End wall of the Stanza del Cane, Paolo Veronese (1560 - 1561)

 

{Click on Image to Enlarge}

Public Domain.

Source: 

Link: https://www.wikiart.org/en/paolo-veronese/end-wall-of-the-stanza-del-cane-1561

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Rapid #risk #assessment, acute event of potential public health concern: #Hantavirus #outbreak caused by #Andes virus (WHO, summary)

 

Risk statement

    -- This risk assessment provides an updated analysis of the current situation related to the hantavirus outbreak associated with the cruise ship MV Hondius. 

    -- The initial rapid risk assessment was issued on 5 May 2026 to the National International Health Regulations (IHR) Focal Points via the secure Event Information Site.

    -- The public health risk has been reassessed with the most current information available, and the global risk remains low. 

    -- The risk for passengers and crew who were onboard the cruise ship remains moderate, as individuals exposed prior to the implementation of control measures may still develop illness during the incubation period and should therefore be closely monitored. 

    -- This assessment takes into account that all the passengers have now disembarked and are under monitoring, although the ship continues with a reduced crew and a medical team to its home port. 

    -- It should also be noted that some passengers had disembarked in a limited number of other locations before the outbreak was identified and have likewise been placed under monitoring. 

    -- Additionally, identified passengers and crew members who travelled on associated flights are also under monitoring. 

    -- The assessment further considers identified risks, operational limitations, and the potential implications for ongoing public health response activities.

    -- Globally, hantavirus infections are considered a serious but generally low-incidence public health threat, primarily associated with environmental exposure to rodents and their excreta, with limited but important outbreak potential in specific geographic regions. 

    -- There are several variants of hantavirus, but Andes virus is the only hantavirus to have documented human-to-human transmission, which has been observed mainly in outbreaks in southern Argentina and Chile. 

    -- Hantavirus infection caused by Andes virus may cause hantavirus pulmonary syndrome (HPS; also called hantavirus cardiopulmonary syndrome, HCPS) and may lead to rapidly progressive severe respiratory distress and cardiogenic shock. 

    -- The case fatality rate (CFR) can reach up to 50%. 

    -- There is currently no approved antiviral treatment, and early clinical management remains primarily supportive.

    -- The current event is related to the notification on 2 May 2026, by the United Kingdom IHR National Focal Point to WHO of a cluster of severe acute respiratory illness cases aboard the Dutch-flagged cruise vessel MV Hondius. 

    -- The cluster initially included two deaths and one critically ill passenger, with the cause unknown at the time of notification. 

    -- On the same day, laboratory testing confirmed hantavirus infection in the critically ill passenger hospitalised in Johannesburg, South Africa. 

    -- Confirmation that the outbreak was caused by Andes virus was subsequently obtained on 5 May 2026 at the Geneva University Hospitals (HUG) laboratory in Geneva from a passenger that had disembarked earlier from the ship and returned to his home country with presentation of symptoms.

    -- The vessel departed from Ushuaia, Argentina on 1 April 2026, with 114 passengers and 61 crew, and followed an itinerary across the South Atlantic, including multiple stops in remote and ecologically diverse regions such as mainland Antarctica, South Georgia, Nightingale Island, Tristan da Cunha, Saint Helena, and Ascension Island. 

    -- During this period several passengers disembarked and embarked the ship at different stops, resulting in a total of 187 persons who were on the ship at some point during the journey. 

    -- From 11 April to 2 May, three passengers died. 

    -- On 3 May, MV Hondius moored off the coast of Cabo Verde where local health authorities visited the vessel to assess the condition of two remaining symptomatic individuals. These individuals and a high-risk contact were evacuated from the ship on 6 May, and the ship continued to the Canary Islands, Spain.

    -- The vessel arrived at the port of Granadilla, in Tenerife, Canary Islands, on 10 May, carrying 150 individuals, including 86 passengers, 60 crew members, and 4 health professionals from WHO, ECDC and the Netherlands. Passengers and crew represented 25 nationalities: Argentina, Australia, Belgium, Canada, the Democratic Republic of the Congo, France, Germany, Greece, Guatemala, India, Italy, Ireland, Japan, Montenegro, the Netherlands, New Zealand, Philippines, Poland, Portugal, the Russian Federation, Spain, Türkiye, Ukraine, the United Kingdom, and the United States. 

    -- Passengers and most of the crew disembarked on 10 and 11 May and were repatriated to their respective countries of residence or transit points via specially arranged non-commercial flights, with WHO and partners supporting the disembarkation process. The ship left the Canary Islands on 11 May and is sailing to the Netherlands, with 25 crew members remaining on board, along with two Dutch health care workers to conduct their health monitoring and provide any healthcare that may be necessary.

    -- As of 15 May 2026, 10 cases (eight confirmed, and two probable cases), including three deaths (two confirmed and one probable), have been reported (CFR 30%). The contact from the United States of America that was previously reported as inconclusive has now been determined to be negative by serology.

    -- Of the eight laboratory-confirmed cases, three were genetically sequenced and identified as Andes virus. 

    -- Since the last RRA published on 5 May 2026, two additional confirmed cases (France=1, Spain=1) have been reported among the passengers. No secondary cases have been reported outside of the ship.

        • Epidemiological investigations traced the travel history of the first two cases, a couple who had spent approximately five months birdwatching across South America. This included visits to several areas where Oligoryzomys are known to occur and includes areas where Andes cases have been recorded in the past. Evidence suggests subsequent human-human transmission onboard the ship. This is also supported by a preliminary analysis of the sequences, which show a near-identical sequence from different cases.

        • Andes virus outbreaks that human-to-human transmission is limited, tends to remain clustered, and generally requires prolonged exposure. It can also be rapidly contained with control measures in place. However, infectious diseases pose an increased risk on cruise ships due to close living quarters, shared enclosed spaces, prolonged exposure, and frequent interpersonal contact, all of which can facilitate transmission. As a result, additional sporadic cases may still occur among previously exposed passengers and crew members.

