#Bundibugyo Virus Disease #Outbreak in #DRC - Weekly #Situation #Report 22, Data as of 11 October 2026 (WHO, summary): 9,066 cases and 4,381 deaths

 

{Summary}

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Event description

Democratic Republic of the Congo

    The BVD outbreak in the Democratic Republic of the Congo continues to evolve, expanding both geographically and in terms of the numbers of cases and deaths. 

    The Dakwa Health Zone in Bas-Uélé Province has become the latest  affected health zone, bringing the total number of impacted health zones to 65  across seven provinces since the start of the outbreak. 

    Transmission remains highly heterogeneous across these regions. Since  External Situation Report #21, a total of 463 additional confirmed cases and 233 confirmed deaths have been reported. This increases the cumulative  total to 9066 confirmed cases, including 4381 confirmed deaths [crude case fatality ratio (CFR) 48.3%] as of 11 October 2026.

    Ituri remains the principal focus of the outbreak, though its relative  contribution is declining; it is currently for 73.8% of cumulative confirmed cases. 

    Substantial transmission persist in Nord-Kivu and Haut-Uélé.

    National incidence remains high and fluctuating, with no sustained  downward trajectory evident. Following rapid expansion through July and August,  the epidemic has entered a more heterogeneous phase characterized by repeated declines and rebounds. This pattern reflects asynchronous transmission  across provinces and health zones; declining activity in established Ituri hotspots  is being offset by persistent or renewed activity elsewhere, particularly in  NordKivu, while sporadic detections continue to extend the geographic footprint. 

    The overall trend suggest a shifting and geographically fragmented  epidemic than sustained contraction.(Figure 1)

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 11 October 2026

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Trend Analysis (21-day comparison): 

    During the most recent 21- days period (21 September – 11 October  2026), a total of 1333 confirmed cases were reported nationally, compared  with 1633 cases during the preceding 21 days (31 August–20 September). 

    This represents a decrease of 300 cases (−18.4%). Cases declined across  the three principal transmission provinces: Ituri: Decreased from 931 to 748  (−19.7%) accounting for 56.1% of national cases in the latest period.

        • Nord-Kivu: Decreased from 589 to 486 (−17.5%)accounting for 36.5% of  national cases

        • