#Andes #hantavirus #outbreak, 20 May 2026 #Update (ECDC, edited): No new cases reported since yesterday

 

    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 20 May, 11 cases have been reported in total, including 9 confirmed and 2 probable cases. 

    No new cases or deaths have been reported since the previous update.

    The cruise ship M/V Hondius is currently docked in Rotterdam, the Netherlands since 18 May and ship sanitation is being carried out.

    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 cases***: 9

    ° Probable cases**: 2

    ° Suspected cases*: 0

    ° 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)

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

____

#WHO DG's opening #remarks at the media #briefing on #Ebola #outbreak in #DRC and #Uganda – 20 May 2026 (edited)

 

    Good morning to everyone in the room, and hello to everybody joining us online. Thank you for joining us.

    Early on Sunday, I declared a public health emergency of international concern over an epidemic of Ebola disease in the Democratic Republic of the Congo and Uganda.

    This is the first time a Director-General has declared a PHEIC before convening an Emergency Committee.

    I took this step in accordance with Article 12 of the International Health Regulations, after consulting the Ministers of Health of DRC and Uganda, and in view of the need for urgent action.

    I determined that the situation was not a pandemic emergency, which is the new and highest classification under the amended International Health Regulations.

    After declaring the PHEIC, I immediately convened an Emergency Committee under the IHR, which met yesterday and agreed that the situation is a public health emergency of international concern, but is not a pandemic emergency.

    WHO assesses the risk of the epidemic as high at the national and regional levels, and low at the global level.

    So far, 51 cases have been confirmed in the DRC, in the northern provinces of Ituri and North Kivu, including in the cites of Bunia and Goma – although we know the scale of the epidemic in DRC is much larger.

    Uganda has also informed WHO of two confirmed cases in the capital Kampala, including one death, among two individuals who travelled from DRC to Uganda.

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

    There are several factors that warrant serious concern about the potential for further spread and further deaths.

    First, beyond the confirmed cases, there are almost 600 suspected cases and 139 suspected deaths.

    We expect those numbers to keep increasing, given the amount of time the virus was circulating before the outbreak was detected.

    Second, the epidemic has expanded, with cases reported in several urban areas.

    Third, deaths have been reported among health workers, indicating healthcare-associated transmission.

    Fourth, there is significant population movement in the area.

    The province of Ituri is highly insecure. Conflict has intensified since late 2025, and fighting has escalated significantly over the past two months, with over 100 000 people newly displaced.

    The area is also a mining zone, with high levels of population movement that increase the risk of further spread.

    And fifth, this epidemic is caused by Bundibugyo virus, a species of Ebola virus for which there are no approved vaccines or therapeutics.

    In light of all these risks, I decided it was urgent to act immediately to prevent more deaths and mobilise an effective and international response.

    I would like to thank the Government of DRC, the National Institute for Biomedical Research, the National Institute of Public Health and the local health authorities in the affected areas for their leadership and cooperation.

    I also thank the Government of Uganda for postponing the annual Martyrs’ Day celebrations, which can attract up to two million people, because of the risk posed by the epidemic.

    My thanks especially to His Excellency President Musiveni for taking this action.

    WHO has a team on the ground supporting national authorities to respond. We have deployed people, supplies, equipment and funds.

    To support our response, I have approved an additional US$ 3.4 million from the Contingency Fund for Emergencies, bringing the total to US$ 3.9 million.

    In the absence of vaccines and therapeutics, there are many other measures countries can take to stop the spread of the virus and save lives, which the Emergency Committee has outlined in its temporary recommendations.

    To say more, I’m pleased to invite the Chair of the Committee, Professor Lucille Blumberg, from the University of Pretoria in South Africa.

    Professor Blumberg, thank you for your leadership at this time. Over to you.

 Source: 

Link: https://www.who.int/news-room/speeches/item/who-director-general-s-opening-remarks-at-the-media-briefing-on-ebola-outbreak-in-drc-and-uganda-20-may-2026

_____

Updated joint FAO/WHO/WOAH public health #assessment of recent #influenza #H5 virus #events in #animals and #people, based on data as of 1 March '26 (18 May 2026)

Key points 

    -- Based on currently available information, Food and Agriculture Organization of the United Nations (FAO)/World Health Organization (WHO) / World Organisation for Animal Health (WOAH) assess the global public health risk posed by Gs/Gd-like high pathogenicity avian influenza (HPAI) A(H5) viruses as low. 

    -- The risk of infection for occupationally or frequently exposed persons (e.g., with backyard poultry) is assessed as low to moderate depending on local epidemiologic conditions and the risk mitigation and hygiene measures in place. 

    -- Transmission among animals continues and sporadic human infections at the human-animal-environment interface continue to be reported. 

    -- While additional human infections associated with exposure to infected animals or contaminated environments are expected, the overall global public health impact of such infections is currently considered minor. 

    -- The assessment may change rapidly as new epidemiological or virological information becomes available. 

    -- This joint FAO/WHO/WOAH risk assessment updates the transmission risk using new global information available since the previous assessment of 28 July 2025. 

    -- Given the potential risk to human health and the wide-ranging impacts on wild birds and mammals, poultry, livestock and other animal populations, timely notification to global authorities and the application of a One Health approach remain essential to monitor and characterize virus circulation, limit transmission within species and between species, reduce spread among animals, and prevent human infections. 

Infections in animals  

    -- To date, HPAI A(H5) viruses have been detected in birds and/or mammals across all continents except Oceania. 

    -- The predominant H5 virus clades currently circulating worldwide derive from clades 2.3.2.1 and 2.3.4.4. 

    -- Between 1 July 2025 and 1 March 2026, an additional 185 A(H5N1) events{i} in animals (including birds and bovines) have been reported to WOAH. 

    -- Of these, 1204 outbreaks occurred in poultry (of any farming system), 6326 outbreaks in wild birds and nine outbreaks occurred in bovines.  

H5 clade 2.3.2.1 viruses 

    -- Between 1 July 2025 and 1 March 2026, A(H5N1) clade 2.3.2.1a viruses were detected in poultry in Bangladesh and India, while A(H5N1) clade 2.3.2.1e viruses were detected in poultry in Cambodia 

H5 clade 2.3.4.4b viruses 

    -- Detections of A(H5) in wild and domestic mammals and wild and domestic birds continued to be reported in many countries worldwide. 

    -- During the period of September-November 2025, Europe experienced an exceptional and early season and a high incidence of HPAI A(H5) activity in wild birds, with more than 3200 detections reported across 28 countries. 

