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FDA approves first and only oral option for COVID-19 postexposure prophylaxis
The US Food and Drug Administration (FDA) has approved ensitrelvir for postexposure prophylaxis (PEP) in adolescents aged ≥12 years and adults following contact with an individual who has coronavirus disease 2019 (COVID-19). It is the first and only oral option licensed to prevent COVID-19 after exposure.
Approval was based on the phase 3 SCORPIO-PEP trial. Ensitrelvir significantly reduced the risk of symptomatic infection by 67% in uninfected individuals, compared with placebo, through to day 10. Common adverse effects were cough, headache, and diarrhoea, and the rates of adverse effects were similar across both groups.
Ensitrelvir is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease inhibitor that inhibits viral replication.
- Pregnancy status should be checked before starting treatment. Ensitrelvir may cause fetal harm, based on animal studies. Women of childbearing potential should use contraception during use and for 2 weeks after the final dose.
- Potential drug-drug interactions should be assessed before starting treatment. Co-administration with drugs primarily metabolised by the CYP3A enzyme may result in serious and/or life-threatening reactions, or a loss of virological response.
Ensitrelvir is also approved in Japan for the treatment of COVID-19. However, the US approval is limited to PEP only.
WHO advises on candidate vaccines and therapeutics for Ebola outbreak
The World Health Organization (WHO) has convened several expert and advisory groups to assess potential vaccines and therapeutics for the prevention and treatment of Ebola disease caused by the Bundibugyo virus, the virus responsible for the current Ebola outbreak in the Democratic Republic of the Congo (DRC) and Uganda. There are currently no known vaccines or specific therapeutics for this strain of the virus.
The most promising vaccine candidates include the rVSV Bundibugyo vaccine and the ChAdOx1 Bundibugyo vaccine. However, their availability for clinical trials is still several months away. Promising therapeutics include the antiviral drugs obeldesivir (for post-exposure prophylaxis) and remdesivir, and the monoclonal antibodies MBP-134 and maftivimab. These therapeutics should be used exclusively only within clinical trials.
There is insufficient evidence to determine whether the Ervebo® vaccine (a vaccine licensed for the prevention of disease caused by a different strain of the virus) provides cross-protection against the Bundibugyo virus. Therefore, the WHO recommends that this vaccine should only be used in carefully designed research settings during the current outbreak.
As of 7 June 2026, 550 confirmed cases and 101 confirmed deaths have been reported in the DRC, with 195 confirmed cases and 2 confirmed deaths in Uganda.
The situation is rapidly developing, and you should consult your local public health authority for current information on the situation. Information is available from the WHO, the US Centers for Disease Control and Prevention (CDC), and the UK Health Security Agency (UKHSA).
- WHO: disease outbreak news
- CDC: Ebola outbreak - current situation
- UK Health Security Agency: Ebola and Marburg haemorrhagic fevers - outbreaks and case locations
The WHO declared that the outbreak constituted a public health emergency of international concern (PHEIC) on 17 May 2026. PHEIC status aims to accelerate funding, research, and international public health measures and cooperation to contain a disease. There are several reasons for the WHO declaring a PHEIC for this outbreak including:
- Significant uncertainty about the true number of infected people and geographical spread at the present time. Also, there is limited understanding of the epidemiological links with known or suspected cases. Early data point toward a potentially much larger outbreak than what is being detected and reported.
- Cases have already been reported in Uganda; therefore, neighboring countries such as South Sudan are considered to be at high risk of further spread.
- There is ongoing insecurity and a humanitarian crisis in the region.
- There are currently no known vaccines or specific therapeutics for Bundibugyo virus.
The case fatality rate for disease caused by the Bundibugyo virus ranges from 30% to 50%, according to the WHO, although data vary based on whether laboratory-confirmed cases or suspected cases were used to calculate the rate.
The overall global risk is considered to be low. However, the risk at the national level in the DRC is very high, and the risk at the regional level (including surrounding countries such as Uganda) is considered to be high.
