#Bundibugyo Virus Disease #Outbreak in #DRC, #Kenya, #Nigeria - Weekly #Report No. 23, Data as of 19 Oct. '26 (WHO, summary)

 

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Event description

    The Bundibugyo virus disease (BVD) outbreak is becoming increasingly  challenging, marked by an expanding cluster of cases linked  to the imported index case in Kenya, further geographic expansion into a new  province of the Democratic Republic of the Congo, and the confirmation of a case  in Nigeria. 

    These developments highlight the widening international dimension  and the growing complexity of the outbreak, particularly in the  Democratic Republic of the Congo, where escalating insecurity, population  displacement and restricted humanitarian access threaten to further undermine  surveillance and response operations.

Democratic Republic of the Congo

    As of 19 October 2026, the BVD outbreak in the Democratic Republic of  the Congo has affected 66 health zones across eight provinces, following  the recent expansion into Wapinda Health Zone in Nord-Ubangi Province. 

    Since External Situation Report #22, an additional 572 confirmed cases and 265 confirmed deaths have been reported, bringing the cumulative total to  9637 confirmed cases, including 4646 confirmed deaths [crude case fatality ratio (CFR) 48.2%].

    Transmission remains highly heterogeneous across affected areas. Ituri  continues to account for the largest proportion of cumulative confirmed  cases (72.7%), although its relative contribution is declining, while substantial  transmission persists in Nord-Kivu and Haut-Uélé.

    National daily incidence increased steadily from May, reaching its highest  levels in late July and mid-August, before fluctuating at persistently high  levels through September. Following a decline in late September,  incidence rebounded in early October. 

    The most recent seven-day moving average indicates a modest upward trend, suggesting renewed intensification of transmission. Provincial trends  remain heterogeneous. Ituri shows a slight recent rebound despite an overall  decline from its August peak, while Nord-Kivu continues to experience elevated  but fluctuating transmission. 

    Haut-Uélé remains relatively stable with a slight increase, and Tshopo  shows renewed upward activity. Transmission remains sporadic in Bas-Uélé, with  newly reported cases in Nord-Ubangi, while Sud-Kivu and Sud-Ubangi report no recent transmission in the last 21 days (Figures 1 and 2).

Figure 1. Daily national trend in confirmed Bundibugyo virus disease cases, with  seven-day moving average, by date of report, Democratic Republic of the Congo, as of 19 October 2026

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Trend Analysis (21-day comparison):

    During the most recent 21-day period (29 September – 19 October 2026),  a total of 1466 confirmed cases were reported nationally, compared with 1328  cases during the preceding 21 days (8 – 28 September), representing an increase  of 138 cases (+10.4%). 

    Provincial trends remain heterogeneous. Cases increased in Ituri from 757  to 785 (+3.7%), accounting for 53.5% of national cases during the latest  period. In Nord-Kivu, cases increased from 460 to 564 (+22.6%), accounting for  38.5% of national cases while in Haut-Uélé cases decreased slightly from 82 to 81  (−1.2%), accounting for 5.5% of national cases.

    During the same period, a total of 692 confirmed deaths were reported  nationally, compared with 644 deaths during the preceding 21 days (8 – 28  September), representing an increase of 48 deaths (+7.5%). Deaths increased  from 302 to 374 (+23.8%) in Ituri, from 213 to 269 (+26.3%) in Nord-Kivu, from  35 to 38 (+8.6%) in Haut-Uélé, and from seven to ten (+42.9%) in Tshopo.  The increase in confirmed deaths, particularly in Ituri and Nord-Kivu,  reflects a worsening mortality burden alongside rising national case incidence.

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

    Of the 66 health zones affected to date, 50 (75.8%) reported at least one  new confirmed case during the most recent 21 days (29 September – 19 October  2026). Case incidence increased in 31 health zones while 21 health zones reported a decreased in cases comparing the two periods. The largest absolute  increase occurred in Mandima, Ituri (87 to 216 cases; +148.3%), while  substantial increases were also observed in Mambasa (12 to 45; +275.0%) and  several health zones in Nord-Kivu, particularly Mabalako (22 to 47; +113.6%),  Oicha (17 to 28; +64.7%) and Beni (158 to 194; +22.8%) (Figure 4).

