#Risk #assessment of avian #influenza #H5N5 virus from the first #human case using the #ferret model

 

ABSTRACT

The incursion of Eurasian-origin genotype A6 A(H5N5) virus into North America expanded the genetic diversity among North American highly pathogenic avian influenza viruses and heightened concern about zoonotic risk. Following a fatal human infection with the A(H5N5) virus A/Washington/2148/2025, viral replication was assessed in polarized human bronchial epithelial cells, and pathogenicity, transmissibility in direct contact and respiratory droplet models, and airborne virus shedding were evaluated in ferrets to inform pandemic risk assessment. A(H5N5) displayed robust replication in Calu-3 cells at 33°C and 37°C, showing kinetics and peak titers comparable to those of contemporary genotype B3.13 and D1.1 A(H5N1) viruses. In ferrets, A(H5N5) replicated efficiently in the respiratory tract, disseminated to extrapulmonary tissues, and caused fatal disease in all inoculated animals. Airborne transmission was not observed, and infrequent, low-level detection of virus in air samples paralleled that of A(H5) viruses that are not transmissible via air in ferrets. In a direct contact model, limited transmission was detected within 4 days of exposure, with evidence of lower respiratory tract replication in contact animals. These findings indicate that the A(H5N5) virus has the capacity for robust replication in an airway epithelial cell line and can cause severe systemic infection and mortality in ferrets but has not acquired adaptations for airborne spread in mammals. Collectively, these results underscore heterogeneity among clade 2.3.4.4b A(H5Nx) viruses in North America and the need for genotype-by-genotype evaluation of newly emerged viruses to understand public health risk.

IMPORTANCE

The emergence of Eurasian-origin genotype A6 highly pathogenic avian influenza A(H5N5) virus in North America has increased viral diversity and raised concerns about zoonotic and pandemic risk. In this study, we evaluated the replication kinetics, pathogenesis, and transmission of A/Washington/2148/2025 A(H5N5) virus, which was isolated from the first reported human infection with this influenza virus subtype, using polarized human bronchial epithelial cells and the ferret model. The A(H5N5) virus replicated efficiently in vitro at temperatures representative of the upper and lower respiratory tracts and caused fatal systemic disease in inoculated ferrets. Limited transmission was observed during 4 days of direct contact. Airborne virus detection was infrequent and did not result in airborne transmission. These findings show that A(H5N5) virus can replicate robustly in mammalian cells and cause severe disease but lacks adaptations supporting efficient airborne spread, informing assessment of the pandemic risk posed by genotype A6 influenza viruses.

Source: 

Link: https://journals.asm.org/doi/10.1128/jvi.00856-26

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Bundibugyo Virus Disease Outbreak in the #DRC, #Uganda & #France - Situation Report 13, Data as of 09 August 2026 (WHO, summary): 4,381 cases & 2,011 deaths in DRC

 

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Event description

Democratic Republic of the Congo

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo remains in a phase of intense and expanding transmission, with cumulative deaths crossing the grim milestone of 2,000 only 86 days after the outbreak was officially declared on 15 May 2026. 

    Since External Situation Report #12, an additional 579 confirmed cases and 304 confirmed deaths have been reported, bringing the cumulative total to 4,381 confirmed cases and 2,011 confirmed deaths as of 9 August 2026, corresponding to a case fatality ratio of 45.9%. 

    Ituri remains the epicentre, accounting for 85.8% of cumulative cases and 80.6% of cumulative deaths.

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    The epidemic is increasingly characterized by sustained transmission within interconnected geographic clusters alongside continued geographic expansion. 

    

    The Bunia–Rwampara–Mongbwalu–Nizi corridor remains the principal transmission focus, while persistent transmission in North Kivu and  increasing activity in Haut-Uélé indicate spread beyond the original Ituri epicentre. 

    The number of affected health zones increased from 51 in External Situation Report #12 to 53 as of 9 August 2026, with Gombari in Haut-Uélé and  Bafwasende in Tshopo being the most recently affected health zones. 

    Overall, the outbreak now affects 53 of 140 health zones across five provinces.

(...)

    Persistently high mortality continues to highlight gaps in early detection  and timely access to care. 

    

    Community deaths remain frequent, with 34 of 51 reported deaths (66.7%)  occurring outside treatment centres on 9 August 2026.

    Surveillance performance improved, with all 242 validated suspected cases  being investigated on 9 August 2026. 

    Contact follow-up also increased to 86.7%, exceeding 85% for the first  time, although performance remained substantially lower in Haut-Uélé at 57.9%,  partly due to incomplete reporting. 

    Despite these improvements, gaps in alert reporting, contact identification  and follow-up around confirmed cases persist. 

    Treatment capacity also remains under pressure, with several treatment  and transit centres in Ituri saturated, while North Kivu continues to face constraints in referral capacity and Haut-Uélé still lacks a standard Ebola  treatment centre in its six affected health zones.

    Intense transmission is also occurring against a backdrop of increasing  operational and workforce pressures. 

    Challenges related to the timely remuneration of response personnel have  been reported in some affected areas, with potential implications for  workforce motivation and the continuity of response activities, including  community-based interventions and operations at points of entry and points of  control. 

    Community resistance, insecurity and operational incidents continued to  pose challenges to the timely implementation of response activities, including safe  and dignified burials. 

    These pressures are particularly concerning as epidemiological analyses  indicate that transmission is occurring faster than cases are being detected and  isolated, while contact-tracing capacity is increasingly stretched. 

