Addressing the Complications of Ebola and Other Viral Hemorrhagic Fever Infections: Using Insights from Bacterial and Fungal Sepsis

Research on Ebola virus (EBOV) has focused on preventing and controlling the infection using vaccines and antiviral therapies. Given the long-term challenge of the current epidemic and the likelihood of future outbreaks of viral hemorrhagic fevers caused by the filoviruses, including EBOV and Marburg virus, efforts should also focus on developing therapies to reduce the deadly complications of infection with these viruses [1,2]. There are striking similarities in the syndromes caused by bacterial and fungal sepsis [3–14] and by EBOV [15–27] (Table 1). Sepsis, defined as the systemic inflammatory response to infection, causes a spectrum of pathology ranging from mild, basic physiologic and laboratory derangements to shock, multiple organ failure, and death [3,7]. While the term “sepsis” is generally used in the context of bacterial and fungal infections, all microorganisms, including viruses, can cause sepsis. This Opinion argues that the wealth of knowledge about bacterial and fungal sepsis (herein referred to as “classical sepsis”) should be used to inform the development of adjunctive therapies to improve the outcome of EBOV and other viral hemorrhagic fevers.