#USA, #Wastewater Data for Avian #Influenza #H5 (US CDC, Sept. 11 '26)

 

{Excerpt}

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A(H5) detections in the past week

Time Period: August 30, 2026 - September 05, 2026

    -- A(H5) Detection: 8 site(s) (1.9%)

    -- No Detection: 422 site(s) (98.1%)

    -- No samples: 95 site(s)

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(...)

Source: 

Link: https://www.cdc.gov/wastewater/emerging-viruses/h5.html?

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Seasonal #surveillance in #humans in 2026 for #WNV - Weekly Report (ECDC, September 11 '26): 1,285 cases so far, of which 590 in #Italy

 

{Excerpt, Summary}

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Week 37, 2026 | Published on 11 September 2026, based on data submitted up until and including 10 September 2026.

Current situation

    ° Since the beginning of the 2026 transmission season, and as at 10 September, 161 areas affected by West Nile virus (WNV) have been identified in 15 countries across Europe.

    ° These areas are located in: 

        § Italy (64), 

        § Greece (21), 

        § Romania (20), 

        § France (14), 

        § the Netherlands (10), 

        § Serbia (7), 

        § Croatia (5), 

        § Spain (5), 

        § North Macedonia (4), 

        § Hungary (3), 

        § Austria (2), 

        § Germany (2), 

        § Albania (1), 

        § Cyprus (1) and 

        § Kosovo (1).

    ° This week, 16 areas are reported as affected for the first time this season. 

    ° The 15 countries have reported 1 285 locally acquired human cases of WNV infection: 

        § Italy (590 cases), 

        § Greece (319 cases, of which 9 had an unknown place of infection), 

        § Spain (104 cases), 

        § Romania (77 cases), 

        § North Macedonia (57 cases), 

        § France (49 cases), 

        § Serbia (37 cases), 

        § the Netherlands (19 cases), 

        § Croatia (10 cases), 

        § Cyprus (10 cases), 

        § Austria (5 cases), 

        § Hungary (4 cases), 

        § Germany (2 cases), 

        § Albania (1 case) and 

        § Kosovo (1 case)

(...)

Source: 

Link: https://www.ecdc.europa.eu/en/west-nile-fever/surveillance-and-disease-data/disease-data-ecdc

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Nationwide Increase in Reported #Human #Rabies #Exposures: Rabies #PEP Administration (US CDC, HAN, Sept. 10 '26, Summary)

 

Summary

    The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory in response to recent reports of increases in human exposures to rabid or possibly rabid animals and rabies post-exposure prophylaxis (PEP) administration errors. 

    Since July 2026, multiple United States jurisdictions have reported local increases in human rabies exposures involving known rabies vectors or animals in which rabies is less commonly reported. 

    Several high-profile rabies outbreaks and mass rabies exposure events have highlighted the importance of performing careful rabies risk assessments and following evidence-based recommendations for administering PEP. 

    Health departments can help clinicians who provide rabies vaccination in their jurisdictions stay aware of the importance of rabies risk assessments before administering PEP. 

    Clinicians and healthcare facilities can work to make sure that PEP is administered only when appropriate and that human rabies immune globulin (HRIG) and rabies vaccines are administered according to Advisory Committee on Immunization Practices (ACIP) recommendations.

(...)

Source: 

Link: https://www.cdc.gov/han/php/notices/han00533.html

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#Ebola disease caused by #Bundibugyo virus - #DRC (WHO, September 10 '26): 6,757 cases and 3,267 deaths so far

 

Situation at a glance

    Since the last Disease Outbreak News was published on 28 August 2026, the Bundibugyo virus outbreak in the Democratic Republic of the Congo has expanded to one additional health zone, Kayna, in North Kivu. 

    This increase brings the total number of affected health zones to 61 across six out of 26 provinces of the country: Bas-Uélé, Haut-Uélé, Ituri, North Kivu, South Kivu, and Tshopo. 

    As of 7 September 2026, the Democratic Republic of the Congo has reported 6757 confirmed cases, including 3267 deaths, resulting in a crude case fatality ratio (CFR) of 48.3%. 

    The transmission dynamics remain variable across affected locations, with evidence of ongoing geographical expansion and sustained increase in cases in some health zones. 

    The continuously high CFR highlights the seriousness of the disease and persistent challenges in timely case detection, access to early and adequate patient care, and effective interruption of transmission. 

    Delayed detection of cases continues to increase the risk of further spread within households, communities, and healthcare settings.

Description of the situation

    Since the publication of the previous Disease Outbreak News on 28 August 2026, additional confirmed cases and deaths of Bundibugyo virus disease (BVD) have been reported only in the Democratic Republic of the Congo.

    As of 7 September 2026, a cumulative total of 6778 confirmed cases has been reported: 6757 in the Democratic Republic of the Congo (including two cases diagnosed in the Democratic Republic of the Congo and subsequently treated in Germany), 20 cases in Uganda and one case in France. 

    Overall, 3269 deaths have been reported, including two in Uganda. 

    As of 7 September, at least 1611 patients have recovered, including 1590 in the Democratic Republic of the Congo, 18 in Uganda, two in Germany and one in France.

    The sustained level of transmission in the Democratic Republic of the Congo continues to pose a risk of cross-border spread. Health screening and surveillance activities remain operational at airports, ports, and official land border crossings; however, travel through informal crossing routes persists and may facilitate virus exportation, importation, and subsequent transmission. In this context, strengthened cross-border coordination, together with ongoing surveillance and preparedness efforts, remains critical to limiting further regional spread and supporting an effective public health response.

(...)

Democratic Republic of the Congo

    Since the previous Disease Outbreak News was published on 28 August 2026, an additional 963 confirmed cases, including 481 confirmed deaths, have been reported in the Democratic Republic of the Congo. 

    While part of this increase may be attributable to strengthened surveillance activities, enhanced laboratory testing, improved diagnostic capacity, and reconciliation of previously unreported data, the continued growth in both cases and deaths also reflects sustained community transmission and significant geographic expansion of the outbreak. 

    As of 7 September, the Democratic Republic of the Congo has reported a total of 6757 confirmed cases, including 3267 deaths (CFR 48.3%). 

    A total of 1590 patients have recovered to date.

    Confirmed cases have been reported from 61 health zones (HZ) across six provinces, with 51 HZ from five provinces reporting at least one case in the last 21 days. 

    Ituri remains the most affected province, with 28 of its 36 health zones reporting cases, followed by North Kivu (16/34), Tshopo (7/23), Haut-Uélé (6/13), Bas-Uélé (3/11), and South Kivu (1/34). 

    No new cases have been reported from South Kivu province since 29 May 2026. 

    Kayna HZ in North Kivu province is the most recently affected area. 

    As of 7 September, 71 new confirmed cases had been reported in the preceding 24 hours from 17 health zones located in Ituri, North Kivu, and Haut-Uélé provinces.

    Ituri continues to be the epicentre of the outbreak, accounting for 5406 confirmed cases since the start of the outbreak, including 1114 new confirmed cases reported in the previous 21 days, as of 7 September. 

    North Kivu is the second most affected province, with a cumulative number of 1066 confirmed cases, including 453 reported in the last 21 days, as of 7 September. 

    One of the highest CFR (65.4%) observed in this outbreak has been reported from North Kivu province; and investigations are ongoing to better understand the factors contributing to this elevated mortality rate.

    The number of individuals requiring follow-up as contact has also risen considerably with the expansion of the outbreak. 

    As of 7 September, 85.3% of identified contacts were successfully monitored during the previous 24 hours with 21 359 contacts seen out of 24 719 requiring follow up. 

    The large volume of contacts under surveillance highlights the extent of potential exposure within affected communities and the substantial demands placed on response operations.

    The outbreak continues to unfold within a complex humanitarian setting characterized by insecurity, armed conflict, and widespread population displacement. 

    More than 26 million people are experiencing acute food insecurity, while approximately one million internally displaced persons reside in Ituri Province alone. 

    Ongoing insecurity and displacement limit access to healthcare and essential services, constrain the ability of response teams to reach affected areas, and impede surveillance, case investigation and contact tracing activities. 

    Overcrowding, limited water, sanitation and hygiene services, and restricted access to healthcare in mining communities, informal settlements and sites for internally displaced persons further undermine early case detection, infection prevention and control measures, and the provision of timely care. These conditions also reduce the effectiveness of response interventions and outreach efforts.

Figure 2: Number of confirmed Bundibugyo virus disease cases in the Democratic Republic of the Congo, by date of notification, as of 7 September 2026

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Figure 3: Number of deaths among confirmed Bundibugyo virus disease cases in the Democratic Republic of the Congo by date of notification, as of 7 September 2026. 

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(...)

WHO advice

    Based on the currently available information, WHO advises against any restriction of travel to, or trade with, affected countries. 