    Despite the absence of further international transmission, the continued high incidence in eastern Democratic Republic  of the Congo poses a substantial risk of cross-border spread, particularly to Uganda and South Sudan through  major population movement corridors. 

    Surveillance at points of entry (PoEs) and points of control (PoCs) continued  along key mobility corridors, although operational constraints persist at  some sites. 

    Continued strengthening of cross-border surveillance, information sharing  and coordination with neighbouring countries remains essential for the early  detection and management of potential cross-border transmission.

Uganda and France

    No new BVD cases have been reported in Uganda. The last confirmed  patient was discharged on 16 July 2026, and all identified contacts subsequently  completed follow-up. As of 9 August 2026, 24 days had elapsed since the last  patient's discharge without a new confirmed case. However, continued high  transmission in neighbouring eastern Democratic Republic of the Congo poses a risk of reintroduction.

    France has reported no secondary transmission following the imported  case detected on 24 June 2026. The patient recovered and was discharged on 4  July 2026 after two consecutive negative polymerase chain (PCR) test results, and all five identified flight contacts completed 21 days of follow-up without  developing symptoms. As of 9 August 2026, 36 days had elapsed since the  patient's discharge without an additional confirmed case being reported in France.

(...)

Situation interpretation

    The BVD outbreak remains uncontrolled, with transmission continuing to  outpace response capacity. Persistent community deaths, geographic expansion  and gaps in contact follow-up indicate continued undetected community transmission, while pressure on treatment facilities, uneven infection  prevention and control capacity, workforce constraints and community resistance continue to challenge response effectiveness. 

    The response should now shift to targeted interruption of transmission in  the main clusters and emerging hotspots, while deepening community leadership  and ownership of the response. This requires empowering trusted local leaders  and community networks to drive active case finding, contact tracing, early care- seeking, and safe and dignified burials, alongside faster case investigation and  isolation and rapid infection prevention and control interventions. Workforce and  payment constraints require urgent resolution, while neighbouring countries  should maintain heightened preparedness given the continued risk of cross-border spread.

Source: 

Link: https://www.afro.who.int/health-topics/ebola-disease

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#Risk #assessment of introduction, spread, and zoonotic #spillover of #MERS-CoV Clade B in #camel populations of the Nile Basin and Across #Africa (WHO, summary)

 

INTRODUCTION  

    The Global Early Warning System for Health Threats and Emerging Risks at the Human-Animal Ecosystems Interface (GLEWS+) is a joint initiative of the Food and Agriculture Organization of the UN (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH). 

    Within this framework, the GLEWS+ Risk Assessment (RA) mechanism enables the three organizations to jointly assess emerging health threats at the human–animal–ecosystem interface and provide evidence-based risk estimates. 

    These assessments support Members and State Parties in strengthening the prevention, detection, response and control measures.  

Event Description and Scope of the Assessment 

    Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic virus for which dromedary camels (Camelus dromedarius) are recognized as the primary animal reservoir. 

    Viral circulation within camel populations poses a risk of transmission to humans, particularly in settings characterized by frequent and close human–camel interactions. 

    Historically, MERS-CoV strains detected in dromedary camels in Africa have belonged to clade C, whereas clade B viruses have been associated with the majority of reported human MERS cases and have predominantly circulated in dromedary camel populations in the Middle East. 

    The recent detection of MERS-CoV clade B genome fragments in camels from the Nile Basin region represents a notable epidemiological development, suggesting the possibility of inter-regional viral movement and genetic mixing. 

    This finding may have implications for virus circulation and transmission dynamics, including potential changes in the risk of zoonotic spillover to humans and/or alterations in viral transmissibility and pathogenicity. 

    This assessment evaluates the risk of spread of MERS-CoV clade B within camel populations at both sub-regional (Nile Basin) and regional (Africa) levels. 

    It also assesses the risk of spillover from infected camels to humans in Nile Basin countries. 

    The assessment considers available virological, epidemiological, ecological, and socio-economic factors that influence virus circulation, including camel husbandry practices, pastoralist mobility patterns, cross-border animal movements, live-animal trade networks, and the extent of human-camel contact in the region.  

    Information used in this assessment was compiled from eight countries in Africa reporting camel populations exceeding 10,000 in 2024. 

    The countries included in the assessment are:     

        ° Chad, 

        ° Egypt*, 

        ° Eritrea*, 

        ° Ethiopia*, 

        ° Kenya*, 

        ° Libya, 

        ° South Sudan* and 

        ° Sudan*. 

    The six countries belonging to the Nile Basin sub-region are indicated by an asterisk (*). 

    This risk assessment reflects information available to 27 July 2026. FAO, WHO and WOAH will review and update the assessment as new information becomes available.  

SUMMARY 

    Middle East respiratory syndrome coronavirus (MERS-CoV) is an enveloped, positive-sense RNA virus belonging to the genus Betacoronavirus. 

    It causes Middle East respiratory syndrome (MERS), a zoonotic respiratory disease first recognized in 2012, following the detection of human cases in Saudi Arabia and Jordan. 

    As of 11 June 2026, a total of 2,637 laboratory-confirmed human cases have been reported to WHO globally, the majority from countries in the Arabian Peninsula, with an estimated crude case fatality ratio (CFR) of approximately 37%. (WHO, 2025c) 

    Dromedary camels (Camelus dromedarius) are the primary animal reservoir of MERS-CoV and the main source of zoonotic transmission to humans. 

    Human infections are thought to occur through direct or indirect contact with infected camels. 

    Consumption of raw camel products is considered a plausible route of exposure, although it has not been definitively confirmed as a primary transmission pathway. 

