The #Bundibugyo Ebola Virus #Emergency and the erosion of global #health #security

 

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Retreating on global public health preparedness efforts through funding disruptions and the withdrawal of support for key agencies such as the WHO, Gavi and others is profoundly short-sighted and will reverse the significant gains that have been made. Ignoring the regional conflicts sustained by misplaced priorities that value mineral extraction above the lives of vulnerable communities only helps create the perfect storm for the next outbreak. The question is not whether there will be another outbreak, or whether there are deadlier viruses still undiscovered, waiting to exploit the fault lines we help create. The question is whether the world's leadership will finally choose to see the basic humanity of vulnerable communities and act to protect them before it is too late. This is not just the right thing to do; it is the only appropriate human response.

Source: 

Link: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006648

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#Filovirus #Surveillance in Communities Bordering Equatorial Guinea, #Marburg #Outbreak, #Cameroon, 2023

 

Abstract

After the 2023 Equatorial Guinea Marburg virus (MARV) outbreak, surveillance of 181 persons in southern Cameroon detected MARV antibodies in 3 persons and Ebola virus antibodies in 7. Testing of 289 captured bats, including 158 Rousettus aegyptiacus bats, did not detect MARV RNA. Enhanced surveillance for regional filovirus spillover risks is warranted.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/8/26-0117_article

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#Ebola disease caused by #Bundibugyo virus, #DRC & #Uganda (WHO D.O.N., July 3 '26): 1460 cases and 452 deaths in DRC

 

Situation at a glance

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continues to evolve rapidly, with sustained transmission and increasing numbers of reported cases. 

    As of 1 July, a cumulative of 1460 confirmed cases, including 452 deaths, have been reported from the Democratic Republic of the Congo. 

    As of 2 July, Uganda has reported 20 confirmed cases including two deaths, as well as one probable case who has died. 

    In addition, on 24 June 2026, French authorities notified WHO of a laboratory-confirmed case of Ebola disease caused by Bundibugyo virus in a medical doctor returning from the Democratic Republic of the Congo. 

    In Uganda, the outbreak remains epidemiologically linked to transmission originating in the Democratic Republic of the Congo, with evidence of both imported infections and secondary transmission among contacts and healthcare workers. 

    Uganda has not reported any new cases since 21 June 2026. 

    National authorities in the two affected countries, in collaboration with WHO and partners, are implementing an extensive set of response measures. 

    A regional preparedness and prioritization framework continues to guide readiness activities across the African Region.

Description of the situation

    Since the last Disease Outbreak News was published on 19 June 2026, the number of confirmed cases and deaths have increased rapidly in the Democratic Republic of the Congo. 

    In total, 1481 confirmed cases; 1460 from the Democratic Republic of the Congo, 20 from Uganda and one from France (linked to DRC); and 454 deaths including two from Uganda, have been reported.  

    At least 229 patients have recovered from the disease; 213 patients from the Democratic Republic of the Congo and 16 patients from Uganda.

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Democratic Republic of the Congo

    Since 19 June when the last Disease Outbreak News was published, an additional 564 confirmed cases, including 220 confirmed deaths, have been reported from the Democratic Republic of the Congo. 

    The increase is in part due to the scale up of surveillance activities, testing and diagnostic capacities.

    As of 1 July 2026, a total of 1460 confirmed cases including 452 deaths (crude case fatality ratio [CFR] 30.9%) have been reported from the Democratic Republic of Congo. 

    So far, 213 patients have recovered. 

    Cases have been reported from 36 health zones (HZ) from Ituri (24/36 HZ), North Kivu (11/35 HZ) and South Kivu provinces (1/34 HZ).[1] 

    To date, 102 confirmed cases including 25 deaths have been reported among health and care workers.

    Of the 36 affected health zones, the outbreak remains active in 21 health zones from where cases have been reported in the past 21 days. The remaining health zones have not reported any new cases during this period. In the past 21 days, 838 confirmed cases, including 314 confirmed deaths, have been reported.

    Ituri Province remains the most affected, accounting for 91.3% (1333/1460) of all confirmed cases and 84% (380/452) of all reported deaths nationwide. Within the province, the highest number of confirmed cases have been reported from Bunia (416 cases), Rwampara (308 cases), Mongbwalu (270 cases), Nyankunde (95 cases), and Nizi (65 cases) health zones. 

    As of 1 July, the outbreak has spread to three additional health zones in the province. Following epidemiological investigations, three confirmed cases with travel history from Nia Nia health zone in Ituri province have been reported on 30 June in Wamba health zone in Haut Uele Province and Kisangani in Tshopo province. These cases have been reported under Nia Nia health zone. Response activities, including contact tracing and follow-up, are ongoing in both provinces. Of the total confirmed cases, 17 are yet to be assigned to a specific health zone.

    As of 1 July, 10 821 contacts have been identified and are under follow-up across Ituri (8376), and North Kivu (2445). Of these, 8954 contacts have been followed up, corresponding to follow-up rates of 83.2% in Ituri, and 81% in North Kivu. Previously listed contacts from South Kivu province have completed 21 days of follow up.  

    In addition, 107 contacts of the case reported in France have been listed and are under follow up in Kinshasa.

