ETIDIOH - NEW

  Date of issue : 30 September 2025 Data as reported by : 28 September 2025 {Summary} The Ebola virus disease outbreak in the Democratic Republic of the Congo continues, with signs of a notable decline in transmission .  Since our last update (Situation Report #2), a total of seven new cases have been reported, comprising six confirmed and one probable cases (retrospectively validated).  The new cases were detected across three health areas within Bulape Health Zone , namely, Bulape (n=4), Mpianga (n=2), and Dikolo (n=1).  During the same reporting period , seven deaths occurred among newly identified and previously hospitalized cases. The reported deaths were distributed across Dikolo (n=3), Bulape (n=2), Mpianga (n=1), and Bulape Communitaire (n=1) health areas. As of 28 September 2025, a total of 64 cases (53 confirmed and 11 probable), including 42 deaths (31 confirmed, 11 probable), have been reported from Bulape Health Zone, Kasai Province , Democratic Republic...

  {Summary} Overall risk and confidence Overall risk -- National: High  -- Regional: Moderate    -- Global: Low    Confidence in available information  -- National: Moderate -- Regional: Moderate -- Global: Moderate Risk statement On 1 September 2025, WHO received an alert from the Ministry of Health of the Democratic Republic of the Congo (DRC) regarding suspected cases of Ebola virus disease (EVD) in the Bulape Health Zone , Kasai Province , DRC.  The first currently known suspected EVD case was admitted to the Bulape General Reference Hospital on 20 August 2025 and reported to have died five days later (25 August 2025). This is a 34-year-old female patient with a 34-week gestational age who presented with fever, bloody diarrhoea, followed by anal, oral, and nasal haemorrhage, vomiting , and asthenia .  She reportedly died on 25 August 2025, with a clinical picture of multiple organ failure.  Two of the contacts of this first case (a m...

  Abstract Background Ebola virus disease (EVD) is a severe and often fatal illness with high transmission potential and recurring outbreaks . Traditional compartmental models often neglect biologically important delays , such as the latent period before an infected individual becomes infectious, limiting their ability to capture real-world epidemic patterns. Including such delays can provide a more accurate understanding of outbreak persistence and control strategies. Methods In this study, we develop and analyze a novel deterministic SIRR model that captures the complex transmission dynamics of Ebola by explicitly combining nonlinear incidence rates with a delay differential equation framework . Unlike traditional models, this approach integrates a biologically motivated delay to represent the latent period before infectiousness, providing a more realistic depiction of disease spread. The basic reproduction number (R0) is derived using the next-generation matrix, and local stabil...

  F AST FACTS • On September 4, the DRC Ministry of Health officially declared an outbreak of Ebola virus disease (EVD) in the Bulape and Mweka health zones in Kasai province. • According the the World Health Organization (WHO), as of September 15 there are 81 suspected cases and 28 deaths , including four nurses . However, data reporting has been challenging, with conflicting statistics reports being circulated by various health authorities. • Kasai is extremely isolated , sometimes requiring multiple days of driving from Kinshasa to Tshikapa, the provincial capital, during the rainy season. Very few air routes reach the province, though an airstrip in Bulape is being established. • Significant gaps exist in the response to EVD , including adequate case management capacity, blood supplies, IPC/WASH support, and more. OUR RESPONSE • International Medical Corps has been responding in the DRC since 1999, and currently has offices in Goma and Kinshasa. • Our Rapid Response Team (RRT) ...

  ABSTRACT Ebola virus (EBOV), the causative agent of Ebola virus disease, remains one of the World Health Organization’s top 10 threats to global health . Infectious EBOV virions can be found on the surface of skin late in infection and may be transmitted to others through skin-to-skin contact . We investigate in vivo EBOV tropism and the kinetics of virus movement to and from the skin. Increasing viral loads were detected over time in the skin of EBOV-infected non-human primates and mice , with antigen detected in dermal stromal and immune cells . Epidermal cells within and surrounding hair follicles also harbored viral antigen , suggesting a novel mechanism of virus egress to the epidermal surface. During late infection, proinflammatory responses were elevated in infected visceral organs but minimal in the skin despite significant viral loads. We observed similar viral trafficking and cell tropism in the skin of mice intraperitoneally infected with a low containment EBOV model v...

  Situation at a glance On 1 September 2025, WHO received an alert from the Ministry of Health of the Democratic Republic of the Congo (DRC) regarding suspected cases of Ebola virus disease (EVD) in the Bulape Health Zone, Kasai Province, DRC .  The first known index case was a pregnant woman who presented at Bulape General Reference Hospital on 20 August 2025 with symptoms of high fever, bloody diarrhoea, haemorrhage and extreme weakness . She died on 25 August from multiple organ failure .  On 4 September 2025 , following confirmatory laboratory testing, the Ministry of Health declared an outbreak of EVD .  Ebola virus disease is a serious , often fatal illness in humans. The virus is transmitted to humans through close contact with the blood or secretions of infected wildlife and then spreads through human-to-human transmission .  As of 4 September 2025, 28 suspected cases, including 15 deaths (case fatality ratio (CFR): 54%), have been reported from three ar...