    Human-to-human transmission can occur, particularly in healthcare settings and among those in close-contact. 

    MERS-CoV antibodies have been found in other camelid species, including Bactrian camels, hybrid camels, llamas and alpacas, indicating susceptibility to infection (Islam, 2003). 

    However, these species are not considered to play a significant role in the current epidemiology of MERS.  

    MERS-CoV has evolved into three genetic clades (A, B, and C) with distinct geographic patterns. 

    Clade B predominates in the Arabian Peninsula and has been associated with all recent human infections. 

    Clade A has not been detected since 2015 and is considered extinct. 

    Clade C circulates among dromedary camels across Africa and despite frequent camel imports from Nile Basin countries into the Arabian Peninsula, has not become established in local camel populations. 

    Experimental and phenotypic studies indicate that clade B viruses exhibit higher replication efficiency in human respiratory tissues and experimentally infected camelids, more efficient cellular entry, and prolonged viral shedding compared with clade C viruses. (Rodon, 2023) 

    These characteristics suggest a greater zoonotic potential and an increased likelihood of transmission to humans. (Zhou, 2021) 

    The global camel population is estimated at over 42 million heads as of 2023, with more than 80% of the population in Africa (FAO, 2025a). 

    Camel trade within Africa is predominantly regional and fragmented, with significant informal cross-border movement. (WHO, 2025d, FAO, 2026) In the Nile Basin and the Horn of Africa {1}. 

    Camel trade and movement are largely driven by informal cross-border pastoralist systems, with frequent but poorly documented movements between neighboring countries such as Sudan, Ethiopia, Kenya, and South Sudan. 

    Sudan plays a central role as a major camel exporter, with substantial formal and informal movements to neighboring countries and toward North Africa, while Egypt functions primarily as a terminal hub where camels from multiple origins converge for trade and slaughter. 

    In contrast, long-distance east-to-west transcontinental movement appears limited, with little evidence of sustained camel movement from the Nile Basin into North or West Africa. (Younan et al., 2016) 

    Recent genomic surveillance studies have suggested the introduction of MERS-CoV clade B strains into camel populations in the Nile Basin, outside its historically recognized circulation in the Arabian Peninsula. 

    In Egypt, phylogenetic analyses of a camel-derived sample identified genome fragments clustering with clade B viruses from the Arabian Peninsula, circulating alongside endemic African clade C viruses (Gomaa, Edwards, Wang, Taweel, et al., 2025). 

    Recombination analyses in these studies were interpreted by the authors as suggesting potential genomic mixing between introduced clade B and endemic clade C lineages, highlighting a potential for inter-regional viral exchange and the emergence of novel variants. 

    However, as the publicly available sequences are incomplete, these findings require confirmation through full genome sequencing.  

    In a separate study (Hassan et al., 2025), metagenomic sequencing of nasal swabs from camels imported from Sudan also detected MERS-CoV genome fragments clustering with clade B human and camel strains. 

    Whole genome sequencing would be necessary to confirm these findings and better characterize their evolutionary relationships. 

    Overall, while these observations suggest the possible introduction of clade B viruses into camel population in the Nile Basin sub-region, additional research is required to determine whether there is sustained circulation, establishment, or recombination of clade B viruses in continental African camel populations. 

    Using a qualitative evidence-based approach and considering the assessed likelihood and consequences in the countries assessed, the overall risk at sub-regional level (Nile Basin) of further introduction and spread of MERS-CoV clade B within camel populations is minor. 

    The risk of introduction and spread from camel populations in the Nile Basin to camel populations in neighbouring countries is also assessed as minor. 

    However, if MERS-CoV clade B is introduced and established in camel populations in the Nile Basin countries, the public health risk of spillover from camels to humans exposed to infected camels or their products is assessed as high.  

    The level of confidence in the risk estimates is considered low for the first two questions, reflecting limitations in the quality and completeness of available genomic data, the presence of plausible but unconfirmed transmission pathways, very limited surveillance in camels and humans, and evolving camel trade dynamics that may facilitate virus spread within and beyond the Nile Basin. 

    The level of confidence is considered moderate for the third question. 

    While the clinical presentation and potential consequences of MERS-CoV infection in humans are well documented and observed in previous outbreaks, important uncertainties remain regarding the social, behavioral, and contextual factors that influence the likelihood of camel- to- human spillover in the Nile Basin.  

(...)

{1} Countries in the Horn of Africa are: Djibouti, Eritrea, Ethiopia, and Somalia

Source: 

Link: https://www.who.int/publications/m/item/risk-assessment-of-the-introduction--spread--and-zoonotic-spillover-of-mers-cov-clade-b-in-camel-populations-of-the-nile-basin-and-across-africa

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#COVID19, Global #Risk #Assessment - Version 10 (WHO, August 6 '26, summary)

{Summary} 

Overall risk statement

    As of 30 July 2026, the global public health risk from COVID-19 remains moderate following an assessment of data and information reported between 1 January and 30 July 2026. 

    While the direct public health impact of COVID-19 has declined compared with the early phases of the pandemic (the COVID-19 Public Health Emergency of International Concern - PHEIC, was lifted on 5 May 2023), the SARS-CoV-2 virus continues to circulate globally, maintaining its capacity to cause severe disease and fatalities, particularly among high-risk populations, including older and immunocompromised adults and people living with comorbidities. 

    As of 28 June 2026, over 779 million confirmed cases and over seven million confirmed deaths have been reported globally to WHO since the event was confirmed to WHO in 2020, while seroprevalence estimates suggest that there are orders of magnitude more infections and reinfections that remain unreported. 