    -- This represents a ten-fold increase compared to the same period in 2024. 

    -- Based on genetic data available so far, the A(H5N1) HPAI viruses identified in Europe all fall into clade 2.3.4.4b, and the majority belong to the genotype EA-2024.DI2.12,{3} 

    -- This surge has disproportionately affected migratory waterfowl and colonial species, with widespread A(H5N1) virus infections confirmed in key migratory hosts (e.g., Eurasian wigeons, Northern pintails, Mute swans, Greylag geese) and severe mass mortality events in Eurasian cranes (Grus grus).{4}  

    -- In Africa, poultry outbreaks of A(H5N1) clade 2.3.4.4b viruses have been reported in Nigeria and South Africa since September 2025. 

    -- Several other countries in sub-Saharan Africa consider HPAI to be present in their territories. 

    -- Detections of A(H5N1) were also made in wild birds in Namibia and South Africa. 

    -- A(H5N1) clade 2.3.4.4b viruses are considered endemic in Egypt’s poultry populations.   

    -- In Asia, clade 2.3.4.4b viruses have been reported in several countries. 

    -- In India, recent poultry outbreaks have involved A(H5N1), while in Kazakhstan, A(H5N1) was detected in wild birds. 

    -- In the Republic of Korea, detections include A(H5N1), A(H5N6), and A(H5N9), while in Japan A(H5N1) and A(H5N5) viruses have been reported. 

    -- In North America, substantial activity of clade 2.3.4.4b A(H5) viruses has continued since the last assessment. 

    -- In the United States of America, more than 3700 A(H5) detections in wild birds and over 400 A(H5) HPAI outbreaks in poultry were reported, while Canada reported nearly 500 A(H5N1) detections in wild birds and over 80 A(H5) HPAI outbreaks in poultry.{5,6} 

    -- A(H5N1) detections in terrestrial and marine mammals have also been reported. 

    -- Notably, A(H5N1) clade 2.3.4.4b was detected for the first time in northern elephant seals in February 2026 in California, involving a virus of the A3 genotype.{7} 

    -- In central America, Mexico reported H5N1 outbreaks in backyard poultry in October 2025 and A(H5N1) detections in wild birds in November. 

    -- A(H5N1) detections of American genotype D1.1 viruses were reported in domestic birds in the Cayman Islands and Guatemala during the second half of 2025. Genotype D1.1 was the most frequently detected A(H5N1) genotype in North America in 2025, affecting wild birds, poultry and multiple mammalian species, including wild and domestic felids and marine mammals. 

    -- A(H5N2) clade 2.3.4.4b viruses belonging to the K.5 genotype were detected in poultry in Mexico.  

    -- In South America, A(H5N1) has continued to spread, with detections in both poultry and wild birds across multiple countries. 

    -- In late 2025, A(H5N1) outbreaks were reported from Argentina, Brazil and Colombia. 

    -- Where sequence data are available, viruses belong to clade 2.3.4.4b.{8} 

    -- In 2026, additional outbreaks occurred across the region. HPAI A(H5) outbreaks occurred in Peru in backyard poultry and in Uruguay in wild birds, although detailed genetic information for these events is not yet available. 

    -- Between 1 February and 1 March 2026, Argentina detected at least 12 A(H5N1) events across domestic and wild birds, while further A(H5N1) outbreaks occurred in backyard and wild birds in Brazil, and in backyard birds in Colombia and Peru.  

    -- Although the full extent of ongoing circulation and establishment in wild bird populations across South America remains uncertain, evidence suggests that A(H5N1) viruses circulating have continued to diversify through reassortment. 

    -- Viruses detected in Brazil in mid- to late 2025 belonged to two distinct genotypes, K.8 and N.1. 

    -- The K.8 genotype is related to “triple reassortant” viruses{9} identified in Argentina in early 2025, combining North American B3.6- and B3.13-like genomes but with multiple internal gene segments derived from South American low pathogenicity avian influenza viruses (LPAIVs).{10,11} 

    -- Its continued presence is consistent with sustained regional spread. 

    -- In contrast, the N.1 genotype clusters with recent North American B3.2 viruses but contains a PB2 segment derived from South American low pathogenicity avian influenza viruses. 

    -- This suggests a separate, more recent introduction of A(H5N1) viruses to South America, followed by reassortment with locally circulating viruses.{12} 

    -- In the Antarctic peninsula and sub-Antarctic islands, A(H5N1) clade 2.3.4.4b viruses have been repeatedly detected in the region, including in sea birds such as skuas and penguins, following their introduction during the 2023–2024 austral summer.{13} 

    -- Detections in wild birds and mammals in the region have continued through 2025–2026. This includes outbreaks in additional sub-Antarctic territories, such as Heard Island, where A(H5N1) was detected in Antarctic fur seals, gentoo penguins and southern elephant seals.{14,15} 

    -- This follows initial detections in southern elephant seals on an earlier voyage in October 2025. 

    -- There was no further evidence of ongoing mass mortality detected on this second voyage in January 2026. 

    -- Further sequencing and phylogenetic analysis are being undertaken. 

    -- The extensive circulation of clade 2.3.4.4b A(H5) viruses in wild and domestic bird populations has resulted in multiple spillover events into wild terrestrial mammals, both carnivorous and omnivorous, wild marine mammals, and domestic cats and dogs.{16} 

    -- Amino acid changes potentially associated with increased virulence, transmission, or adaptation to mammalian hosts have been sporadically identified.{17,18,19}  

    -- Since 2024 and as of 1 March 2026, 1088 dairy herds in 19 states of the United States of America have tested positive for A(H5N1). 

    -- Since the last assessment of 28 July 2025, 14 additional A(H5N1) detections have been reported in the country, with the latest detection confirmed in December 2025 in Wisconsin.{20} 

    -- Analyses of virus sequence data suggest that there have been at least four independent spillovers of A(H5N1) into dairy cattle with the most recent occurring in December 2025.{21} 

    -- In January 2026, Netherlands (Kingdom of the) reported the detection of A(H5N1) HPAI antibodies in the milk of a dairy cow at a dairy farm in Friesland Province, following the investigation of a cat living on that dairy farm that died from an A(H5N1) infection.{22} 

    -- The virus detected in the cat belonged to clade 2.3.4.4b genotype EA-2024.DI2.1—which is distinct from the B3.13 and D1.1 genotypes detected in dairy cattle in the United States of America. No evidence of active infection was found in  the herd, but antibodies were later detected in four additional cows on the same farm, therefore, they do not constitute a case according to the WOAH case definition.  

    -- Mammalian detections of A(H5N5) clade 2.3.4.4b viruses have also been reported in recent years, particularly those belonging to the A6 genotype. 

    -- Since 2023, detections have been reported in terrestrial carnivora (northern racoon, striped skunk, red fox, Eurasian lynx, Eurasian Otter, American mink, Arctic fox and domestic cats) across North America and Europe and in marine mammals. 

    -- For the latest information on avian influenza situation in animals worldwide, see the FAO Global Avian Influenza Viruses with Zoonotic Potential situation update and the WOAH situation reports on HPAI, as well as WOAH’s World Animal Health Information System. 

Detections in humans 

    -- Since the last joint assessment of July 2025 and as of 1 March 2026, nine additional human cases of A(H5N1) virus infections, and single cases of A(H5), A(H5N2), A(H5N5) virus infections have been detected (based on date of reporting) in Bangladesh, Mexico and the United States of America. 

    -- Eight A(H5N1) cases were detected in Cambodia, and one was detected in Bangladesh. 

    -- All cases reported direct or indirect exposure to domestic birds or contaminated environments. 

    -- No human-to-human transmission was suspected associated with these confirmed cases. 

    -- The viruses from two cases in Bangladesh belong to clade 2.3.2.1a viruses, viruses from six of the cases from Cambodia belong to clade 2.3.2.1e, and viruses from the cases in Mexico and the United States of America belong to clade 2.3.4.4b.  

Virus characteristics  

    -- Routine monitoring and screening of viral sequences from birds have rarely identified markers of mammalian adaptation in A(H5) viruses, and when detected, these have primarily involved the polymerase proteins. 

    -- Such mutations have been observed more frequently in viruses isolated from mammals. 

    -- The PB2 D701N amino acid mutation has been identified in genotype D1.1 viruses detected in poultry (including chickens and turkeys), wild birds, cats, dairy cattle and wild mammals such as red foxes.{23} 

    -- The PB2 E627K mutation has been detected in some B3.13 viruses identified in dairy cattle and in clade 2.3.2.1 and 2.3.4.4 A(H5) viruses detected in poultry, cats and wild birds across multiple regions. 

    -- Some genetic markers in A(H5N1) virus sequences from human cases have been linked to potentially lower lab-based susceptibility to common antivirals like oseltamivir or baloxavir marboxil; the clinical significance of some of these markers remains uncertain.{24} 

    -- Experimental studies with A(H5N1) clade 2.3.4.4b viruses have generally not demonstrated efficient transmission via respiratory droplets.{25,26,27,28,29,30,31} 

    -- Ferret studies conducted by the US CDC using a D1.1 A(H5N1) virus (A/Washington/239/2024) did not show respiratory droplet transmission.{32} 

    -- Overall, currently circulating A(H5N1) viruses would require additional genetic changes to acquire efficient human-to-human transmission via respiratory droplets, consistent with the current low public health risk. 

    -- Based on limited seroprevalence information available on A(H5) viruses, human population immunity against the HA of A(H5) viruses is expected to be minimal; human population immunity targeting the N1 neuraminidase is found to be present although the impact of this immunity is yet to be understood.{33}  

Candidate vaccine viruses (CVV) 

    -- The WHO Global Influenza Surveillance and Response System (GISRS), in collaboration with animal health partners (FAO, WOAH, OFFLU (Joint WOAH-FAO network of expertise on animal influenza), continue to evaluate candidate vaccine viruses for pandemic preparedness purposes both biannually and on an ad hoc basis. 

    -- Regular genetic and antigenic characterization of contemporary zoonotic influenza viruses are published here with the most recent update on A(H5) CVVs published in February 2026 following the WHO Consultation on the Composition of Influenza Virus Vaccines for Use in the 2026-2027 Northern Hemisphere Influenza Season.  

 

Assessment of current public health risk posed by influenza A(H5N1) viruses{34} 

    -- Despite continued detections of A(H5) viruses in animals and ongoing human exposure at the human-animal-environment interface, relatively few human infections have been reported to date. 

    -- Since the beginning of 2021, the vast majority of reported human A(H5) infections have been associated with direct or indirect exposure to infected animals such as milking cows on an infected dairy farm or participating in mass culling and disposal events at poultry farms, or contaminated environments, such as live poultry markets, or beaches with sick and dying wild birds and marine mammals.{35,36} 

    -- Illness severity has ranged from mild to fatal. 

    -- To date, no human-to-human transmission has been identified through epidemiologic, virologic and serologic investigations, although investigations for some of cases are ongoing. 

    -- Current evidence indicates that these viruses remain avian-adapted, without established mammalian adaptive mutations or the capacity for sustained human-to-human transmission.  

    -- Based on currently available information, FAO/WHO/WOAH assess the global public health risk posed by currently circulating influenza A(H5) viruses as low and unchanged from the previous risk assessment, while the risk of infection for occupationally or frequently exposed persons remains low to moderate depending on local epidemiological conditions and mitigation measures in place. 

    -- However, as influenza viruses are constantly evolving and spreading in animal populations, zoonotic influenza risk assessments require continuous review and may change rapidly. 

    -- WHO, together with FAO and WOAH, continues to evaluate A(H5) viruses closely and will re-assess the risk associated with the currently circulating A(H5) viruses as more information becomes available. 

    -- Further antigenic characterization of A(H5) viruses, including in relation to the existing CVVs, and development of specific reagents are being prioritized at the WHO Collaborating Centres and Essential Regulatory Laboratories of GISRS in collaboration with public health, animal health, and veterinary sector colleagues. 

Recommended actions  

    -- It is recommended that Member States and national authorities: 

        • increase surveillance and vigilance, and assess the risk in human populations, especially amongst occupationally exposed persons, for the possibility of zoonotic infections, particularly through National Influenza Centres (NICs) and other influenza laboratories associated with GISRS, using such methods as active case finding and molecular and serologic methods; 

        • reduce the risk among occupationally exposed persons by reducing environmental exposures and providing adequate and appropriate personal protective equipment; and 

        • conduct epidemiological investigations including case finding around suspected and confirmed human cases to determine if there are additional cases or indications of humanto-human transmission.  