Prior to this outbreak, there have only been two outbreaks of disease caused by Bundibugyo virus: Uganda in 2007 and the DRC in 2012.
UK NICE guideline update: adjunctive corticosteroids for severe community-acquired pneumonia (NG250)
The updated UK National Institute for Health and Care Excellence (NICE) guideline on pneumonia (NG250) recommends considering adjunctive systemic corticosteroids for adults admitted to hospital with severe community-acquired pneumonia (CAP).
For patients with a CURB-65 score of 3-5, together with clinical assessment indicating severe disease, a short course of systemic corticosteroids may be added to appropriate antibiotic therapy unless contraindicated. This represents a change from previous UK guidance, which did not recommend routine corticosteroid use.
In daily practice:
- Assess severity using CURB-65 alongside clinical judgement.
- Consider adjunctive corticosteroids for patients admitted with severe CAP.
- Do not use corticosteroids routinely in low- or moderate-severity disease, or in patients managed in the community.
- Weigh potential benefits, including reduced mortality and faster clinical recovery, against risks such as hyperglycaemia and secondary infection.
Hantavirus outbreak linked to cruise ship
A cluster of hantavirus cases have been reported on a Dutch-flagged cruise ship, the MV Hondius, which departed Argentina on 1 April 2026. The ship travelled across the South Atlantic, with various stops in remote regions, and carried 147 passengers and crew.
The outbreak was first reported to the World Health Organization (WHO) on 2 May 2026. As of 27 May 2026, 13 cases have been reported (11 confirmed and 2 probable cases), including 3 deaths (case fatality rate 23%). Cases have been reported from France, Canada, the Netherlands, and Spain. All cases to date have been passengers or crew members on the ship.
Illness has been characterised by fever, gastrointestinal symptoms, and rapid progression to pneumonia, acute respiratory distress syndrome, and shock. Symptoms typically appear within 4 to 42 days after exposure.
Hantaviruses are primarily transmitted to humans from contact with infected rodents or their urine, saliva, or feces (or with contaminated surfaces). Infection can cause a range of illnesses including severe disease, and even death. Clinical manifestations are divided into two clinical syndromes:
- Hantavirus cardiopulmonary syndrome (HCPS) - seen in the Americas
- Haemorrhagic fever with renal syndrome (HFRS) - seen in Asia and Europe
This outbreak is due to the Andes virus (ANDV), which is typically found in South America and causes HCPS. It is the only species of hantavirus that has been associated with limited human-to-human transmission, particularly in community settings involving close and prolonged contact, and among healthcare professionals looking after infected patients. The case fatality rate is reported to be 30% to 50%.
The situation is developing, and you should consult your local public health authority for updates. Information is available from the WHO, the US Centers for Disease Control and Prevention (CDC), and the UK Health Security Agency (UKHSA).
- WHO: disease outbreak news
- CDC: Andes virus outbreak on a cruise ship - current situation
- UKHSA: update on the hantavirus cruise ship outbreak
The WHO has currently assessed the risk to the global population as low.
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Bacterial meningitis in adults: explore our topic
Meningitis is currently important in the UK and many other countries around the world. This topic will help you learn how to:
- Diagnose the condition confidently
- Manage patients effectively
- Share information with patients
- Advise about vaccination
Have you used our Comorbidities Manager?
Managing the treatment of patients with comorbidities is hard – clinical guidelines only focus on single conditions – but failure to manage comorbidities leads to worse clinical outcomes and longer lengths of stay.
Our unique Comorbidities Manager* provides guidance on the treatment of a patient’s acute condition alongside their preexisting comorbidities.
*This feature is only available if your institution has purchased the Comorbidities Manager. If you have access it will appear under the ‘Your Profile’ section in the menu at the top of the page.
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At a glance
One in three adults suffer from multiple chronic conditions and most patients in the acute setting have more than one medical condition.
- Treat patients with comorbidities with confidence
- Better understand the complexities of treating multiple conditions
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