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Event description
The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continues to expand rapidly, with sustained transmission, persistently high mortality, and ongoing geographic spread.
It is now the largest BVD outbreak ever recorded and the second largest Ebola disease outbreak in history after the 2013 – 2016 West Africa epidemic.
Since its detection only a few months ago, the epidemic has grown at an exceptional rate, highlighting its intensity and the challenges facing response efforts.
Although no new international spread has been detected, continued transmission indicates that the outbreak remains in an expansion phase and continues to pose a high risk of regional and international spread.
Democratic Republic of the Congo
Since the last update of 26 July 2026 (Weekly External Situation Report #11), the Democratic Republic of the Congo has reported an additional 540 confirmed cases and 270 confirmed deaths, representing increases of 16.6% and 18.8%, respectively, in cumulative confirmed cases and deaths.
Although the absolute numbers of newly reported cases and deaths remain substantial, the proportional increases are markedly lower than those reported during the previous reporting period, reflecting the absence of the large retrospective data reconciliation that contributed to last week's increase.
Nevertheless, the reporting of more than 500 additional confirmed cases and more than 250 confirmed deaths within a single week indicates that transmission remains intense and that the outbreak continues to expand.
The crude case fatality ratio (CFR) increased from 44.1% to 44.9%, reflecting persistently high mortality despite ongoing response efforts.
During the reporting period, the cumulative number of affected health zones increased from 48 to 51, with Kabondo and Wanie-Rukula in Tshopo Province and Lubero in North Kivu Province becoming the latest affected health zones, further demonstrating the continued geographic expansion of the outbreak.
Figure 1. Weekly trend of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo by epidemiological week of notification, epidemiological weeks 18 – 31, 2026
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During the last 21 days, transmission remained highly concentrated geographically, with an additional 1,867 confirmed cases and 953 confirmed deaths reported nationally.
Approximately 87.9% (n=1,641) of recently reported confirmed cases and 84.8% (n=808) of deaths occurred in Ituri Province, with the Bunia–Rwampara–MongbwaluNizi corridor continuing to represent the principal transmission focus.
North Kivu, Haut-Uélé, and Tshopo together accounted for 223 cases (11.9%) and 144 deaths (15.1%), while South Kivu reported no new confirmed cases.
However, an imported confirmed death from Tshopo Province generated new contacts requiring follow-up in South Kivu.
Of the 51 affected health zones, 42 reported at least one confirmed case during the preceding 21 days, whereas nine health zones (Gety, Kambala, Lubunga, Mangobo, Mabalako, Makiso-Kisangani, Miti-Murhesa, Rungu, and Vuhovi) have not reported a confirmed case for more than three weeks, suggesting that transmission may have been interrupted in these areas, provided surveillance remains sufficiently sensitive to detect any ongoing transmission.
The largest increases in confirmed cases over the previous 21 days were recorded in Bunia (312 cases), Nizi (285), Rwampara (216), Mongbwalu (207), Katwa (104), Lita (84), Nia-Nia (66), Mangala (63), Fataki (31), and Butembo (29).
Together, these ten health zones accounted for approximately 84% of all additional confirmed cases reported nationally during the period.
Bunia, Nizi, Mongbwalu, and Rwampara remained the principal transmission corridor, accounting for nearly 55% of all newly reported confirmed cases.
Continued increases in Lita, Nia-Nia, Mangala, and Fataki indicate sustained transmission within the Ituri epicentre, while ongoing transmission in Katwa and Butembo confirms persistent transmission in North Kivu.
Continued increases in Isiro and Wamba further indicate that the outbreak is becoming increasingly established in Haut-Uélé Province.
Mortality remained concentrated within the same transmission corridor driving the epidemic.
More than half (55.4%) of all confirmed deaths continue to occur outside designated treatment facilities, indicating that many patients are still being detected only late in illness or after death.
Delayed case detection and delayed access to specialised treatment therefore remain major contributors to mortality.
Recent analyses indicate a median interval of eight days from symptom onset to death, with almost half of deaths occurring within the first week of illness, emphasizing the narrow window available for life-saving clinical intervention.
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Children younger than five years continue to experience disproportionately high mortality.