    -- Under the International Health Regulations (IHR) (2005),{37} States Parties are required to notify WHO within 24 hours of any laboratory-confirmed case of human influenza caused by a new subtype according to the WHO case definition.{38} 

    -- WHO has published the case definition for human infections with avian influenza A(H5) virus requiring notification under IHR (2005).{39}  

    -- Avian influenza is a WOAH-listed disease. Based on Chapter 10.440 of the Terrestrial Animal Health Code, three categories of avian influenza should be notified to WOAH by national Veterinary Authorities through WAHIS. It includes infection with HPAI in poultryii, infection of birds other than poultry including wild birds, and infection of domestic and captive wild birds with low pathogenicity avian influenza (LPAI) viruses having proven natural transmission to humans associated with severe consequences. 

    -- Member States and national authorities are also recommended to: 

        • conduct joint epidemiological investigations in and around suspected and confirmed outbreak areas in animals to determine the extent of spillover; 

        • increase surveillance, including joint/collaborative genomic surveillance, and sharing surveillance data applying One Health principles;  

        • timely reporting efforts for the early detection of A(H5) influenza viruses in domestic birds, wild birds and wild mammals{41}; 

        • include infection with an A(H5) influenza virus as a differential diagnosis, in non-avian species, including cattle, swine and other livestock and farmed domestic and wild animal populations, with high likelihood of exposure to A(H5) viruses; 

        • implement preventive and early response measures to break the chain of infection among domestic animals (for example, poultry and dairy cattle), including considering the use of vaccination to reduce circulation in poultry as per national policies and according to guidance provided by animal health organizations{42,43}; 

        • promptly report high pathogenicity avian influenza (HPAI) events in all animal species, including cattle (according to the WOAH case definition{44}) and other domestic and wild mammals, to WOAH and other international organizations such as FAO;  

        • conduct genetic sequencing and share genetic sequences of influenza viruses and associated metadata in publicly available databases in a timely manner; 

        • protect animals by mitigating the risk of introduction and spread of the disease through implementation and/or strengthening biosecurity in livestock holdings/premises and along the value chain; 

        • protect persons by employing good production and hygiene practices when handling animals and animal products; and 

        • protect persons in contact with suspected/infected animals by providing appropriate personal protective equipment and communicating and educating on the importance and proper use of personal protective equipment and providing information and access to testing. 

    -- Additional sets of recommendations related to avian influenza viruses with zoonotic potential can be found here: 

        • FAO and WOAH Global strategy for the prevention and control of high pathogenicity avian influenza (2024–2033) 

        • Recommendations from the FAO Global Dialogue - Tackling high pathogenicity avian influenza together. Foz do Iguaçu, Brazil – 11 September 2025 

        • FAO recommendations for Global Avian Influenza Viruses with Zoonotic Potential 

        • FAO Recommendations for the surveillance of influenza A(H5N1) in cattle. With broader application to other farmed mammals 

        • WOAH Surveillance of High Pathogenicity Avian Influenza for Smallholder Poultry Systems in Resource-Limited Settings 

        • WHO Practical interim guidance to reduce the risk of infection in people exposed to avian influenza viruses 

        • WHO Surveillance for human infections with avian influenza A(H5) viruses: objectives, case definitions, testing and reporting 

        • WHO Considerations for the use of human A(H5) influenza vaccines during non-pandemic period 

        • WHO guidance on the use of licensed human influenza A(H5) vaccines for the interpandemic and emergence periods 

    -- Additional studies/surveillance, applying One Health principles are warranted, which could provide information to enhance confidence in the risk assessment. 

    -- These may include serological studies in high-risk animal populations, in high-risk human populations, and epidemiological investigations.  

    -- Anyone who may have been exposed to infected or potentially infected animals or contaminated environments should be advised to promptly seek health care if they feel unwell, and to inform their health care provider of their possible exposure. 

    -- Following prompt testing, early and appropriate clinical management should be initiated, and precautionary measures put in place to assess and prevent potential further spread among humans and animals.

    -- Clinicians should also be alerted to potential zoonotic infection in patients with an exposure history to birds or animals especially in areas where A(H5) viruses are known or suspected to be circulating in animals but also in areas where surveillance in animals may be limited.  

    -- Routine epidemiologic and virologic surveillance for influenza should be conducted ideally yearround using a standard case definition in health care facilities according to WHO guidance.{45}  

    -- Timely sharing of information and sequence data from both the human and animal health sectors from all regions should continue to be strongly recommended and is critical for rapid and robust joint risk assessment. 

    -- The rapid sharing of virus materials with WHO Collaborating Centres of GISRS continues to be essential to conduct a thorough risk assessment and develop or adjust targeted response measures. 

    -- The Tool for Influenza Pandemic Risk Assessment (TIPRA) provides an in-depth assessment of risk associated with some zoonotic influenza viruses – notably the likelihood of the virus gaining human-to-human transmissibility, and the impact should the virus gain such transmissibility. 

    -- TIPRA maps relative risk amongst viruses assessed using multiple elements.{46} 

    -- Data pertaining to the risk elements within TIPRA should be generated and shared with WHO.  

    -- Efforts to reduce human exposure to birds, livestock, and other mammals infected with or potentially infected with avian and other animal influenza viruses should be implemented and enhanced to minimize the risk of zoonotic infections. 

    -- Individuals with activities that involve exposure to infected animals and/or contaminated environments are at higher risk and should take necessary precautions to prevent infection. 

    -- Those who are exposed to potentially infected animals should have access to, be trained in their use under different environmental conditions, and wear personal protective equipment including eye protection.{47} 

    -- If they develop respiratory symptoms or conjunctivitis, they should be rapidly tested, and precautionary infection control measures should be put in place to prevent potential further spread among humans and to animals. 

    -- For detailed guidance on treatment, refer to relevant global and national guidance.{48} 

    -- Some manufacturers have initiated production of an A(H5) human vaccine that matches current circulating strains. 

    -- Updated WHO guidance on the use of licensed human influenza A(H5) vaccines for the interpandemic and emergence periods were published in December 2025.{49} 

    -- FAO, WHO and WOAH advise consuming pasteurized milk, instead of raw/unpasteurized milk. Due to the potential health risks from many dangerous zoonotic pathogens, raw/unpasteurized milk consumption should be avoided.{50} 

    -- If pasteurized milk is not available, heating raw milk until it boils makes it safer for consumption.{51}  

___

{i} An event includes all related epidemiologically related outbreaks reported from the time of the immediate notification through to the final report. Separately the total number of outbreaks is also stated. 

