Monday, May 25, 2026

Connecting the #region during #crisis: a Community of Practice #response to the MV Hondius #hantavirus #outbreak

 


Abstract

This article describes the rapid activation of the Asia Pacific Health Security Action Framework Community of Practice following the MV Hondius hantavirus outbreak. It highlights regional knowledge-sharing, multidisciplinary engagement, preparedness activities, and the importance of timely communication and collaboration in strengthening readiness and response during emerging public health emergencies.

Source: 


Link: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/1488

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#Italy, #Ebola: Health #monitoring has been activated for some #individuals returning from #Uganda (Min. Salute, May 25 '26)

 


Press release number 32  |  Press release date May 25, 2026


    The Ministry of Health announces, with reference to the Bundibugyo-BVD virus disease outbreak in the Democratic Republic of the Congo, that health investigations are currently underway on several individuals who recently returned from Uganda and are undergoing, as a precaution, specialist clinical evaluation at highly specialized hospitals

    Specifically, two individuals with fever symptoms have been transferred to the Sacco Hospital in Milan, a facility equipped with the highest levels of biocontainment and management of high-risk infectious diseases, where diagnostic tests will be performed in accordance with national and international protocols. 

    The other members of the affected households are subject to health surveillance and monitoring by the competent authorities. 

    The Ministry of Health, through its Department of Prevention, is in contact with the Lombardy Region, which has taken immediate action.

    The Ministry is constantly monitoring the evolving situation regarding the Ebola virus in close collaboration with the Regions, the Italian National Institute of Health (Istituto Superiore di Sanità), the relevant hospitals, national health authorities, and all other relevant bodies. 

    Yesterday, the Ministry of Health's Department of Prevention participated in the meeting of the European Commission's HSC (Health Security Committee) and organized a national coordination point dedicated to the Ebola situation, with the participation of representatives of the Ministries of Foreign Affairs, Defense, and the Interior, the Crisis Unit, the Italian National Institute of Health, the Italian National Health Council, the Interregional Prevention Coordination Unit, the Spallanzani Institute, the Sacco Hospital in Milan, and the Policlinico San Matteo in Pavia.

    The national infectious disease emergency preparedness and response system is fully operational, and all procedures for managing any suspected cases have been activated.

    The Ministry of Health will continue to provide official updates based on the evolving epidemiological situation and ongoing diagnostic results. 

    The risk in Italy remains very low.

 Source: 


Link: https://www.salute.gov.it/new/it/comunicato-stampa/ebola-attivato-monitoraggio-sanitario-alcuni-soggetti-rientrati-dalluganda/

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#Hantavirus #seroprevalence and associated factors for exposure in south-central #Uganda

 


ABSTRACT

Orthohantaviruses are largely rodent-borne pathogens that can cause haemorrhagic fever with renal syndrome and hantavirus cardiopulmonary syndrome. In Uganda, the risk of human exposure is heightened by known rodent hosts, close human-rodent interaction in rural areas, and poor housing conditions. Despite this risk, data on human exposure remain scarce. This study sought to ascertain the seroprevalence of orthohantavirus exposure and identify associated factors with exposure among residents of the greater Masaka-Rakai region in Uganda. Seropositivity was assessed for orthohantavirus-specific IgG antibodies using commercial enzyme-linked immunosorbent assays. Logistic regression models were used to identify factors associated with seropositivity. Among 1,199 sera samples, orthohantavirus population-weighted seroprevalence was 7.4% (95% CI: 3.91–10.80). Males had a higher seroprevalence, while higher socioeconomic status was associated with a reduced burden of exposure to orthohantavirus. This study reports evidence of orthohantavirus exposure in Uganda, highlighting a previously underrecognized zoonotic risk in the region likely driven by close contact with rodent reservoirs and poor living conditions. The higher burden among males and lower-burden association with higher socioeconomic status, highlights the need for improved housing, rodent control, and integration of orthohantavirus surveillance into national public health programmes.

Source: 


Link: https://www.tandfonline.com/doi/full/10.1080/22221751.2026.2665002

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#WHO DG's #remarks at the Virtual Ministerial #Briefing on the #Bundibugyo Ebola #Outbreak – 25 May 2026 (Edited)

 


    Your Excellency President Cyril Ramaphosa,

    Thank you so much for your leadership, and for announcing the financial contribution, which is important for Africa CDC.