    The outbreak is unfolding in a complex humanitarian and conflict-affected environment, characterized by highly mobile and often displaced populations, often lacking access to basic services, including food, clean water, shelter, healthcare and protection which poses an increased risk of transmission to the populations living in overcrowded internally displaced camps. These dynamics, combined with increasing security-related incidents affecting health facilities, have posed additional operational challenges in affected provinces, such as constrained access for response teams, disrupted surveillance and response activities, and heightened risk of undetected transmission. These conditions underscore the need for response efforts to be led by local leaders and anchored in communities.

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Figure 2: Number of confirmed cases (n = 1460), in the Democratic Republic of the Congo, by date of reporting, as of 1 July 2026  Confirmed cases in DRC

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Figure 3: Number of deaths among confirmed cases (n = 452), in the Democratic Republic of the Congo, by date of reporting, as of 1 July 2026. Deaths in DRC

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NB: Newly reported confirmed cases/deaths may be part of the backlog of samples and therefore not necessarily newly acquired infections. 

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Uganda

    The last confirmed case was reported to be identified on 21 June 2026.  

    As of 2 July 2026, a cumulative of 20 confirmed cases including two deaths in imported cases (reported on 15 May and 5 June), and one probable case who has died, have been reported. 

    Of the confirmed cases, 15 are imported cases, while five are secondary cases among contacts and health workers with links to imported cases from the Democratic Republic of the Congo. 

    The cases have been reported in two districts, Kampala and Wakiso, both part of the Kampala Metropolitan Area. 

    To date, there has been no documented community transmission in Uganda. 

    Exposure risks are associated with healthcare settings and cross-border movements. 

    Following case reclassification, the number of affected healthcare workers was revised from five to four. In total, 16 recoveries have been reported to date.

    Of the 831 contacts listed as of 28 June, 821 contacts have completed their 21-day follow-up period as of 2 July.

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Figure 4: Number of confirmed cases (n = 20), in Uganda by date of reporting, as of 2 July 2026 

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France:

    On 24 June 2026, French authorities notified WHO of a laboratory-confirmed case of Ebola disease caused by Bundibugyo virus in a middle-aged male medical doctor returning from the Democratic Republic of the Congo. 

    The patient had been deployed for five weeks in Ituri Province, where he was involved in the care of patients with BVD. 

    Upon arrival at Charles de Gaulle Airport on 23 June 2026, the patient self-reported symptoms to airport health authorities, prompting immediate isolation and referral to a designated high-containment healthcare facility.

    At the time of reporting, the patient was clinically stable and had no fever, with no reported vomiting, diarrhoea, or haemorrhagic manifestations during travel. PCR testing detected Bundibugyo virus. Comprehensive contact tracing has been initiated in the Democratic Republic of the Congo and in France.

Epidemiology

    Bundibugyo virus disease (BVD) is a severe Ebola disease caused by the Bundibugyo virus, one of the Orthoebolavirus species. It is a zoonotic disease, with fruit bats suspected to be the natural reservoir. Human infection is thought to occur through close contact with the blood or secretions of infected wildlife, such as bats or non-human primates, and it subsequently spreads from person to person through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals or contaminated surfaces or items. Transmission is particularly amplified in health-care settings when infection prevention and control (IPC) measures are inadequate, and during unsafe burial practices involving direct contact with the deceased.

    The incubation period for BVD ranges from two to 21 days, and individuals are not infectious until symptom onset. Early symptoms such as fever, fatigue, muscle pain, headache, and sore throat, are non-specific, which complicates clinical diagnosis and can delay detection. These symptoms then progress to gastrointestinal symptoms, organ dysfunction, and in some cases haemorrhagic manifestations. CFRs in the past two BVD outbreaks, reported in Uganda and in the Democratic Republic of the Congo in 2007 and 2012 were 30% and 50%, respectively.

    Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. Outbreak control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.

Public health response

    Health authorities in the Democratic Republic of the Congo and Uganda, in collaboration with WHO and partners, are implementing extensive public health measures including implementing the continental response plan, engaging donors and mobilizing additional resources to address critical funding gaps and sustain response operations across affected and at-risk areas.

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WHO risk assessment

    On 6 June 2026, WHO reassessed the risk of the outbreak of BVD to incorporate newly available information and align with the WHO Temporary Recommendations. 

    The risk for countries sharing land borders with countries with documented Bundibugyo virus (BVDV) detection, currently the Democratic Republic of the Congo and Uganda, has been separated out from the risk for other countries in the African Region.

    The risk in the Democratic Republic of the Congo remains assessed as very high due to ongoing transmission and the continued expansion of the outbreak into new health zones, increasing the potential for further national and regional spread.

    The risk in Uganda is assessed as high due to confirmed cross-border spread through imported cases and ongoing epidemiological links along the eastern Democratic Republic of the Congo–western Uganda corridor, historically affected by Ebola outbreaks, including Bundibugyo and Sudan virus disease outbreaks.

    The risk for countries with land borders adjoining countries with documented BDBV detection is assessed as high due to sustained population mobility linked to cross-border trade and mining activities, variation in capacities and experience of BVD response, and variable levels of readiness.

    The risk for the rest of the Africa region and at the global level is assessed as low.

