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Event description
Democratic Republic of the Congo
The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo has expanded to a seventh province, with the first confirmed case reported in Bulu Health Zone, Sud-Ubangi, a province bordering the Central African Republic and the Republic of the Congo.
This latest geographic expansion heightens concern about further spread towards international borders, while transmission within the country remains increasingly heterogeneous across affected provinces and health zones.
Since External Situation Report #17, a further 572 confirmed cases and 284 confirmed deaths have been reported, bringing the cumulative total to 7258 confirmed cases, including 3510 deaths [case fatality ratio (CFR) 48.4%], as of 13 September 2026.
Ituri remains the principal focus but its relative contribution continues to decline, accounting for 78.0% of cumulative confirmed cases, while transmission continues to increase in Nord-Kivu and persists in Haut-Uélé.
The outbreak now affects 62 health zones across seven provinces, with Bulu Health Zone in Sud-Ubangi being the latest affected.
At the national level, daily incidence remains high and fluctuating, with the seven-day moving average declining from its mid-August peak, followed by a modest rebound in early September. This national pattern masks increasingly divergent provincial trajectories.
Ituri continues to decline from its mid-August peak but remains at a high level, while Nord-Kivu is experiencing a sharp and sustained increase, reaching its highest incidence since the start of the outbreak and increasingly driving the national trajectory.
Transmission in Haut-Uélé remains sustained but has declined from its August peak.
Tshopo shows a recent increase from a low baseline, while Bas-Uélé continues to report sporadic transmission, and no recent transmission is evident in Sud-Kivu.
Overall, the epidemic is becoming more geographically heterogeneous, with declining transmission in Ituri and Haut-Uélé occurring alongside rapid intensification in Nord-Kivu, renewed activity in Tshopo and continued geographic expansion to new areas.
Figure 1. Daily national trend in confirmed Bundibugyo virus disease cases, with seven-day moving average, by date of report, Democratic Republic of the Congo, as of 13 September 2026
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During the most recent 21 days (24 August – 13 September 2026), 1674 confirmed cases were reported nationally.
Compared with 1782 cases during the preceding 21-day period (3 – 23 August 2026), this represents a decrease of 108 cases (−6.1%). Reported cases declined by 25.0% in Ituri, from 1338 to 1004, and by 16.7% in Haut-Uélé, from 120 to 100.
In contrast, cases increased sharply by 76.1% in Nord-Kivu, from 314 to 553, while Tshopo increased from 8 to 13 cases and Bas-Uélé from 2 to 3 cases. One case was also reported in the newly affected province of Sud-Ubangi during the latest period. Consequently, Ituri’s contribution to newly reported cases fell markedly from 75.1% to 60.0%, while Nord-Kivu’s contribution nearly doubled from 17.6% to 33.0%; Haut-Uélé’s contribution declined slightly from 6.7% to 6.0%.
Overall, the modest 6.1% national decline masks a pronounced geographic redistribution of transmission, with the substantial decline in Ituri increasingly offset by rapidly intensifying transmission in Nord-Kivu and continued geographic expansion.
During the same period, 830 confirmed deaths were reported nationally, compared with 973 deaths during the preceding 21 days, representing a decrease of 143 deaths (−14.7%). The national decline was driven largely by Ituri, where reported deaths decreased from 706 to 495 (−29.9%), while deaths also declined in Haut-Uélé, from 50 to 31 (−38.0%).
In contrast, deaths increased substantially in Nord-Kivu, from 213 to 299 (+40.4%). Consequently, Ituri’s contribution to newly reported deaths fell markedly from 72.6% to 59.6%, while Nord-Kivu’s contribution increased from 21.9% to 36.0%; Haut-Uélé’s contribution declined from 5.1% to 3.7%. Tshopo and Bas-Uélé each reported two deaths during the latest period, while one death was reported in Sud-Ubangi.
Overall, the national reductions in both cases (−6.1%) and deaths (−14.7%) were driven predominantly by declining transmission and mortality in Ituri and mask sharply divergent provincial trajectories. In particular, the simultaneous increases in cases (+76.1%) and deaths (+40.4%) in Nord-Kivu indicate substantial intensification of the outbreak there, with the province now accounting for one-third of newly reported cases and more than one-third of newly reported deaths nationally.
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Additionally, during the most recent 21 days (24 August – 13 September 2026), 49 of the 62 affected health zones (79.0%) reported at least one new confirmed case, while 13 (21.0%) reported no new cases. Health zones reporting no cases were Adja, Ariwara, Aungba, Kambala and Mahagi in Ituri; Goma in Nord-Kivu; Gombari in Haut-Uélé; Lubunga, Tshopo and Wanie-Rukula in Tshopo; Miti-Murhesa in Sud-Kivu; and Buta and Viadana in Bas-Uélé.
Provincial trends also mask important differences between health zones. In Ituri, where cases declined by 25.0% overall, several health zones continued to increase, notably Komanda (22 to 76; +245.5%), Mangala (92 to 116; +26.1%), Lita (56 to 65; +16.1%) and Mongbwalu (50 to 61; +22.0%).
In contrast, major transmission areas declined substantially, including Bunia (384 to 285; −25.8%), Nizi (210 to 120; −42.9%), Rwampara (258 to 106; −58.9%) and Nia-Nia (89 to 46; −48.3%).
Nord-Kivu shows the opposite pattern, with broad-based intensification rather than an increase confined to a few hotspots. Cases increased in Katwa (162 to 175; +8.0%), Beni (53 to 111; +109.4%), Butembo (51 to 101; +98.0%) and Musienene (27 to 46; +70.4%), alongside transmission in newly or recently affected health zones. Haut-Uélé declined overall, but this also concealed a marked increase in Pawa, from eight to 38 cases (+375%), while Isiro and Wamba declined.
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