    Uncertainties persist regarding the long-term consequences for the health of individuals suffering repeated infections and/or affected by post-COVID-19 condition (PCC). 

    Global estimates indicate that 6% of people with symptomatic COVID-19 infection develop PCC, with reduced risk in vaccinated individuals. 

    Of these, approximately 15% have persistent symptoms even at 12 months.

    Continued global circulation and ongoing virus evolution and diversification, including in established animal reservoirs, warrant constant monitoring and vigilance. 

    While available vaccines remain effective against severe disease and death despite continued COVID-19 variants evolution, the global vaccine uptake was very low in 2025, even by those at high risk of developing severe disease. 

    This further enables virus circulation and genetic evolution and increases health risks for vulnerable individuals. 

    Decreased reporting, reduced genomic sequencing (and sharing of sequence information) have led to gaps in surveillance, especially from low- and middle-income countries, which affects the representativeness and completeness of available data. 

    Consequently, the ability to accurately assess the public health risk from COVID-19 remains constrained, resulting in a low level of confidence in the current assessment.

    As indicated by sentinel surveillance through WHO’s Global Influenza Surveillance and Response System (GISRS) and wastewater surveillance, SARS-CoV-2 circulation continues at a low level globally, with test positivity remaining below 5% since December 2025. 

    The virus is co-circulating with seasonal influenza and Respiratory Syncytial Virus (RSV). 

    The previously observed decline in deaths and hospitalizations continued throughout this assessment period and can be explained by high population immunity, improved clinical management, and unchanged virulence of circulating variants. 

    Most currently circulating SARS-CoV-2 variants belong to the JN.1 Omicron sublineages, which show immune escape but do not result in increased disease severity compared to other Omicron sublineages, reflected by the stability of severity indicators.

    In December 2025, WHO published the Strategic Plan for Coronavirus Disease Threat Management (2025–2030) which recommends continued integration of COVID-19 into broader respiratory disease surveillance systems. 

    In March 2026, WHO provided updated recommendations for routine COVID-19 vaccination with a continued focus on targeting populations at high risk of severe disease. WHO also regularly updates recommendations for vaccine composition, with the latest published in May 2026.

(...)

Source: 

Link: https://www.who.int/publications/m/item/covid-19-global-risk-assessment--version-10

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#Ebola Bundibugyo Virus Disease Outbreak, #DRC & #Uganda - Situation #Report 12, Data as of 02 August 2026 (WHO, edited): 3802 cases & 1707 deaths in DRC

 

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Event description  

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continues to expand rapidly, with sustained transmission, persistently high mortality, and ongoing geographic spread. 

    It is now the largest BVD outbreak ever recorded and the second largest Ebola disease outbreak in history after the 2013 – 2016 West Africa epidemic. 

    Since its detection only a few months ago, the epidemic has grown at an exceptional rate, highlighting its intensity and the challenges facing response efforts. 

    Although no new international spread has been detected, continued transmission indicates that the outbreak remains in an expansion phase and continues to pose a high risk of regional and international spread. 

Democratic Republic of the Congo 

    Since the last update of 26 July 2026 (Weekly External Situation Report #11), the Democratic Republic of the Congo has reported an additional 540 confirmed cases and 270 confirmed deaths, representing increases of 16.6% and 18.8%, respectively, in cumulative confirmed cases and deaths. 

    Although the absolute numbers of newly reported cases and deaths remain substantial, the proportional increases are markedly lower than those reported during the previous reporting period, reflecting the absence of the large retrospective data reconciliation that contributed to last week's increase. 

    Nevertheless, the reporting of more than 500 additional confirmed cases and more than 250 confirmed deaths within a single week indicates that transmission remains intense and that the outbreak continues to expand. 

    The crude case fatality ratio (CFR) increased from 44.1% to 44.9%, reflecting persistently high mortality despite ongoing response efforts. 

    During the reporting period, the cumulative number of affected health zones increased from 48 to 51, with Kabondo and Wanie-Rukula in Tshopo Province and Lubero in North Kivu Province becoming the latest affected health zones, further demonstrating the continued geographic expansion of the outbreak. 

Figure 1.  Weekly trend of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo by epidemiological week of notification, epidemiological weeks 18 – 31, 2026 

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    During the last 21 days, transmission remained highly concentrated geographically, with an additional 1,867 confirmed cases and 953 confirmed deaths reported nationally. 

    Approximately 87.9% (n=1,641) of recently reported confirmed cases and 84.8% (n=808) of deaths occurred in Ituri Province, with the Bunia–Rwampara–MongbwaluNizi corridor continuing to represent the principal transmission focus. 

    North Kivu, Haut-Uélé, and Tshopo together accounted for 223 cases (11.9%) and 144 deaths (15.1%), while South Kivu reported no new confirmed cases. 

    However, an imported confirmed death from Tshopo Province generated new contacts requiring follow-up in South Kivu. 

    Of the 51 affected health zones, 42 reported at least one confirmed case during the preceding 21 days, whereas nine health zones (Gety, Kambala, Lubunga, Mangobo, Mabalako, Makiso-Kisangani, Miti-Murhesa, Rungu, and Vuhovi) have not reported a confirmed case for more than three weeks, suggesting that transmission may have been interrupted in these areas, provided surveillance remains sufficiently sensitive to detect any ongoing transmission. 