    WHO continues to closely monitor and, where necessary, verify travel and trade measures in relation to this event.

    The updated Temporary Recommendations issued to States Parties on 24 August 2026 underscore the importance of coordinated outbreak control, strengthened cross‑border collaboration, and sustained surveillance and preparedness to prevent further regional spread and ensure an effective public health response. 

    Rapid recognition of cases, testing and optimized supportive care can reduce mortality, and improve community perceptions and acceptance of health care within the response.

    On 7 August, the WHO Technical Advisory Group on candidate vaccine prioritization released a report regarding possible candidate vaccines for Bundibugyo virus disease. 

    The members recommended that Ervebo, the only licensed Ebola vaccine (previously known as ebolavirus Zaire), be prioritized for inclusion in a randomized clinical trial in the context of the ongoing outbreak in the Democratic Republic of the Congo. 

    Following a review of additional evidence on 19 August 2026, the WHO Strategic Advisory Group of Experts on Immunization (SAGE) concluded that available evidence remains insufficient to support the programmatic use of Ervebo for the prevention of BVD, and that its efficacy against BVD in humans remains unknown. 

    WHO therefore recommends that Ervebo be used for BVD only within the context of a research protocol.  

    Ervebo vaccination of healthcare and frontline workers is now underway. As of 6 September 2026, a total of 2007 people had been vaccinated across six health zones in three provinces: Tshopo, Bas-Uélé and Ituri.

    On 2 July, a clinical trial to find effective treatments against BVD began patient enrollment on 2 July. The trial, known as the PARTNERS trial, is now open in five different clinical management facilities in Ituri province, and has enrolled over 300 people who are confirmed cases.  

(...)

Source: 

Link: https://www/who.int/emergencies/disease-outbreak.news.item/2026-DON617

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#Italy, #WNV & #Usutu Virus Seasonal #Surveillance #Report No. 7, September 10 '26 (ISS, summary): 594 human cases & 41 deaths

 

{Excerpt}

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{Highlights}

    ° Since the beginning of 2026 season in Italy, 594 confirmed human cases of infection with West Nile Virus have been recorded (they were 521 in the last week report). Of these: 

        § 306 were WNND (West Nile Neuroinvasive Disease) (5 imported: 1 from Maldives, 1 France, 1 Belgium, 1 Greece and 1 the Netherlands), 

        § 81 were asymptomatic cases among blood donors, 

        § 202 were West Nile Fever (1 imported case from Burkina Faso), 

        § 4 were cases of unspecified nature, 

        § 1 was an asymptomatic case.

    ° The number of affected provinces has risen to 79 in 19 Regions.

    ° Among confirmed cases, 41 fatalities have been recorded. The case-fatality rate (CFR) among WNND cases is now at 13.3% (last year it was at 15.0%).

    ° So far this season 12 confirmed human cases of infection with Usutu virus have been reported (of which 7 in Lombardy, 1 Emilia-Romagna, 1 Marche, 1 Latium, 1 Piedmont, 1 Veneto).

(...)

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(...)

Source: 

Link: https://www.epicentro.iss.it/westnile/bollettino/Bollettino_WND_2026_7.pdf

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#Taiwan, Seasonal #Influenza and #COVID19 Epidemics Weekly #Update (CDC, September 8 '26): H1N1pdm09 flu virus & SARS-CoV-2 PQ.16.1.1 variant are predominant

 

{Excerpts}

(...)

    The CDC pointed out that in week 35 (August 30th - September 5th), there were 115,136 outpatient and emergency room visits for influenza-like illnesses, an increase of 11.0% from the previous week, showing a recent upward trend. 

    The percentage of emergency room visits reached 11.2%, exceeding the epidemic threshold (11.0%), indicating the start of the epidemic period. 

    Additionally, last week (September 1st - September 7th), there were 105 new cases of severe influenza complications (97 H1N1, 4 H3N2, 4 untyped A cases) and 19 deaths (18 H1N1, 1 untyped A case). 

    Laboratory monitoring data shows that the influenza virus currently circulating in the community is mainly type A, with type A H1N1 accounting for 79.4% of the cases. 

    This flu season (2023-2024) has seen a cumulative total of 1,329 severe cases (717 H1N1, 498 H3N2, 24 untyped type A, and 90 type B) and 253 deaths (131 H1N1, 102 H3N2, 8 untyped type A, and 12 type B). 

    The majority of severe cases are among those aged 65 and above (65.1%) and those with a history of chronic diseases (82.8%). 68.6% of those affected have not received the flu vaccine this season.