    Your Excellency Chairperson Mahmoud Ali Youssouf,

    Honourable Minister Khaled Abdel Ghaffar,

    Africa CDC Director-General Dr Jean Kaseya,

    Dear colleagues and friends,

    I thank President Ramaphosa and Chairperson Youssouf for their leadership, and I thank my brother Dr Jean Kaseya for convening this briefing.

    As you know, in the early hours of on Sunday the 17th of May, I declared the Ebola outbreak in DRC a public health emergency of international concern, after consulting the Ministers of Health of both DRC and Uganda, and after the Africa CDC’s notification.

    The outbreak is spreading rapidly.

    So far, 101 cases have been confirmed in DRC, with 10 confirmed deaths.

    But we know the epidemic in DRC is much larger. There are now more than 900 suspected cases and 220 suspected deaths.

    This past Friday, WHO upgraded our risk assessment from high to very high at the national level.

    We continue to assess the risk as high at the regional level and low at the global level.

    Countries bordering DRC are at especially high risk and should take immediate action.

    In Uganda, there are five confirmed cases and one death.

    I appreciate the leadership of President Museveni in cancelling the Martyrs’ Day commemoration to prevent the further spread of the virus.

    As you know, Martyrs’ Day attracts up to 2 million people.

    I thank the governments of DRC and Uganda for their leadership of the response, which WHO is supporting, in close partnership with Africa CDC and many others.

    On Friday, we convened a meeting of African health ministers on the margins of the World Health Assembly to update them and urge them to take action.

    The community based interventions were underlined during the discussion, where there is trust deficit.

    Together with the Africa CDC, WHO is establishing a continental Incident Management Support Team.

    And we are finalizing a multi-agency Strategic Preparedness and Response Plan, aligned with the national plans of both DRC and Uganda, and with our partners.

    In the IMST and the Strategic Plan, we have experience with Africa CDC in previous outbreaks.

    WHO is on the ground, supporting national authorities with every pillar of the response, including contact tracing, establishing treatment centres, strengthening laboratory capacity, case management, infection prevention and control, risk communication, community engagement and more.

    We have also released US$ 3.9 million from the WHO Contingency Fund for Emergencies.

    Tomorrow I will be travelling to DRC with Dr Chikwe Ihekweazu, Executive Director of the WHE Health Emergencies Programme.

    There are several aspects of this outbreak that make it especially challenging.

    First, the delay in detecting the outbreak means that we are now playing catch-up with a very fast-moving epidemic.

    We are urgently scaling up operations, but at the moment, the epidemic is outpacing us.

    Second, as you know, the provinces of Ituri and North Kivu are highly insecure, with intensified fighting in recent months, causing more than 100 000 people to be newly displaced.

    There is also significant distrust of outside authorities among the local population.

    In the past week there have been two security incidents at health facilities.

    Building trust in the affected communities is critical to a successful response, and is one of our highest priorities.

    Third, there are no approved vaccines or therapeutics for Bundibugyo virus.

    There have only been two previous outbreaks of Bundibugyo, in Uganda in 2007 and DRC in 2012.

    Last week, WHO convened the leaders of several partner organizations under the interim Medical Countermeasures Network, to review the pipeline of vaccines, therapeutics and diagnostics.

    WHO has recommended prioritizing two monoclonal antibodies to advance in clinical trials.

    We are also recommending the evaluation of the antiviral obeldesivir in a clinical trial as post-exposure prophylaxis for people who are high-risk contacts.

    This clinical trial is now being developed jointly with Africa CDC and the Collaborative Open Research Consortium on filovuruses.

    We are also discussing with partners candidate vaccines in the development and manufacturing pipeline.

    Excellencies,

    We are facing an extremely serious and difficult outbreak. It will get worse before it gets better.

    But we know this virus, and we know how to stop it. We have stopped every previous Ebola outbreak, and we will stop this one too.

    As President Ramaphosa said, this can only be done with unity.

    The question is just how quickly we can do it, and how many more lives will be lost before we do.

    WHO is fully committed to working under the leadership of the Governments of DRC and Uganda, side by side with Africa CDC and all other partners.

    We will not rest until we bring this outbreak under control.

    Thank you once again for this opportunity, and for your leadership.

    I thank you.

Source: 


Link: https://www.who.int/news-room/speeches/item/who-director-general-s-remarks-at-the-virtual-ministerial-briefing-on-the-bundibugyo-ebola-outbreak-25-may-2026

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Clade 2.3.4.4b #H5N1 #HPAIV from Migratory #Birds in Beidaihe #Wetland, North #China

 


Abstract

During 2022–2024, a highly pathogenic avian influenza virus (HPAIV) H5N1 strain, designated A/Seagull/Hebei/qhd6/2024 (H5N1), was isolated from migratory birds in Beidaihe National Wetland Park, North China. Phylogenetic analyses revealed that its hemagglutinin (HA) gene belongs to the 2.3.4.4b clade, while the neuraminidase (NA) gene and internal genes clustered with strains originating from multiple continents, consistent with a transcontinental reassortment event. The virus also exhibited 90.1–98.1% nucleotide homology with human-derived H5N1 isolates. Molecular characterization identified key virulence-associated mutations, including the classic HPAIV HA cleavage site, HA-T160A (associated with enhanced human receptor-binding capacity), and NA-I117T (potentially linked to drug resistance). BALB/c mouse infection experiments confirmed systemic replication and high pathogenicity of strain qhd6, with a 50% lethal dose (LD50) of 0.95 log10EID50/mL. Antigenic analysis revealed good cross-reactivity with the widely used H5-Re14 vaccine strain. This study reports the identification, in Beidaihe National Wetland Park, of an HPAIV H5N1 strain whose genetic characteristics suggest intercontinental reassortment and indicate cross-species transmission risk. It clarifies the genetic characteristics and pathogenicity of this strain, providing an important theoretical and practical basis for precise surveillance, risk early warning, and comprehensive prevention and control of AIV at migratory bird stopover sites in North China.

Source: 


Link: https://www.mdpi.com/1999-4915/18/6/595

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#Situation #Report of the 17th #Ebola Virus Disease Outbreak / #DRC (WHO/Min. Health, May 25 '26): 904 cases, 119 deaths

 


{Excerpts, automatic translation, edited}

Situation Report of the 17th Ebola Virus Disease Outbreak / DRC - SitRep No. 009/MVB_24/2026


    ° Cumulative Confirmed Cases: 101

    ° Cumulative Deaths Among Confirmed Cases: 10

    ° Cumulative Suspected Cases: 904

    ° Cumulative Suspected Deaths: 119

    ° Occupation Rate Among Suspected Cases: NA

    ° Occupation Rate Among Confirmed Cases:  NA

    ° Recoveries: 0


I. CONTEXT

    -- Ituri Province is located in the northeast of the Democratic Republic of Congo and shares a long border with Uganda and South Sudan

        - For more than two decades, it has faced a chronic humanitarian crisis linked to armed conflict and recurring population displacements

        - It has an estimated population of over 8 million, including more than one million internally displaced persons

        - In September 2018, this province was affected by an Ebola virus disease outbreak that was raging in the neighboring province of North Kivu.

    -- The Mongbwalu health zone is one of the 36 health zones in Ituri province. 

        - Considered the starting point of the epidemic, it is located in the Djugu territory, where several armed groups operate

        - It is situated 70 km from Bunia, the capital of Ituri province, with frequent population movements towards Uganda

        - This area is characterized by several construction sites that attract people from other territories within the province and from neighboring provinces.


II. HISTORICAL BACKGROUND OF THE EPIDEMIC

    -- As of May 5, 2026, social media reported a surge in deaths of unknown cause, with nearly 50 deaths already recorded in the Mongbwalu health zone

        - Following confirmation of this alert, the Chief Medical Officer of the Mongbwalu health zone shared the preliminary investigation report on May 9, 2026. 

        - On May 11, 2026, provincial health authorities held an emergency meeting and decided to deploy rapid response teams to Mongbwalu and Rwampara, which had reported suspected deaths from viral hemorrhagic fever among patients admitted to the Rwampara Evangelical Medical Center, who had been transferred from Mongbwalu.

    -- Investigations conducted simultaneously on May 12, 2026, in the Mongbwalu and Rwampara health zones by the Rapid Response Teams of the Ituri Provincial Health Division (DPS) revealed that most of the patients or suspected deaths presented with fever, headaches, vomiting, and severe physical asthenia

        - Deaths occurred 2 to 3 days after the onset of illness, presenting with hematemesis, epistaxis, or blackish vomit. 

        - During investigations in the Rwampara health zone, 20 samples were collected from suspected cases or deaths. 

        - The majority of those sampled came from the Mongbwalu health zone

        - Preliminary tests conducted at the Bunia Laboratory were all negative for Ebola Zaire, dengue, rotavirus, cholera, malaria, Yersinia pestis, medullary tuberculosis, and COVID-19. 