        • While additional cases may still occur among passengers and crew members exposed before containment measures were implemented, the risk of onward transmission is expected to be reduced following disembarkation and the implementation of control measures, including rapid identification and isolation of suspected cases. There is no approved antiviral treatment for HPS; suspected cases require prompt medical evaluation, close monitoring, and supportive management, including intensive care where necessary.

    -- Consequently, the overall risk at the global level remains assessed as Low.

    -- The epidemiological situation will continue to be monitored, and the risk assessment will be updated as needed.

(...)

Source: 

Link: https://www.who.int/publications/m/item/who-rapid-risk-assessment---hantavirus-outbreak-caused-by-andes-virus--global-v.2

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#Ebola disease caused by #Bundibugyo virus, #DRC & #Uganda (WHO D.O.N., May 17 '26)

 

Situation at a glance

    -- On 5 May 2026, the World Health Organization (WHO) was alerted of a high-mortality outbreak of unknown illness in Mongbwalu Health Zone, Ituri Province, Democratic Republic of the Congo (DRC), including deaths among health workers. 

    -- On 14 May 2026, the Institut national de recherche biomédicale (INRB) Kinshasa analyzed 13 blood samples from Rwampara Health Zone, Ituri Province. 

    -- Laboratory analysis confirmed Bundibugyo virus disease (BVD) in eight of these samples on 15 May, a species of Ebola. 

    -- The case fatality rates in the past two BVD outbreaks have ranged from 30% to 50%. 

    -- Unlike Ebola virus disease, there is no licensed vaccine or specific therapeutics against Bundibugyo virus, though early supportive care is lifesaving. 

    -- On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare, DRC, officially declared the 17th Ebola Disease outbreak in DRC. 

    -- Concurrently, the Uganda Ministry of Health confirmed an outbreak of BVD following the identification of one imported case from DRC, a Congolese man who died in the capital city of Kampala. 

    -- On 16 May 2026, WHO Director-General, after having consulted the States Parties where the event is known to be currently occurring, determined that the Ebola disease caused by Bundibugyo virus in DRC and Uganda constitutes a public health emergency of international concern (PHEIC), as defined in the provisions of IHR. 

    -- Response measures include deployment of rapid response teams, delivery of medical supplies, strengthened surveillance, laboratory confirmation, infection prevention and control assessments, the set-up of safe treatment centers, and community engagement. 

    -- WHO is supporting the coordination of the response, case management, and cross-border preparedness. 

    -- WHO advice has been issued to countries.

Description of the situation

    -- On 5 May 2026, WHO received an alert regarding an unknown illness with high mortality reported in Mongbwalu Health Zone, Ituri Province, including four health workers who died within four days. 

    -- Following an in-depth investigation by the rapid response team in Mongbwalu and Rwampara health zones (HZ) on 13 May, the outbreak was subsequently confirmed as Bundibugyo virus disease (BVD) due to Bundibugyo virus (BDBV) (Orthoebolavirus bundibugyoense, species) on 15 May.

    -- On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare officially declared the 17th Ebola Disease outbreak in the DRC, occurring in Rwampara, Mongwalu and Bunia HZ.

    -- The first currently known suspected case, a health worker, reported onset of symptoms including fever, hemorrhaging, vomiting and intense malaise on 24 April 2026. The case died at a medical centre in Bunia.

    -- As of 15 May, a total of 246 suspected cases and 80 deaths (four deaths among confirmed cases) have been reported from three HZ: Rwampara (six health areas affected), Mongbwalu (three health areas affected), and Bunia .  

    -- Twenty four suspected cases are currently in isolation facilities across the three HZ.  

    -- In addition, unusual clusters of community deaths with symptoms compatible with Bundibugyo virus disease (BVD) are being investigated across other HZ in Ituri and North Kivu.

    -- A further case reported on 16 May, an individual returning from Ituri to Kinshasa, has tested NEGATIVE for Bundibugyo virus on confirmatory testing by the Institut National de la Recherche Biomédicale (INRB) of DRC, and is therefore not considered a confirmed case.

    -- Most of the suspected cases are between 20 and 39 years old, with females accounting for over 60%, suggesting significant risks associated with household and caregiver transmission.

    -- Initial testing of 20 samples collected in Rwampara HZ and analysed at the Provincial Public Health Laboratory in Bunia using standard Ebola Xpert were negative for Ebola virus. 

    -- Samples were sent to INRB for further analysis, of which eight samples analysed were confirmed as Orthoebolavirus by polymerase chain reaction (PCR) on 15 May. Genomic sequencing confirmed the virus species as Bundibugyo virus (BDBV).

    -- As of 15 May, 65 contacts have been listed, with 15 identified as high-risk. However, follow-up remains weak due to insecurity and movement restrictions. Several listed contacts became symptomatic and died before they could be isolated.

    -- On 15 May 2026, the Ministry of Health of Uganda confirmed an outbreak of BVD following the identification of an imported case from the DRC. 

    -- The case is an elderly man who was admitted to a private hospital on 11 May with severe symptoms and died on 14 May. 

    -- The post-mortem transfer of the body to DRC was completed the same day. 

    -- A clinical sample collected when the case was admitted on 11 May was tested at the Central Emergency Surveillance and Response Support Laboratory, Wandegeya, and was confirmed as Bundibugyo virus on 15 May 2026. 

    -- A second imported case was confirmed on 16 May in Kampala, in an individual returning from DRC with no apparent links to the first case. 

    -- At the time of reporting, no local transmission has been identified in Uganda.

    -- On 16 May 2026, the Director-General of WHO, after having consulted the States Parties where the event is known to be currently occurring as defined in the provisions of the International Health Regulations (2005) (IHR), determined that the Ebola disease caused by Bundibugyo virus in DRC and Uganda constitutes a PHEIC.

    -- It is currently thought that the event originated in the Mongbwalu HZ, DRC, a high-traffic mining area, with cases subsequently migrating to Rwampara and Bunia to seek medical care. 

    -- Ituri province borders South Sudan and Uganda (and Bunia HZ is less than 500km from Uganda). 

    -- A full epidemiological investigation and trace back exercise is ongoing.

