Post-exposure prophylaxis with a monoclonal antibody cocktail after Bundibugyo ebolavirus exposure in adults and children
Year: 2026
Type: article
Study design: Case Report
Abstract: Five individuals from a single-family cluster, one rVSV-ZEBOV-vaccinated adult and four unvaccinated children aged 1–7 years, received investigational MBP134 as post-exposure prophylaxis (PEP) 5–6 days after high- to intermediate-risk occupational or household exposure to Bundibugyo ebolavirus (BDBV). MBP134 is a broadly neutralizing monoclonal antibody cocktail that has conferred protection against BDBV in non-human primates but to our knowledge has not previously been evaluated as PEP in humans. Given the absence of approved preventive interventions against BDBV and the substantial case fatality rate of Bundibugyo virus disease (BVD), MBP134 was administered as an individual treatment attempt under emergency Investigational New Drug (eIND) authorizations. Administration was well tolerated, with no treatment-related adverse events. Throughout the 21-day monitoring period, all family members remained free of clinical or laboratory evidence of BVD, as assessed by daily medical evaluation and serial PCR testing. Plasma Orthoebolavirus-reactive antibodies were detected after infusion, persisted throughout follow-up and mediated broad neutralizing activity against multiple Orthoebolavirus species, including authentic BDBV. Notably, endogenous BDBV-reactive IgM and IgA were detected in the adult following high-risk exposure despite persistently negative PCR results. Together, these findings support prospective evaluation of MBP134 as PEP for high-risk adult and pediatric contacts during BDBV outbreaks. In a case series of an adult and four children with high- to intermediate-risk exposure to Bundibugyo ebolavirus, emergency use post-exposure prophylaxis monoclonal antibody cocktail (MBP134) treatment was well tolerated with no evidence of Bundibugyo virus disease, supporting future evaluation of MBP134 as a post-exposure prophylaxis for outbreaks.
Source: Nature Medicine
Authors: Christian Gaebler, Han Ngoc Le, Luise Martin, Paulina Tarnow, Alexander Gratopp, Stefanie Hort, Anke Wendt, Monika Rottstegge, Pinkus Tober-Lau, Matthias Zehner, Henning Gruell, Manuel Koch, Victor Corman, Till Dominik Best, Shreeya Amatya, Mary J. Choi, William A. Fischer, Wesley R. Campbell, Aneesh K. Mehta, Marylyn M. Addo, Renate Krüger, Susanne Lau, Philip Bufler, Marcus A. Mall, Christian Drosten, Lisa Oestereich, Charité Ebola Task Force, Joram Arzig, Lara Bardtke, Clara Bergmann, Andreas Binke, Tobias Bleicker, Markus Brack, Katharina Breuer, Sophia Brumhard, Carolin Burschberg, Martin Büttner, Nilgün Cetrefli, Anika Cleemann, Jan Doehn, Daniel Dyba, Martin Eicher, Jana Faller, Paul Feldmann, Susanne Fieberg, Frieder Gabriel, Dominik Geus, Louise Götze, Julia Gradwohl, Chris Grätz, Matthias Gröschel, Tamara Hartmann, Kim Heimsch, Wolfgang Hinkeldey, Julius Hoffmann, Johanna Hopp, Johanna Horn, Mareen Höwler, Silvija Ilic, Jennifer Janssen, Stefanie Jentzsch, Terence C. Jones, Jannina Kadereit, Jonas Kerbaum, Katharina Klement, Thomas Klotzkowski, Christoph Knoch, Sören Kolbe, Anett Kolizius, Helene Kriedemann, Tassilo Kruis, Fiona Lawrenz, Julia Lichtblau, Rebecca Lorenz, Felix Machleidt, Tiina Mauno, Shima Mecklenbräuker, Julia Melchert, Nikolai Menner, Gina Maria Michalsky, Marcel A. Müller, Miriam Müller, Holger Müller-Redetzky, Joanna Muszynska, Viola Marie Nagata, Nino Neumann, Anne Österby, Michela Perotti, Lennart Pfannkuch, Moritz Pfeiffer, Ursula Pfitzner, Brar Piening, Peter Radünzel, Sibylle Reinsch, Julia Riedmann, Stephanie Rohrbach, Laura Rose, Violeta Sanchez Alvarez, Bricel Selene Santiago Quintana, Sylvia Schaber, Renate Schaffernicht, Viktoria Schenkel, Melanie Schmele, Marie L. Schmidt, Birgit Schnödewind, Maike Schröder, Saskia Schulz, Josua Sellmaier, Rincy Simon, André Solarek, Benjamin Stadtmann, Clara Steinacker, Ansgar Stenzel, Yasmin Stoppe, Montana Louis Tatum, Talitha Veith, Tobias Wagelöhner, Ulrich Wagner, Michael Weber, Nadine Weeverink, Friedrich Welz, Martin Witzenrath, Dana Wolff, Ellen Wrzolek, Nikolai W. Zaki, Desiree Zeegers-Bachmann, Thomas Zoller, Tilman Lingscheid, Katrin Moira Heim, Alexander Uhrig, Frieder Pfäfflin, Miriam S. Stegemann, Florian Klein, Florian Kurth, Leif Erik Sander
Institutions: Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charité – Universitätsmedizin Berlin, Stiftung Charité, University of Cologne, University Hospital Cologne, German Center for Infection Research, Bernhard Nocht Institute for Tropical Medicine, Weill Cornell Medicine, Centers for Disease Control and Prevention, United States Public Health Service, University of North Carolina at Chapel Hill, United States Department of State, Uniformed Services University of the Health Sciences, Emory University, University Medical Center Hamburg-Eppendorf, German Center for Lung Research, Bundeswehr, Centre de Recherche Médicales de Lambaréné
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $12,690
Funders: U.S. Department of State, Deutsches Zentrum für Infektionsforschung, European Commission, Deutsche Forschungsgemeinschaft, Bundesministerium für Bildung und Forschung, Else Kröner-Fresenius-Stiftung, Einstein Stiftung Berlin, Universitätsklinikum Köln, Stiftung Charité, Hector Stiftung, Centers for Disease Control and Prevention, Horizon 2020 Framework Programme
OpenAlex ID: W7204126212