        - These samples were sent to the National Institute of Biomedical Research (INRB) in Kinshasa for further testing.

    -- As of May 14, 2026, 13 of these 20 samples had been tested, and 8 were found to be positive for non-Zaire Ebola virus disease at the INRB Kinshasa. 

        - On May 15, 2026, sequencing of positive samples identified the Bundibugyo strain, allowing the Minister of Public Health, Hygiene and Social Welfare (MSHPS) to officially declare the 17th Ebola virus disease outbreak.

    -- On May 17, 2026, in consultation with member states, the WHO Director-General determined that the event occurring in the DRC and Uganda met the criteria of the definition set forth in Article 1 of the IHR, and declared it a  Public Health Emergency of International Concern, while specifying that the risk at  the global level was low but high at the regional level. 

    -- On May 18, 2026, the Executive Director of Africa CDC officially declared a Continental Public Health Security Emergency (CPHSE) under Article 3 of its statutes. 

        - This declaration followed an emergency meeting of the Africa CDC Advisory Group, which determined that the worsening outbreak posed an acute risk to continental health security. 

        - As a result, the Continental Incident Management Support Team was activated to provide support to affected and at-risk Member States in their response and preparedness efforts.


III. EPIDEMIOLOGICAL SITUATION UPDATE

    ° 10 New Confirmed Cases (Mongbwalu: 9 and Katwa: 1)

    ° Cumulative confirmed cases in Ituri as of May 23, 2026: 94 cases, North Kivu: 6 cases and South Kivu: 1 case

    ° Three provinces affected: ITURI, NORTH KIVU and SOUTH KIVU:

    ° ITURI: Ã©picentre avec 7/36 ZS touchées (Rwampara, Bunia, Mongbwalu, Nyankunde, Nizi, Kilo et Aru,)

    ° NORD-KIVU : 3/35 ZS touchées (Goma, Butembo et Katwa)

    ° SUD-KIVU : 1/34 ZS touchée (Miti-Murhesa)

(...)

Source: 


Link: https://reliefweb.int/report/democratic-republic-congo/rapport-de-situation-de-la-17eme-epidemie-de-la-maladie-virus-ebolardc-sitrep-mve-sitrep-ndeg-009mvb242026

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Predicting #Influenza Virus #Host #Tropism and Zoonotic #Spillover #Risk from #Protein Sequences

 


Abstract

Novel infectious diseases, predominantly originating from non-human animals, pose a significant threat to global public health and economic stability. Avian influenza virus presents an especially significant challenge due to its high mortality rates and spillover capability into new host species. Recent H5N1 spillover events into poultry and cattle resulted in massive economic burden and increased human health risk. Traditional methods of disease surveillance rely on reactive case detection and pathogen characterization, providing insufficient lead time for effective intervention. Computational tools that allow efficient and proactive prediction of zoonotic potential are critical in mitigation of influenza outbreaks and identification of strains with human spillover risk. Existing models predicting influenza virus subtypes or host have been developed; however, the complexity of spillover events, including the non-binary nature of zoonotic potential, limits the capabilities of these models. In the approach reported here, rich protein language model embeddings were generated from ESM-2 for each protein in influenza virus strains and used to predict the protein host tropism probabilities across nine animal families. The protein host tropism model achieved weighted precision and recall scores of 0.95 and 0.95, respectively. We then constructed a zoonotic risk prediction model using the outputs from the protein host tropism prediction model to classify the strains into six classifications: avian, mammal, human, avian-to-human zoonotic, avian-to-mammal zoonotic, or mammal-to-human zoonotic. The average weighted precision and recall scores for this model were 0.90 and 0.90, respectively. This framework advances the prediction of influenza zoonotic risk by being agnostic to influenza subtype, incorporating non-human mammals and mammal zoonotic spillover classifications, and using the full influenza proteome to capture the complexity of spillover dynamics.


Competing Interest Statement

The authors have declared no competing interest.

Source: 


Link: https://www.biorxiv.org/content/10.64898/2026.05.21.726772v1

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Sunday, May 24, 2026

Here is a Man (Ecce Homo), Hieronymus Bosch (1475 - 1480)

 


{Click on Image to Enlarge}

Public Domain.