    -- Ituri’s role as a commercial and migratory hub and proximity to Uganda and South Sudan increases the risk of regional exportation and cross-border transmission.

Epidemiology

    -- Bundibugyo virus disease (BVD) is a severe and often fatal form of Ebola disease caused by the Bundibugyo virus, one of the Orthoebolavirus species. 

    -- It is a zoonotic disease, with fruit bats suspected to be the natural reservoir. 

    -- Human infection occurs through close contact with the blood or secretions of infected wildlife, such as bats or non-human primates, and subsequently spreads from person to person through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals or contaminated surfaces. 

    -- Transmission is particularly amplified in health-care settings when infection prevention and control (IPC) measures are inadequate, and during unsafe burial practices involving direct contact with the deceased.

    -- The incubation period for BVD ranges from 2 to 21 days, and individuals are usually not infectious until symptom onset. 

    -- Early symptoms are non-specific, including fever, fatigue, muscle pain, headache, and sore throat, which complicates clinical diagnosis and can delay detection. 

    -- These progress to gastrointestinal symptoms, organ dysfunction, and in some cases haemorrhagic manifestations. 

    -- Case fatality rates in the past two BVD outbreaks, reported in Uganda and in DRC in 2007 and 2012, have ranged from approximately 30% to 50%.

    -- Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. 

    -- Control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.

Public health response

    -- Health authorities in DRC are implementing public health measures, including but not limited to the following:

Coordination

    ° Rapid response teams have been deployed to Rwampara and Mongbwalu HZ.

    ° Provincial coordination and emergency meetings by le centre d’operation des urgences en sante publique (COUSP) have been held.

Surveillance and Laboratory

    ° Surveillance for suspected and probable cases is ongoing (including at relevant Points of Entry and borders).

    ° Operational case definitions have been elaborated in Ituri.

    ° Sequencing confirmed Bundibugyo virus in positive RT-PCR samples.

Risk Communication and Community Engagement (RCCE)

    ° Social mobilization meeting was held with community leaders in the Rural commune of Mongbwalu under the leadership of the Mayor.

Infection Prevention and Control (IPC)

    ° IPC assessment in key health facilities is ongoing: Bunia Hospital Centre of the Evangelical Medical Centre (CME), Mongbwalu General Referral Hospital and Abelkozo Health Centre.

    ° CME Bunia is maintaining isolation protocols. Healthcare workers have been briefed on the specific diagnostic profile of this strain.

Logistics

    ° Logistical support has been provided for investigations in Mongbwalu and Rwampara Health Zones.

    ° Support has been provided for the transportation of samples to INRB Kinshasa.

    ° Health authorities in Uganda are implementing public health measures, including but not limited to the following:

    -- Activating national and district-level emergency measures, including enhanced surveillance, screening at borders, deployment of rapid response teams, isolation of a high-risk contact, and quarantine of all identified contacts.

    -- Strengthening of preparedness activities such as mobile laboratory deployment, infection prevention, and risk communication.

    -- Rapid response readiness teams have been deployed at all official and informal points of entry along the western border, major transit routes, and pilgrimage corridors.

    -- Advising health workers to remain vigilant and adhere strictly to infection prevention measures.

    -- WHO is supporting the national authorities, including through:

        - Deployment of technical expertise and rapid response teams to support response efforts.

        - Deployment of IPC, clinical management and sample collection kits.

        - Identification of isolation facilities for case management in Bunia, Rwampara, and Mongbwalu HZ .

        - Dissemination of WHO case management protocol.

        - In-depth investigations and listing of contacts of suspected/probable cases.

        - Strengthening epidemiological surveillance, IPC and RCCE at all points of entry.

        - Strengthening Point of Entry (PoE) screening and cross border coordination, including mass gatherings.

        - Supporting the Ministry of Health in implementation of the Response Plan and WHO internal Response Plan.

        - Following up with the IHR National Focal Points (IHR NFP) in DRC and Uganda on the official IHR notification while concurrently managing communication across the IHR NFP network to ensure timely coordination.

        - Coordinating the delivery of key supplies.

        - Engaging experts on research and development priorities. 

WHO risk assessment

    -- On 16 May 2026, WHO Director-General, after having consulted the States Parties where the event is known to be currently occurring, determined that the Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern (PHEIC), as per the provisions of the IHR. Temporary recommendations for State Parties will be issued.  In the meantime, WHO issued advice to countries, as stated below.

    -- This is the 17th Ebola disease outbreak in the DRC since 1976. The last Ebola disease outbreak in the country was declared on 4 September 2025 with total of 64 cases (53 confirmed, 11 probable), including 45 deaths (CFR 70.3%), reported from six health areas in Bulape Health Zone, Kasai Province. 

    -- The end of outbreak was declared on 1 December 2025. 

    -- The last BVD outbreak was reported on 17 August 2012 by the DRC Ministry of Health in Province Orientale.  A total of 59 cases, 38 confirmed and 21 probable cases, including 34 deaths were reported. The outbreak was declared over on 26 November 2012 by the MOH.

    -- This outbreak is occurring in a complex epidemiological and humanitarian context. 

    -- A critical four-week detection gap between the onset of symptoms of the presumed index case (25 April 2026) and the laboratory confirmation of the outbreak (14 May 2025) suggests a low clinical index of suspicion among healthcare providers. This is compounded by the presence of co-circulating arboviruses and influenza-like illnesses, masking the initial index of suspicion for Ebola disease and exacerbating community transmission. 

    -- Furthermore, the infection and death of four healthcare workers within a four-day span at Mongbwalu General Referral Hospital underscores critical breaches in IPC protocols. A large number of community deaths has been reported potentially associated with unsafe burial practices.

    -- Ongoing conflict in Ituri province restricts the movement of surveillance teams, limits the deployment of Rapid Response Teams, and hinders the secure transport of laboratory samples. Contact tracing is challenging due to difficult access and highly mobile populations, increasing the risk of high-risk contacts being lost to follow up or never identified.