{ii} All birds reared or kept in captivity for the production of any commercial animal products or for breeding for this purpose, fighting cocks used for any purpose, and all birds used for restocking supplies of game or for breeding for this purpose, until they are released from captivity. Birds that are kept in a single household, the products of which are used within the same household exclusively, are not considered poultry, provided that they have no direct or indirect contact with poultry or poultry facilities. Birds that are kept in captivity for other reasons, including those that are kept for shows, racing, exhibitions, zoological collections and competitions, and for breeding or selling for these purposes, as well as pet birds, are not considered poultry, provided that they have no direct or indirect contact with poultry or poultry facilities. 

References 

{1} WHO. Genetic and antigenic characteristics of zoonotic influenza A viruses and development of candidate vaccine viruses for pandemic preparedness. February 2026 (https://cdn.who.int/media/docs/default-source/vcm-northern-hemisphere-recommendation-20262027/c.-27-feb-2026_zoonotic_vaccinvirus-update.pdf?sfvrsn=8532151e_5). 

{2} European Food Safety Authority (EFSA), European Union Reference Laboratory (EURL) for Avian Influenza, Ducatez M, Fusaro A, Gonzales J L, Kuiken T, et al. Unprecedented high level of highly pathogenic avian influenza in wild birds in Europe during the 2025 autumn migration. EFSA Journal 2025;23(11):9811, 9 pp (https://doi.org/10.2903/j.efsa.2025.9811). 

{3} EURL. Avian flu data portal. 2026 (eurlaidata.izsvenezie.it/epidemio.php). 

{4} EFSA, European Centre for Disease Prevention and Control (ECDC), EURL for Avian Influenza; Buczkowski H, Ducatez M, Fusaro A, et al. Avian influenza overview September-November 2025. EFSA J. 2025 Dec 18;23(12):e9834 (efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2025.9834).  

{5} United States Department of Agriculture (USDA). 2026. Highly Pathogenic Avian Influenza (HPAI) Detections in Wild Birds (www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/wild-birds?page=1). 

{6} Canada Food Inspection Agency (CFIA). 2026. National Avian Influenza dashboard (cfiancr.maps.arcgis.com/apps/dashboards/89c779e98cdf492c899df23e1c38fdbc). 

{7} GISAID: EPI_ISL_20420880, EPI_ISL_20420879, EPI_ISL_20420878. 

{8} FAO. FAO alert on avian influenza – risk of upsurge and regional spread through wild birds in Latin America and the Caribbean, 8 April 2026 (https://openknowledge.fao.org/server/api/core/bitstreams/02a3ab2c-0f8d-427f-a71a-3f378a6474bd/content). 

{9} GISAID: EPI_ISL_19752381 and EPI_ISL_19823059–68. 

{10} Vanstreels R, Nelson MI, Artuso MC, Marchione VD, Piccini LE, Benedetti E, et al. Novel Highly Pathogenic Avian Influenza A(H5N1) Virus, Argentina, 2025. Emerg Infect Dis. 2025;31(12):2279-2283 (https://doi.org/10.3201/eid3112.250783).  

{11} Benedetti, E, Artuso, MC, Byrne, AMP, Garibotto, MDB, Avaro, M, Piccini, LE et al.  Emergence and Evolution of Triple Reassortant Highly Pathogenic Avian Influenza A(H5N1) Virus, Argentina, 2025. Preprint (https://doi.org/10.20944/preprints202512.0962.v1). 

{12} Rivetti AV Jr, Reischak D, Carnegie L, Otaka JNP, Domingues CS, Cardoso FG et al. Genomic diversity and reassortment of highly pathogenic avian influenza A/H5N1 virus (clade 2.3.4.4b) in Brazil: Evidence of multiple introductions and intra-epidemic reassortment in 2025. Virology. 2026 Feb;615:110751 (https://doi.org/10.1016/j.virol.2025.110751). 

{13} Steinfurth A, Lynton-Jenkins JG, Cleeland J, Mollett BC, Coombes HA, Moores A et al. Investigating high pathogenicity avian influenza virus incursions to remote islands: detection of H5N1 on Gough Island in the South Atlantic Ocean. Emerg Microbes Infect. 2026 Dec;15(1):2627076 (https://doi.org/10.1080/22221751.2026.2627076). 

{14} WOAH. World Animal Health Information System (WAHIS). Heard and McDonald Islands - Influenza A viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification [FINAL] ( https://wahis.woah.org/#/inreview/7261?fromPage=event-dashboard-url). 

{15} WOAH. Sharing other important animal health information with WOAH (https://www.woah.org/en/what-we-do/animal-health-andwelfare/disease-data-collection/sharing-other-important-animal-health-information-with-woah/). 

{16} OFFLU. Beyond poultry: Rethinking monitoring and control of HPAI H5Nx anticipating spillover risks for mammals. 2026 (https://offlu.org/publications/beyond-poultry-rethinking-monitoring-and-control-of-hpai-h5nx-anticipating-spilloverrisks-for-mammals/). 

{17} Puryear W, Sawatzki K, Hill N, Foss A, Stone JJ, Doughty L, et al. Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in New England Seals, United States. Emerg Infect Dis. 2023;29(4):786-791 (https://doi.org/10.3201/eid2904.221538). 

{18} Uhart MM, Vanstreels RET, Nelson MI, Olivera V, Campagna J, Zavattieri V et al. Epidemiological data of an influenza A/H5N1 outbreak in elephant seals in Argentina indicates mammal-to-mammal transmission. Nat Commun 15, 9516 (2024) (https://doi.org/10.1038/s41467024-53766-5). 

{19} OFFLU. Beyond poultry: Rethinking monitoring and control of HPAI H5Nx anticipating spillover risks for mammals. 2026 (https://offlu.org/publications/beyond-poultry-rethinking-monitoring-and-control-of-hpai-h5nx-anticipating-spilloverrisks-for-mammals/). 

{20} USDA. Highly Pathogenic Avian Influenza (HPAI) Detections in Livestock. 2026 (www.aphis.usda.gov/livestock-poultrydisease/avian/avian-influenza/hpai-detections/livestock). 

{21} USDA. Update: Genetic sequencing results for Wisconsin dairy herd detection of highly pathogenic avian influenza. 19 December 2025 (www.aphis.usda.gov/news/agency-announcements/update-genetic-sequencing-results-wisconsin-dairy-herd-detection-highly). 

