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Event description
° Transmission of Bundibugyo virus disease (BVD) remained intense in the Democratic Republic of the Congo during the reporting week, with continued detection of new confirmed cases and deaths across multiple affected areas, alongside further expansion of the outbreak's geographic footprint.
° The epidemiological situation outside the Democratic Republic of the Congo remained stable, with no new cases or evidence of secondary transmission reported in Uganda or France.
° However, the persistence and geographic expansion of transmission within the Democratic Republic of the Congo continue to increase the risk of cross-border spread, highlighting the need for sustained regional surveillance, preparedness, and response efforts.
Democratic Republic of the Congo
° Since the last update of 12 July 2026 (Situation Report #9), the epidemiological situation in the Democratic Republic of the Congo has continued to deteriorate, with sustained transmission and ongoing geographic expansion.
° An additional 460 confirmed cases and 248 confirmed deaths have been reported, representing increases of 23.4% and 34.5% in cumulative confirmed cases and confirmed deaths, respectively.
° The crude case fatality ratio (CFR) among confirmed cases increased from 36.6% to 39.9%, likely reflecting delayed case detection, late presentation for care, and the persistently high proportion of deaths occurring outside designated treatment facilities, rather than increased disease severity.
° During the reporting period, the outbreak expanded to five additional health zones across Haut-Uélé and Ituri provinces, increasing the total number of affected health zones from 42 to 47.
° The newly affected health zones were Pawa, Boma Mangbetu, and Isiro in Haut-Uélé Province, and Mahagi and Adja in Ituri Province.
Figure 1. Weekly trend of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo by epidemiological week of report, epidemiological weeks 18 – 29, 2026
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° Despite this continued geographic expansion, recent transmission remains concentrated in a subset of affected areas.
° Of the 47 affected health zones, 40 have reported at least one confirmed case during the past 21 days.
° During this period, 1,090 confirmed cases and 568 confirmed deaths were reported.
° Ituri Province continues to bear the overwhelming burden of the outbreak, accounting for 946 cases (86.8%) and 476 deaths (83.8%), while the remaining four affected provinces together accounted for 144 cases (13.2%) and 92 deaths (16.2%).
° In contrast, seven affected health zones have now gone more than 21 consecutive days without reporting a confirmed case, suggesting an absence of recent transmission, provided that surveillance remains sufficiently sensitive to detect ongoing transmission.
° These health zones include Miti-Murhesa (60 days) in South Kivu Province; Aungba (30 days) and Gety (59 days) in Ituri Province; and Goma (55 days), Kalunguta (56 days), Mabalako (36 days), and Vuhovi (38 days) in North Kivu Province.
° Recent transmission remained highly concentrated in a limited number of health zones.
° The largest increases over the 21-day period were recorded in Bunia (281 cases), Nizi (173), Rwampara (155), Mongbwalu (105), Katwa (59), Lita (49), Nia-Nia (40), Mangala (37), and Bambu and Butembo (24 each). Together, these ten health zones accounted for approximately 86.9% of all additional confirmed cases reported during the period.
° Bunia, Rwampara, Mongbwalu, and Nizi remained the principal transmission corridor.
° The rapid increase in cases in Nizi, a health zone hosting several internally displaced persons (IDP) camps, together with the emergence of cases in Adja Health Zone, indicates continued westward and northward expansion of transmission within Ituri Province.
° Mortality was similarly concentrated. The largest increases in confirmed deaths over the same 21-day period were reported in Bunia (129 deaths), Nizi (84), Mongbwalu (80), Rwampara (73), Katwa (45), Mangala (26), Lita (18), Butembo (16), Nyankunde (13), and Beni (11).
° Collectively, these ten health zones accounted for approximately 87.0% of all additional confirmed deaths reported during the period.
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° Overall, the distribution of confirmed deaths remained heavily skewed towards deaths occurring outside designated treatment centres, highlighting persistent delays in case detection, referral, and access to treatment.
° Between 24 June and 19 July 2026, 673 confirmed deaths were reported, of which 400 (59.4%) occurred outside designated treatment centres and 273 (40.6%) occurred within designated treatment centres.
° During the most recent reporting week (13 – 19 July 2026), mortality remained high, with community deaths (defined as deaths occurring outside designated treatment centres) accounting for 65.4% of all reported deaths, compared with 34.6% occurring within designated treatment centres.
° This persistent predominance of community deaths suggests that delays in case detection, referral, and timely access to treatment continue to contribute substantially to mortality and underscore the need to strengthen community surveillance, rapid referral, and early access to care.
° Since the beginning of the outbreak, the Democratic Republic of the Congo has reported 2,423 confirmed cases, including 967 confirmed deaths, corresponding to a crude case fatality ratio (CFR) of 39.9%.
° Ituri Province remains the epicentre, accounting for 2,160 confirmed cases (89.1%) and 811 confirmed deaths (83.9%) reported nationally.
° The most affected health zones continue to be Bunia (639 cases, 211 deaths), Rwampara (450 cases, 133 deaths), Mongbwalu (363 cases, 203 deaths), Nizi (214 cases, 93 deaths), Nyankunde (99 cases, 28 deaths), Lita (78 cases, 27 deaths), and Mangala (61 cases, 38 deaths) in Ituri Province, together with Katwa (104 cases, 72 deaths), Butembo (58 cases, 30 deaths), and Beni (37 cases, 25 deaths) in North Kivu Province.