    -- Ituri’s role as a commercial and migratory hub increases the risk of regional exportation. The proximity to Uganda and South Sudan increases the risk of cross-border transmission if PoE screening and cross border coordination and information sharing are not immediately reinforced. On 15 May 2026, the Ministry of Health of Uganda reported an imported case of BVD.

    -- Humanitarian needs in the area are dire. Ituri has 273 403 displaced people, with a total of 1.9 million people in need according to the Humanitarian Response Plan 2026 for DRC. From January to March 2026, 32 600 newly displaced and 30 200 returnees were recorded. The province recorded 5800 protection incidents and 11 incidents against humanitarian actors.

    -- Unlike Ebola virus disease, there is no licensed vaccine or specific therapeutics against BDBV. Research and development activities are activated to coordinate efforts to advance potential candidate medical countermeasures. Response and outbreak control relies entirely on a range of interventions and public health measures that will need to be thoroughly implemented, including supportive care, early detection, adequate IPC, rigorous contact tracing, safe burials, and community engagement.

WHO advice

    -- For countries where the event is occurring (the Democratic Republic of the Congo and Uganda)

Coordination and high-level engagement

    ° Activate their national disaster/emergency management mechanisms and establish an emergency operation centre, under the authority of the Head of State and relevant government authority, to coordinate response activities across partners and sectors to ensure efficient and effective implementation and monitoring of comprehensive Bundibugyo virus disease control measures. These measures must include enhanced surveillance including contact tracing, infection prevention and control (IPC), risk communication and community engagement, laboratory diagnostic testing, and case management. Coordination and response mechanisms should be established at national level, as well as at subnational level in affected areas and at-risk areas.

    ° Should national capacities be overwhelmed, collaboration with partners should be enhanced to strengthen operations and ensure the ability to implement control measures in all affected and neighbouring areas. 

Risk communication and community engagement 

    ° Ensure that there is a large-scale and sustained effort to fully engage the community – through local, religious and traditional leaders and healers – so communities play a central role in case identification, contact tracing and risk education; the population should be made fully aware of the benefits of early treatment.

    ° Strengthen community awareness, engagement, and participation in particular to identify and address cultural norms and beliefs that serve as barriers to their full participation in the response, and integrate the response within the wider response required to address the needs of the population, particularly in contexts of the protracted humanitarian crisis in Eastern DRC.

Surveillance and laboratory  

    ° Strengthening surveillance and laboratory capacity across affected provinces and neighbouring provinces, through the establishment of (1) dedicated surveillance and response cells within affected health zones and across key at-risk neighbouring health zones; (2) enhanced community surveillance, particularly focused on community deaths; and (3) decentralized laboratory capacity for testing of Bundibugyo virus. 

Infection prevention and control in health facilities and in the context of care

    ° Strengthen measures to prevent nosocomial infections, including systematic mapping of health facilities, triage, targeted IPC interventions and sustained monitoring and sustained supervision.

    ° Ensure healthcare workers receive adequate training on IPC, including the proper use of PPE, and that health facilities have appropriate equipment to ensure the safety and protection of their staff, their timely payment of salaries and, as appropriate, hazard pay.

    ° Patients’ referral pathway and access to safe and optimized intensive care. 

    ° Ensure that suspected cases can be safely transferred to specialized clinical units for their isolation and management in a human and patient-centred approach.

    ° Establish specialized treatment centers or units, located close to outbreak epicenter(s), with staff trained and equipped to implement optimized intensive supportive care. 

Research and development of medical countermeasures

    ° Implement clinical trials to advance the development and use of candidate therapeutics and vaccine, supported by partners. 

Border health, travels and mass-gathering events 

    ° Undertake cross-border screening and screening at main internal roads to ensure that no suspected case is missed and enhance the quality of screening through improved sharing of information with surveillance teams.

    ° There should be no international travel of Bundibugyo virus disease contacts or cases, unless the travel is part of an appropriate medical evacuation. To minimize the risk of international spread of Bundibugyo virus disease:

    ° Confirmed cases should immediately be isolated and treated in a Bundibugyo virus disease Treatment Centre with no national or international travel until two Bundibugyo virus-specific diagnostic tests conducted at least 48 hours apart are negative;

    ° Contacts (which do not include properly protected health workers and laboratory staff who have had no unprotected exposure) should be monitored daily, with restricted national travel and no international travel until 21 days after exposure;

    ° Probable and suspect cases should immediately be isolated and their travel should be restricted in accordance with their classification as either a confirmed case or contact.

    ° Implement exit screening of all persons at international airports, seaports and major land crossings, for unexplained febrile illness consistent with potential Bundibugyo virus disease. The exit screening should consist of, at a minimum, a questionnaire, a temperature measurement and, if there is a fever, an assessment of the risk that the fever is caused by Bundibugyo virus disease. Any person with an illness consistent with Bundibugyo virus disease should not be allowed to travel unless the travel is part of an appropriate medical evacuation.

    ° Consider postponing mass gatherings until BVD transmission is interrupted.

Safe and dignified burials 

    ° Ensure funerals and burials are conducted by well-trained personnel, with provision made for the presence of the family and cultural practices, and in accordance with national health regulations, to reduce the risk of Bundibugyo virus infection. The cross-border movement of the human remains of deceased suspect, probable or confirmed Bundibugyo virus disease cases should be prohibited unless authorized in accordance with recognized international biosafety provisions.

Operations, supplies and logistics

    ° Strong supply pipeline needs to be established to ensure that sufficient medical and laboratory commodities and other critical items, especially personal protective equipment (PPE), are available to those who appropriately need them. WHO advises against any restrictions on travel and/or trade to DRC or Uganda based on available information for the current outbreak.

For countries with land borders adjoining countries with documented Bundibugyo virus disease 

    ° Unaffected States Parties with land borders adjoining States Parties with documented Bundibugyo virus disease  transmission should urgently enhance their preparedness and readiness capacity, including active surveillance across health facilities with active zero reporting, enhancement of community surveillance for clusters of unexplained deaths; establish access to a qualified diagnostic laboratory; ensure that health workers are aware of and trained in appropriate IPC procedures; and establish rapid response teams with the capacity to investigate and manage BVD cases and their contacts.