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WHO advice

    WHO advises against any restriction of travel to, or trade with, the Democratic Republic of the Congo or Uganda based on the currently available information. WHO continues to closely monitor and, where necessary, verify travel and trade measures in relation to this event.

    For further information on the considerations for implementing border health and international travel-related temporary recommendations, please see the relevant technical note issued on 26 May 2026.

    The Temporary Recommendations issued to State Parties on 22 May 2026 underscore the importance of coordinated outbreak control, enhanced cross‑border collaboration, and sustained surveillance and preparedness to prevent further regional spread and ensure an effective public health response.

    WHO has convened several technical advisory groups, including the Strategic Advisory Group of Experts on Immunization (SAGE) to assess candidate vaccines and therapeutics for BVD. Key recommendations made are available in the news release published on 28 May 2026.

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Citable reference: World Health Organization (3 July 2026). Disease Outbreak News; Bundibugyo Virus Disease, Democratic Republic of the Congo and Uganda. Available at https://www/who.int/emergencies/disease-outbreak/news/item/2026-DON612

 [1] #Data source: Centre des opérations d'urgences de sante publique (COUSP-DRC) 

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON612

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#Ebola #laboratory #preparedness at #frontline hospitals: can we or can’t we?

 

ABSTRACT

Frontline hospitals are required to care for patients with suspected viral hemorrhagic fever (VHF), yet guidance on laboratory preparedness remains fragmented and incomplete. We conducted a multidisciplinary risk assessment of our institutional capacity to perform routine diagnostic testing for VHF persons under investigation (PUI), focusing on the feasibility of using automated core laboratory instruments. Our assessment revealed substantial gaps between CDC guidance (which permits core lab testing) and the practical ability to implement it safely. Public health mandates for VHF preparedness have not been accompanied by granular guidance on biosafety, laboratory infrastructure, or regulatory clarity necessary for implementation. Community hospitals, which would benefit most from safely using their existing automated core laboratory instruments, lack the infrastructure, staffing expertise, and clear guidance to do so, while well-resourced tertiary centers are often best positioned to develop dedicated point-of-care testing (POCT)-based workflows. Federal and state authorities must provide explicit, validated examples of acceptable mitigation strategies for testing using core lab instrumentation and reconcile conflicting recommendations across guidance documents. Without such authoritative clarity, frontline hospitals cannot confidently meet their mandated VHF preparedness obligations.

Source: Journal of Clinical Microbiology, https://journals.asm.org/journal/jcm

Link: https://journals.asm.org/doi/10.1128/jcm.00903-26

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Past #lessons for the 2026 #Bundibugyo virus #outbreak: #filovirus infection #prevention in #conflict-affected settings

 

Summary

In May 2026, the World Health Organization declared a Public Health Emergency of International Concern after Bundibugyo virus disease re-emerged in Ituri Province, Democratic Republic of the Congo, with cross-border transmission to Uganda. The suspected index case was a healthcare worker, and at least four healthcare workers had died before the outbreak was confirmed. The outbreak is unfolding in a region characterised by armed conflict, mass displacement, fragile governance and disrupted clinical infrastructure — a setting in which the high-containment infection prevention measures developed for filovirus disease in well-resourced facilities are difficult to implement reliably. In this narrative, evidence-informed review we propose an achievable infection prevention bundle for filovirus outbreaks in conflict-affected settings, framing personal protective equipment, training, supervised doffing, supply chains, staffing, environmental controls and facility organisation as interdependent components of a single coherent system rather than as alternatives. We summarise outbreak situation reports, operational documentation and simulation evidence; identify operational failure modes in austere conditions; and propose an eight-element bundle prioritised by implementation urgency. The bundle is anchored in WHO core IPC programme guidance. Most of the available evidence base is filovirus-general or Zaire ebolavirus-derived; extrapolation to Bundibugyo virus is reasonable but limited, and the bundle should be understood as a framework for decision-making rather than as a validated intervention package.

Source: Journal of Hospital Infection, https://www.journalofhospitalinfection.com/

Link: https://www.journalofhospitalinfection.com/article/S0195-6701(26)00266-5/abstract

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#Ebola at 50 — #Lessons for #Outbreak Response and #Preparedness

 

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Key Lessons from Ebola’s History for Outbreak Response and Preparedness.

1. Discovery is a continuum. 
• Ebola virus was identified by means of an interdependent process involving African clinical recognition, patient care, field investigation, epidemiology, specimen collection, and international laboratory science.
2. Recognition matters. 
• A complete historical account should acknowledge the contributions of African clinicians, scientists, health workers, and communities alongside international collaborators.
3. Partnerships are essential to outbreak response. 
• Effective outbreak response depends on coordination among frontline health workers, communities, ministries of health, research institutions, and national and international partners.
4. Frontline responders are central contributors. 
• Clinicians, nurses, laboratory personnel, community health workers, burial teams, and other responders play indispensable roles in outbreak detection, control, and knowledge generation.
5. Community trust is a preparedness asset. 
• Trust, meaningful community engagement, respectful care, and transparent communication are fundamental determinants of outbreak-control success.
6. Equity must be built before emergencies. 
• Shared leadership, equitable authorship, sample and data governance, benefit sharing, and sustained support for local and regional institutions are essential for effective and sustainable outbreak science.
7. Outbreak response and preparedness must extend beyond Zaire ebolavirus. 
• The Bundibugyo outbreak highlights the need for diagnostics, vaccines, therapeutics, and clinical trial readiness across pathogenic ebolaviruses.
8. Sustained investment between outbreaks is essential. 
• Long-term investment in workforce development, laboratories, surveillance systems, clinical research platforms, regulatory capacity, and manufacturing strengthens preparedness.

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Source: 

Link: https://www.nejm.org/doi/full/10.1056/NEJMp2607819?query=TOC

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#Ebola #Bundibugyo virus disease #outbreak: #DRC, #Uganda - Weekly External #Situation #Report 07, Data as of 28 June 2026 (#WHO, edited): 1,307 cases and 377 deaths in DRC

 

Summary 

[Country - Confirmed Cases - Confirmed Deaths - Probable Cases - Probable Deaths - Total Cases (Confirmed & Probable) - Total Deaths (Confirmed & Probable) - CFR (%) Confirmed & Probable ]

    -- Democratic Republic of the Congo

        ° 1 307 - 377 - ...  - ... - ... - 1 307- 377 - 28.8% 

    -- Uganda

        ° 20 - 2 - 1 - 1 - 21 - 3 - 14.3% 

    -- France

        ° 1 - 0 - 0 - 0 - 1 - 0 - 0.0%

Event description

    The Bundibugyo virus disease (BVD) outbreak remains active, with ongoing transmission in the Democratic Republic of the Congo and one imported case reported in France in a physician returning from the affected country. 

    In the Democratic Republic of the Congo, the number of confirmed cases continue to rise, and an additional health zone reported cases during the current reporting week. 

    No new confirmed cases were reported in Uganda over the past week.

Democratic Republic of the Congo

    Since the last update of 21 June 2026 (Situation Report #6), cumulative case incidence in the Democratic Republic of the Congo has increased by 24.7%, with 259 new confirmed cases reported. 

    Cumulative deaths also increased by 41.2%, with 110 new confirmed deaths recorded during the reporting period. 

    An additional health zone, Mandima in Ituri Province, reported its first confirmed case, bringing the total number of affected health zones since the start of the outbreak to 35.

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    Of the 35 affected health zones, the outbreak remains active in 28 health zones that have reported cases in the past 21 days. 

    

    The remaining seven health zones have not reported any new cases during this period. 

    These include Gety (38 days), Mambasa (26 days), Rimba (25 days), and Aru (24 days) in Ituri Province; Kalunguta (35 days) and Goma (34 days) in North Kivu Province; and Miti-Murhesa (39 days) in South Kivu Province.

    Among the 28 health zones that have reported 709 confirmed cases, including 262 confirmed deaths in the past 21 days, transmission remains heavily concentrated in Ituri Province, which accounts for 89.4% of reported cases (634 cases) and 86.3% of deaths (226 deaths) during this period. 

    Most cases reported during this period were from Bunia (181), Rwampara (173), Mongbwalu (144), Nyankunde (62), and Nizi (34) in Ituri  Province, as well as Butembo (27) and Katwa (26) in North Kivu Province. 

    Together, these health zones account for 91.3% of all confirmed cases reported nationally over the past 21 days. 

    No new confirmed case has been reported from South Kivu since 26 May 2026.

    Deaths reported during the same period were also concentrated in a limited number of health zones, particularly Mongbwalu (81), Bunia (59), Rwampara (36), Katwa (15), Nyankunde (12), Mangala (12),and Butembo (10). 

    Together, these health zones account for 85.9% of all deaths reported nationally in the past 21 days.

    Cumulatively, a total of 1307 confirmed cases, including 377 confirmed deaths [case fatality ratio (CFR) 28.8%], have been reported in the Democratic Republic of the Congo since the start of the outbreak. 

    Ituri Province remains the most affected, accounting for 91.6% (1197) of all confirmed cases and 84.4% (318) of all reported deaths nationwide.

    The most affected health zones are Bunia (344 cases, 74 deaths), Rwampara (295 cases, 56 deaths), Mongbwalu (258 cases, 121 deaths), Nyankunde (94 cases, 13 deaths), and Nizi (39 cases, 9 deaths), all located in Ituri Province, as well as Katwa (38 cases, 23 deaths) and Butembo (33 cases, 14 deaths) in North Kivu Province. Together, these seven health zones account for 84.2% of cumulative confirmed cases and 82.2% of confirmed deaths reported nationally.

    The CFR remains highest in North Kivu Province at 54.2% (58 deaths/107 cases), followed by South Kivu at 33.3% (1/3), and Ituri at 26.6% (318/1197), indicating persistently higher mortality among reported cases in North Kivu.

    The geographic distribution of recent transmission largely mirrors the cumulative outbreak pattern, with sustained concentration in Ituri Province and continued high mortality reported from a limited number of health zones.

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    As of 28 June 2026, a total of 9968 contacts were under follow-up across affected provinces in the Democratic Republic of the Congo, of whom 8105 (81.3%) were successfully seen in the past 24 hours. 

