#Ebola #Bundibugyo Virus Disease #Outbreak, #DRC, #Uganda - Situation #Report No. 14, Data as of 16 August '26 (WHO, edited): 5,021 cases & 2,378 deaths in DRC

 

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Event description

Democratic Republic of the Congo

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo has expanded to a sixth province, with the detection of a confirmed  case in Bas-Uélé province in the north-east, indicating further geographic  spread beyond the main transmission areas in the eastern part of the country. 

    Since External Situation Report #13, an additional 640 confirmed cases and 367 confirmed deaths have been reported, reflecting continued sustained  transmission and high mortality. 

    The crude case fatality ratio (CFR) has increased from 45.9% to 47.4%,  continuing the upward trend observed over several weeks.

    As of 16 August 2026, a total of 5 021 confirmed cases, including 2 378 confirmed deaths have been reported across 55 health zones in six provinces. 

    Buta health zone in Bas-Uélé province and Tshopo health zone in Tshopo  province are the latest affected health zones. 

    Ituri remains the epicentre, accounting for 84.8% of cumulative confirmed  cases and 79.0% of cumulative confirmed deaths.

Figure 1. Daily growth trend in confirmed Bundibugyo virus disease cases in the Democratic Republic of the Congo, by date of report, as of 16 August 2026

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    During the most recent 21 days (27 July – 16 August 2026), a total of 1 759 confirmed cases and 941 confirmed deaths were reported nationally. 

    Transmission remained concentrated in Ituri, which accounted for 1 356  cases (77.1%) and 671 deaths (71.3%), followed by Nord-Kivu with 293 cases  (16.7%) and 224 deaths (23.8%), and Haut-Uélé with 101 cases (5.7%) and 42  deaths (4.5%). 

    Compared with the preceding 21-day period (6 – 26 July 2026), the  number of newly reported cases increased by 121 (+7.4%), and deaths by 25  (+2.7%). However, trends varied substantially between provinces. In Ituri, newly  reported cases and deaths declined by 68 (−4.8%) and 97 (−12.6%)  respectively. 

    In contrast Nord-Kivu reported an increase of 123 newly reported cases  (+72.4%) and 101 deaths (+82.1%). Haut-Uélé recorded the largest relative  increase, with 61 additional newly reported cases (+156.4%) and 21 additional  newly reported deaths (+100.0%). Tshopo remained a smaller transmission focus,  while the detection of a case and death in Bas-Uélé indicates further  geographic expansion.

    At the health-zone level, transmission remained geographically widespread. Of the 55 health zones affected since the start of the outbreak, 47  (85.5%) reported at least one confirmed case during the most recent 21 days.  

    Eight health zones reported no new confirmed cases during this period: Adja, Ariwara, Boga and Kambala in Ituri; Goma in NordKivu; Rungu in Haut-Uélé; Lubunga in Tshopo; and Miti-Murhesa in Sud-Kivu. 

    Seven health zones reported confirmed cases for the first time since the  beginning of the outbreak: Gombari in Haut-Uélé, Lubero in Nord-Kivu, Bafwasende, Kabondo, Tshopo and Wanie-Rukula in Tshopo, and Buta in Bas-Uélé.  This indicates continued geographic expansion, including into previously  unaffected health zones.

    Despite this expansion, transmission remains highly concentrated in a limited number of health zones. Bunia, Rwampara, Nizi, Katwa, Mongbwalu and  Nia-Nia together reported 1 186 cases during the most recent 21 days, accounting  for 67.4% of all cases reported nationally during this period. 

    The distribution of transmission is also changing. Cases increased  substantially in Bunia (+80; +24.9%), Rwampara (+69; +31.5%) and Katwa  (+63; +71.6%), while substantial relative increases were observed in Wamba  (+31; +281.8%), Beni (+34; +226.7%), Fataki (+37; +246.7%) and Isiro (+18;  +150.0%). Conversely, cases declined in established transmission foci such as Mongbwalu (−134; −61.5%) and Nizi (−97; −34.8%). Overall, the data indicate a redistribution of transmission, with declining activity in some established hotspots occurring alongside intensification in others and continued geographic expansion into new health zones.

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    Mortality remains high and varies substantial across affected areas. Ituri continues to account for the largest absolute burden, with 1 878 cumulative confirmed deaths, representing 79.0% of all deaths nationally.  However, the CFR is considerably higher in Nord-Kivu (70.5%), than in Ituri  (44.1%) and Haut-Uélé (45.3%). This disparity was also evident during the most  recent 21 days, when Nord-Kivu accounted for only 16.7% of reported cases but  24.0% of reported deaths nationally.

