#Bundibugyo Virus Disease #Outbreak in #DRC - Weekly Situation #Report No. 21, as of 4 Oct. '26 (#WHO, summary): 8,603 cases and 4,148 deaths in DRC

 

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Event description

    The ongoing Bundibugyo virus disease (BVD) outbreak in the Democratic  Republic of the Congo has now extended to Kenya, the fourth country affected during the current outbreak, following earlier detections in  Uganda and France, where the events have since been controlled. 

    Kenya has reported its first confirmed case and associated death in a traveller arriving from the Democratic Republic of the Congo. This latest  development further underscores the regional and international dimensions of the outbreak and the continuing risk of cross-border spread.

Democratic Republic of the Congo

    The BVD outbreak in the Democratic Republic of the Congo continues to expand geographically, with Alimbongo Health Zone in Nord-Kivu Province  becoming the latest affected health zone, bringing the total number affected since  the start of the outbreak to 64 health zones across seven provinces. 

    Transmission remains increasingly heterogeneous across affected  provinces and health zones. 

    In the last week ending 4 October 2026, a further 487 confirmed cases and 224 confirmed deaths were reported, increasing the cumulative total to  8603 confirmed cases, including 4148 deaths [crude case fatality ratio (CFR): 48.2%]. 

    Ituri remains the principal focus, although its relative contribution  continues to decline, accounting for 75.0% of cumulative confirmed cases, while  substantial transmission continues in Nord-Kivu and persists in Haut-Uélé.

    At the national level, daily incidence remains high and fluctuating, with  the seven-day moving average rising again in early October following a decline  through the second half of September. This pattern continues to mask divergent provincial trajectories. 

    Ituri has declined substantially from its late-July/early-August peak but shows a recent upturn, while Nord-Kivu has rebounded sharply after a  temporary decline from its mid-September peak. 

    Transmission in HautUélé remains sustained but below its August peak,  while Tshopo continues to report intermittent activity from a low baseline. 

    Bas-Uélé and Sud-Ubangi report sporadic cases, with no recent  transmission evident in Sud-KivuOverall, the epidemic remains geographically  heterogeneous, with the recent national rebound driven particularly by renewed transmission in parts of Ituri and Nortrd-Kivu.

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    During the most recent 21 days (14 September – 4 October 2026), a total  of 1345 confirmed cases were reported nationally, compared with 1674 cases  during the preceding 21 days (24 August – 13 September), representing a  decrease of 329 cases (−19.7%). 

    

    Cases declined in the three principal transmission provinces: from 1004  to 791 (−21.2%) in Ituri, 553 to 448 (−19.0%) in Nord-Kivu, and 100 to 78  (−22.0%) in Haut-Uélé. 

    Consequently, Ituri accounted for 58.8% of cases reported during the  latest period and Nord-Kivu for 33.3%, compared with 60.0% and 33.0%,  respectively, during the preceding period. 

    However, the overall 21-day decline masks a recent reversal in  trajectory, with cases increasing again during the latest week, particularly in Ituri  and Nord-Kivu. The decline over the longer comparison period should therefore be interpreted cautiously and does not yet indicate sustained epidemic contraction.

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    During the same period, 638 confirmed deaths were reported nationally,    compared with 830 deaths during the preceding 21 days, representing a decrease  of 192 deaths (−23.1%). 

    

    Deaths declined from 495 to 385 (−22.2%) in Ituri and from 299 to 208  (−30.4%) in Nord-Kivu. In contrast, deaths increased from 31 to 37 (+19.4%) in  Haut-Uélé, while Tshopo reported seven deaths compared with two during the preceding period. 

    Consequently, Ituri accounted for 60.3% of deaths during the latest period  and Nord-Kivu for 32.6%, compared with 59.6% and 36.0%, respectively,  during the preceding period. However, as with cases, the overall 21-day decline  masks a recent reversal in trajectory, with reported deaths increasing again during the latest week.

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    Transmission remained active in nearly three-quarters of all health zones affected since the start of the outbreak. 

    

    Of the 64 health zones affected to date, 46 reported at least one new  confirmed case in the last 21 days. 

    

    Encouragingly, 18 health zones have not reported a new confirmed case  in the last 21 days. These include Adja, Aru, Ariwara, Aungba, Boga, Drodro,  Kambala, Logo and Mahagi in Ituri; Goma in Nord-Kivu; Gombari in Haut-Uélé;  Bafwasende, Lubunga, Tshopo and Wanie-Rukula in Tshopo; Miti-Murhesa in Sud- Kivu; and Buta and Ganga in Bas-Uélé. 

    Provincial trends continue to mask important differences between health  zones. 