    

    Ituri accounted for the largest number of contacts under follow-up, with 7706 contacts, of whom 6319 (82.9%) were reached. 

    In North Kivu, 2244 of 1696 contacts (75.6%) were seen, while all 18 identified contacts in South Kivu were followed up, corresponding to a 100% follow-up rate. 

    Despite recent improvements, contact follow-up coverage remains suboptimal overall, leaving a significant proportion of contacts not reached and increasing the risk of missed infections and ongoing transmission.

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Uganda

    No new case has been reported from Uganda since the last update. The most recent case, reported on 21 June 2026, involved a truck driver operating along the Democratic Republic of the Congo–Uganda international route. The case developed symptoms on 15 June 2026, entered Uganda on 19 June 2026, and was isolated on 20 June 2026 at the Mulago Ebola Treatment Unit.

    As of 28 June 2026, a cumulative total of 21 cases (20 confirmed and one probable), including three deaths (two confirmed and one probable), had been reported in the Kampala. 

    A total of 15 patients have recovered and been discharged, while three remain admitted for care. 

    Of the 831 contacts identified since the start of the outbreak, five remained under follow-up as of 28 June 2026.

{Click on Image to Enlarge}

France

    On 24 June 2026, French authorities notified WHO of a laboratory-confirmed case of Ebola disease caused by Bundibugyo virus in a middle-aged male physician returning from the Democratic Republic of the Congo. 

    The patient had been deployed for five weeks in Ituri Province, where he was involved in the care of patients with BVD. 

    Upon arrival at Charles de Gaulle Airport on 23 June 2026, the patient self-reported symptoms to airport health authorities, prompting immediate isolation and referral to a designated high-containment healthcare facility.

    At the time of reporting, the patient was clinically stable and apyretic, with no reported vomiting, diarrhoea, or haemorrhagic manifestations during travel. 

    PCR testing detected Bundibugyo virus. Comprehensive contact tracing has been initiated.

Risk Assessment

    The overall risk remains very high in the Democratic Republic of the Congo, with transmission continuing at a scale that exceeds current response capacity, particularly in the Bunia–Rwampara–Mongbwalu corridor and across other affected health zones. 

    North Kivu’s markedly higher CFR points to possible delays in diagnosis and access to care, while clinical capacity in Ituri is approaching saturation. 

    Although contact follow-up and alert investigation have improved, performance remains insufficient to rapidly interrupt transmission. 

    Uganda remains exposed through sustained population movement from eastern Democratic Republic of the Congo, including trucking routes and possible informal cross-border movement linked to border closures. 

    

    The imported case reported in France further confirms that international exportation risk persists, requiring strengthened surveillance, traveller awareness, and cross-border coordination

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Situation interpretation

The BVD outbreak continues to expand at a pace that exceeds current response capacity, with sustained high-intensity transmission ongoing in several hotspot areas. 

    Although important operational gains have been achieved, including improved contact follow-up, expanded decentralized laboratory capacity, increased treatment capacity, and strengthened cross-border coordination, overall response performance remains below the level required to rapidly interrupt transmission. 

    The continued increase in cases and deaths, near-saturation of treatment facilities, and suboptimal IPC readiness in health facilities underscore the need for a stronger operational surge focused on hotspot containment, rapid case detection and isolation, expansion of decentralized clinical and laboratory services, enhanced community engagement, and strengthened cross-border surveillance. 

    The imported case reported in France further highlights the continuing risk of international spread and reinforces the need for sustained regional and international mobilization, including rapid operationalization of pledged resources and intensified support to frontline response activities.

Source: 

Link: https://reliefweb.int/report/democratic-republic-congo/ebola-bundibugyo-virus-disease-outbreak-democratic-republic-congo-uganda-weekly-external-situation-report-07-data-28-june-2026

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#Bundibugyo virus disease: #transmission dynamics, infectiousness and viral #persistence

 

Abstract

BVD is a severe filoviral haemorrhagic fever caused by the Bundibugyo virus (BDBV), for which outbreak-related evidence remains limited compared with that available for Zaire ebolavirus. This perspective summarizes current evidence on transmission dynamics, presymptomatic infectiousness, post-recovery viral persistence and the duration of infectiousness, distinguishing BDBV-specific data from evidence extrapolated from other ortho-Ebolaviruses.

Available epidemiological data from the 2007–2008 outbreak in Uganda indicate that BDBV transmission occurs primarily through direct contact with the blood or body fluids of symptomatic or deceased individuals, with the handling of corpses representing a significant risk factor (adjusted odds ratio 3.83; 95% confidence interval 1.78–8.23).

The average incubation period is 6.3 days, and prolonged chains of transmission were documented in household and healthcare settings. No documented evidence of pre-symptomatic transmission in humans is currently available, although experimental animal data suggest biological plausibility.

No BDBV-specific data are available regarding viral persistence and duration of infectiousness. Consequently, current recommendations rely largely on evidence derived from other orthoebolaviruses. Viral RNA may persist after recovery in immunoprivileged sites, particularly in semen, with rare but documented episodes of delayed transmission. The ongoing outbreak highlights the need for BDBV-specific studies to strengthen the evidence base underpinning public health recommendations.

