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Event description
The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continues at a high, sustained level of transmission, with no sign of decline: close to 390 confirmed cases were added during the reporting period and the national seven-day average has stayed between 65 and 67 cases per day.
Nord-Kivu now contributes almost as many cases as Ituri and accounts for the entire increase observed over the last 21 days, while contact follow-up fell to its lowest level in weeks at the end of the period.
The importation events in Kenya and Nigeria remain contained: no new case has been reported in Kenya since 19 October, six of the seven surviving patients have been discharged and the last contacts will complete monitoring on 11 November, while no secondary case has been identified in Nigeria, where contact monitoring is expected to end on 13 November.
In the Democratic Republic of the Congo, insecurity in Beni health zone in North Kivu and Bafwasende in Tshopo, health-worker strikes in Bas-Uélé and Tshopo and the continued suspension of response activities in Bafwasende constrain surveillance and response operations.
Democratic Republic of the Congo
As of 7 November 2026, the BVD outbreak in the Democratic Republic of the Congo has affected 67 health zones and 247 health areas across eight provinces; no new health zone was affected during the reporting period.
Since External Situation Report #24, an additional 388 confirmed cases and 197 confirmed deaths have been reported, bringing the cumulative total to 10 920 confirmed cases, including 5 323 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 (69.7%), although its relative contribution is declining, while Nord-Kivu (24.7% of cumulative cases; CFR 54.8%) accounted for 46.1% of the cases reported since the previous report, almost as many as Ituri (47.2%).
Transmission persists at lower levels in Haut-Uélé (4.9% of new cases), Tshopo and Nord-Ubangi.
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 65 and 67 confirmed cases per day during the reporting period (64.7 on 7 November, compared with 67.0 on 1 November and a late-October high of 76), still well below the mid-August peak of 94.
Provincial trends continue to diverge. Ituri continues its slow decline from the late-July peak (seven-day average of 29 cases per day on 7 November, down from 31 on 1 November and 38 on 19 October), while Nord-Kivu has risen to 31 cases per day (up from 30 on 1 November and 26 on 19 October) and exceeded Ituri on several days of the period. Haut-Uélé remains stable at three to four cases per day, Tshopo reports sporadic cases (last case on 5 November) and Nord- Ubangi reported three further cases in Yakoma and Wapinda. Bas-Uélé, Sud-Kivu and Sud-Ubangi have reported no case in the last 21 days (Figures 1 and 2).
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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) belong to a single known chain of transmission, were epidemiologically linked to the index case and were already under quarantine when they developed symptoms; no community spread has been detected.
The last confirmed case was reported on 19 October 2026.
On 6 November, day 32 since the first case was confirmed, the Ministry of Health announced that a sixth patient had recovered and was being discharged after testing negative and meeting all discharge criteria.; only one patient remains under care and continues to be closely monitored.
The 42-day countdown to the end of the outbreak will start once this last patient has recovered and been discharged.
Of the nine confirmed cases, seven were male and two were female, with ages ranging from 24 to 65 years. Designated isolation facilities have 211 isolation beds (scalable to 241).
A total of 135 contacts have been listed since the index case was confirmed, 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.
Of the remaining 118 contacts, 66 had completed their 21 days of monitoring and returned home by 6 November and the remaining 52 are expected to complete quarantine by 11 November 2026.
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Nigeria
Nigeria has 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 11 October; the Nigeria Centre for Disease Control and Prevention (NCDC) was notified on 19 October and the National Reference Laboratory confirmed the infection on 20 October. The patient was clinically stable and, at the request of her country and with clearance from the Nigerian authorities, was medically evacuated to Switzerland on 26 October 2026, where she remains in isolation and under medical care in Geneva.
No additional confirmed case has been reported. As of 5 November 2026, a cumulative 62 contacts linked to the index case had been identified, categorized and followed up; none had developed symptoms, no new contact had been identified, and seven contacts had completed the mandatory 21-day follow- up and left the quarantine facility, with the remaining contacts due to complete follow-up on a staggered basis between 31 October and 13 November 2026.
Exposure remains confined to a single epidemiological cluster directly linked to the index case. 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: close to 390 confirmed cases and 200 deaths were added in one week, the national seven-day average has held between 65 and 76 cases per day for five weeks, and the epicentre continues to shift towards Nord-Kivu, which accounted for the entire 21-day increase in cases (513 to 661) and deaths (250 to 322) and now reports as many cases as Ituri each day. Beni, Mutwanga, Oicha, Mabalako and Kalunguta are the health zones where transmission is intensifying most. At the same time, the performance of the response weakened at the end of the period: contact follow-up fell to 69.8% on 7 November, safe burial completion dropped to 85%, refusals increased, and only half of investigated suspected cases are isolated within 24 hours. Insecurity in Beni, the suspension of activities in Bafwasende and health- worker strikes in Bas-Uélé and Tshopo further increase the risk of undetected transmission.
The absence of new cases in Kenya since 19 October, the discharge of six of the seven surviving patients and the imminent end of contact monitoring in Kenya (11 November) and Nigeria (13 November) indicate that the exported chains have been contained, although surveillance must be sustained until the end-of-outbreak criteria are met. Priorities should focus on reinforcing response capacity in Nord-Kivu, particularly in Beni, Mutwanga, Oicha and Mabalako, restoring contact follow-up and safe burial.
Source: World Health Organization, Regional Office for Africa, https://www.afro.who.int/countries/kenya/publication/bundibugyo-virus-disease-outbreak-democratic-republic-congo-kenya-nigeria-weekly-external-situation
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