{22} Rijksoverheid (Government of the Netherlands). Antibodies Against the Avian Influenza Virus Found in Dairy Cow. News, 23 January 2026 (www.rijksoverheid.nl/actueel/nieuws/2026/01/23/antistoffen-vogelgriepvirus-gevonden-bij-melkkoe). 

{23} GISAID. 

{24} US CDC. CDC A(H5N1) Bird Flu Response Update November 18, 2024 (www.cdc.gov/bird-flu/spotlights/h5n1-response-11152024.html). 

{25} US CDC. CDC Reports A(H5N1) Ferret Study Results. 7 June 2024 (www.cdc.gov/bird-flu/spotlights/ferret-study-results.html). 

{26} Pulit-Penaloza JA, Brock N, Belser JA, Sun X, Pappas C, Kieran TJ et al. Highly pathogenic avian influenza A(H5N1) virus of clade 2.3.4.4b isolated from a human case in Chile causes fatal disease and transmits between co-housed ferrets. Emerg Microbes Infect. 2024 Mar 17:2332667 (https://doi.org/10.1080/22221751.2024.2332667). 

{27} Eisfeld AJ, Biswas A, Guan L, Gu C, Maemura T, Trifkovic S et al. Pathogenicity and transmissibility of bovine H5N1 influenza virus. Nature (2024) (https://doi.org/10.1038/s41586-024-07766-6). 

{28} Restori KH, Septer KM, Field CJ, Patel DR, VanInsberghe D, Raghunathan V et al. Risk assessment of a highly pathogenic H5N1 influenza virus from mink. Nat Commun 15, 4112 (2024) (https://doi.org/10.1038/s41467-024-48475-y). 

{29} Pulit-Penaloza JA, Belser JA, Brock N, Kieran TJ, Sun X, Pappas C et al. Transmission of a human isolate of clade 2.3.4.4b A(H5N1) virus in ferrets. Nature. Published online October 28, 2024. (https://doi.org/10.1038/s41586-024-08246-7). 

{30} Gu C, Maemura T, Guan L, Eisfeld AJ, Biswas A, Kiso M et al. A human isolate of bovine H5N1 is transmissible and lethal in animal models. Nature (2024). (https://doi.org/10.1038/s41586-024-08254-7). 

{31} Brock N, Pulit-Penaloza JA, Belser JA, Pappas C, Sun X, Kieran TJ, et al. Avian Influenza A(H5N1) Isolated from Dairy Farm Worker, Michigan, USA. Emerg Infect Dis. 2025;31(6):1253-1256 (https://doi.org/10.3201/eid3106.250386). 

{32} US CDC. Influenza Risk Assessment Tool (IRAT) - Virus Report. Highly pathogenic avian influenza A(H5N1) virus; clade 2.3.4.4b Viruses: A/California/147/2024 and A/Washington/239/2024. Date of Evaluation: March 14, 2025 (www.cdc.gov/pandemicflu/media/pdfs/2025/IRATA-California-Washington.pdf). 

{33} Daulagala P, Cheng S, Chin A, Luk L, Leung K, Wu JT, et al. Avian Influenza A(H5N1) Neuraminidase Inhibition Antibodies in Healthy Adults after Exposure to Influenza A(H1N1)pdm09. Emerg Infect Dis. 2024;30(1):168-171 (https://doi.org/10.3201/eid3001.230756). 

{34} WHO. (2012). Rapid risk assessment of acute public health events (iris.who.int/handle/10665/70810). 

{35} Garg S, Reinhart K, Couture A, Kniss K, Davis CT, Kirby MK et al. Highly Pathogenic Avian Influenza A(H5N1) Virus Infections in Humans. N Engl J Med. 2025 Feb 27;392(9):843-854 (https://doi.org/10.1056/nejmoa2414610). 

{36} Pardo-Roa, C., Nelson, M.I., Ariyama, N. et al. Cross-species and mammal-to-mammal transmission of clade 2.3.4.4b highly pathogenic avian influenza A/H5N1 with PB2 adaptations. Nat Commun 16, 2232 (2025) (https://doi.org/10.1038/s41467-025-57338-z). 

{37} WHO. International Health Regulations (2005), as amended through resolutions WHA67.13 (2014), WHA75.12 (2022), and WHA77.17 (2024) (https://apps.who.int/gb/bd/pdf_files/IHR_2014-2022-2024-en.pdf). 

{38} WHO. Case definitions for the four diseases requiring notification to WHO in all circumstances under the IHR (2005). 2009 (www.who.int/publications/m/item/case-definitions-for-the-four-diseases-requiring-notification-to-who-in-all-circumstances-under-theihr-(2005)). 

{39} WHO. WHO case definition for human infections with avian influenza A(H5) virus requiring notification under IHR (2005). 2024 (www.who.int/teams/global-influenza-programme/avian-influenza/case-definitions). 

{40} WOAH. Terrestrial Animal Health Code Chapter 10.4 Infection with high pathogenicity avian influenza viruses (https://www.woah.org/en/what-we-do/standards/codes-and-manuals/, cited on 05/05/2026). 

{41} El Masry I, Delgado AH, Silva GOD, Dhingra M, Lyons NA. 2024. Recommendations for the surveillance of influenza A(H5N1) in cattle – With broader application to other farmed mammals. FAO Animal Production and Health Guidelines, No. 37. Rome, FAO (https://doi.org/10.4060/cd3422en). 

{42} OFFLU. OFFLU Avian Influenza Vaccine Matching (AIM) for poultry vaccines: H5Nx executive summary, September 2025 (https://offlu.org/publications/offlu-aim-technical-report-september-2025/). 

{43} WOAH. Avian influenza vaccination: why it should not be a barrier to safe trade, December 2023 (www.woah.org/app/uploads/2023/12/en-woah-policybrief-avianinfluenzavaccinationandtrade.pdf). 

{44} WOAH. Case definition for infection of bovines with influenza a viruses of high pathogenicity in poultry (high pathogenicity avian influenza in cattle), 29 October 2025 (https://www.woah.org/app/uploads/2025/03/2025-10-case-definiton-hpai-cattle-2.pdf). 

{45} WHO. Implementing the integrated sentinel surveillance of influenza and other respiratory viruses of epidemic and pandemic potential by the Global Influenza Surveillance and Response System: standards and operational guidance. 2024 (https://iris.who.int/handle/10665/379678). 

{46} WHO. Tool for influenza pandemic risk assessment. 2026 (www.who.int/teams/global-influenza-programme/avian-influenza/tool-forinfluenza-pandemic-risk-assessment-(tipra)). 