Although they account for fewer than one in ten confirmed cases nationally, they represent approximately 17% of all confirmed deaths, experience the highest case fatality ratios of any age group, and have the shortest interval between symptom onset and death.
Conversely, adults aged 20 – 59 years continue to account for most transmission, representing nearly two-thirds of confirmed cases. These findings suggest that outbreak control should continue to prioritise interrupting transmission among working-age adults while simultaneously strengthening rapid identification and referral of young children to reduce mortality.
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Surveillance performance remains suboptimal. As of 2 August 2026, 18,276 contacts were under follow-up nationally, of whom 14,466 (79.2%) were successfully seen during the previous 24 hours, remaining well below the operational target of 95%.
Contact tracing capacity continues to lag behind the growing number of contacts to follow, particularly in Ituri and North Kivu, while persistently low follow-up rates and intermittent reporting in Haut-Uélé and Tshopo limit interpretation of recent trends.
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Since the beginning of the outbreak, the Democratic Republic of the Congo has reported 3,802 confirmed cases, including 1,707 confirmed deaths, corresponding to a crude CFR of 44.9%.
The outbreak now affects 51 health zones across five provinces. Ituri Province remains the epicentre, accounting for 3,317 confirmed cases (87.2%) and 1,382 confirmed deaths (81.0%) nationwide.
The most affected health zones remain Bunia (914 cases, 270 deaths), Rwampara (655 cases, 263 deaths), Mongbwalu (552 cases, 263 deaths), Nizi (402 cases, 194 deaths), Lita (141 cases, 84 deaths), and Nyankunde (115 cases, 34 deaths) in Ituri Province, together with Katwa (186 cases, 122 deaths) and Butembo (87 cases, 69 deaths) in North Kivu Province. Collectively, these health zones account for the overwhelming majority of confirmed cases and deaths reported nationwide.
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Uganda and France
No new cases have been reported in Uganda or France since the previous update.
In Uganda, the last confirmed patient was discharged on 16 July 2026, and 17 days have passed without a new confirmed case.
All identified contacts have completed the required 21-day follow-up, and no contacts remain under active monitoring.
In France, the imported confirmed BVD case reported on 24 June 2026 recovered and was discharged on 4 July 2026 after two consecutive negative PCR test results.
No secondary transmission was identified, and all five flight contacts completed their 21-day follow-up without developing symptoms.
As of 2 August 2026, 29 days have passed since the patient's discharge without any additional confirmed BVD cases being reported from France.
Despite the absence of new cases, Uganda remains at high risk of reintroduction because of the ongoing outbreak in the neighbouring Democratic Republic of the Congo.
Risk Assessment
The overall public health risk in the Democratic Republic of the Congo remains very high. The outbreak continues to expand, with sustained transmission, persistently high mortality, and continued spread to newly affected health zones.
Transmission remains concentrated within the Bunia–Rwampara–Mongbwalu–Nizi corridor, while ongoing spread in Haut-Uélé and Tshopo indicates progressive geographic expansion beyond the original epicentre.
The risk of further national and international spread remains high because transmission continues along major internal and cross-border mobility corridors linking the outbreak to Uganda, South Sudan, and other neighbouring countries.
Although Uganda and France have reported no additional cases since their previous imported events, sustained transmission in eastern Democratic Republic of the Congo continues to pose a significant risk of crossborder spread. Continued cross-border surveillance, rapid information sharing, and preparedness remain essential to ensure early detection and rapid containment of any imported cases.
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Situation interpretation
The BVD outbreak in the Democratic Republic of the Congo remains in an expansion phase despite an increasingly robust response.
Persistently high mortality, frequent community deaths, delayed case detection, and suboptimal contact tracing continue to sustain transmission, while weak infection prevention and control in health facilities contributes to ongoing healthcare-associated transmission.
Although response capacity has expanded substantially, including laboratory services, case management, logistics, and regional preparedness, further progress will depend on rapidly improving early case detection, achieving high-quality contact tracing, strengthening infection prevention and control, reducing community deaths through earlier access to treatment, and maintaining coordinated crossborder preparedness to prevent regional and international spread.
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