    ° Dedicated coordination mechanisms should be in place at national and subnational level in all Unaffected States Parties with land borders adjoining States Parties with documented cases of Bundibugyo virus disease. States should be prepared to detect, investigate, and manage Bundibugyo virus disease cases; this should include assured access to a qualified diagnostic laboratory for Bundibugyo virus disease, isolation and case management capacity and activation of rapid response teams. 

    ° Any State Parties newly detecting a suspected or confirmed Bundibugyo virus disease case or contact, or clusters of unexplained deaths should treat this as a health emergency, take immediate steps in the first 24 hours to investigate and stop a potential outbreak by instituting case isolation, case management, establishing a definitive diagnosis, and undertaking contact tracing and monitoring as required.

    ° If Bundibugyo virus disease is confirmed to be occurring in the State Party, the full recommendations for State Parties with Bundibugyo virus disease transmission should be implemented, on either a national or subnational level, depending on the epidemiologic and risk context. State Parties should immediately report the confirmation of Bundibugyo virus disease to WHO.

    ° Risk communications and community engagement, especially at points of entry, should be increased.

    ° At-risk countries should put in place approvals for investigational therapeutics as an immediate priority for preparedness.

For all other countries

    ° No country should close its borders or place any restrictions on travel and trade. Such measures are usually implemented out of fear and have no basis in science. They push the movement of people and goods to informal border crossings that are not monitored, thus increasing the chances of the spread of disease. Most critically, these restrictions can also compromise local economies and negatively affect response operations from a security and logistics perspective.

    ° National authorities should work with airlines and other transport and tourism industries to ensure that they do not exceed WHO’s advice on international traffic.

    ° States Parties should provide travelers to Bundibugyo virus disease affected and at-risk areas with relevant information on risks, measures to minimize those risks, and advice for managing a potential exposure.

    ° The general public should be provided with accurate and relevant information on the Bundibugyo virus disease outbreak and measures to reduce the risk of exposure.

    ° State Parties should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to Bundibugyo virus disease.

    ° Entry screening at airports or other ports of entry outside the affected region are not considered needed for passengers returning from areas at risk.

Further information

-- Epidemic of Ebola Disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda determined a public health emergency of international concern.  https://www.who.int/news/item/17-05-2026-epidemic-of-ebola-disease-in-the-democratic-republic-of-the-congo-and-uganda-determined-a-public-health-emergency-of-international-concern

-- The Ministry of Public Health, Hygiene and Social Welfare, DRC, officially declares the 17th Ebola Disease outbreak. https://administration.sante.gouv.cd/wp-content/uploads/2026/05/Declaration-de-la-17e-Epidemie-de-la-maladie-a-virus-Ebola-dans-les-zones-de-sante-de-Rwampara-Mongwalu-et-Bunia-dans-la-province-dIturi.pdf

-- WHO Democratic Republic of Congo confirms new Ebola outbreak.  https://www.afro.who.int/countries/democratic-republic-of-congo/news/democratic-republic-congo-confirms-new-ebola-outbreak-who-scales-upsupport

-- Ebola  disease fact sheet: http://www.who.int/en/news-room/fact-sheets/detail/ebola-virus-disease

-- Disease Outbreak News. Ebola outbreak in Democratic Republic of Congo – update. WHO. 14 September 2012: Ebola outbreak in Democratic Republic of Congo – update

-- Disease Outbreak News. Ebola outbreak in Democratic Republic of Congo – update. WHO. 26 October 2012: Ebola outbreak in Democratic Republic of Congo – update

-- WHO Launches Online Training to Strengthen Filovirus Outbreak Response. https://www.who.int/news/item/26-03-2025-who-launches-online-training-to-strengthen-filovirus-outbreak-response#

-- Infection prevention and control guideline for Ebola and Marburg disease. WHO. August 2023: https://www.who.int/publications/i/item/WHO-WPE-CRS-HCR-2023.1

-- Infection prevention and control and water, sanitation and hygiene in health facilities during Ebola or Marburg disease outbreaks: rapid assessment tool, user guide https://www.who.int/publications/i/item/9789240107205

-- Assessment and management of health and care workers with possible occupational exposures to Orthoebolavirus or Orthomarburgvirus: implementation guidance https://www.who.int/publications/i/item/9789240107328

-- Optimized Supportive Care for Ebola Virus Disease. Clinical management standard operating procedures. WHO. 2019. https://www.who.int/publications/i/item/9789241515894 

-- Ebola clinical management. https://www.who.int/teams/health-care-readiness/ebola-clinical-management 

-- Framework and toolkit for infection prevention and control in outbreak preparedness, readiness and response at the national level. https://www.who.int/publications/i/item/framework-and-toolkit-for-infection-prevention-and-control-in-outbreak-preparedness--readiness-and-response-at-the-health-care-facility-level

-- Considerations for border health and points of entry for filovirus disease outbreaks: https://www.who.int/publications/m/item/considerations-for-border-health-and-points-of-entry-for-filovirus-disease-outbreaks

-- Diagnostic testing for Ebola and Marburg virus diseases: interim guidance, 20 December 2024: https://www.who.int/publications/i/item/B09221 

Citable reference: World Health Organization (17 May 2026). Disease Outbreak News; Bundibugyo Virus Disease, Democratic Republic of the Congo (The) and Uganda. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON602 

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON602

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#Andes #hantavirus #outbreak - multi-country, 17 May 2026 (ECDC, edited): One New Confirmed Case in BC, #Canada

 

    On 2 May 2026, ECDC was notified of a cluster of severe respiratory illness on MV Hondius, a Dutch-flagged cruise ship with passengers and crew from 23 countries, including nine EU/EEA countries. 

    The virus has been identified as Andes hantavirus.

    As of 17 May, a total of twelve cases have been reported, including nine confirmed, two probable, and one inconclusive. 

    No new deaths have been reported since the previous update.

    On 16 May 2026, Canada reported that a passenger of the cruise ship tested presumptively positive for Andes hantavirus. 

