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Open research questions in Viral Infections and Outbreaks Research

28 unresolved questions extracted from the limitations and future-work sections of 660 Viral Infections and Outbreaks Research papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • For example, evidence on human convalescent immune responses and vaccine immunogenicity for BDBV are currently lacking, and the evidence on any association between antibody binding and vaccine protection in NHP is sparse.

    Filovirus Evidence Maps: A community resource to identify and curate the published evidence on immunity and vaccination for BDBV, EBOV, MARV, and SUDV · 2026 · DOI

  • With candidate antivirals under evaluation, but limited evidence on how best to use them if they become available, we assessed HCW-targeted antiviral post-exposure prophylaxis (PEP) across deployment and disruption scenarios.

    Evaluating the impact of antiviral post-exposure prophylaxis for health-care workers during ebolavirus outbreaks: a modelling study · 2026 · DOI

  • Its clinical management is severely limited by the absence of licensed vaccines or targeted antiviral therapies, necessitating a heavy reliance on intensive Romanian medical JouRnal – Volume 73, no.

    Marburg virus disease outbreaks: A narrative review of epidemiology and response · 2026 · DOI

  • The use of a narrative synthesis limits quantita- tive comparison across outbreaks. Reliance on heter- ogeneous and secondary data introduces potential bias and limits generalizability. Variability in CFR and diagnostic confirmation complicates interpreta- tion. Additionally, the absence of primary field data restricts empirical evaluation of socio-behavioral and operational factors. cOncLuSIOn In conclusion, MARV disease remains a significant global health threat characterized by high case fatal- ity rates and substantial barriers to effective contain- ment. Its clinical management is severely limited by the absence of licensed vaccines or targeted antiviral therapies, necessitating a heavy reliance on intensive Romanian medical JouRnal – Volume 73, no. 1, 2026 Romanian medical JouRnal – Volume 73, no. 1, 2026 143 supportive care. Delayed diagnosis is a serious chal- lenge, as it facilitates sustained community and noso- comial transmission and directly impacts survival rates; data indicate that laboratory-confirmed cases often experience lower lethality due to earlier access to appropriate clinical interventions. The management of MARV disease is further com- plicated by systemic vulnerabilities, including the scarcity of high-containment laboratories in re- source-limited regions and the high risk of cross-bor- der spread through porous national boundaries. The frequent occurrence of nosocomial transmission highlights critical gaps in infection prevention and healthcare worker safety. To move beyond reactive outbreak responses, it is essential to implement a “One Health” framework that integrates longitudinal wildlife surveillance with improved diagnostic ca- pacity and regional coordination. Ultimately, strengthening these foundational pub- lic health pillars is vital for reducing the global bur- den and may help prevent future MARV spillover events. Availability of data and materials: All data generated or analyzed during this study are included in this published article and its refer- ences. rEfErEncES 1. Martini GA. Marburg virus disease. Clinical syndrome. In: Martini GA, Siegert R, eds. Marburg Virus Disease. New York: Springer-Verlag; 1971. pp. 1–9. 2. Bhattacharjee S, Goswami S, Agarwal S, Bose A, Roy S. Filoviridae: Ebola Virus and Marburg Virus. In: Emerging and Re-Emerging Viral Diseases. Boca Raton: CRC Press; 2026. pp. 60-79. 3. Okesanya OJ, Manirambona E, Olaleke NO, Osumanu HA, Faniyi AA, Bouaddi O, et al. Rise of Marburg virus in Africa: a call for global preparedness. Ann Med Surg (Lond). 2023 Sep 1;85(10):5285-5290. doi: 10.1097/MS9.0000000000001257. 4. Karami H, Letafati A, Fakhr SSH. Can Marburg virus be sexually transmitted? Health Sci Rep. 2024 Aug 2;7(8):e2270. doi: 10.1002/ hsr2.2270. 5. Schuh AJ, Amman BR, Jones ME, Sealy TK, Uebelhoer LS, Spengler JR, et al.

    Marburg virus disease outbreaks: A narrative review of epidemiology and response · 2026 · DOI

  • Baseline BDBV GP seroreactivity observed prior to vaccination warrants further investigation into the origins and epidemiological significance of pre-existing filovirus-reactive antibodies, including the possibility of prior exposure to related filoviruses, cross-reactive immune responses, high non-specific background reactivity unrelated to filoviruses, or other unrecognized sources of earlier antigenic stimulation.

    Longitudinal Bundibugyo Virus Glycoprotein Seroreactivity Following rVSVΔG-ZEBOV-GP Vaccination in Outbreak-Affected Populations of the Democratic Republic of the Congo · 2026 · DOI

  • This commentary argues that pathogen-specific preparedness may remain insufficient in settings characterized by diagnostic uncertainty and proposes an “IPC-first” outbreak response framework based on rapid syndromic IPC activation before definitive laboratory confirmation becomes available.