    At health-zone level, the largest numbers of deaths were reported from  major transmission foci in Ituri, particularly Bunia, Rwampara and Mongbwalu.  However, CFRs were substantially higher in several health zones in Nord-Kivu, including, Butembo (85.6%), Beni (75.8%) and Katwa (68.1%), compared  with Bunia (29.8%), Rwampara (38.9%), and Mongbwalu (49.9%). These marked  geographic variation indicate that mortality is not explained by  transmission intensity alone and warrants further assessment of differences in case detection, timeliness of presentation and referral, community  deaths, access to care and clinical management. 

    Mortality remains high both in the community and among patients in treatment facilities. During the past six weeks, an average of approximately 162  community deaths and 98 treatment facility deaths were reported each week. 

    Community deaths accounted for approximately 60% of all confirmed  deaths during this period. The high proportion of community deaths highlights  persistent challenges in early case detection, referral and access to designated  treatment facilities. 

    Mortality among patients reaching treatment facilities may reflect late  presentation and severe disease at admission, while further assessment is needed  to determine the contribution of clinical management capacity, quality of  care and patient vulnerabilities, including age, malnutrition and comorbidities. For  the purposes of this report, community death refers to death occurring outside a  designated Ebola treatment facility, including at home, in the community, or in  another (non-Ebola) health facility.

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    The current BVD outbreak continues to follow a markedly different trajectory from previous major Ebola disease outbreaks. 

    

    During the first 95 days of reporting, the 7-day moving average increased  progressively, reaching more than 90 confirmed cases per day, substantially  higher than the levels observed during comparable period of the 2014 – 2016 

West Africa and 2018 – 2020 Democratic Republic of the Congo outbreaks. 

    With 5 021 confirmed cases reported as of 16 August 2026, this has  become the largest BVD outbreak ever recorded and the second-largest Ebola  disease outbreak on record. 

    The sustained high incidence and continued geographic expansion indicates  that transmission remains intense and that the outbreak has not yet entered a  clear declining phase.

Figure 5. Comparison of three major Ebola disease outbreak trajectories during the first 95 days of reporting using seven-day moving averages of the daily number of confirmed cases reported.

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Uganda and France

    Uganda has now recorded 31 consecutive days without a new confirmed  BVD case since the last patient was discharged on 16 July 2026. All identified  contacts have completed follow-up, with no further cases detected. The continued  high level of transmission in neighbouring eastern Democratic Republic of the  Congo, however, means that the risk of crossborder reintroduction remains.

    France has reported no new confirmed BVD cases for 43 consecutive days  since the imported case was discharged on 4 July 2026. This period is more  than twice the maximum 21-day incubation period for BVD. No secondary  transmission has been detected, and all five identified flight contacts completed  follow-up without developing symptoms.

Risk Assessment

    The risk of further geographic spread within the Democratic Republic of the Congo remains very high, while the risk of cross-border spread remains  elevated. 

    The detection of a case in Buta, Bas-Uélé and additional affected health  zones in Tshopo, together with sustained transmission in highly mobile areas of  Ituri, Nord-Kivu and Haut-Uélé, increases the potential for onward spread along major transport corridors. Tshopo, particularly the Kisangani transport hub, is of 

particular concern because of its connectivity with other parts of the country and  the potential for longer-distance dissemination towards Kinshasa. 

    Continued transmission in eastern and north-eastern Democratic  Republic of the Congo also increases the likelihood of cross-border movements of  infected persons. 

    Uganda, South Sudan and the Central African Republic remain at  particularly high risk of importation, given their geographic proximity to affected 

areas of the Democratic Republic of the Congo, established cross-border population movements and connectivity along major mobility corridors. 

    Enhanced surveillance, information sharing, preparedness and cross- border coordination should therefore be maintained along priority mobility corridors and at points of entry.

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Situation interpretation

    The BVD outbreak is evolving into a more geographically dispersed emergency, with persistent transmission in established hotspots occurring  alongside intensification in other areas and continued seeding of new locations. 

    The combination of very high mortality, substantial deaths outside  designated treatment facilities, increasing surveillance workload and  uneven response capacity suggests that current interventions are not yet  achieving sufficient speed, coverage or intensity to interrupt transmission. 

    The response should therefore be increasingly risk-informed and geographically differentiated, with the intensity and combination of  interventions adapted to local transmission patterns and operational gaps, while  simultaneously establishing sufficient response capacity ahead of transmission in 

newly affected and high-risk areas. 

    Given increasing connectivity between affected areas and major  populationmovement corridors, stronger interprovincial and cross-border  surveillance and preparedness are also critical to prevent further geographic spread.

Source: 

Link: https://www.afro.who.int/countries/democratic-republic-of-congo/publication/ebola-bundibugyo-virus-disease-outbreak-5

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