    The person who was already under quarantine and has mild symptoms (as of 16 May, according to the Public Health Agency of Canada). 

    Given the available information this case is classified as confirmed.

    The identification of additional cases after former passengers and crew have returned to their home country is expected given the long incubation period of Andes hantavirus and the possibility that some infections occurred on board on the ship. 

    The risk to the EU/EEA general population remains very low.

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    ° Confirmed cases***: 9

    ° Probable cases**: 2

    ° Suspected cases*: 0

    ° Inconclusive cases****: 1

    ° Number of deaths: 3

Notes

{*} A suspected case is a person who has been on or visited the same transport (e.g. ship or plane) where a confirmed or probable Andes hantavirus (ANDV) case was present, 

    - OR - 

    - has been in contact with a passenger or crew member of the MV Hondius since 5 April, 

    - AND - 

    - has a fever (currently or recently), plus at least one of the following symptoms: 

        - muscle aches

        - chills

        - headache

        - stomach problems (such as nausea, vomiting, diarrhoea, or abdominal pain)

        - breathing problems (such as cough, shortness of breath, chest pain, or difficulty breathing)

{**} A probable case is a person who has the symptoms listed above, and is known to have been in contact with a confirmed or probable ANDV case

{***} A confirmed case is a person who meets the suspected or probable case definition, and has a laboratory test that confirms ANDV infection (PCR or antibody test)

{****} An inconclusive case means awaiting further laboratory investigations.

Non-case: A non-case is a person who was initially considered a suspected or probable case, but tests negative for ANDV using laboratory tests (PCR or antibody test).

Source: 

Link: https://www.ecdc.europa.eu/en/infectious-disease-topics/hantavirus-infection/surveillance-and-updates/andes-hantavirus-outbreak

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#Canada, Media #update on #Andes #hantavirus situation: diagnostic tests confirmed the case announced yesterday (PHAC, May 17 '26)

 

Statement | May 17, 2026 | Ottawa, ON

    The Public Health Agency of Canada (PHAC) has confirmed a case of Andes hantavirus in Canada through laboratory testing. 

    This case was reported by the British Columbia Provincial Health Officer on May 16 and was among the passengers on the MV Hondius cruise ship.

    Samples from British Columbia were sent to PHAC’s National Microbiology Laboratory (NML) in Winnipeg for confirmatory testing. 

    One individual’s sample was confirmed positive for hantavirus on May 16. 

    A second individual who was a travelling partner of the confirmed case was confirmed negative by the NML. 

    There have been no further cases identified at this time. 

    All high-risk contacts are isolating and will continue to be monitored closely by local public health.

    PHAC, the province of British Columbia, and local public health are working together to ensure all public health measures continue to be followed to protect the health of Canadians.

    The overall risk to the general population in Canada from the Andes hantavirus outbreak linked to the MV Hondius cruise ship remains low at this time. 

    All confirmed cases to date have been passengers or crew on the MV Hondius cruise ship. 

    Given the severity of this virus, we are taking a precautionary approach to ensure Canadians are protected.

    PHAC provided the information about the positive case to the World Health Organization as part of the International Health Regulations and will share information to support the ongoing global investigation of the outbreak.

    “We want to thank public health authorities and frontline staff in British Columbia for the dedicated care that they are providing and for their ongoing management of the situation, and the passengers for their cooperation with public health direction to help keep others safe," said Dr. Joss Reimer, Chief Public Health Officer of Canada.

    PHAC will continue to actively monitor the situation, provide guidance and support to provincial and territorial public health partners, and share updates as needed.

Contacts: Media Relations, Public Health Agency of Canada, 613-957-2983, media@hc-sc.gc.ca

Source: 

Link: https://www.canada.ca/en/public-health/news/2026/05/media-update-on-andes-hantavirus-situation1.html

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In response to #WHO's declaration of #Ebola #outbreak as a #PHEIC, the #Taiwan CDC has raised its travel advisory for #DRC and #Uganda to Level 2 Alert (May 17 '26)

 

    The Centers for Disease Control (CDC) announced today (May 17) that the World Health Organization (WHO) officially declared the Ebola virus outbreak in the Democratic Republic of the Congo (DRC) and Uganda a Public Health Emergency of International Concern (PHEIC) on May 17, 2026, indicating the risk of cross-border spread and its significant international public health importance.

    According to the latest WHO information, the outbreak is currently mainly occurring in the DRC and has already spread to Uganda. 

    The WHO points out that the outbreak is caused by the Bundibugyo ebolavirus. 

    Because there is currently no treatment or vaccine for this virus, and some cases have entered urban areas, epidemic prevention and control face a high challenge. 

    The WHO currently assesses the regional risk as "high" and the global risk as "low."

    The Taiwan Centers for Disease Control (CDC) announced that, based on risk assessments conducted by the WHO and other international sources, it has adjusted the international travel advisory level for the Democratic Republic of Congo and Uganda from Level 1 "Watch" to Level 2 "Alert."

    The CDC stated that while the overall threat posed by this outbreak to Taiwan remains low, considering international travel and global transportation convenience, the possibility of imported cases cannot be completely ruled out. 

    Therefore, the CDC will continue to strengthen border monitoring, medical reporting, and epidemic prevention preparedness.

    The CDC reminds the public that those traveling to the Democratic Republic of Congo, Uganda, and surrounding affected areas should take enhanced protective measures. 

    The CDC also noted that the Ebola virus has an incubation period of up to 21 days. 

    Upon returning to Taiwan, individuals should undergo 21 days of self-health management. 

    If symptoms such as fever, fatigue, muscle aches, vomiting, diarrhea, or bleeding occur, individuals should wear a mask, seek medical attention immediately, and proactively disclose their travel and contact history. 

    If necessary, individuals can call the 1922 epidemic prevention hotline for assistance from the CDC's regional control centers in conjunction with local health bureaus for subsequent medical treatment and epidemic prevention measures.

    The Centers for Disease Control (CDC) emphasized that it will continue to closely monitor the epidemic information from the WHO and various countries, and adjust epidemic prevention measures as needed to safeguard the health and safety of the people.