  Kinshasa – Health authorities in the Democratic Republic of the Congo have declared an outbreak of Ebola virus disease in Kasai Province where 28 suspected cases and 15 deaths , including four health workers, have been reported as of 4 September 2025. The outbreak has affected Bulape and Mweka health zones in Kasai Province where health officials have been carrying out investigations after the cases and the deaths reported presented with symptoms including fever, vomiting, diarrhoea and haemorrhage . Samples tested on 3 September at the country’s National Institute of Biomedical Research in the capital Kinshasa confirmed the cause of the outbreak as Ebola Zaire caused by Ebola virus disease.    A national Rapid Response Team joined by World Health Organization (WHO) experts in epidemiology, infection prevention and control, laboratory and case management has been deployed to Kasai Province to rapidly strengthen disease surveillance, treatment and infection prevention an...

ABSTRACT A cocktail of human monoclonal antibodies 1C3 and 1C11 previously protected macaques from a lethal exposure to either Ebola virus (EBOV) or Sudan virus (SUDV). 1C3 is of particular interest because its paratope strongly binds with unique stoichiometry to the glycoprotein head of several orthoebolaviruses , resulting in neutralization of EBOV and SUDV . Therefore, we evaluated the protective activity of 1C3 as a standalone therapeutic in macaques exposed to either EBOV or SUDV. Two doses of 1C3 monotherapy, administered 4 and 7 days post-exposure, did not protect SUDV-exposed macaques and partially protected EBOV-exposed macaques . Notably, in a macaque that succumbed to EBOV infection, we identified two mutually exclusive escape mutations that emerged immediately after the first dose and resulted in two amino acid changes at the 1C3 binding site . We also detected a subconsensus treatment-emergent mutation likely affecting the 1C3 binding site in all three deceased SUDV-expose...

Abstract Background .  Sudan virus (SUDV) has caused multiple outbreaks in Uganda over the past two decades, leading to significant morbidity and mortality . The recent outbreaks in 2022 and 2025 highlight the ongoing threat posed by SUDV and the challenges in its containment. This study aims to characterize the epidemiological patterns and phylogenomic evolution of SUDV outbreaks in Uganda, identifying key factors influencing transmission and disease severity.  Methods .  We conducted a retrospective observational study analyzing epidemiological and genomic data from SUDV outbreaks in Uganda between 2000 and 2025. Epidemiological data were collected from official sources, including the Ugandan Ministry of Health and the World Health Organization, supplemented with reports from public health organizations. Genomic sequences of SUDV were analyzed to investigate viral evolution and identify genetic variations associated with pathogenicity and transmissibility.  Results...

Abstract In 2018, a clinical trial of four investigational therapies for Ebola virus disease (EVD), known as the PALM trial , was conducted in the Democratic Republic of Congo . All patients received either the antiviral remdesivir (RDV) or a monoclonal antibody product : ZMapp, mAb114 (Ebanga), or REGN-EB3 (Inmazeb). The study concluded that both mAb114 and REGN-EB3 were superior to ZMapp and RDV in reducing mortality from EVD. However, the data suggested that some patients in the RDV and ZMapp groups might have been sicker at the time of treatment initiation. Here, we assessed the efficacy of each of these therapies in a uniformly lethal rhesus monkey model of EVD when treatment was initiated 5 days after Ebola exposure. Treatment with RDV, mAb114, REGN-EB3, and ZMapp each resulted in similar survival (approximately 40% ). Survival was associated with circulating viral load at treatment initiation. A trend of more escape mutants in the GP1 and GP2 domains was observed for the mAb114 ...

Abstract Ebola virus (EBOV) and Marburg virus (MARV) are zoonotic filoviruses that cause hemorrhagic fever in humans . Correlative data implicate bats as natural EBOV hosts , but neither a full-length genome nor an EBOV isolate has been found in any bats sampled. Here, we model filovirus infection in the Jamaican fruit bat (JFB), Artibeus jamaicensis, by inoculation with either EBOV or MARV through a combination of oral, intranasal, and subcutaneous routes . Infection with EBOV results in systemic virus replication and oral shedding of infectious virus. MARV replication is transient and does not shed. In vitro, JFB cells replicate EBOV more efficiently than MARV, and MARV infection induces innate antiviral responses that EBOV efficiently suppresses. Experiments using VSV pseudoparticles or replicating VSV expressing the EBOV or MARV glycoprotein demonstrate an advantage for EBOV entry and replication early , respectively, in JFB cells. Overall, this study describes filovirus species-sp...

{Excerpt} In a global first, Uganda’s Ministry of Health, the World Health Organization (WHO) and other partners today launched a first ever vaccine trial for Ebola from the Sudan species of the virus, and at an unprecedented speed for a randomized vaccine trial in an emergency . The principal investigators from Makerere University and the Uganda Virus Research Institute (UVRI), with support from WHO and other partners, have worked tirelessly to get the trial ready in 4 days since the outbreak was confirmed on 30 January. It is the first trial to assess the clinical efficacy of a vaccine against Ebola disease due to Sudan virus . The speed was achieved through advanced research preparedness, while ensuring full compliance with national and international regulatory and ethical requirements. The candidate vaccine was donated by IAVI , with financial support from WHO, the Coalition for Epidemic Preparedness Innovations (CEPI), Canada’s International Development Research Centre (IDRC), and...