Source: 


Link: https://www.wikiart.org/en/hieronymus-bosch/this-is-a-human-ecce-homo

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#Andes #hantavirus #outbreak #Update, 24 May 2026 (ECDC, edited): One new case notified since last report



    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 24 May, 12 cases have been reported in total, including 10 confirmed and 2 probable cases

    One new case and no new deaths have been reported since the previous update.

    The cruise ship M/V Hondius is currently docked in Rotterdam, the Netherlands, undergoing sanitation.

    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.

___

    ° Confirmed cases10

    ° Probable cases2

    ° Suspected cases0

    ° Number of deaths3

(...)

Source: 


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

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Dairy #cows infected with #influenza #H5N1 reveals low infectious dose and #transmission #barriers

 


Abstract

Highly pathogenic avian influenza A(H5N1) virus exhibits a strong tropism for the bovine mammary gland, challenging our understanding of influenza A virus host range and tissue specificity. We performed experimental studies with an influenza A(H5N1) B3.13 genotype virus in female lactating dairy cattle to define the infectious dose, routes of exposure, and factors linked to morbidity and mortality. Here, we demonstrate that intramammary inoculation with as few as 10 TCID50 establishes a robust infection and shedding of high-titer virus in milk. Despite this low infectious dose, H5N1 does not readily transmit via contaminated milking equipment and close contact with infected animals. High-dose intramammary exposure results in severe disease and mortality, while respiratory and oral exposures are less likely to establish productive infection and associated morbidity. This study challenges current hypotheses of H5N1 transmission on dairy farms, raising important questions about potential agent, host, or environmental cofactors contributing to viral spread.

Source: 


Link: https://www.nature.com/articles/s41467-026-73490-6

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Spatiotemporal #Dynamics of Highly Pathogenic Avian #Influenza #H5 Virus Introductions and Regional Spread in the Republic of #Korea

 


Abstract

Highly pathogenic avian influenza (HPAI) viruses from clade 2.3.4.4 have caused recurrent outbreaks in poultry since 2014. In the Republic of Korea, clade 2.3.4.4b viruses have driven five epidemic waves, yet the factors underlying HPAI introduction and farm-to-farm spread remain poorly understood. We compiled hemagglutinin gene sequences of clade 2.3.4.4b viruses from wild birds and poultry in the Republic of Korea (October 2016–March 2024) and reconstructed dispersal dynamics using Bayesian phylogeography. Dispersal patterns suggest that domestic duck farms in the western provinces likely form a key interface for spillover from wild birds into poultry. Mixed-effects generalized linear models showed that both wild-to-poultry and farm-to-farm transition rates were positively associated with the number of poultry farms in the destination province, while wild-to-poultry rates were further associated with higher avian influenza virus infection probability among wild birds. Wild-to-poultry transition rates were lower in 2020–2024 than in 2016–2018, which may reflect strengthened interventions. These findings suggest that poultry farm abundance and introduction pressure from wild birds jointly shape the spatial dynamics of HPAI introduction and spread. More broadly, these factors may provide operational indicators to guide risk-based surveillance and control strategies.


Competing Interest Statement

The authors have declared no competing interest.

Source: 


Link: https://www.biorxiv.org/content/10.64898/2026.05.21.726857v1

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Understanding the emergence of the #influenza #H3N2 K #subclade in its historical and evolutionary context



Abstract

The emergence in 2025/26 of the influenza A/H3N2 K substrain (H3N2/K) was the cause of significant public health concern. This genetically divergent virus was assessed to have a strongly decreased reactivity to contemporary vaccine strains. Respectively prolonged and early influenza seasons in the Southern and Northern Hemispheres contributed to concerns about vaccine efficacy. Here we retrospectively assessed the genetic and antigenic properties of this virus, combining epidemiological surveillance data, computational antigenic analysis, and serological data using samples from a well-stratified UK cohort. In contrast to initial indications, we found that despite the genetic distinctiveness of H3N2/K the virus had undergone limited antigenic change, suggesting that its emergence was instead the result of selection for non-antigenic properties. We confirmed previous results showing that contemporary vaccines produced an enhanced neutralising response to H3N2/K but, in a stratified serological analysis, showed that responses to the J and K substrains were age-dependent, largely driven by patterns of vaccination. Our results have implications for antigenic surveillance and for public communication strategies in future influenza seasons.


Competing Interest Statement

PRM declares funding by MSD. EH has received an honorarium for advisory board work for Seqirus.