{47} Animal and Plant Health Inspection Service (APHIS), USDA. APHIS Recommendations for Highly Pathogenic Avian Influenza (HPAI) H5N1 Virus in Livestock For Workers, 12 April 2024 (www.aphis.usda.gov/sites/default/files/recommendations-workers-hpai-livestock.pdf). 

{48} WHO. Guidelines for the clinical management of severe illness from influenza virus infections. 2022 (https://apps.who.int/iris/handle/10665/352453). 

{49} WHO. WHO guidance on the use of licensed human influenza A(H5) vaccines for the interpandemic and emergence periods. Weekly Epidemiological Record, 100(51), 643 - 660 (https://iris.who.int/handle/10665/384548). 

{50} FAO. Preliminary rapid risk assessment of foodborne avian influenza A (H5N1) virus. 14 June 2024 (https://openknowledge.fao.org/server/api/core/bitstreams/ca83524e-b3f9-4abe-b52b-dea213227fcf/content). 

{51} Joint FAO/WHO Codex Alimentarius Commission. Codex Alimentarius: Code of hygienic practice for milk and milk products (http://www.fao.org/fileadmin/user_upload/livestockgov/documents/CXP_057e.pdf). 

DISCLAIMER 

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO) or of the World Organisation for Animal Health (WOAH) concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. All reasonable precautions have been taken by WHO, FAO and WOAH to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO, FAO and WOAH be liable for damages arising from its use. 

© FAO, WHO, WOAH, 2026 

Source: 

Link: https://www.who.int/publications/m/item/updated-joint-fao-who-woah-public-health-assessment-of-recent-high-pathogenicity-avian-influenza-a(h5)-virus-events-in-animals-and-people

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A mouse #model of #human-derived #H10N3 #influenza enables preclinical evaluation of #antiviral efficacy

 

Highlights

• Revealing one human-derived H10N3 virus was highly lethal to C57BL/6J, ICR, and BALB/c mice;

• Successfully establishing the first human-derived H10N3-infected mice model.

• In vitro antiviral assay revealed that this human-origin H10N3 virus exhibits natural resistance to oseltamivir, but remains sensitive to peramivir and baloxavir.

• Oseltamivir or BM immediate treatment after infection effectively prevented mortality caused by H10N3,but their efficacy with a 24h delay were significantly weaker than that of peramivir.

• BM one-dose treatment with a 24h delay has no protective effect, but BM combination with NAIs exhibits significant additive effect on mortality caused by H10N3.

• BM and NAIs combination may be a promising therapy for combating novel H10N3 virus infection.

Abstract

    Human infections with avian influenza A (H10N3) have recently been reported, representing a notable global public health concern. To seek effective strategies for emerging H10N3 virus infection and provide tools for vaccine and antiviral drugs development, we established a mouse model with a novel human-derived H10N3 virus. Our findings revealed that this human-derived H10N3 virus was highly lethal to C57BL/6J, ICR, and BALB/c mice. Neuraminidase inhibitors (oseltamivir or peramivir) effectively conferred protection for H10N3 low-lethal infection, but the efficacy of peramivir is superior to that of oseltamivir. One single dose of baloxavir marboxil (BM) treatment at 2 h post-infection provides complete protection against mortality, but BM treatment with a 24h delay has no protective effect against mortality caused by H10N3 virus infection. Furthermore, BM multiple doses treatment with a 24h delay for H10N3 infection remains effective in preventing weight loss and enhancing viral clearance, but its protective efficacy against mortality was significantly attenuated. However, both in vitro and in vivo combination of BM with NAIs exhibit significant additive effect against H10N3 virus infection than BM or NAIs monotherapy. Our findings suggest that combination of BM with NAIs represents a promising therapeutic strategy for emerging H10N3 infections in clinical practice.

Source: 

Link: https://www.sciencedirect.com/science/article/abs/pii/S0166354226000951?via%3Dihub

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#USA, #Hawaii DoH Monitoring #Ebola, #Hantavirus Outbreaks (May 20 '26)

 

    HONOLULU — The Hawaiʻi Department of Health (DOH) is actively monitoring an outbreak of Bundigbugyo virus, a strain of Ebola virus, that is occurring in the Democratic Republic of the Congo and Uganda.

    On May 16, the World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus declared a public health emergency of international concern due to the outbreak. 

    This declaration enables the WHO and international public health partners to surge specialized outbreak response resources to the affected countries. 

    The risk of the outbreak to Hawaiʻi is currently very low. 

    However, this is a good reminder to use common sense when traveling internationally to stay healthy. 

    “The recent hantavirus and Ebola outbreaks are reminders of the need to continue to invest in public health and to remain engaged globally,” said Governor Josh Green. “Infectious pathogens don’t recognize borders. The risk to Hawai’i from these outbreaks is very low, but we continue to be vigilant.” 

What is Bundigbugyo virus? 

    Bundigbugyo virus (BDBV) is a strain of the Ebola virus group first identified during an outbreak in the Bundigbugyo District of Uganda in 2007. 

    Like other Ebola viruses, BDBV causes a severe illness called Bundigbugyo Virus Disease (BVD). 

    BVD symptoms include fever, vomiting, diarrhea, multi-organ damage and in some cases, hemorrhage or bleeding. 

    The WHO reports BVD is fatal in 30 to 50% of cases. 

    Unlike the Ebola Zaire virus strain, there is currently no licensed vaccine or therapeutic medication for BDBV infection. 

    BDBV is believed to occur naturally in fruit bats that live in Central Africa, with occasional spillover to the human population. 

    BDBV can spread from person to person through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals or contaminated surfaces. 

Why is the risk for Hawaiʻi considered very low? 

    Human infections of Ebola viruses have rarely occurred outside endemic locations in Africa. 

    Hawaiʻi does not have BDBV naturally occurring in bats or animals. 

    There are also no direct air travel connections between the outbreak area and Hawaiʻi. 

    National and international public health authorities are placing additional traveler screening measures in place in outbreak-affected areas to reduce the likelihood of traveler spread. 

    BDBV transmission between people requires direct contact with body fluids and does not spread through the air by cough like measles or flu. Outbreaks typically occur in locations with low infection controls standards and resources. 

What do I need to know if the risk is very low? 

    First, know that even though the WHO has declared a public health event of international concern, this is not a pandemic and nothing needs to change in our everyday lives due to this outbreak overseas.  

