Beyond Efficacy: Sustaining Environmental Disinfection During Filovirus Disease Outbreaks in Conflict-affected, Resource-limited Settings

Abstract Purpose of Review Filoviruses, including Bundibugyo virus, spread through contact with body fluids and with surfaces and materials soiled by those fluids, so environmental disinfection is central to infection prevention and control (IPC). This review reframes filovirus disinfection. For practical field response the broad classes of effective agents and their target concentrations are reasonably well established, and the decisive problem is the implementation and sustainability of disinfection under field constraints. The 2026 Bundibugyo virus disease outbreak in the Democratic Republic of the Congo (DRC) and Uganda serves as the anchoring example. Recent Findings Recent laboratory and field work shows that organic matrix and porous surfaces substantially reduce real-world efficacy, that chlorine solutions can degrade quickly under tropical heat, and that the choice of chlorine source involves a storage-versus-stability trade-off. Disinfection data specific to Bundibugyo virus remain very limited, so practice extrapolates from Zaire ebolavirus. Global surveys show that IPC monitoring is weakest in low-income facilities, and modeling of prior eastern DRC outbreaks shows that conflict and mistrust directly degrade response quality. Summary Although species-specific efficacy data for Bundibugyo virus are still desirable, the major unresolved challenge is not the discovery of new virucides but the delivery, monitoring and sustainability of proven disinfection under outbreak conditions. Treating disinfection as an implementation and quality-improvement problem, resourced and measured from the first day of response, is an urgent and operationally actionable priority that the current emergency brings into focus.