Funder Information Declared

Medical Research Council, MR/Y03368X/1, MC_UU_0034/1, MC_UU_0034/2, MC_UU_0034/3, MC_UU_0034/5, MC_UU_0034/6

Source: 


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Saturday, May 23, 2026

#Andes virus on a cruise #ship: person-to-person #transmission and an empty #pipeline

 


{Extract}

The outbreak of Andes virus aboard the expedition cruise ship MV Hondius with 10 cases, three deaths, and more than 440 contacts including passengers of 23 nationalities, is a stark reminder that neglected zoonotic viruses can rapidly become international public health emergencies.

A WHO-led emergency scientific consultation on May 15, 2026, convened experts to assess the situation and coordinate research priorities.1 The outbreak in the ship might have potentially involved up to three generations of person-to-person transmission from a single index case, with two epidemic peaks during 18 days and one asymptomatic PCR-positive case. The meeting highlighted three urgent realities: the Andes virus can sustain person-to-person transmission, the medical countermeasure pipeline remains immature, and existing scientific networks require urgent support.

(...)

Source: 


Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00283-5/fulltext?rss=yes

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History of Mass Transportation: Electric Multiple Unit 58 of Romanian Railways in Cluj-Napoca station

 


{Click on Image to Enlarge}

By Dr 2005 - Wk Ro, http://ro.wikipedia.org/wiki/Imagine:58-0001-6-P4105-Cluj-001.jpg, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=2246047

Source: 


Link: https://en.wikipedia.org/wiki/Rolling_stock_of_the_Romanian_Railways

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#Coronavirus Disease Research #References (AMEDEO, May 23 '26)

 


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#Ebola disease caused by #Bundibugyo virus - #DRC (WHO D.O.N., May 23 '26)

 


{Excerpt}

Situation at a glance

    -- On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare, Democratic Republic of the Congo (DRC), and the Ministry of Health of Uganda declared an outbreak of Ebola Disease following the confirmation of Bundibugyo virus disease (BVD) in both countries

    -- On 16 May 2026, the World Health Organization (WHO) Director-General 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. 

    -- On 19 May 2026, the Director-General of WHO convened the first meeting of the IHR Emergency Committee, and temporary recommendations were issued to State Parties. 

    -- As of 21 May, 746 suspected cases and 176 deaths among suspected cases were reported in DRC. 

    -- So far 85 confirmed cases, including two in Uganda, and ten deaths, with one in Uganda, among confirmed cases were reported across both countries. 

    -- In DRC, transmission is concentrated in Ituri, North Kivu and South Kivu provinces, with challenges in contact follow-up, insecure conditions, and inadequate isolation and referral systems complicating response efforts. 

    -- Uganda has reported two imported cases with no confirmed local transmission. 

    -- An American national who was working in DRC has also been confirmed positive and transferred to Germany for care. 

    -- National authorities, in collaboration with WHO and partners, are implementing response measures including deployment of rapid response teams, delivery of medical supplies, strengthened surveillance, laboratory confirmation, infection prevention and control assessments, the set-up of safe and optimized treatment centers, and community engagement.


Description of the situation

    -- On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare of Democratic Republic of the Congo (DRC) officially declared the 17th Ebola disease outbreak following the laboratory confirmation of Bundibugyo virus disease (BVD) in eight samples. 

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

    -- On 16 May 2026, the 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 International Health Regulation (IHR)

    -- Since the last Disease Outbreak News was published on 16 May 2026, the number of suspected and confirmed cases has increased rapidly in DRC, with geographical expansion into North Kivu and South Kivu. 

    -- In total, 746 suspected cases, including 176 deaths among suspected cases have been reported from DRC as of 21 May 2026; and 85 confirmed cases (two in Uganda), including ten deaths (one in Uganda) (CFR 12%) have been reported from both countries.

    (...)

    -- As of 21 May 2026, a total of 83 confirmed cases including nine deaths (CFR 11%); and 746 suspected cases including 176 deaths have been reported from 15 health zones (HZ) in Ituri, North Kivu and South Kivu Provinces, DRC. 

    -- Four health worker deaths have been reported to date. 

    -- Epidemiological and laboratory investigations are ongoing to reclassify all suspected cases and deaths reported in DRC.

    -- The most affected HZ are Mongbwalu, Rwampara and Bunia, which all account for 96% of suspected cases and 79% of confirmed cases.  

    -- As of 21 May, 1603 contacts have been listed in Ituri province and one contact became a suspected case. However, follow-up remains weak due to insecurity and movement restrictions. 