    The largest increases in confirmed cases over the previous 21 days were recorded in Bunia (312 cases), Nizi (285), Rwampara (216), Mongbwalu (207), Katwa (104), Lita (84), Nia-Nia (66), Mangala (63), Fataki (31), and Butembo (29). 

    Together, these ten health zones accounted for approximately 84% of all additional confirmed cases reported nationally during the period. 

    Bunia, Nizi, Mongbwalu, and Rwampara remained the principal transmission corridor, accounting for nearly 55% of all newly reported confirmed cases. 

    Continued increases in Lita, Nia-Nia, Mangala, and Fataki indicate sustained transmission within the Ituri epicentre, while ongoing transmission in Katwa and Butembo confirms persistent transmission in North Kivu. 

    Continued increases in Isiro and Wamba further indicate that the outbreak is becoming increasingly established in Haut-Uélé Province.  

    Mortality remained concentrated within the same transmission corridor driving the epidemic. 

    More than half (55.4%) of all confirmed deaths continue to occur outside designated treatment facilities, indicating that many patients are still being detected only late in illness or after death. 

    Delayed case detection and delayed access to specialised treatment therefore remain major contributors to mortality. 

    Recent analyses indicate a median interval of eight days from symptom onset to death, with almost half of deaths occurring within the first week of illness, emphasizing the narrow window available for life-saving clinical intervention.  

(...)

    Children younger than five years continue to experience disproportionately high mortality. 

    Although they account for fewer than one in ten confirmed cases nationally, they represent approximately 17% of all confirmed deaths, experience the highest case fatality ratios of any age group, and have the shortest interval between symptom onset and death. 

    Conversely, adults aged 20 – 59 years continue to account for most transmission, representing nearly two-thirds of confirmed cases. These findings suggest that outbreak control should continue to prioritise interrupting transmission among working-age adults while simultaneously strengthening rapid identification and referral of young children to reduce mortality. 

(...)

    Surveillance performance remains suboptimal. As of 2 August 2026, 18,276 contacts were under follow-up nationally, of whom 14,466 (79.2%) were successfully seen during the previous 24 hours, remaining well below the operational target of 95%. 

    Contact tracing capacity continues to lag behind the growing number of contacts to follow, particularly in Ituri and North Kivu, while persistently low follow-up rates and intermittent reporting in Haut-Uélé and Tshopo limit interpretation of recent trends.  

(...)

    Since the beginning of the outbreak, the Democratic Republic of the Congo has reported 3,802 confirmed cases, including 1,707 confirmed deaths, corresponding to a crude CFR of 44.9%. 

    The outbreak now affects 51 health zones across five provinces. Ituri Province remains the epicentre, accounting for 3,317 confirmed cases (87.2%) and 1,382 confirmed deaths (81.0%) nationwide. 

    The most affected health zones remain Bunia (914 cases, 270 deaths), Rwampara (655 cases, 263 deaths), Mongbwalu (552 cases, 263 deaths), Nizi (402 cases, 194 deaths), Lita (141 cases, 84 deaths), and Nyankunde (115 cases, 34 deaths) in Ituri Province, together with Katwa (186 cases, 122 deaths) and Butembo (87 cases, 69 deaths) in North Kivu Province. Collectively, these health zones account for the overwhelming majority of confirmed cases and deaths reported nationwide. 

(...)

Uganda and France  

    No new cases have been reported in Uganda or France since the previous update. 

    In Uganda, the last confirmed patient was discharged on 16 July 2026, and 17 days have passed without a new confirmed case. 

    All identified contacts have completed the required 21-day follow-up, and no contacts remain under active monitoring. 

    In France, the imported confirmed BVD case reported on 24 June 2026 recovered and was discharged on 4 July 2026 after two consecutive negative PCR test results. 

    No secondary transmission was identified, and all five flight contacts completed their 21-day follow-up without developing symptoms. 

    As of 2 August 2026, 29 days have passed since the patient's discharge without any additional confirmed BVD cases being reported from France. 

    Despite the absence of new cases, Uganda remains at high risk of reintroduction because of the ongoing outbreak in the neighbouring Democratic Republic of the Congo. 

Risk Assessment 

    The overall public health risk in the Democratic Republic of the Congo remains very high. The outbreak continues to expand, with sustained transmission, persistently high mortality, and continued spread to newly affected health zones. 

    Transmission remains concentrated within the Bunia–Rwampara–Mongbwalu–Nizi corridor, while ongoing spread in Haut-Uélé and Tshopo indicates progressive geographic expansion beyond the original epicentre. 

    The risk of further national and international spread remains high because transmission continues along major internal and cross-border mobility corridors linking the outbreak to Uganda, South Sudan, and other neighbouring countries. 

    Although Uganda and France have reported no additional cases since their previous imported events, sustained transmission in eastern Democratic Republic of the Congo continues to pose a significant risk of crossborder spread. Continued cross-border surveillance, rapid information sharing, and preparedness remain essential to ensure early detection and rapid containment of any imported cases. 

(...)

Situation interpretation 

    The BVD outbreak in the Democratic Republic of the Congo remains in an expansion phase despite an increasingly robust response. 

    Persistently high mortality, frequent community deaths, delayed case detection, and suboptimal contact tracing continue to sustain transmission, while weak infection prevention and control in health facilities contributes to ongoing healthcare-associated transmission. 

    Although response capacity has expanded substantially, including laboratory services, case management, logistics, and regional preparedness, further progress will depend on rapidly improving early case detection, achieving high-quality contact tracing, strengthening infection prevention and control, reducing community deaths through earlier access to treatment, and maintaining coordinated crossborder preparedness to prevent regional and international spread. 