° Collectively, these ten health zones account for approximately 86.8% of all confirmed cases (2,103 of 2,423) and 88.9% of all confirmed deaths (860 of 967) reported nationally, demonstrating that, despite continued geographic expansion, the burden of the outbreak remains highly concentrated.
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° As of 19 July 2026, a total of 10,519 contacts were under follow-up in the Democratic Republic of the Congo, of whom 8,531 (81.1%) were successfully seen within the previous 24 hours.
° Ituri Province accounted for the majority of contacts under follow-up, with 7,537 contacts, including 6,123 (81.3%) successfully seen during the reporting period.
° In North Kivu Province, 1,801 of 2,149 contacts (83.8%) were successfully followed up, while Haut-Uélé Province, one of the newly affected provinces, reported 607 contacts, of whom only 317 (52.3%) were seen within the previous 24 hours.
° South Kivu Province had no contacts under active follow-up, reflecting the absence of recent transmission requiring contact monitoring, whereas contact follow-up data for Tshopo Province were not reported.
° The overall contact follow-up rate remains below the operational target for effective contact tracing. Although follow-up performance in Ituri Province improved slightly compared with previous weeks, more than 1,400 contacts were not reached during the reporting period. The markedly low follow-up rate in Haut-Uélé Province is of particular concern given the recent geographic expansion of the outbreak. These gaps increase the risk of undetected infections, missed chains of transmission, and sustained community transmission in both established and newly affected areas.
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Uganda
° No new confirmed cases have been reported in Uganda since the previous update.
° The most recent confirmed case, reported on 21 June 2026, was identified in a truck driver travelling along the Democratic Republic of the Congo Uganda international route.
° Since then, no additional imported or locally acquired cases have been detected, and there is no evidence of ongoing transmission.
° As of 19 July 2026, the outbreak remains limited to 21 cases (20 confirmed and one probable), including three deaths (two confirmed and one probable).
° All 18 recovered patients have now been discharged from care, with the last confirmed patient discharged on 16 July 2026.
° Since the beginning of the outbreak, 836 contacts have been identified, all of whom successfully completed the required 21-day follow-up period, during which six secondary cases were detected.
° No contacts are currently under follow-up, reflecting the absence of active transmission chains.
° Following the discharge of the last confirmed patient on 16 July 2026, Uganda entered the 42-day countdown required to declare the end of the outbreak. As of 19 July 2026, the country was on Day 5 of the countdown.
° Nevertheless, Uganda remains at high risk of reintroduction due to the ongoing outbreak in the neighbouring Democratic Republic of the Congo.
° Continued population movement across the shared border underscores the importance of maintaining cross-border coordination, surveillance, rapid case detection, and response readiness until transmission has been interrupted in both countries.
Figure 5. Weekly trends of confirmed cases of Bundibugyo virus disease in Uganda by epidemiological week of report, epidemiological weeks 18 – 29, 2026
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France
° No additional Bundibugyo virus disease (BVD) cases have been reported in France since the previous update.
° No secondary transmission has been identified among the five flight contacts who were placed under precautionary quarantine following exposure to the imported case reported on 24 June 2026.
° All five flight contacts successfully completed the 21-day monitoring period.
Risk Assessment
° The overall public health risk in the Democratic Republic of the Congo remains very high, driven by sustained transmission, increasing mortality, and continued geographic expansion from three to five affected provinces.
° Although transmission remains concentrated in Ituri Province, the emergence of newly affected health zones in HautUélé and Tshopo provinces highlights the continued potential for spread into previously unaffected areas.
° The rising CFR and the high proportion of community deaths continue to indicate delays in case detection, isolation, referral, and access to clinical care.
° Contact tracing performance remains below the operational target, particularly in Ituri Province, where follow-up coverage is substantially lower than in North Kivu despite Ituri accounting for the majority of ongoing transmission.
° Uganda remains at high risk of reintroduction because of the ongoing outbreak in neighbouring Democratic Republic of the Congo, despite reporting no new cases during the reporting period.
° The absence of secondary transmission following the imported case in France demonstrates the effectiveness of rapid public health measures, but also underscores the continued risk of international spread through travel.
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Situation interpretation
° The BVD outbreak in the Democratic Republic of the Congo continues to intensify despite the ongoing scale-up of response operations.
° Although transmission remains highly concentrated in a limited number of health zones in Ituri Province, continued geographic expansion into Haut-Uélé and Tshopo provinces indicates that new transmission foci continue to emerge.
° Persistently high mortality, driven by the large proportion of deaths occurring outside designated treatment centres, together with a rising CFR, indicates that many patients are still being detected and referred too late to benefit from optimal clinical care.
° While surveillance, laboratory, case management, and operational capacities continue to expand, important gaps remain in contact tracing, infection prevention and control, and community engagement, particularly in newly affected areas.
° Strengthening early case detection, improving contact follow-up, expanding timely access to clinical care, reinforcing infection prevention and control measures in healthcare settings, and sustaining community trust and cross-border preparedness will be critical to interrupt transmission and reduce mortality
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