    -- The follow-up rate as of 21 May is 21%. On 21 May, 84 new alerts were reported, and 77 alerts were investigated, all of which were validated.

    -- An American national, who was working in DRC as a surgeon, has also been identified as a confirmed case. Exposure is thought to have occurred during a medical procedure on 11 May. Onset of symptoms was reported on 16 May and laboratory confirmation was received on 20 May. The case is currently at a High-Level isolation unit in Berlin, Germany undergoing treatment.

(...)

    -- Response efforts continue to face a number of challenges, including:

        ° absence of standardized isolation and treatment facilities and weak screening and referral pathways;

        ° inconsistent implementation of safe and dignified burial measures further underscores the significant risk of healthcare-associated transmission;

        ° cross-border transmission risks remain elevated due to insecurity, humanitarian crises, high population mobility, urban/semi-urban transmission hotspots, and porous borders, requiring intensified surveillance and information sharing;

        ° deeply challenging situation for affected communities, with growing concerns over access to free and supportive healthcare services, the ability to ensure respectful and dignified burials, and the spread of misinformation and rumour;

        ° ongoing conflict in Ituri province restricting the movement of surveillance teams, the deployment of Rapid Response Teams, and the transporting of laboratory samples.

    -- 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 with Bunia HZ being 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.


Uganda

    -- As of 20 May 2026, a total of two confirmed cases including one death have been reported in Kampala, Uganda. Both cases were imported from the DRC. The first case was admitted to a private hospital on 11 May and died on 14 May. The transfer of the body to DRC was completed the same day. The second case was confirmed on 16 May in Kampala, in an individual returning from DRC with no apparent links to the first case. The case is currently admitted in Uganda at the Mulago Isolation Treatment Unit. At the time of reporting, no local transmission has been identified in Uganda.

    -- As of 18 May, a total of 127 contacts, linked to both confirmed imported cases, have been identified and under follow-up. These include close household contacts and hospital contacts where the cases were hospitalized.

    -- Exposure risks are associated with healthcare settings and cross-border movements. Eighteen alerts were reported on 18 May and investigated. Four active cross-border exposure clusters identified in Ntoroko District are under investigation. 


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 or items

    -- 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, in collaboration with WHO and partners are implementing public health measures, including but not limited to the following:


Coordination

    ° The Incident Management System has been activated to coordinate response to the outbreak, with technical support from WHO and health partners

    ° Subnational coordination structures are being activated at the provincial and health zones level to coordinate operational activities. Daily provincial coordination meetings involving all response pillars and operational partners are ongoing.

    ° Rapid response teams from MoH and WHO have been deployed to Bunia, Mongbwalu, and Rwampara HZ.


Surveillance

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

    ° Alert management and case investigations are being scaled up. Investigation teams have been deployed to Bunia and Rwampara, with alerts under investigation in Ituri, North Kivu, South Kivu, and Tshopo provinces.

    ° Contact tracing has been initiated with 541 contacts identified, although major operational challenges persist due to insecurity.

    ° Data managers have been trained on the DHIS2 tracker, and a surveillance and digital health coordination meeting is being implemented to improve harmonization across digital platforms.

    ° The International Organization for Migration (IOM) is supporting points-of-entry (PoEs) surveillance; however, informal crossings and weak alert management at PoEs remain significant gaps.


Case Management

    ° WHO and partners are supporting the ongoing establishment and operationalization of isolation and treatment facilities in affected areas

    ° WHO and partners are working to maintain access to essential health and other services.


Laboratory

    ° Laboratory surge capacity is being scaled-up. The Institut National de la Recherche Biomédicale (INRB) teams are deploying to Bunia to establish and scale-up testing. A decentralization strategy is being developed to add additional field laboratories to Mongbwalu and Mahagi (Ituri – Uganda border). Goma laboratory is activated and provide testing capacities for North Kivu.

    ° PCR kits have been sourced, while WHO Regional Emergency Hub in Dakar is deploying reagents, Piccolo machines, and cold-chain modules to strengthen field laboratory operations.

    ° Genomic and epidemiological analyses are underway, and sequences have been uploaded through a joint publication (by DRC and Uganda) on virological.org.


Risk Communication and Community Engagement (RCCE)

    ° Community mobilization has started in Mongbwalu, while social listening activities and deployment of UNICEF digital platforms (U-Report and I-Hear-You) are underway to improve community feedback and information sharing.