    According to data from the Taiwan Centers for Disease Control (CDC), the COVID-19 epidemic in Taiwan is declining, but it is still in its epidemic period. 

    In week 35 (August 30 - September 5), there were 20,199 outpatient and emergency room visits related to COVID-19, a 9.7% decrease compared to the previous week (August 23 - August 29). 

    Last week (September 1 - September 7), there were 73 new severe cases and 15 deaths. 

    Since October 2025, there have been a cumulative total of 622 locally transmitted cases of COVID-19 complicated by severe illness, of which 106 have died. 

    The majority of severe cases are among those aged 65 and above (72.7%) and those with a history of chronic diseases (83.0%). 84.9% of these cases have not received the COVID-19 vaccine this season. 

    In the past four weeks, the predominant variant strain in locally transmitted cases has been PQ.16.1.1.

(...)

Source: 

Link: https://www.cdc.gov.tw/Bulletin/Detail/5gJTj70wu9L3psY5kQLUuA?typeid=9

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#Bundibugyo Virus Disease #Outbreak in #DRC - Situation #Report No. 17, Data as of 06 September 2026 (WHO, summary): 6,686 cases & 3,226 deaths in DRC

 

{Summary}

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Event description

Democratic Republic of the Congo

    The epidemiological pattern of the Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo is becoming increasingly heterogeneous, with divergent transmission trends across affected provinces  and health zones.

    Ituri remains the principal focus, while substantial transmission continues  in Nord-Kivu and Haut-Uélé and new areas continue to be affected. 

    Since External Situation Report #16, a further 586 confirmed cases and  276 confirmed deaths have been reported, bringing the cumulative total to 6686 confirmed cases, including 3226 deaths [case fatality ratio (CFR)  48.3%], as of 6 September 2026. 

    Ituri accounts for 80.2% of cumulative confirmed cases, down from  82.2% in the previous update, while Nord-Kivu has now surpassed 1000  cumulative cases. 

    The number of affected health zones increased from 60 to 61 across six  provinces, with Kayna Health Zone in Nord-Kivu being the latest affected.

    At the national level, daily incidence remains high but fluctuating, with  the seven-day moving average declining from its mid-August peak before  rising again in early September. This overall pattern masks increasingly divergent  provincial trajectories. 

    Ituri, while still the main driver of the outbreak, has declined substantially from its mid-August peak but remains at a high level with recent  fluctuations. 

    In contrast, Nord-Kivu is experiencing a marked and sustained increase, reaching its highest incidence since the start of the outbreak, while  transmission remains sustained in Haut-Uélé. Tshopo and Bas-Uélé continue to  report low but intermittent transmission, while no recent transmission is evident in  Sud-Kivu.

    Overall, the trends reinforce an increasingly heterogeneous epidemic,  with declining transmission in some areas occurring alongside intensification and  continued geographic spread elsewhere.

    During the most recent 21 days (17 August – 6 September 2026), 1665 confirmed cases were reported nationally.

    Compared with 1759 cases during the preceding 21-day period (27 July  – 16 August 2026), this represents a decrease of 94 cases (−5.3%). 

    Reported cases declined by 18.3% in Ituri, from 1356 to 1108, but  increased by 47.4% in Nord-Kivu, from 293 to 432, and by 14.0% in Haut-Uélé,  from 100 to 114. Consequently, Ituri’s contribution to newly reported cases fell  from 77.1% to 66.5%, while Nord-Kivu’s contribution increased from 16.7% to  25.9% and Haut-Uélé’s from 5.7% to 6.8%. The latest period also included eight  cases in Tshopo and three in Bas-Uélé. Overall, the modest national decline masks  a continued redistribution of transmission away from Ituri, particularly towards Nord-Kivu, where incidence continues to increase.

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 06 September 2026

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(...)

    During the same period, 848 confirmed deaths were reported nationally,  compared with 941 deaths during the preceding 21 days, representing a decrease  of 93 deaths (−9.9%). The national decline was driven by Ituri,  where reported deaths decreased from 671 to 548 (−18.3%). In contrast, deaths  increased from 224 to 253 (+12.9%) in NordKivu and from 42 to 43 (+2.4%) in  Haut-Uélé. Consequently, Ituri’s contribution to newly reported deaths declined  from 71.3% to 64.6%, while Nord-Kivu’s increased from 23.8% to 29.8% and  Haut-Uélé’s from 4.5% to 5.1%. Tshopo and BasUélé reported two deaths  respectively during the latest period, with no net increase in cases and deaths.  