Source: 

Link: https://www.ijidonline.com/article/S1201-9712(26)00574-6/fulltext

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#Fact-finding #mission on #airport exit #screening - EU Health Task Force mission to #DRC and #Uganda, #Bundibugyo virus disease #outbreak 2026 (ECDC, summary)

 

Executive summary

    This report provides a snapshot of the infrastructure and procedures in place for exit screening in the main international airports of each capital city: N’djili International Airport in Kinshasa (DRC) and Entebbe International Airport in Kampala (Uganda). 

    Exit screening in these airports, including symptom checks and exposure assessment, can contribute to reducing the risk of onward transmission by identifying travellers who are symptomatic before they board, and preventing them travelling with symptoms. 

    It also helps dissuade people who are ill from travelling, and enhances public and stakeholder confidence in the public health response. 

    However, it cannot fully prevent the exportation of cases, as the absence of symptoms at departure does not exclude subsequent onset of disease upon or after arrival. 

    The mission team found that both countries have established coordinated exit screening systems, supported by strong political commitment and national leadership to prevent international transmission of Ebola disease. 

    These function alongside domestic containment efforts based on extensive experience of managing previous Ebola disease outbreaks. 

    In both countries, the mission team observed a high degree of transparency and willingness to engage with stakeholders through facilitating access to systems and operations. 

    The site visit at both airports demonstrated that the exit screening systems in place are in line with international standards and benefit from effective multi-sectoral collaboration, involving public health authorities, aviation actors, border services, security forces, and international partners. 

    Screening processes have clear referral and escalation pathways supported by trained medical personnel and infection, prevention and control (IPC) measures. 

    While the systems in place are functional, the mission identified opportunities for further targeted interventions, particularly in relation to passenger processing, digital integration, IPC measures and risk communication. 

    These findings have been communicated to the national authorities in both countries. 

    Regular training, supervision and monitoring over time by national teams and international partners will help to sustain and further improve practices.

Source: 

Link: https://www.ecdc.europa.eu/en/publications-data/fact-finding-mission-airport-exit-screening-eu-health-task-force-mission

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TAG-TP #statement on #immunomodulators and host-directed #therapies for #Bundibugyo virus disease (WHO, June 26 '26)

    In the context of prioritization of therapeutics to be included in clinical research for Bundibugyo virus disease (BVD) the Technical Advisory Group on Therapeutics Prioritization (TAG-TP) has begun examining the landscape of immunomodulatory and host-directed new or repurposed agents. 

    Currently, there are no studies in patients characterizing the downstream pathogenesis that follows infection with Bundibugyo virus (BDBV). 

    The available evidence derives mainly from data collected with Ebola virus, specifically Zaire ebolavirus (EBOV) that provides relevant information from animal models and patients, but not sufficient to allow a proper assessment for the selection of immunomodulatory and host-directed candidates for clinical trials in BVD. 

    In addition, it is noted that even corticosteroids have never been tested in a stringent filovirus animal model. 

    For other infectious diseases leading to sepsis or other severe disease evolutions, it is also noted that immunomodulators can be beneficial or detrimental depending on the timing of the administration.

    To allow for a proper scientific evaluation of the different potential interventions, the appropriate timing of administration and the appropriate patient selection for inclusion in large clinical trials, it is imperative to generate quality data on the natural history of BVD from people infected with BDBV. 

    This would likely need to occur at select clinical sites that are adequately equipped to collect and analyze samples from patients with BVD. 

    Suggested data for collection include immune makers associated with inflammation and innate/adaptive immunity, correlative viral load and clinical features, markers of coagulation perturbation and organ/tissue damage. 

    This will help identify biomarkers pertaining to a pro-inflammatory status with co-relation to clinical phenotypes and organ dysfunction.

    Only in this way will it be possible to identify and/or confirm potential pharmacological targets and related potential interventions. 

    Collecting further evidence is paramount to minimizing risks to participants in clinical trials, as, depending on individual patient phenotypes and the status of disease evolution, the administration of some immunomodulatory agents may result in detrimental effects (e.g. on viral replication).

    In addition, some of these clinical investigations may have to be tailored to specific immune phenotypes based on the pharmacological activity of the investigational candidate, but sophisticated biomarker testing should be avoided to ensure implementation of clinical trials at BDBV Treatment Units.

    Lastly, timely availability of data from animal models would also provide evidence to facilitate the identification of the most promising therapies for inclusion in clinical trials.

Source: 

Link: https://www.who.int/news/item/26-06-2026-tag-tp-statement-on-immunomodulators-and-host-directed-therapies-for-bundibugyo-virus-disease

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Size of the 2026 #Ebola #outbreak and #risk of cross-border #spillover from #Bundibugyo virus in Ituri Province, #DRC, and its implications for #preparedness: a recalibrated stochastic modelling study

 

Summary

Background

On May 15, 2026, WHO declared a Bundibugyo virus (BDBV) outbreak in Ituri Province, DR Congo with an estimated index case on April 1, 2026 (6-week pre-declaration interval). By May 24, DR Congo reported 906 suspected cases (105 confirmed and ten confirmed deaths) across three provinces. Uganda reported seven confirmed cases (three imported; four locally acquired including three health-care workers; case-fatality ratio 14%). WHO declared a Public Health Emergency of International Concern on May 17, 2026; Africa Centres for Disease Control and Prevention declared a Public Health Emergency of Continental Security on May 18, 2026. The study aimed to establish a short-term trajectory of the BDBV outbreak and probability of cross-border spillover into countries with elevated risk of importation to guide preparedness priorities.