    Healthcare-associated transmission and early IPC system vulnerabilities during the 2026 Bundibugyo Ebola outbreak in eastern Democratic Republic of the Congo · 2026 · DOI

  • However, our data add to the preliminary yet limited evidence that EBOV GP-based vaccines might offer at least some degree of protection against BDBV, the virus driving current Public Health Emergency of International Concern (PHIEC) in the Central-East Africa region.

    Cross-protection against Bundibugyo by Ebola and Sudan vaccines · 2026 · DOI

  • While correlates of protection for EVD are not well established, sustained IgG seroreactivity to EBOV GP may serve as a marker for future understandings of the durability of and variation in immune responses to this high-consequence pathogen.

    Sustained Specific EBOV GP Immunogenicity Five-Years Post-Vaccination: Longitudinal Results from North Kivu and Equateur, Democratic Republic of the Congo · 2026 · DOI

  • Despite increasing recognition of wildlife susceptibility to CCHFV infection, their epidemiological role remains poorly understood, and existing seroprevalence studies are fragmented, heterogeneous, and geographically uneven.

    Seroprevalence of crimean-congo hemorrhagic fever virus in large wildlife: a systematic review and meta-analysis · 2026 · DOI

  • While these results may enhance understanding of rVSV-based vectors, in vivo relevance remains unclear, as does whether the effects come from the VSV backbone or Ebola GP.

    <i>In vitro</i> cellular tropism and immunomodulatory response to rVSVΔG-ZEBOV-GP in human cells derived from tissues associated with adverse events · 2026 · DOI

  • First, the 200 simulation scenarios derive from a computational model rather than direct experimental measurement; calibration of the full dynamic equation—particularly the intracellular viral replication term ρvV(t)—against time-resolved intracellular viral load data remains to be performed.

    Immune synapse stability predicts Ebola elimination better than cytotoxic potency alone · 2026 · DOI

  • Safe delivery of intensive care for Marburg virus disease in Rwanda is documented, but the scalability of these clinical management protocols to other endemic regions with varying healthcare infrastructure and resource availability is not addressed.

    Marburg virus disease: the next threat in the making? · 2026 · DOI

  • The paper discusses intensive care management of Marburg virus disease in Rwanda but does not identify specific gaps in clinical trial data for therapeutic interventions or vaccine candidates currently in development for Marburg virus.

    Marburg virus disease: the next threat in the making? · 2026 · DOI

  • While point-of-care diagnostic testing for Marburg virus is referenced through rapid antigen tests, there is no specification of validation data comparing sensitivity and specificity of rapid diagnostic tests versus laboratory-based confirmatory methods across different disease stages and patient populations.

    Marburg virus disease: the next threat in the making? · 2026 · DOI

  • The paper references genomic evolution and phylodynamics of Orthomarburgvirus marburgense but does not specify which viral adaptation mechanisms or transmission dynamics remain uncharacterized across different geographic outbreak contexts.

    Marburg virus disease: the next threat in the making? · 2026 · DOI

  • Early detection of Marburg virus disease relies on symptom-based case definitions, but the paper identifies a need to leverage predictive symptom clusters to enhance and refine case definitions for faster identification in clinical settings, particularly in resource-limited regions.

    Marburg virus disease: the next threat in the making? · 2026 · DOI

  • The 7-1-7 framework (detection 7 days, notification 1 day, response 7 days) is a global target for epidemic preparedness, but its prospective value during an active cross-border outbreak has not been quantified.

    Projected epidemiologic and economic impact of the 7-1-7 outbreak response framework in Uganda: a stochastic modelling study of Bundibugyo Ebola virus · 2026 · DOI

  • The paper mentions validation of hotspot maps by cross-referencing with historical outbreak records, but does not elaborate on validation metrics, sample sizes, or temporal validation approaches.

    Spatial Epidemiology of Lassa Fever in Nigeria: Mapping and Predictive Analytics for Improved Disease Control · 2026 · DOI

  • This means that there are 2000 vaccines that need to be investigated and specially to know who was secretly vaccinated.

    Vacunagate scandal and its possible impact on the vaccination against COVID-19 of health professionals in Peru · 2021 · DOI

  • One student reflected that “[the simulation] was very effective in furthering my limited knowledge on pandemics, the characteristics of disease spread, experimental design, writing grants, types of assays, and vaccine development.

    An Evolving Outbreak Simulation Using Active Learning · 2020 · DOI

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28 open questions have been extracted from the limitations and future-work passages of 660 Viral Infections and Outbreaks Research papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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