Source: 

Link: https://www.afro.who.int/countries/uganda/publication/ebola-bundibugyo-virus-disease-outbreak-democratic-republic-congo-5

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#WHO TAG-VE #Risk #Evaluation for #SARS-CoV-2 #Variant Under Monitoring: PQ.16.1.1 (WHO, Accesed on August 4 '26)

Executive Summary 

    PQ.16.1.1, an NB.1.8.1-descendent SARS-CoV-2 lineage, has been designated a variant under monitoring (VUM) with increasing proportions globally, driven largely by detections in the Western Pacific Region, particularly Singapore. 

    Considering the available evidence, the additional public health risk posed by PQ.16.1.1 is evaluated as low at the global level. 

    Its mutation profile may confer additional immune escape, although direct phenotypic evidence is currently limited. 

    Available surveillance does not indicate increased clinical severity compared with other circulating variants, and existing vaccines are expected to continue providing protection against severe disease. 

Initial Risk Evaluation of PQ.16.1.1, 27 July 2026 

    PQ.16.1.1 is a descendant of the Omicron JN.1-derived lineage NB.1.8.1, with the earliest available sequence collected on 25 March 2026. 

    Compared with NB.1.8.1, PQ.16.1.1 has the additional Spike substitutions D253G, N417T, D420N and I478T, together with Nucleocapsid T135I and ORF8 G8E [1]. 

    PQ.16.1.1 is one of seven VUMs tracked by the WHO and was designated as a VUM on 27 July 2026. 

    The parent lineage NB.1.8.1 has demonstrated robust soluble human ACE2 engagement and pseudovirus infectivity, with only marginal additional immune evasion compared with LP.8.1 [2,3]. 

    Preliminary PQ.16.1.1-specific data indicate that its receptor-binding domain binds human ACE2 with significantly lower affinity than that of NB.1.8.1 (KD: 16.5 nM versus 8.22 nM). 

    Consistent with this, soluble human ACE2 showed reduced neutralization of PQ.16.1.1 pseudoviruses compared to NB.1.8.1 (IC50: 0.22 µg/mL versus 0.17 µg/mL). 

    Neutralizing antibody titres against PQ.16.1.1 and NB.1.8.1 were broadly similar in plasma from individuals with prior Omicron exposure. 

    In plasma from Wuhan-Hu-1-primed individuals, titres against PQ.16.1.1 were modestly lower than those against NB.1.8.1. 

    PQ.16.1.1 also showed substantially reduced susceptibility to class 1 RBD-targeting monoclonal antibodies. 

    These preliminary findings suggest that the growth of PQ.16.1.1 is unlikely to be explained by enhanced ACE2 receptor binding alone and may instead be partly related to escape from specific antibody classes [4]. 

    As of 8 July 2026, 457 PQ.16.1.1 sequences with collection dates through epidemiological week (EW) 25 had been submitted to GISAID from eight countries [1]. 

    Of these, 438 (95.8%) were from the Western Pacific Region (WPR), including 388 (84.9% of the global total) from Singapore. 

    The remaining sequences were reported from Hong Kong SAR (34), Australia (10), the United States of America (10), Canada (8), the Republic of Korea (5), France (1) and Taiwan, China (1). 

    No PQ.16.1.1 have been reported from the African (AFR) and Eastern Mediterranean (EMR) Regions. 

    Globally, the proportion of PQ.16.1.1 among available sequences increased from 2.7% in EW 18 to 29.6% in EW 25, Table 1. 

    Over the same period, its proportion increased from 5.4% to 39.3% in WPR. In the Region of the Americas, PQ.16.1.1 represented 6.4% of available sequences in EW 25, although this estimate was based on only three of 47 sequences. 

    Singapore reported an increase from 12.6% in EW 18 to 55.1% in EW 25. In Hong Kong SAR, the proportion increased from 20.0% to 66.7%, with fluctuations, but the EW 25 estimate was based on four of six sequences submitted that week. In Singapore, sentinel SARS-CoV-2 test positivity increased rapidly from 6.5% in EW 16 to a peak of 19.8% in EW 19. Test positivity remained elevated through EW 22 before declining through EW 25. 

    The timing and magnitude of the increase were consistent with the seasonal pattern observed in 2024 and 2025. 

    Compared with 2025, however, the period of elevated test positivity was shorter, with a more rapid decline following the peak. 

    No case or death data were reported to WHO during the reporting period [5]. 

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    WHO and its Technical Advisory Group on Virus Evolution (TAG-VE) continue to recommend that Member States prioritize specific actions to address the remaining uncertainties concerning PQ.16.1.1: 

        • Confirm the preliminary neutralization findings using live-virus and pseudovirus assays with contemporary human sera representative of affected populations and varied vaccination and infection histories. 

        • Undertake comparative studies of cell entry, replication, fusogenicity and Spike processing in the complete PQ.16.1.1 genetic background. 

        • Conduct comparative evaluations of hospitalization, intensive-care admission and death, controlling for age, prior immunity, comorbidities and time since vaccination or infection. 

        • Assess the performance of antigen-based and molecular diagnostic assays and determine phenotypic susceptibility to available direct-acting antivirals. 

    WHO and its Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC) continue to assess the impact of SARS-CoV-2 evolution on the performance of COVID-19 vaccines. 

    In its May 2026 recommendation, WHO TAG-CO-VAC advised the use of monovalent LP.8.1 as a COVID-19 vaccine antigen, while noting that other antigens, including XFG or NB.1.8.1, could also be used if they demonstrate broad and robust neutralizing-antibody responses or effectiveness against circulating variants. 