Methods

We calibrated a stochastic SEIRD (susceptible, exposed, infectious, recovered, and dead) ensemble model to the laboratory-confirmed case series, anchoring on 598 cumulative confirmed cases on June 8, 2026 (day 68) using simulation filtering (calibration window ±30%; reporting fraction 1·0 for laboratory-confirmed cases). The case-fatality ratio was drawn from a previous value centred on the observed confirmed-case ratio of approximately 19% (115 of 598). A linked daily-hazard spillover model estimated importation probability for Uganda, South Sudan, Rwanda, and Burundi over a 12-week horizon. The early suspected-case series, which peaked at 1077 on May 26, 2026, before being substantially revised downward by laboratory reclassification, is reported for context but was not used for calibration.

Findings

Laboratory-confirmed DR Congo cases rose from 33 on May 18, 2026, to 598 by June 8, 2026. Calibrated to the confirmed-case anchor (598 on June 8, 2026; central basic reproduction number [R0]=1·71), the confirmed-case trajectory is most consistent with the central scenario. Under the central scenario the ensemble projected a median of 990 cumulative confirmed cases by week 12 (June 24, 2026; 90% prediction interval [PI] 709–1293) and 174 deaths; the low scenario projected 870 confirmed cases (90% PI 641–1133) and 160 deaths. The early suspected-case count (peak 1077 on 26 May 2026) was substantially revised by laboratory reclassification and is reported for context only. Cross-border spillover remained material: Uganda 94·2% importation probability (19 confirmed cases as of June 4, 2026, including five health-care worker infections and two deaths); South Sudan 69·3%; Rwanda 8·6%; and Burundi 2·0%. As of June 22, 2026, DR Congo has 1048 confirmed cases and 267 confirmed deaths and Uganda has 20 confirmed cases, two confirmed deaths, and one probable death. These numbers are changing daily and are likely to align with what is predicted in the central scenario.

Interpretation

From the most recent laboratory-confirmed data, the outbreak is closer to what is predicted by the central scenario, even with the intensified response within DR Congo. However, uncertainty remains around reported case numbers due to low rate of contact tracing. Sustained control nonetheless remains the primary determinant of regional risk: importation into Uganda is already established, and South Sudan must continue to reinforce infection prevention and control, rapid response capacity, and cross-border surveillance under International Health Regulations 2005. These projections should be interpreted as exploratory preparedness-oriented estimates derived from a stochastic scenario-based modelling framework, rather than predictions generated from formally fitted epidemiological models using comprehensive parameter estimation and identifiability analyses.

Funding

None.

Translations

For the French and Swahili translations of the abstract see Supplementary Materials section.

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00320-8/fulltext

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#Antibodies Cross-Reactive with #Bundibugyo Virus in #Ferrets Vaccinated with #Ebola Virus #Vaccine

 

Abstract

Banked serum samples from ferrets previously immunized with the Ebola virus vaccine revealed a prominent but limited humoral immune response that cross-reacted with Bundibugyo virus. The supporting immunogenicity data we report may help guide the ongoing response to the current outbreak of Bundibugyo virus in the Democratic Republic of the Congo.

Source: Emerging Infectious Diseases Journal, https://wwwnc.cdc.gov/eid/

Link: https://wwwnc.cdc.gov/eid/article/32/8/26-0948_article

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#Bundibugyo Virus Disease in 2026 — #Clinical and Public Health #Responses

 

Summary

Bundibugyo virus is a relatively rare orthoebolavirus that has caused only two previously recognized disease outbreaks but remains capable of producing severe epidemic disease with substantial mortality. The 2026 outbreak of Bundibugyo virus disease in the Democratic Republic of Congo has highlighted persistent challenges in the detection of filovirus disease outbreaks, as well as in diagnosis, clinical management, and the public health response, particularly in resource-limited settings. As with other filovirus infections, effective control of the Bundibugyo virus disease outbreak depends on rapid identification of cases, laboratory confirmation of infection, isolation of cases, contact tracing, infection-prevention measures, protection of health care workers, and community engagement. Although no licensed vaccines or approved therapeutics specific to Bundibugyo virus disease are currently available, advances in supportive care have improved outcomes during recent filovirus disease outbreaks. Experimental evidence from studies involving nonhuman primates, serologic investigations with human samples, and monoclonal antibody research suggests that vaccines and therapeutics developed against Ebola virus may provide cross-protective activity against Bundibugyo virus. These observations support prototype-pathogen approaches to preparedness while underscoring the need for continued development of pathogen-specific countermeasures. The current outbreak reinforces the principle that a successful response to filovirus disease requires integration of medical countermeasures, clinical care, surveillance, diagnostics, and coordinated multinational public health operations.