    Overall, the modest national reduction in both cases (−5.3%) and deaths (−9.9%) masks divergent provincial trajectories and should be interpreted  cautiously given reporting delays and retrospective data  reconciliation. The continued increase in both cases and deaths in Nord-Kivu,  alongside sustained transmission in Haut-Uélé, indicates that the outbreak is  increasingly geographically heterogeneous rather than showing a uniform decline.

(...)

    Additionally, during the most recent 21 days, 52 of the 61 affected health zones (85.2%) reported at least one new confirmed case, while nine  (14.8%) reported no new cases: Adja, Kambala and Mahagi in Ituri; Goma in  Nord-Kivu; Lubunga, Tshopo and Wanie-Rukula in Tshopo; Miti-Murhesa in Sud- Kivu; and Buta in Bas-Uélé. Importantly, provincial trends should not be  interpreted as uniform across their constituent health zones. In Ituri, for example,  the overall 18.3% decline in cases occurred alongside renewed or  increasing transmission in several health zones, including Bunia, Nizi, Mangala,  Bambu, Komanda, Lita and Mandima, while previously prominent hotspots such as  Mongbwalu showed declining activity. Similarly, the overall increase in Nord- Kivu reflects both strong resurgence in established hotspots, particularly Katwa,  Beni and Butembo, and recent or renewed activity in additional health zones.  

    These divergent subprovincial trajectories indicate that transmission is shifting geographically rather than declining uniformly, underscoring the need to  monitor and target response interventions at the health-zone level rather than  relying on provincial or national trends alone.

(...)

    Weekly confirmed deaths peaked at 364 during 10 – 16 August, followed  by declines to 302 and 270 over the subsequent two weeks. However,  this downward trend did not continue in the most recent week, with deaths  increasing slightly to 276 during 31 August – 6 September (+2.2%). More  importantly, the latest increase was driven entirely by community deaths, which  rose sharply from 171 to 207 (+21.1%), while deaths occurring in treatment  facilities continued to decline from 99 to 69 (−30.3%). Consequently, the  proportion of confirmed deaths occurring in the community increased from 56.6%  during 17 – 23 August to 63.3% during 24 – 30 August and 75.0% during 31  August – 6 September, the highest weekly proportion observed during the  reporting period. This divergence is concerning, as the increase in community deaths alongside the continued decline in treatment facilities deaths  indicates that the earlier reduction in overall mortality has not been sustained.

    The persistence of high community mortality may reflect multiple barriers along the pathway to care, including delayed detection and notification,  delayed referral or transfer to treatment facilities, limited recognition of illness or  perceived severity, geographic and transport barriers, care-seeking outside formal  health facilities, and community acceptance or trust. These factors may result in  patients reaching treatment facilities late or dying before referral can be  completed.

    The increasing proportion of community deaths, despite expanding  treatment capacity, therefore suggests that increasing bed capacity alone may be  insufficient and reinforces the need to strengthen early case detection, rapid referral and community-level pathways to timely care.

(...)

Risk Assessment

    The risk of further spread remains very high within the Democratic Republic of the Congo and high for neighbouring countries sharing land borders  with the country. This assessment reflects sustained transmission, continued  geographic expansion, high mortality, population mobility, insecurity and  persistent response challenges. 

    The risk is considered low  elsewhere in Africa and globally. 

    The second IHR Emergency Committee, convened on 18 August 2026, also  reviewed the evolving situation and emphasized that the outbreak remains far  from controlled, and continues to constitute a Public Health Emergency of International Concern.

(...)

Situation interpretation

    The outbreak remains uncontrolled and increasingly heterogeneous,  with improving trends in some areas occurring  alongside continued  transmission, geographic redistribution and the emergence of new hotspots. The  widening geographic footprint is creating an increasingly complex operational  environment, requiring response capacity to be sustained across widely dispersed  and sometimes difficult-to-access areas. 

    The six affected provinces collectively  cover an area of approximately 630 000 km², although transmission remains concentrated within specific health  zones and health areas. This geographic dispersion increases demands on  surveillance, contact tracing, referral and case management capacity, laboratory  networks, logistics and field coordination, and increases the risk that emerging transmission may not be detected or contained rapidly. Further gains  will therefore depend on translating the substantial expansion in response capacity  into rapid, locally delivered action in active and emerging hotspots. 