    Vaccination should not be delayed in anticipation of access to vaccines containing an updated antigen, and populations at highest risk of severe disease remain the priority [6]. 

    No PQ.16.1.1-specific vaccine-effectiveness estimates are currently available. 

    The risk evaluation below follows the published WHO framework for risk evaluation of SARS-CoV-2 variants [7] and is based on evidence available as of 21 July 2026. 

    This risk evaluation should be revised as additional epidemiological, phenotypic and clinical evidence becomes available. 

(...)

References  

{1} Khare, S.; Gurry, C.; Freitas, L.; Schultz, M.B.; Bach, G.; Diallo, A.; Akite, N.; Ho, J.; Lee, R.T.C.; Yeo, W.; et al. GISAID’s Role in Pandemic Response. China CDC Wkly. 2021, 3, 1049–1051, doi:10.46234/ccdcw2021.255. 

{2} Guo, C.; Yu, Y.; Liu, J.; Jian, F.; Yang, S.; Song, W.; Yu, L.; Shao, F.; Cao, Y. Antigenic and Virological Characteris cs of SARS-CoV-2 Variants BA.3.2, XFG, and NB.1.8.1. Lancet Infect. Dis. 2025, doi:10.1016/S1473-3099(25)00308-1. 

{3} WHO World Health Organiza on Technical Advisory Group on COVID-19 Vaccine Composition: Statement on the Antigenic Compositon of COVID-19 Vaccines 15 May 2025. 

{4} He, P.; Song, Y.; Guo, C.; Yu, L.; Yu, Y.; Jian, F.; Shao, F.; Cao, Y. Antibody Evasion and Receptor Binding of SARS-CoV-2 Variants PQ.16.1.1 and RK.1. 2026, doi:10.64898/2026.07.21.739818. 

{5} World Health Organiza on WHO COVID-19 Dashboard 2026. 

{6} WHO World Health Organiza on Technical Advisory Group on COVID-19 Vaccine Composition: Statement on the Antigen Composition of COVID-19 Vaccines 16 May 2026. 

{7} World Health Organiza on SARS-CoV-2 Variant Risk Evaluation, 30 August 2023; World Health Organization: Geneva, 2023; 

{8} Planas, D.; Staropoli, I.; Michel, V.; Lemoine, F.; Dona , F.; Prot, M.;Porrot, F.; Guivel-Benhassine, F.; Jeyarajah, B.; Brisebarre, A.; et al. Distinct Evolution of SARS-CoV-2 Omicron XBB and BA.2.86/JN.1 Lineages Combining Increased Fitness and An body Evasion. Nat. Commun. 2024, 15, 2254, doi:10.1038/s41467-02446490-7. 6  

Source: 

Link: https://cdn.who.int/media/docs/default-source/documents/epp/tracking-sars-cov-2/21072026_pq1611_ire.pdf?sfvrsn=5d73f0b_4#:~:text=Considering%20the%20available%20evidence%2C%20the,profile%20may%20confer%20additional%20immune

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#Ebola disease caused by #Bundibugyo virus - #DRC (WHO D.O.N., August 1 '26): 3605 cases and 1587 deaths, CFR: 44% in DRC

Situation at a glance

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo is intensifying, with sustained transmission and continued increases in reported cases and deaths. 

    

    Initially confined to the Mongbwalu health zone in Ituri Province, over the last two months, the outbreak has expanded to five provinces (Ituri, North Kivu, South Kivu, Haut-Uélé and Tshopo), now affecting 49 health zones. 

    The outbreak is now the largest Ebola outbreak ever reported in the Democratic Republic of the Congo. 

    As of 30 July 2026, a total of 3605 confirmed cases, including 1587 deaths, have been reported, corresponding to a crude case fatality ratio (CFR) of 44%. 

    The continued increase in cases, expanding geographic spread, and persistently high mortality underscore the rapidly evolving nature of this public health emergency. 

    During the most recent complete reporting week (epidemiological week 30), the highest weekly number of reported cases (567) and deaths (296) to date were recorded, underscoring the exceptional pace of transmission. 

    The convergence of insecurity, population displacement and mobility, and cross-border movements complicate response operations and increase the risk of further geographical spread. 

    National authorities in the Democratic Republic of the Congo, in collaboration with WHO and partners, continue to implement extensive response measures, however, a substantial scaling up of response activities is needed to get ahead of the outbreak. 

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

    On 28 July, the Ministry of Health of Uganda declared the end of the BVD outbreak in the country, following 42 days without a new confirmed locally transmitted case after the last confirmed case was discharged from care on 16 June 2026. 

    The most recent imported case was discharged from a treatment centre on 16 July after two negative tests results. 

    Following international guidance WHO will be monitoring the situation for 42 days from this date to ensure no chains of transmission have been missed. 

    Uganda remains at risk of imported cases and re-introduction of BVD, due to ongoing transmission in neighbouring Democratic Republic of the Congo. 

    WHO reiterates the need to maintain heightened surveillance, preparedness and control measures, particularly in view of continued population movement and the risk of cross-border transmission.

Description of the situation

    Since the previous Disease Outbreak News was published on 17 July 2026, additional confirmed cases and deaths have been reported only in the Democratic Republic of the Congo.

    Cumulatively, 3626 confirmed cases have been reported: 3605 in the Democratic Republic of the Congo (including two cases diagnosed in the Democratic Republic of the Congo and subsequently treated in Germany), 20 in Uganda and one in France. 