Source: 

Link: https://www.nejm.org/doi/full/10.1056/NEJMra2607216?query=TOC&cid=DM2454531_NEJM_Non_Subscriber&bid=-732391206

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#Clinical Characteristics of #Patients Infected with #Bundibugyo Virus, #DRC 2026

 

{Excerpt}

To the Editor:

The clinical characterization of Bundibugyo virus disease (BVD), caused by Bundibugyo virus, a species of orthoebolavirus, is less well described than infection with more frequently encountered filovirus species.1 We report here signs and symptoms and basic laboratory data from the current 2026 BVD outbreak in the Democratic Republic of Congo (DRC). Ethics approval for this study was obtained from the ethical review committee of the University of Kinshasa.

(...)

In this cohort, we report signs and symptoms at the time of presentation that were mostly consistent with previous descriptions of infection with Bundibugyo virus3 and other filovirus species.

(...)

Link: https://www.nejm.org/doi/full/10.1056/NEJMc2608070?query=TOC

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#Healthcare-associated #transmission and early #IPC system #vulnerabilities during 2026 #Bundibugyo #Ebola #outbreak in eastern #DRC

 

Abstract

The 2026 Bundibugyo Ebola outbreak in eastern DRC highlighted important early infection prevention and control (IPC) challenges, including healthcare-associated transmission, healthcare worker infections, unsafe triage systems, limited isolation capacity, and shortages of IPC supplies. This commentary argues that pathogen-specific preparedness may remain insufficient in settings characterized by diagnostic uncertainty and proposes an “IPC-first” outbreak response framework based on rapid syndromic IPC activation before definitive laboratory confirmation becomes available.

Source: 

Link: https://link.springer.com/article/10.1186/s13756-026-01779-8

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#France, #Ebola: First case identified in a humanitarian #doctor returning from a mission in the #DRC (Min. Health, June 24 '26)

 

    France has specialized capabilities for managing highly transmissible infectious diseases. Patients are treated in a designated healthcare facility, following strict biosafety protocols (negative pressure room, dedicated equipment and protocols). Health authorities are fully mobilized and the situation is being continuously monitored.

    All precautionary measures, including the patient's isolation, were taken upon his arrival in the country, with transfer to the hospital under secure conditions to prevent any risk of contamination. 

    A thorough epidemiological investigation is underway to identify individuals who may have been in contact with the patient. 

    These individuals will be contacted without delay by the regional health agency, will undergo 21 days of home isolation, and will be closely monitored during this period. 

    Following the Public Health Emergency of International Concern (PHEIC) declared by the World Health Organization (WHO) on May 17 in response to the active circulation of the Ebola virus in Ituri Province, DRC, the European Centre for Disease Prevention and Control (ECDC) has assessed the risk of infection as low for European residents and travelers to areas of active transmission, and very low for the general European population.

    A dedicated monitoring system is in place for the return of French aid workers to the national territory.

What is the Ebola virus?

    Ebola virus disease is a serious and often fatal illness. The virus is transmitted to humans from wild animals and then from person to person through direct contact with:

        ° Bodily fluids (blood, saliva, urine, semen, breast milk, sweat, feces and vomit from infected persons, whether alive or not);

        ° The bodies of people who died from Ebola virus disease;

        ° Objects that have been contaminated by the bodily fluids of infected patients (e.g., needles);

        ° Bushmeat from wild animals.

    The disease is characterized by high fevers and often fatal hemorrhages. 

    The incubation period, that is, the time between contact with the virus and the appearance of the first symptoms, varies from 2 to 21 days. 

    As long as they do not show symptoms, infected individuals are not contagious. 

    Currently, there is no specific treatment for Ebola {Bundibugyo virus} disease; treatment focuses on managing the symptoms, particularly through rehydration.

What are the health recommendations?

    Given the absence of the virus circulating on French territory, the precautionary health recommendations apply mainly to the French territories bordering the Indian Ocean, and to travelers going to or returning to the DRC in the provinces of Ituri, North Kivu and South Kivu and Uganda.

    {1} For French nationals currently in the country, it is recommended to avoid areas experiencing outbreaks of the epidemic and, if this is impossible, to:

        ° Respect basic hygiene rules, including regular hand washing;

        ° Avoid close contact with people who have a fever. The virus is transmitted through direct contact with blood or bodily fluids;

        ° Avoid all contact with wild animals, alive or dead;

        ° Do not consume or handle bushmeat.

    {2} For travelers going to areas where the virus is circulating, it is recommended that those who can postpone their trip, especially the most vulnerable (elderly people, people with disabilities, pregnant women, or those with comorbidities). If the trip must proceed, it is recommended to follow the aforementioned health guidelines and to:

        ° Regularly consult the information from the embassy or the "Travel Advice" section of the Ministry for Europe and Foreign Affairs;

        ° Register for free on the Ariane Thread , in order to receive in real time all information and alerts from the French authorities;

    {3} For travelers returning to France from an area with active virus transmission, the following is required:

        ° Monitor your temperature every day for 21 days;

        ° If you develop a fever of 38°C or higher, and up to 21 days after returning to France, contact 15 immediately and await instructions. Do not go to your doctor or the hospital emergency room.

(...)

Source: 

Link: https://sante.gouv.fr/actualites-presse/presse/communiques-de-presse/article/ebola-identification-d-un-1er-cas-chez-un-medecin-humanitaire-de-retour-de

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