    Second, this outbreak also reminds us of the importance of being an informed and proactive international traveler to stay healthy. 

    The DOH recommends Hawaiʻi residents routinely consult with their healthcare provider well in advance of planned international travel to assess potential health risks and discuss the most appropriate disease prevention measures. 

    The DOH encourages all international travelers to review the Centers for Disease Control and Prevention (CDC) Travelers’ Health website and review any travel health notices for their destination(s). 

    Travel to international locations with an ongoing outbreak of a severe disease may require additional monitoring and activity restrictions upon return home, as recommended by the CDC and the DOH. 

What is Hawaiʻi DOH doing to monitor the situation? 

    The DOH Disease Outbreak Control Division (DOCD) and Office of Public Health Preparedness (OPHP) work every day to monitor new and emerging public health risks around the globe to protect our community’s health here at home. 

    The DOH is regularly connected with the CDC and the WHO Global Outbreak Alert and Response Network for situation updates. BDBV outbreaks can go on for months. The DOH will notify the public if anything changes in the future for our risk assessment here at home.

What about the hantavirus outbreak on a cruise ship?

    The DOH also continues to closely monitor an outbreak of Andes virus, a strain of hantavirus, among passengers and crew of the cruise ship MV Hondius. 

    The CDC has confirmed that no Hawaiʻi residents were on the cruise ship. The DOH remains in regular contact with the CDC investigation team, continues to closely monitor developments, and will provide an update should the situation change.

    Andes virus, a type of hantavirus endemic in South America, is the only hantavirus known to spread from person to person, typically through close or prolonged contact in confined settings. 

    Several other New World hantaviruses are endemic to the United States and are not transmissible from person to person. 

    Cases of infections caused by these other hantaviruses, although relatively rare, are seasonal and typically increase in the continental U.S. during the spring and summer as people come into contact with infected rodents.

(...)

Source: 

Link: https://health.hawaii.gov/news/newsroom/doh-monitoring-ebola-hantavirus-outbreaks/

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Avian #Influenza #Report, May 10 - 16 '26 (Wk 20) (HK CHP, May 19, 2026): One new #human case with #H9N2 virus

 

{Excerpt}

-- Avian influenza A(H9N2): 

    ° Sichuan Province: 

        - 1) A three-year-old girl with onset on April 25, 2026. 

(...)

Source: 

Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk20.pdf

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#DRC #Ebola #outbreak: hundreds of suspected cases, no vaccine (UN News Centre, May 19 '26)

 

By Dominika Tomaszewska-Mortimer, Geneva | 19 May 2026 Health

    A fast-spreading Ebola outbreak in the Democratic Republic of the Congo (DRC) has health workers rushing to stop transmission while the roll out of any potential vaccine is months away, the UN World Health Organization (WHO) said on Tuesday. 

    WHO’s representative in DRC, Dr Anne Ancia, told reporters in Geneva that there are more than 500 suspected cases including 130 suspected deaths, but that only 30 cases have been confirmed in the country so far.

    The agency is working closely with the authorities and rushing more testing kits to eastern DRC to identify cases of infection of Bundibugyo virus, a species of Ebola virus for which there are no vaccines or therapeutics.

    “We have significant uncertainty about the number of infections and how far the virus has spread,” Dr Ancia said.

    Speaking from Bunia in Ituri province, where cases were initially detected, Dr Ancia said that the outbreak has also reached North Kivu, with confirmed cases in Butembo and Goma. Uganda has also confirmed two imported cases.

    WHO chief Tedros Adhanom Ghebreyesus declared the outbreak a public health emergency of international concern on Sunday morning. He has expressed concern about the “scale and speed of the epidemic”.

    Uncertainty still surrounds how and where outbreak started. 

    “I don't think that we have the ‘patient zero’ for now,” said Dr Ancia. “What we know for now is that on 5 May, there was…a person who died in Bunia. The body was brought back [to] Mongbwalu…and put in a coffin. And then the family decided that the coffin was not worth the person. And therefore…they changed the coffin. And then there was the funeral, and it's from where it started.”

    Detection of the initial cases was slowed down by the fact that local tests in Bunia showed negative results for the Zaire strain of Ebola. The wide range of symptoms - fever, fatigue, diarrhoea and vomiting - also complicated the task of making a swift diagnosis, with the additional difficulty that the nosebleeds that are also associated with the disease did not begin until day five of infection, the WHO official explained.

Kinshasa breakthrough

    In the end, it was only through tests in Kinshasa that the presence of Bundibugyo virus was finally revealed. 

    Dr Ancia said that there is a focus on the international level on potential candidate vaccines or treatments which could help fight the outbreak. A WHO technical advisory group was scheduled to meet on Tuesday afternoon “to provide further recommendation to the WHO and its Member States on which potential vaccine should be prioritized”, she explained.

    Ervebo, a vaccine against the Zaire Ebola virus, is under consideration, the WHO representative said, but “it would take two months for it to be available”.

    While a vaccine could bring additional prevention and protection to the affected populations, the key to containing transmission lies in grassroots work within the communities to raise awareness, fight misinformation and ensure adherence to sanitary measures, especially around funerals.

    “If we use coercive measures and the population does not agree, we will see bodies disappear. We will see suspected cases refusing to come to the hospitals and health facilities,” Dr Ancia warned, underscoring health workers’ continuing engagement with schools, churches and community leaders. 

    WHO is supporting the Government-led response with more than 40 health professionals on the ground and through the deployment of supplies and extra diagnostic capacity, in what remains a “highly complex epidemiological, operational and humanitarian context”, characterized by insecurity and displacement, the WHO representative said.

IDP vulnerability

    The UN Refugee Agency (UNHCR) said on Tuesday that the affected provinces of Ituri and North Kivu are home to more than two million internally displaced people and returnees, while healthcare capacity remains weakened by conflict. 

    There is also concern for refugees living in the affected areas. In Ituri some 11,000 South Sudanese refugees require preventive assistance while in North Kivu’s capital, the rebel-held city of Goma, more than 2,000 Rwandan and Burundian refugees need sanitary supplies.

    The most recent outbreak of the Ebola Zaire virus in DRC ended in December 2025, and the trauma of a major epidemic in North Kivu and Ituri in 2018-19 persists among the population.

    Dr Ancia stressed that while it may be two months until a vaccine is available, “it is not two months before the outbreak will be done”. 

    “Remember the previous one, it took two years,” she warned.

Link: https://news.un.org/en/story/2026/05/1167542

____