    

    A total of 1589 deaths have been reported, including two in Uganda. 

    As of 30 July, at least 651 people in the Democratic Republic of the Congo, and 18 from Uganda have recovered.

    This outbreak is now the largest recorded Ebola virus disease outbreak in the country, surpassing the previous largest outbreak, which occurred from 2018 to 2020, and resulted in 3317 confirmed cases. 

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Democratic Republic of the Congo

    Since 17 July 2026 when the last Disease Outbreak News was published, an additional 1481 confirmed cases, including 759 confirmed deaths, have been reported in the Democratic Republic of the Congo. 

    The increase is in part due to expansion of surveillance activities, enhanced laboratory testing, and diagnostic capacity. However, most of the increase reflects the expansion of the outbreak.

    As of 30 July 2026, a total of 3605 confirmed cases, including 1587 deaths (CFR 44%), have been reported in the Democratic Republic of the Congo. 

    To date, 651 patients have recovered.

    Cases have been reported from 49 health zones (HZ) across five provinces: Ituri (28/36 HZ), North Kivu (11/34 HZ), South Kivu (1/34 HZ), Haut- Uélé (5/13 HZ) and Tshopo (4/23 HZ).[1] An additional HZ, Wanie-Rukula in Tshopo, is awaiting data harmonisation at the health province level.

    Of the 49 affected health zones, the outbreak remains active in 33, with confirmed cases reported within the past seven days. During this period, 641 confirmed cases, including 282 confirmed deaths, were reported.

    Ituri remains the most affected province, accounting for 88% (3176/3605) of all confirmed cases and 82.6% (1311/1587) of reported deaths nationwide. Within the province, the highest number of confirmed cases have been reported from Bunia (880 cases), Rwampara (627 cases), Mongbwalu (541 cases), Nizi (377 cases), Lita (131 cases), and Nyankunde (114 cases) health zones.

    As of 30 July, 17 863 contacts have been identified and are under follow-up across Ituri (11 638), North Kivu (5667), Haut-Uélé (458) and 65 in Tshopo. Of these, 13 455 contacts were under active follow-up, corresponding to follow-up rates of 75.5% in Ituri, 74.6% in North Kivu, 80.6% in Haut-Uélé, and 66.2% in Tshopo. Previously identified contacts in South Kivu have completed the required 21-day follow-up period.

    Infections among health workers continue, with 151 confirmed cases, including 44 deaths (CFR: 29%) and 68 recoveries. These infections highlight ongoing occupational exposure risks, persistent challenges in implementing infection prevention and control (IPC) in health-care facilities, and continued exposure risk in the community.

    The outbreak is occurring in a complex humanitarian and conflict-affected setting, characterized by population displacement, high population mobility, and limited access to essential services, including health care, clean water, food, shelter, and protection.  These conditions increase the risk of disease transmission, including in overcrowded sites for internally displaced persons (IDPs).

    Insecurity and attacks affecting health facilities have hampered response operations in affected provinces, by restricting access for response teams, disrupting surveillance and response activities and increasing the risk of undetected transmission. These challenges underscore the importance of community-centred response efforts led by local authorities and trusted community leaders. 

Figure 2: Number of confirmed cases (n = 3605), in the Democratic Republic of the Congo, by date of reporting, as of 30 July 2026

{Click on Image to Enlarge}

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{*} Note that the large number of reported cases on 22 July represents the completion of a data reconciliation exercise, including cases that occurred earlier in the outbreak, rather than newly recorded cases.

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Figure 3: Number of deaths among confirmed cases (n = 1587), in the Democratic Republic of the Congo, by date of reporting, as of 30 July 2026. 

{Click on Image to Enlarge}

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{*} Note that the large number of reported deaths on 22 July represents the completion of a data reconciliation exercise, including deaths that occurred earlier in the outbreak, rather than newly recorded deaths.

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 and materials. Transmission is particularly amplified in health-care settings when IPC measures are inadequate and during unsafe burial practices involving direct contact with deceased individuals.

    The incubation period for BVD ranges from two to 21 days, and infected 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- or 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, in collaboration with WHO and partners, continue to implement extensive public health measures, including implementing the continental preparedness and response plan a strategic six-month framework plan designed to guide coordinated efforts to strengthen outbreak response measures, including emergency coordination, disease surveillance, laboratory testing, infection prevention and control, clinical care, community engagement, research, logistics and support for essential health services, engaging donors and mobilizing additional resources to address critical funding gaps and sustain response operations across affected and at-risk areas. A substantial scale-up will be needed in all pillars to get ahead of the outbreak.

    For further information about public health response actions by the respective Ministry of Health, WHO and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa: Ebola Bundibugyo Virus Disease Outbreak Democratic Republic of the Congo | Uganda Weekly External Situation Report | WHO | Regional Office for Africa 

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 detection, the Democratic Republic of the Congo and Uganda at the time of assessment, was separated from the risk for other countries in the African Region.

    The risk in the Democratic Republic of the Congo was 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 was 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, which has historically been affected by Ebola outbreaks, including Bundibugyo virus and Sudan virus disease.

    The risk for countries sharing land borders with countries reporting BDBV detection was 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 African region and at the global level was assessed as low.

    For further information, please see the WHO Rapid Risk Assessment – Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo, Uganda and countries with land borders adjoining countries with documented BDBV detection v3.

    An updated Rapid Risk Assessment is currently being developed in advance of the upcoming IHR Emergency Committee meeting regarding the epidemic of Ebola Bundibugyo virus disease scheduled for 18 August. 

(...)

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON614

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