    There were also 16 health zones without a new case in the last 21 days.  These include Adja, Ariwara, Aungba, Boga, Drodro, Kambala and Mahagi in Ituri;  Goma in Nord-Kivu; Dungu and Gombari in Haut-Uélé; Lubunga and Wanie-Rukula in Tshopo; Miti-Murhesa in Sud-Kivu; Buta and Viadana in Bas-Uélé; and Bulu in Sud-Ubangi.

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    Weekly confirmed deaths (Figure 6) declined by 5.2%, from 233 during  5–11 October to 221 during 12–18 October 2026, reversing the upward trend  observed over the preceding two weeks. Community deaths decreased from 157  to 135 (−14.0%), while deaths in treatment facilities increased from 76 to 86  (+13.2%). Consequently, the proportion of deaths occurring in the community  declined from 67.4% to 61.1%. Despite the overall reduction, more than six in ten  confirmed deaths continued to occur in the community, highlighting persistent  challenges in early case detection, timely referral and access to treatment.

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Kenya

    Since the previous report, Kenya has confirmed eight additional cases of BVD, bringing the cumulative total to nine cases, including one death (CFR: 11.1%). 

    

    All eight new cases were epidemiologically linked to the imported index  case and were already under quarantine when they developed symptoms. 

    The secondary cases included four family members and four hospital  staff.

    Of the nine confirmed cases, seven were male and two were female,  with ages ranging from 24 to 65 years. 

    Eight patients are currently in isolation and receiving treatment at two  designated facilities. All are reportedly in stable condition.

    A total of 135 contacts have been listed, comprising 46 airport staff, 45  hospital staff, 26 passengers, 14 relatives and four flight crew members. 

    Of these, eight have tested positive for BVD (four relatives and four  hospital staff). 

    Eight passengers travelled outside Kenya, and the authorities in their  destination countries were notified. Among the 119 contacts remaining under  follow-up in Kenya, 118 (99.2%) are in quarantine, while one passenger remains  outside quarantine.

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Nigeria

    On 20 October 2026, the Federal Ministry of Health of Nigeria announced a confirmed case of BVD in the Federal Capital Territory, Abuja. 

    The case involved a woman who reportedly travel from Uganda to  Nigeria on 3 October 2026. She developed symptoms on 7 October 2026 and  sought care at a private health facility on 11 October 2026. 

    Following clinical deterioration, laboratory testing confirmed BVD on 20  October 2026. The patient is currently in isolation and receiving treatment. 

    A total of 44 close contacts have so far been identified, including  healthcare workers, patients, caregivers and travel contacts. Additional  investigation is underway to establish her travel itinerary, including all those who may have been potentially exposed while the case was symptomatic. 

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Situation interpretation

    The BVD outbreak remains at a critical juncture, with sustained  transmission in the Democratic Republic of the Congo and international  spread highlighting persistent gaps in outbreak containment. 

    In the Democratic Republic of the Congo, escalating insecurity,  displacement and restricted humanitarian access are further challenging response  operations and increasing the risk of undetected transmission. 

    In Kenya, the identification of all secondary cases among known, quarantined contacts is encouraging, suggesting that transmission  chains remain traceable, although continued surveillance is essential to detect any  unrecognized spread. 

    In Nigeria, the prolonged period between symptom onset and confirmation  raises concern about potentially undetected exposures and secondary  transmission, requiring urgent retrospective investigation and intensified  surveillance. 

    Priorities should focus on targeted interventions in transmission hotspots, restoring operational access in insecure areas,  strengthening early detection and rapid containment, and intensifying coordinated  cross-border surveillance and information sharing to prevent further  international spread.

Source: 

Link: https://www.afro.who.int/countries/nigeria/publication/ebola-bundibugyo-virus-disease-outbreak-democratic-republic-congo-uganda-weekly-external-situation

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