2022 Uganda outbreak: 164 cases with CFR 46.3%, highlighted super-spreading at private facilities
Monoclonal antibody comparisons (28-day mortality) not formally randomized; source does not specify whether comparisons are from the same trials or meta-analysed data Monoclonal antibodies Inmazeb and Ebanga showed 28-day mortality of 33.5% and 35.1% versus 49.7% for ZMapp
Clinicians and public health professionals should note the CFR variability across outbreaks (29–70%), the improved efficacy of approved monoclonal antibodies (Inmazeb, Ebanga) over ZMapp, and the critical gap in Sudan ebolavirus therapeutics and vaccines. Future prevention requires integrated surveillance, equitable access to therapeutics, and community engagement.
A scoping review synthesizing recent outbreak reports and evidence through May 2026, descriptive in nature with no comparative efficacy analysis, presenting epidemiological patterns and therapeutic comparisons without formal meta-analysis or controlled design.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians and public health professionals should note the CFR variability across outbreaks (29–70%), the improved efficacy of approved monoclonal antibodies (Inmazeb, Ebanga) over ZMapp, and the critical gap in Sudan ebolavirus therapeutics and vaccines. Future prevention requires integrated surveillance, equitable access to therapeutics, and community engagement.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background Ebola Virus Disease (EVD) remains among the most lethal zoonotic hemorrhagic fevers, with case fatality rates (CFRs) of 25% to over 90%. Since 2018, successive major outbreaks; the 10th Democratic Republic of the Congo (DRC) epidemic (2018–2020), the 2021 Guinea resurgence, the Uganda Sudan ebolavirus outbreaks (2022, 2025), the 16th DRC (Kasai) outbreak (2025), and the 2026 Bundibugyo virus emergency declared a Public Health Emergency of International Concern have claimed thousands of lives, underscoring EVD’s persistent threat at the human–animal–environment interface and critical preparedness gaps. Objectives This scoping review synthesizes recent evidence on EVD outbreak dynamics, zoonotic transmission, genomic epidemiology, therapeutic and vaccine developments, and the sociocultural and ecological drivers of outbreaks. Methods Following PRISMA-ScR, we searched PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar (inception to May 2026), supplemented by WHO outbreak reports. Fifty eligible sources were included, over 90% published 2018–2026. Results The DRC 10th outbreak (3,470 cases; CFR 66.2%) was exacerbated by armed conflict, nosocomial transmission, and community resistance. The 2021 Guinea resurgence was genetically linked to a 2014–2016 survivor, revealing viral persistence in immune-privileged tissues. The 2022 Uganda outbreak (164 cases; CFR 46.3%) highlighted super-spreading and inadequate infection control at private facilities. Frugivorous Pteropodidae bats remain the likely reservoir. Approved monoclonal antibodies Inmazeb and Ebanga showed 28-day mortality of 33.5% and 35.1% versus 49.7% for ZMapp; rVSV-ZEBOV protects against Zaire but not Sudan ebolavirus. Recent events reinforced these themes: 2025 Uganda (14 cases; CFR 29%) saw the first SUDV ring-vaccination trial; 2025 DRC-Kasai (64 cases; CFR 70.3%) was contained within ~ 3 months; and 2026 Bundibugyo again exposed absent countermeasures for non-Zaire species. Conclusion Integrated One Health surveillance, equitable therapeutic and vaccine access, community engagement, and genomic epidemiology must anchor future EVD prevention. Urgent investment in Sudan ebolavirus vaccines and outbreak-resilient health systems is essential.
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