#Bundibugyo Virus Disease #Outbreak - #DRC, #Kenya, #Nigeria - Sit. #Report No. 24, Data as of 1 Nov. '26 (WHO, summary): 10,532 cases & 5,126 deaths in DRC

  

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Event description

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic  of the Congo passed 10 000 confirmed cases during the reporting period and  continues at a high, sustained level of transmission, driven increasingly by  Nord-Kivu while Ituri remains the largest contributor. 

    The importation events in Kenya and Nigeria have so far remained  contained: no new case has been reported in Kenya since 19 October and all  secondary cases occurred among contacts already in quarantine, while no  secondary case has been identified in Nigeria. 

    However, a one new death was reported in Kenya, bring the total number of  deaths to two. 

    In the Democratic Republic of the Congo, insecurity, health-worker strikes  in Bas-Uélé and Tshopo and the suspension of response activities in Bafwasende  Health Zone continue to constrain surveillance and response operations.

Democratic Republic of the Congo

    As of 1 November 2026, the BVD outbreak in the Democratic Republic of  the Congo has affected 67 health zones across eight provinces; Yakoma  Health Zone in Nord-Ubangi Province was added to the list of affected zones on 28  October.

    Since External Situation Report #23, an additional 895 confirmed cases and 480 confirmed deaths have been reported, bringing the cumulative total to  10 532 confirmed cases, including 5 126 confirmed deaths [crude case fatality  ratio (CFR) 48.7%]. 

    Transmission remains highly heterogeneous across affected areas. Ituri  continues to account for the largest proportion of cumulative confirmed cases  (70.6%), although its relative contribution is declining, while Nord-Kivu (23.9% of cumulative cases; CFR 55.4%) accounted for 60.0% of the cases reported on 1 November. 

    Transmission persists at lower levels in Haut-Uélé and Tshopo.

    National daily incidence rose steadily from May to its highest levels in late  July and mid-August, declined through late September and has fluctuated at  a high plateau since early October. 

    The seven-day moving average ranged between 67 and 76 confirmed  cases per day during the reporting period, peaking at 76 cases per day on 29–30  October before easing to 67 on 1 November, still below the mid-August peak of  94. 

    Provincial trends diverge. Ituri continues its gradual decline from the late- July peak (seven-day average of 31 cases per day on 1 November, down from 38  on 19 October), while Nord-Kivu is rising again (30 cases per day, up from 26)  and now reports almost as many cases as Ituri each day. HautUélé remains stable  at four to five cases per day, Tshopo shows low-level but sustained transmission,  and Nord-Ubangi reported its first cases in October. Bas-Uélé, Sud-Kivu and Sud-Ubangi have reported no case in the last 21 days (Figures 1 and 2).

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Trend Analysis (21-day comparison):

    During the most recent 21-day period (12 October – 1 November 2026), a  total of 1 466 confirmed cases were reported nationally, compared with 1 333  cases during the preceding 21 days (21 September – 11 October), representing  an increase of 133 cases (+10.0%). 

    Provincial trends remain heterogeneous. Cases in Ituri decreased slightly  from 748 to 736 (−1.6%), accounting for 50.2% of national cases during the  latest period. 

    In Nord-Kivu, cases increased from 486 to 607 (+24.9%), accounting for  41.4% of national cases, while in Haut-Uélé cases increased from 72 to 84  (+16.7%), accounting for 5.7% of national cases. Tshopo reported 33 cases  compared with 20 in the preceding period (+65.0%), and Nord-Ubangi reported  its first six cases. Bas-Uélé and Sud-Ubangi, which reported six and one cases  respectively in the preceding period, reported none.

    During the same period, a total of 745 confirmed deaths were reported  nationally, compared with 649 deaths during the preceding 21 days (21  September – 11 October), representing an increase of 96 deaths (+14.8%). 

    Deaths increased from 377 to 393 (+4.2%) in Ituri, from 230 to 303  (+31.7%) in Nord-Kivu and from 34 to 43 (+26.5%) in Haut-Uélé and decreased  from eight to five in Tshopo; Nord-Ubangi reported its first death. The rise in  deaths, concentrated in NordKivu, outpaced the rise in cases, reflecting a  worsening mortality burden in the province where transmission is now intensifying.

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    Transmission remained active in two-thirds of all health zones affected  since the start of the outbreak. Of the 67 health zones affected to date,  45 (67.2%) reported at least one new confirmed case during the most recent 21  days(12 October – 1 November 2026). 

    Case incidence increased in 26 health zones, decreased in 27 and was  unchanged in one when the two periods are compared. 

    

    The largest absolute increase occurred in Beni, Nord-Kivu (177 to 262  cases; +48.0%), followed by Mambasa, Ituri (22 to 62; +181.8%), Mandima,  Ituri (199 to 233; +17.1%), Mutwanga, Nord-Kivu (14 to 43; +207.1%), Oicha,  Nord-Kivu (28 to 51; +82.1%) and Wamba, Haut-Uélé (26 to 49; +88.5%).  Bafwasende in Tshopo (11 cases), Wapinda and Yakoma in Nord-Ubangi (three  cases each) and Damas and Mahagi in Ituri (one case each) reported cases after  none in the preceding period (Figure 4).

