A case of Bundibugyo virus disease treated with monoclonal antibodies and remdesivir.

Authors

Alexander Uhrig, Frieder Pfäfflin, Pinkus Tober-Lau, Victor M Corman, Miriam S Stegemann, Paulina Tarnow, Monika Rottstegge, Katrin Moira Heim, Felix Bremer, Thomas Cronen, Tilman Lingscheid, Han Ngoc Le, Dominik Geus, Mary J Choi, William A Fischer, Wesley R Campbell, Aneesh K Mehta, Marylyn M Addo, Placide Mbala-Kingebeni, David Hillus, Christian Gaebler, Stephan Becker, Janine Michel, Andreas Nitsche, Andreas Kurth, Martin Witzenrath, Till D Best, Stephan Günther, Lisa Oestereich, Manuel Koch, Matthias Zehner, Henning Gruell, Christian Drosten, Florian Klein, Charité Ebola Task Force, Florian Kurth, Leif E Sander

Published in

Nature medicine. Aug 24, 2026. Epub Aug 24, 2026.

Abstract

Clinical data on Bundibugyo virus (BDBV) infection are limited, and no approved virus-specific treatment exists. We describe the case of a previously healthy 39-year-old healthcare worker who acquired BDBV infection while working in Ituri Province, Democratic Republic of the Congo (DRC), and was medically evacuated to Germany. He received MBP134, an investigational combination of two monoclonal antibodies, under an FDA Emergency Investigational New Drug (eIND) authorization, together with remdesivir and supportive care. Viral RNA concentrations were highest in oropharyngeal swabs and plasma, and became undetectable in blood, throat swabs, urine, and stool by day 13 after symptom onset and in semen by day 25. The patient's serum demonstrated neutralizing activity against the current BDBV outbreak strain and other orthoebolaviruses. We detected BDBV-induced antibody responses not attributable to MBP134 or prior vaccination, providing evidence of endogenous humoral immunity following combined antiviral treatment. The patient recovered and was discharged on day 22 after symptom onset. This case report provides detailed insights into the clinical course, virologic dynamics and immune responses in BDBV infection during combined antiviral treatment, while larger clinical studies are needed to assess the efficacy and clinical utility of these therapeutic approaches.

PMID:
42742180
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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