Source: 

Link: https://www.cdc.gov.tw/Bulletin/Detail/xBPWe8i0QAsDSdgYUXfp8Q?typeid=9

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#Epidemic of #Ebola Disease caused by #Bundibugyo virus in #DRC and #Uganda determined a #PHEIC (WHO, May 17 '26)

 

    Pursuant to paragraph 2 of Article 12 - Determination of a public health emergency of international concern, including a pandemic emergency of the International Health Regulations (2005) (IHR), the Director-General of the World Health Organization (WHO), after having consulted the States Parties where the event is known to be currently occurring, is hereby determining that the Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern (PHEIC), but does not meet the criteria of pandemic emergency, as defined in the IHR.

    The Director-General of WHO expresses his gratitude to the leadership of the Democratic Republic of the Congo and Uganda for their commitment to take necessary and vigorous actions to bring the event under control, as well as for their frankness in assessing the risk posed by this event to other States Parties, hence allowing the global community to take necessary preparedness actions.

    In his determination the Director-General of WHO has considered, inter alia, information provided by the States Parties – the Democratic Republic of the Congo and Uganda – scientific principles as well as the available scientific evidence and other relevant information; and assessed the risk to human health, the risk of international spread of disease and of the risk of interference with international traffic.

    The Director-General of WHO considers that the event meets the criteria of the definition of PHEIC, contained in Article 1 - Definitions of the IHR, for the following reasons:

1. The event is extraordinary for the following reasons:

    ° As of 16 May 2026, eight laboratory-confirmed cases, 246 suspected cases and 80 suspected deaths have been reported in Ituri Province of the Democratic Republic of the Congo across at least three health zones, including Bunia, Rwampara and Mongbwalu. 

    ° In addition, two laboratory confirmed cases (including one death) with no apparent link to each other have been reported in Kampala, Uganda, within 24 hours of each other, on 15 and 16 May 2026, among two individuals travelling from the Democratic Republic of the Congo. 

    ° On 16 May, a laboratory confirmed case has also been reported in Kinshasa, the Democratic Republic of the Congo, among someone returning from Ituri.

    ° Unusual clusters of community deaths with symptoms compatible with Bundibugyo virus disease (BVD) have been reported across several health zones in Ituri, and suspected cases have been reported across Ituri and North Kivu. 

    ° In addition, at least four deaths among healthcare workers in a clinical context suggestive of viral haemorrhagic fever have been reported from the affected area raising concerns regarding healthcare-associated transmission, gaps in infection prevention and control measures, and the potential for amplification within health facilities.

    ° There are significant uncertainties to the true number of infected persons and geographic spread associated with this event at the present time. In addition, there is limited understanding of the epidemiological links with known or suspected cases.

    ° However, the high positivity rate of the initial samples collected (with eight positives among 13 samples collected in various areas), the confirmation of cases in both Kampala and Kinshasa, the increasing trends in syndromic reporting of suspected cases and clusters of deaths across the province of Ituri all point towards a potentially much larger outbreak than what is currently being detected and reported, with significant local and regional risk of spread. 

    ° Moreover, the ongoing insecurity, humanitarian crisis, high population mobility, the urban or semi-urban nature of the current hotspot and the large network of informal healthcare facilities further compound the risk of spread, as was witnessed during the large Ebola virus disease epidemic in North Kivu and Ituri provinces in 2018-19. 

    ° However, unlike for Ebola-zaire strains, there are currently no approved Bundibugyo virus-specific therapeutics or vaccines. As such, this event is considered extraordinary.

2. The event constitutes a public health risk to other States Parties through the international spread of disease. 

    ° International spread has already been documented, with two confirmed cases reported in Kampala, Uganda on 15 and 16 May following travel from the Democratic Republic of the Congo. 

    ° Both confirmed cases were admitted to intensive care units in Kampala. 

    ° Neighboring countries sharing land borders with the Democratic Republic of the Congo are considered at high risk for further spread due to population mobility, trade and travel linkages, and ongoing epidemiological uncertainty.

3. The event requires international coordination and cooperation to understand the extent of the outbreak

    ° to coordinate surveillance, prevention and response efforts, to scale up and strengthen operations and ensure ability to implement control measures.

    The Director-General of WHO, under the provisions of the IHR, will be convening an Emergency Committee, as soon as possible to advise, inter alia, on the proposed temporary recommendation for States Parties to respond to the event.

    The WHO advice is enumerated below and will be subject to further refinement as appropriate after having considered the advice from the Emergency Committee and issuing of Temporary Recommendations.

WHO advice

    For States Parties where the event is occurring (the Democratic Republic of the Congo and Uganda)

Coordination and high-level engagement

    ° Activate their national disaster/emergency management mechanisms and establish an emergency operation centre, under the authority of the Head of State and relevant government authority, to coordinate response activities across partners and sectors to ensure efficient and effective implementation and monitoring of comprehensive Bundibugyo virus disease control measures. 

    ° These measures must include enhanced surveillance including contact tracing, infection prevention and control (IPC), risk communication and community engagement, laboratory diagnostic testing, and case management. 

    ° Coordination and response mechanisms should be established at national level, as well as at subnational level in affected areas and at-risk areas.

    ° Should national capacities be overwhelmed, collaboration with partners should be enhanced to strengthen operations and ensure the ability to implement control measures in all affected and neighbouring areas.

Risk communication and community engagement

    ° Ensure that there is a large-scale and sustained effort to fully engage the community – through local, religious and traditional leaders and healers – so communities play a central role in case identification, contact tracing and risk education; the population should be made fully aware of the benefits of early treatment.

    ° Strengthen community awareness, engagement, and participation in particular to identify and address cultural norms and beliefs that serve as barriers to their full participation in the response, and integrate the response within the wider response required to address the needs of the population, particularly in contexts of the protracted humanitarian crisis in Eastern DRC.