    Priorities should include early detection and referral, enhanced contact  tracing, IPC interventions around cases, addressing the drivers of community  deaths, and maintaining operational readiness in areas at risk of further spread. 

Source: 

Link: https://www.afro.who.int/countries/democratic-republic-of-congo/publication/ebola-bundibugyo-virus-disease-outbreak-0

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Avian Influenza Report: August 30 – September 5 '26 (Wk 36) (CHP, HK SAR, September 8, '26): 1 New Human Case of Infection with #H9N2 virus in #China

 

{Excerpt}

(...)

Avian influenza A(H9N2):

    ° Beijing:

        § A six-year-old girl with onset on August 15, 2026.

(...)

Source: 

Link: https://www.chp.gov.hk/files/pdf/2026_avian_influenza_report_vol22_wk36.pdf

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#USA, #Wastewater Data for Avian #Influenza #H5 (CDC, Sept. 4 '26)

 

{Excerpts}

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A(H5) detections in the past week

Time Period: August 23, 2026 - August 29, 2026

    -- A(H5) Detection: 3 site(s) (0.7%)

    -- No Detection: 439 site(s) (99.3%)

    -- No samples: 74 site(s)

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(...)

Source: 

Link: https://www.cdc.gov/wastewater/emerging-viruses/h5.html?

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Seasonal #surveillance in #humans in 2026 for #WNV (ECDC, Sept. 4 '26), Weekly Update: 1,086 cases so far, of which 516 in #Italy

{Excerpt, Summary}

(...)

Week 36, 2026 | Published on 04 September 2026, based on data submitted up  until and including 3 September 2026.

Current situation

    ° Since the beginning of the 2026 transmission season, and as at 3 September, 144 areas affected by West Nile virus (WNV) have been identified in 15 countries across Europe.

    ° These areas are located in: 

        

        § Italy (62), 

        § Greece (19), 

        § Romania (17), 

        § France (13), 

        § Serbia (seven), 

        § the Netherlands (five), 

        § Croatia (four), 

        § Spain (four), 

        § Hungary (three), 

        § North Macedonia (three), 

        § Germany (two), 

        § Albania (one), 

        § Austria (one), 

        § Cyprus (one) and 

        § Kosovo* (one).

    ° This week, 20 areas are reported as affected for the first time this season. (...)

    ° The 15 countries have reported 1 086 locally acquired human cases of WNV infection: 

    

        § Italy (516 cases), 

        § Greece (284 cases, of which 11 with unknown place of infection), 

        § Spain (88 cases), 

        § Romania (56 cases), 

        § North Macedonia (55 cases), 

        § France (36 cases), 

        § Serbia (18 cases), 

        § the Netherlands (nine cases), 

        § Croatia (seven cases), 

        § Cyprus (six cases), 

        § Austria (four cases), 

        § Hungary (three cases), 

        § Germany (two cases), 

        § Albania (one case) and 

        § Kosovo* (one case)

(...)

Source: 

Link: https://www.ecdc.europa.eu/en/west-nile-fever/surveillance-and-disease-data/disease-data-ecdc

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#Italy, #WNV & #Usutu Virus Weekly #Surveillance #Report No. 6 (ISS, Sept. 4 '26): 521 human cases so far this season, 26 fatal

 

{Excerpt, Summary}

(...)

    ° Since the beginning of the epidemic season and as of September 2 '26, 521 human cases of confirmed infection with West Nile Virus were reported. They were 432 in the last week report. 

        § Of these, 269 were WNND (West Nile Neuroinvasive Disease), of which 4 were imported: 1 from Maldives, 1 France, 1 Belgium and 1 Greece; 

        § 70 cases were detected among blood donors; 

        § 179 cases were of West Nile Fever (1 case imported from Burkina Faso), 

        § 2 cases were of unspecified nature; 

        § 1 case was asymptomatic. 

    ° The number of affected provinces has risen to 75 in 19 Regions.

    ° Among confirmed cases, 26 fatalities have been recorded. The Case-Fatality Rate is now at 9.4% (during 2025, it was 14.6%).

    ° So far this season, 10 human cases of infection with Usutu virus have been confirmed (6 in Lombardy, 1 Emilia-Romagna, 1 Marche, 1 Latium, 1 Piedmont).

(...)