    ° WHO is supporting engagement interventions with community and religious leaders

    ° WHO shared a multi-country infodemic management report providing an initial analysis of community perceptions, including key questions, concerns, rumours, misinformation, and disinformation, to guide targeted risk communication and community engagement interventions.

    ° WHO and partners have developed a shared RCCE message repository to harmonize risk communication content


Infection Prevention and Control (IPC)

    ° Coordination mechanism for IPC response is being established under the leadership of the Division of Provincial Health  and the Public Health Emergency Operations Centre.

    ° Local human resources are being scaled-up to enable required key intervention.

    ° More than 150 health workers have been trained on basic IPC and Ebola-specific measures, with an ongoing cascade training plan targeting an additional 500 health workers.

    ° Operational teams are being established and briefed for decontamination, safe and dignified burials and health facility assessments.

    ° IPC supplies including PPE are being donated to priority health facilities.


Operational support and Logistics

    ° Over 17 tons of emergency supplies were shipped to DRC, including personal protective equipment (PPE), Viral Haemorrhagic Fever supplies, tents, body bags, infection prevention and control materials, stretchers, medicines and other case management supplies.

    ° Deployment of EpiShuttle patient isolation transport systems, vehicles, telecommunications equipment, laboratory consumables, portable point-of-care diagnostic machines, reagents, cold-chain modules, and Ebola polymerase chain reaction (PCR) testing kits to strengthen clinical transport, laboratory diagnostics, and field response operations are ongoing.

    ° Coordination is underway to mobilize one helicopter, three ambulances, and two armored vehicles to support cargo and personnel movement. Human resource deployment structures are being finalized and United Nations Humanitarian Air Service (UNHAS) is supporting staff movement to Bunia.


Global Logistics 

    ° Cluster partners briefed on situation and work is under way for planning WFP/Logistics Cluster support for common partner services.

    ° Efforts are ongoing with partners to provide subsidized air cargo into the region, and into Bunia

    ° A four-week forecast of critical PPE requirements across case management, infection, prevention and control, and burial operations has been finalized to support sustained response activities.

    ° A high priority items list has been finalized to facilitate collective monitoring. Item-needs calculator being finalized for sharing.


Border Health, Travel and Mass Gatherings

    ° WHO travel and border health guidance has been disseminated across countries and transport sectors, emphasizing that suspected, probable and confirmed cases and their contacts should avoid travel unless medically evacuated, and advising against travel or trade restrictions and border closures.

    ° Affected and neighbouring countries are strengthening their preparedness to detect, investigate, refer, isolate and care for any suspected cases, including activation of health emergency plans, enhanced screening at airports, seaports, land crossings and major internal transit routes.


    -- Health authorities in Uganda, in collaboration with WHO and partners, are implementing public health measures, including but not limited to the following:


Coordination

    ° The Incident Management System has been activated to coordinate response to the outbreak, with technical support from WHO and health partners

    ° The National Public Health Emergency Operations Centre and regional Emergency Operations Centres (EOCs) were activated in Fort Portal, Arua, Yumbe, Kampala Capital City Authority, Kabale, and Hoima, with the national response plan and rapid risk assessment finalized.


Surveillance and Laboratory

    ° Field teams are utilizing Go.Data for contact tracing, benefiting from experience in implementing the tool during previous mpox, cholera and Sudan virus disease outbreaks.

    ° Screening is being strengthened at official and informal border crossings, major transit routes, and pilgrimage corridors.


Case Management

    ° Isolation facilities in high-risk districts have been activated and the Uganda National Emergency Medical Team deployed to support clinical management.


Laboratory

    ° Sequencing and sample transport systems are being strengthened

    ° A mobile laboratory is being deployed to Kasese near the DRC border, with a virtual diagnostics coordination meeting supporting cross-country laboratory operations.


Risk Communication and Community Engagement (RCCE)

    ° Risk communication systems have been activated with community messaging and public awareness campaigns ongoing through District Health Officer networks, with health workers receiving guidance on standard precautions and public health messaging.


Infection Prevention and Control (IPC)

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


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.

    -- This is the 17th Ebola disease outbreak in the DRC since 1976. The last Ebola disease outbreak in the country was an outbreak and Ebola virus disease which 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. In Uganda, the last outbreak reported was an outbreak of Sudan ebolavirus in 2022. The last BVD outbreak was recorded in the country in 2007.

    -- 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 assessed the risk of the outbreak of BVD to be very high at the national level in DRC, high at the regional level, and low at the global level.

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Source: 


Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON603

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