Surveillance and laboratory 

    ° Strengthening surveillance and laboratory capacity across affected provinces and neighbouring provinces, through the establishment of 

        - (1) dedicated surveillance and response cells within affected health zones and across key at-risk neighbouring health zones, 

        - (2) enhanced community surveillance, particularly focused on community deaths, and 

        - (3) decentralized laboratory capacity for testing of Bundibugyo virus.

Infection prevention and control in health facilities and in the context of care

    ° Strengthen measures to prevent nosocomial infections, including systematic mapping of health facilities, triage, targeted IPC interventions and sustained monitoring and sustained supervision.

    ° Ensure healthcare workers receive adequate training on IPC, including the proper use of PPE, and that health facilities have appropriate equipment to ensure the safety and protection of their staff, their timely payment of salaries and, as appropriate, hazard pay

Patients’ referral pathway and access to safe and optimized intensive care

    ° Ensure that suspected cases can be safely transferred to specialized clinical units for their isolation and management in a human and patient-centred approach.

    ° Establish specialized treatment centers or units, located close to outbreak epicenter(s), with staff trained and equipped to implement optimized intensive supportive care.

Research and development of medical countermeasures

    ° Implement clinical trials to advance the development and use of candidate therapeutics and vaccine, supported by partners. 

Border health, travels and mass-gathering events

    ° Undertake cross-border screening and screening at main internal roads to ensure that no suspected case is missed and enhance the quality of screening through improved sharing of information with surveillance teams.

    ° There should be no international travel of Bundibugyo virus disease contacts or cases, unless the travel is part of an appropriate medical evacuation. 

    ° To minimize the risk of international spread of Bundibugyo virus disease:

        - confirmed cases should immediately be isolated and treated in a Bundibugyo virus disease Treatment Centre with no national or international travel until two Bundibugyo virus-specific diagnostic tests conducted at least 48 hours apart are negative;

        - contacts (which do not include properly protected health workers and laboratory staff who have had no unprotected exposure) should be monitored daily, with restricted national travel and no international travel until 21 days after exposure;

        - probable and suspect cases should immediately be isolated and their travel should be restricted in accordance with their classification as either a confirmed case or contact.

        - Implement exit screening of all persons at international airports, seaports and major land crossings, for unexplained febrile illness consistent with potential Bundibugyo virus disease. The exit screening should consist of, at a minimum, a questionnaire, a temperature measurement and, if there is a fever, an assessment of the risk that the fever is caused by Bundibugyo virus disease. Any person with an illness consistent with Bundibugyo virus disease should not be allowed to travel unless the travel is part of an appropriate medical evacuation.

        - Consider postponing mass gatherings until BVD transmission is interrupted.

Safe and dignified burials

    ° Ensure funerals and burials are conducted by well-trained personnel, with provision made for the presence of the family and cultural practices, and in accordance with national health regulations, to reduce the risk of Bundibugyo virus infection. 

    ° The cross-border movement of the human remains of deceased suspect, probable or confirmed Bundibugyo virus disease cases should be prohibited unless authorized in accordance with recognized international biosafety provisions.

Operations, supplies and logistics

    ° Strong supply pipeline needs to be established to ensure that sufficient medical and laboratory commodities and other critical items, especially personal protective equipment (PPE), are available to those who appropriately need them.

    ° For States Parties with land borders adjoining States Parties with documented Bundibugyo virus disease

        - Unaffected States Parties with land borders adjoining States Parties with documented Bundibugyo virus disease  transmission should urgently enhance their preparedness and readiness capacity, including active surveillance across health facilities with active zero reporting, enhancement of community surveillance for clusters of unexplained deaths; establish access to a qualified diagnostic laboratory; ensure that health workers are aware of and trained in appropriate IPC procedures; and establish rapid response teams with the capacity to investigate and manage BVD cases and their contacts.

    ° Dedicated coordination mechanisms should be in place at national and subnational level in all Unaffected States Parties with land borders adjoining States Parties with documented cases of Bundibugyo virus disease. 

    ° States should be prepared to detect, investigate, and manage Bundibugyo virus disease cases; this should include assured access to a qualified diagnostic laboratory for Bundibugyo virus disease, isolation and case management capacity and activation of rapid response teams.

    ° Any State Parties newly detecting a suspected or confirmed Bundibugyo virus disease case or contact, or clusters of unexplained deaths should treat this as a health emergency, take immediate steps in the first 24 hours to investigate and stop a potential outbreak by instituting case isolation, case management, establishing a definitive diagnosis, and undertaking contact tracing and monitoring as required.

    ° If Bundibugyo virus disease is confirmed to be occurring in the State Party, the full recommendations for State Parties with Bundibugyo virus disease transmission should be implemented, on either a national or subnational level, depending on the epidemiologic and risk context. State Parties should immediately report the confirmation of Bundibugyo virus disease to WHO.

    ° Risk communications and community engagement, especially at points of entry, should be increased.

    ° At-risk countries should put in place approvals for investigational therapeutics as an immediate priority for preparedness.

For all Other States Parties

    ° No country should close its borders or place any restrictions on travel and trade. 

    ° Such measures are usually implemented out of fear and have no basis in science. 

    ° They push the movement of people and goods to informal border crossings that are not monitored, thus increasing the chances of the spread of disease. 

    ° Most critically, these restrictions can also compromise local economies and negatively affect response operations from a security and logistics perspective.

    ° National authorities should work with airlines and other transport and tourism industries to ensure that they do not exceed WHO’s advice on international traffic.

    ° States Parties should provide travelers to Bundibugyo virus disease affected and at-risk areas with relevant information on risks, measures to minimize those risks, and advice for managing a potential exposure.

    ° The general public should be provided with accurate and relevant information on the Bundibugyo virus disease outbreak and measures to reduce the risk of exposure.

    ° State Parties should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to Bundibugyo virus disease.

    ° Entry screening at airports or other ports of entry outside the affected region are not considered needed for passengers returning from areas at risk.

Source: 

Link: https://www.who.int/news/item/17-05-2026-epidemic-of-ebola-disease-in-the-democratic-republic-of-the-congo-and-uganda-determined-a-public-health-emergency-of-international-concern

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