Source: 

Link: https://www.epicentro.iss.it/westnile/bollettino/Bollettino_WND_2026_6.pdf

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#WHO emergency #guidance on use of licensed #Ebola {Zaire} #vaccine during #Bundibugyo virus disease #outbreaks - Interim guidance 31 August 2026 (Summary)

 

Context

    Ervebo® is currently the only licensed Ebola vaccine available. Ervebo®  (rVSV-EBOV-GP) is a live, recombinant vesicular stomatitis virus (rVSV)-based vaccine licensed that was prequalified by the World Health Organization (WHO) in 2019 for the prevention of Ebola virus disease caused by Ebola virus (EBOV, species Orthoebolavirus zairense, previously known as Zaire ebolavirus) in individuals aged one year or older. It is not licensed for use against Bundibugyo virus (BDBV) and therefore the use of Ervebo® against BDBV constitutes off-label use{1} BDBV and EBOV cause Ebola disease that is  clinically similar but are genetically and antigenically distinct virus species. Their  glycoproteins share approximately only 60–65% amino acid sequence  identity, a distinction that is particularly relevant for vaccination because currently  available Ebola vaccines, including Ervebo®, target the viral  glycoprotein.

    Consequently, although Ervebo® is highly effective against EBOV, the  extent to which Ervebo®-induced immunity provides clinically meaningful  protection against BDBV remains unknown. (1)

    On 19 August 2026 (2), the Strategic Advisory Group of Experts on Immunization (SAGE) reviewed and deliberated on the additional evidence that  had become available following the publication of the WHO emergency guidance  on the use of licensed Ebola virus vaccine during Bundibugyo virus disease  outbreaks, 28 May 2026. (3)

    The BDBV outbreak in the Democratic Republic of the Congo has spread  substantially, with continued transmission and high mortality, creating an urgent  need to strengthen outbreak response and reduce preventable deaths. (4) The  severity of the disease and evolving epidemiological situation increases the  imperative to consider all potentially beneficial interventions, while at the same  time carefully weighing the unknown efficacy of Ervebo® against BDBV, and resultant risks.

    A ring vaccination randomized controlled trial (henceforth referred to as  ring RCT) of Ervebo® and BDBV-specific vaccine candidates is planned to be  conducted in the Democratic Republic of the Congo as a matter of urgency. (5) If  well designed and rigorously implemented, the trial would provide the critical  evidence currently lacking on the efficacy of Ervebo® against BDBV.

Assessment of additional evidence on Ervebo® performance against BDBV since May 2026

    Findings from an increased, albeit still limited, number of studies  conducted to date in nonhuman primates and ferrets suggest some  protection by Ervebo® against BDBV-related mortality, while showing little or no  protection against viraemia and clinical disease (...).

    In the absence of an established correlate or surrogate of  protection  against BDBV, the extent to which findings from animal challenge  models (disease and laboratory-based immunological studies) can predict  protection in humans remains unknown. 

    Available human immunogenicity data regarding potential cross-protection  conferred by Ervebo® against BDBV showed that Ervebo® induces cross-reactive BDBV glycoproteinbinding antibodies which are at levels  approximately 5-fold lower than against EBOV, and that cross-neutralization of  BDBV pseudoviruses with neutralizing titres are approximately 3.5–4-fold lower  than against EBOV (...).

    No Ervebo® vaccine efficacy data against BDBV in humans have been  generated yet. 

    There are a small number of anecdotal reports of previously vaccinated  health care workers who subsequently developed BDBV disease and survived.  However, no conclusions regarding vaccine efficacy or effectiveness can be drawn  from these observations because of the very small sample size, the absence of an  appropriate comparator group, the potential for substantial bias, non-systematic  data collection, and the resulting considerable statistical uncertainty.

    Overall, the limited data and anecdotal reports are suggestive of some  protection against BDBV-related mortality and are consistent in trending towards  some as yet unquantified benefit.

    In conclusion, the available data remain insufficient to determine whether Ervebo® provides any clinically meaningful protection against  BDBV in humans or to reliably estimate the magnitude of such protection,  including protection against infection, disease, severe disease or death.

Benefit–risk considerations regarding off-label use of Ervebo® in the context of unknown efficacy against BDBV

    There is currently clinical equipoise regarding the efficacy of Ervebo®  against    BDBV. 

    Vaccine efficacy in humans remains to be established and could range  from high efficacy, with substantial clinical and public health benefit, through  moderate or partial efficacy, to limited or negligible efficacy, with little or no  meaningful protection. The lower limit of the range of potential effects may even  include harm. The potential ratio of benefits and risks of broader use therefore  differ considerably depending on where within this range the true efficacy ultimately lies.

