Risk of Bundibugyo virus transmission through substances of human origin in the European Union/European Economic Area (EU/EEA)

Individuals arriving from Ebola disease-affected areas

A deferral from SoHO donation for two incubation periods provides a reasonable margin of safety for asymptomatic prospective donors arriving from areas affected by Ebola disease caused by BDBV. The longest incubation period for Ebola disease is estimated to be 21 days. ECDC recommends temporarily deferring an asymptomatic individual who has not been deferred for other infectious disease risks from donating SoHO for at least six weeks after arriving from areas with community transmission of BDBV (see updated information at Ebola disease outbreak in the Democratic Republic of the Congo and Uganda).

The multiple pathogen inactivation steps used in the manufacturing process for plasma-derived medicinal products are considered effective for the inactivation of enveloped viruses [21-23], but have not been specifically validated for orthoebolaviruses. Bearing this in mind, and also to minimise potential exposure of SoHO professionals, a similar six-week deferral from donating plasma for industrial manufacturing would be a prudent precaution for asymptomatic travellers or residents arriving from areas with community BDBV transmission.

For organ donors, each donation from a deceased or living donor returning from an affected area should be evaluated individually, by assessing the urgency of recipient need and the donor’s potential risk of exposure, obtaining the recipient’s informed consent, carrying out specific post-transplant monitoring and considering the risk for healthcare workers and the recipient’s family members. Based on this assessment, a shorter deferral period could be considered. (For information on risk of exposure to BDBV in the context of the current outbreak, see Threat assessment brief: Ebola disease outbreak caused by Bundibugyo virus – Democratic Republic of the Congo and Uganda – 2026).
 

Individuals monitored after exposure to Bundibugyo virus

In the context of the current Ebola disease outbreak, individuals who are being monitored due to contact with a patient with an infection, or other exposure to BDBV are ineligible to donate SoHO for at least six weeks from the beginning of the monitoring period.
 

Individuals with current Bundibugyo virus infection

During acute infection, orthoebolaviruses are present in blood and other bodily fluids, tissues, cells and organs. Individuals with evidence of current BDBV infection are not suitable as donors of SoHO, and both living and deceased donors should be excluded from donation.
 

Individuals having recovered from Ebola disease

Convalescence following Ebola disease is long and often associated with sequelae such as myelitis, recurrent hepatitis, psychosis or uveitis. Data on the post-recovery viraemic period are limited. Shedding of orthoebolaviruses has been reported in semen, breast milk, and ocular (eye) and cerebrospinal fluid after the virus has been cleared from blood [7,11,12].

Based on these findings and on the theoretical possibility of intermittent low-level viremia after recovery from illness, ECDC recommends permanent deferral from the donation of blood, cells and tissues for donors who have recovered from Ebola disease.

For organ donors, each donation from a deceased or living donor having recovered from Ebola disease should be evaluated individually, by assessing the urgency of recipient need and obtaining the recipient’s informed consent, carrying out specific post-transplant monitoring and considering the risk for healthcare workers and the recipient’s family member specifically monitoring the recipient post-transplant and considering the risk for healthcare workers and the recipient’s family. Due to the persistence of orthoebolaviruses in some tissues and bodily fluids, a deferral period of 1.5 years could be considered for organ donors having recovered from Ebola disease [24].

Individuals having had sexual contact with a person convalescing after Ebola disease

Viable viruses have been isolated from semen, and sexual transmission of EBOV has been documented [12,25,26]. Hence, transmission of BDBV through sexual contact is considered possible. ECDC therefore recommends deferring individuals who have had sexual contact with a person who has recovered from Ebola disease from SoHO donation for at least six weeks since the exposure, irrespective of the time elapsed since the recovery of the convalescent sexual contact.

More information on the risk assessment and background is available in the document below.