    In Ituri, the most pronounced increase  occurred in Mandima, where cases  rose from 15 to 129 (+760.0%), while Mambasa increased from 3 to 20 and Nia- Nia from 46 to 72 (+56.5%). 

    In contrast, cases declined in several established transmission hotspots, including Bunia, from 285 to 196 (−31.2%), Nizi, from 120 to 54  (−55.0%), Mangala, from 116 to 52 (−55.2%), Lita, from 65 to 32 (−50.8%),  and Komanda, from 76 to 40 (−47.4%). 

    Rwampara remained a major focus despite a more modest decline, from  106 to 95 cases (−10.4%).

    Nord-Kivu showed continued broad-based intensification, with Beni  increasingly driving transmission. Cases in Beni increased from 111 during the  preceding 21 days to 165 during the most recent period (+48.6%), while  Butembo declined from 101 to 41 (−59.4%) and Musienene from 46 to 22  (−52.2%). Katwa also declined substantially, from 175 to 77 cases (−56.0%),  although it remained an important focus of transmission. Haut-Uélé declined  overall, driven largely by a sharp reduction in Isiro (−82.8%), while transmission  remained relatively stable in Wamba and Pawa. However, the first case in Dungu  indicates continued geographic expansion despite the provincial decline.

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    Weekly confirmed deaths generally declined after peaking at 364 in mid-August, reaching 192 during 21–27 September.

    However, this trend reversed in the latest week, with deaths increasing  by 16.7% to 224 during 28 September–4 October. 

    The latest increase occurred in both settings, with community deaths  rising from 123 to 150 (+22.0%) and deaths in treatment facilities increasing  from 69 to 74 (+7.2%). 

    Consequently, the proportion of deaths occurring in the community  increased from 64.1% to 67.0%, continuing an upward trend from 61.3% during  14 – 20 September. The latest increase in both community and facility deaths  indicates a reversal of the declining mortality trend observed during the preceding  weeks, with two-thirds of confirmed deaths continuing to occur in the  community.

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Kenya

    A confirmed case of BVD has been reported in Kenya. The case is a 40-year-old Kenyan male and resident of the Democratic Republic of the Congo.  

    Preliminary investigations indicate that he travelled from Buta in Bas-Uélé  Province to Kisangani, Tshopo Province, arriving on 20 September 2026, where symptom onset was reportedly noted. 

    He subsequently travelled to Beni, Nord-Kivu Province, on 1 October,  stayed overnight, and continued by road to Kampala, Uganda, on 2 October. 

    After an overnight stay in Kampala, he travelled by air from Entebbe,  Uganda to Nairobi, Kenya on 3 October 2026, arriving at approximately 13:10,  and proceeded directly to a healthcare facility accompanied by family members,  where he was isolated. 

    He presented with fever, chills, intense fatigue and weakness, muscle  pain, painful swallowing, sore throat, and bleeding under the skin at injection  sites. 

    Samples collected on 3 October tested positive for Bundibugyo virus at the  National Virology Reference Laboratory of the Kenya Medical Research Institute 

(KEMRI), with laboratory confirmation reported on 5 October 2026. 

    He died later that day while undergoing care. Safe and dignified burial has  been conducted.

    A total of 28 contacts, including family members and healthcare workers,  have so far been listed. An additional 23 passengers and crew members who  travelled on the same flight as the case from Kampala, Uganda, to Nairobi, Kenya, are being traced. 

    Contacts already identified are being quarantined while further  investigations are ongoing to establish the detailed travel itinerary of the case and  identify all persons who may have been exposed in the Democratic Republic  

of the Congo, Uganda, and Kenya.

Risk Assessment

    The risk of further spread remains very high within the Democratic Republic of the Congo, reflecting sustained transmission, continued geographic  expansion, high mortality, population mobility, insecurity and persistent response 

challenges. 

    The risk is considered high for neighbouring countries sharing land  borders with the Democratic Republic of the Congo and low elsewhere in Africa and globally. 

    The second IHR Emergency Committee, convened on 18 August 2026, also  reviewed the evolving situation and emphasized that the outbreak remains far  from controlled, and continues to constitute a Public Health Emergency of International Concern.

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Situation interpretation

    The outbreak of BVD remains uncontrolled despite expanded response capacity. 

    

    Recent increases in cases and deaths, shifting transmission hotspots,  persistent community deaths, suboptimal contact follow-up and delayed isolation 

indicate continuing gaps in breaking transmission chains. 

    The confirmed exportation to Kenya following travel through Uganda  further demonstrates the growing cross-border risk and its associated regional  consequences. 

    The immediate priorities should be to improve response performance across the different response pillars while strengthening crossborder coordination and preparedness.

Source: 

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

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