    If efficacy is high or clinically meaningful, broader use while the ring RCT  is underway could potentially reduce severe disease and deaths and, if the vaccine  also protects against infection and transmission, contribute to outbreak  control. In a context where other medical countermeasures remain limited, earlier  access could provide populations at high risk with a vaccine that has a  well-characterized safety profile, while BDBV-specific vaccines remain under  evaluation and are not yet available for use. Use within appropriately designed  research frameworks could also generate complementary real-world effectiveness  data. In addition, vaccinated individuals would be expected to benefit from  protection against Ebola virus disease should they subsequently be exposed during a future EBOV outbreak.

    Conversely, if efficacy is low, negligible or absent, the balance of benefits  and risks would be substantially less favourable. Considerable financial, logistic  and human resources would be diverted to an intervention providing little or no  clinical or public health benefit. These resources could otherwise support  outbreak-control measures of established effectiveness, including surveillance,  contact tracing, timely testing and case detection, isolation, infection prevention  and control, and safe and dignified burials. These resources could also have been better invested in the development of BDBV-specific vaccines.

    A scenario in which Ervebo® provides meaningful protection against  severe disease or death, but limited or no protection against infection, viraemia or  onward transmission, would require careful consideration. Protection against  severe disease or death would constitute an important individual and public health  benefit, even in the absence of substantial effects on infection or  transmission. However, vaccination could then reduce morbidity and mortality without necessarily interrupting transmission. If this efficacy profile is  not clearly understood and communicated, vaccination could lead to false  reassurance among vaccinated individuals, communities and responders,  potentially reducing adherence to established outbreak-control measures. Such  behavioural changes could offset some of the benefits of vaccination and, if  infection and onward transmission are not sufficiently reduced, could contribute to continued transmission and potentially prolong or exacerbate the outbreak.

    If efficacy proves limited or negligible, substantial numbers of  breakthrough cases or deaths could also undermine public trust in the outbreak  response and confidence in Ebola vaccines, vaccination programmes generally,  and the health sector more broadly. Once broader vaccination has commenced, a  subsequent decision to restrict or discontinue Ervebo® use, if the evidence shows  limited efficacy, could itself create important communication and trust challenges.

    There are also important evidence-generation trade-offs. The use of  Ervebo® outside rigorous research protocols could interfere with the feasibility,  recruitment, implementation and scientific integrity of studies, particularly the ring  RCT, designed to establish vaccine efficacy for Ervebo® and BDBV-specific  vaccine candidates (which are expected to have the potential for better  performance against BDBV). This could delay the generation of the robust evidence needed to guide policy. Observational Ervebo® effectiveness  studies could provide useful complementary information but are inherently more  susceptible to bias and confounding than RCTs and may therefore be more difficult  to interpret or insufficiently robust to resolve the central question of  efficacy. Vaccine effectiveness (VE) studies of vaccines with modest efficacy are  particularly prone to these limitations. Hence the value of any observational study  depends partly on the extent to which its design can ensure that uptake of the  intervention is as close to random as possible and that outcome data are collected  systematically from all participants allowing comparable analysis, thereby reducing selection and information biases. Conversely, if the ring RCT  demonstrates clinically meaningful efficacy of Ervebo® and/or BDBV-specific  vaccine candidates, such a trial would provide a strong basis for rapidly updating  policy and expanding vaccine(s) use to benefit the wider population.

    Extensive reliance on Ervebo® could potentially affect community willingness to participate in future studies or receive BDBV-specific vaccines,  which become especially important if the efficacy of Ervebo® against BDBV is insufficient.

    Finally, widespread deployment would have implications for global vaccine security. Largescale use of available Ervebo® doses against BDBV could  temporarily deplete the International Coordinating Group on Vaccine  Provision stockpile and potentially compromise timely access to vaccine for  response to a future outbreak caused by EBOV, against which Ervebo® has demonstrated efficacy and is licensed.

    Taken together, the uncertainties described above reinforce the importance of obtaining robust efficacy data as rapidly as possible while  carefully weighing the potential benefit of any broader use against its potential negative consequences.

(...)

{1} Use of a vaccine for an unapproved indication (not described in the approved  labelling) or in an unapproved age group, dosage, or route of administration. 

(...)

© World Health Organization 2026. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence.

Suggested citation. WHO emergency guidance on the use of licensed Ebola vaccine during Bundibugyo virus disease outbreaks, 31 August 2026. Geneva:  World Health Organization; 2026. https://doi.org/10.2471/B09884

Source: 

Link: https://doi.org/10.2471/B09884

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