    There were also 22 health zones without a new case in the last 21 days.  These include Adja, Ariwara, Aungba, Boga, Drodro, Fataki, Gety, Kambala and  Logo in Ituri; Goma and Kayna in Nord-Kivu; Dungu and Gombari in Haut-Uélé;  Lubunga, Mangobo and Wanie-Rukula in Tshopo; Miti-Murhesa in Sud-Kivu; Buta, Dakwa, Ganga and Viadana in BasUélé; and Bulu in Sud-Ubangi.

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    Weekly confirmed deaths (Figure 6) rose to 286 during 19–25 October 2026,  the highest weekly total since late August, before declining by 16.4% to  239 during 26 October – 1 November. Community deaths decreased from 184 to  155 (−15.8%) and deaths in treatment facilities from 102 to 84 (−17.6%), so  that the proportion of deaths occurring in the community was essentially  unchanged at 64.9% (64.3% the previous week). 

    On 1 November alone, 20 of the 23 confirmed deaths (87.0%) occurred in  the community. Close to two-thirds of confirmed deaths continue to occur outside treatment facilities, highlighting persistent challenges in early case  detection, timely referral and access to treatment.

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Kenya

    Since the previous report, Kenya has reported no new confirmed case of BVD. The cumulative total remains nine confirmed cases, including two deaths (CFR 22.2%): the imported index case, who died on 5 October, and a  65-year-old family member who died on 23 October. All eight secondary cases  (four family members and four hospital staff) were epidemiologically linked to the  index case and were already under quarantine when they developed symptoms. 

    The last confirmed case was reported on 19 October 2026; the 42-day  countdown to the end of the outbreak will start once the last confirmed patient  has been discharged after two negative tests.

    Of the nine confirmed cases, seven were male and two were female, with  ages ranging from 24 to 65 years. Seven patients remain under treatment in  isolation at designated facilities, which have 211 isolation beds (scalable to 241), 

corresponding to a bed occupancy of 3.3%.

    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 (5.9%) tested positive for BVD during quarantine (four relatives and  four hospital staff), one of whom has died. 

    As of 28 October, 98 contacts remained  in quarantine in Kenya (41 hospital staff, 33 airport staff, 14 passengers  and 10 family members), all of whom were followed up in the  previous 24 hours (100%); 20 contacts (13 airport staff, four flight crew and three  passengers) had completed follow-up and been discharged from quarantine; and nine passengers who travelled outside Kenya are being  followed up through bilateral engagement with their Countries of destination.

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Nigeria

    Nigeria reported a single confirmed case of BVD, announced by the  Federal Ministry of Health on 20 October 2026 in the Federal Capital Territory,  Abuja. The case, a 42-year-old woman, arrived in Abuja from Uganda via Addis  Ababa on 3 October, developed symptoms on 7 October and was admitted to a  private health facility on 11October. 

    The patient was clinically stable and received supportive care before  being medically evacuated to Switzerland on 26 October 2026. 

    As of 31 October, no additional confirmed cases had been reported. As of  29 October, 62 contacts had been identified in Abuja Municipal Area Council, none  of whom had developed symptoms, and 18 samples had been tested, of which one  was positive. 

    No secondary transmission has been detected; the 12-day  interval  between symptom onset and notification, eight days of which were spent in  private-facility care, remains the main concern for undetected exposures.

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Situation interpretation

    The BVD outbreak remains at a critical juncture. In the Democratic  Republic of the Congo, transmission is not declining:  the cumulative count  passed 10 000 confirmed cases, the national seven-day average has held between  67 and 76 cases per day for three weeks, and the epicentre is shifting  towards Nord-Kivu, where cases rose by a quarter and deaths by a third over the  last 21-day period, where one in three patients is managed outside dedicated  treatment centres, and where contact follow-up and safe burial performance are  the weakest. 

    Health-worker strikes in Bas-Uélé and Tshopo, insecurity in Beni and Nizi and  the suspension of activities in Bafwasende further increase the risk of  undetected transmission. 

    The absence of new cases in Kenya since 19 October and of secondary  transmission in Nigeria is encouraging and indicates that the exported chains have  so far been contained, although continued surveillance is essential until the  end-of-outbreak criteria are met. 

    Priorities should focus on reinforcing response capacity in NordKivu,  particularly in Beni, Mutwanga, Oicha and Mabalako, restoring operational access  in insecure and strike-affected areas, improving the timeliness of isolation of  suspected cases and the completion of safe burials, and maintaining coordinated  cross-border surveillance and information sharing to prevent further international  spread.

Source: World Health Organization, https://www.afro.who.int/countries/nigeria/publication/bundibugyo-virus-disease-outbreak-democratic-republic-congo-kenya-nigeria-weekly-external-situation

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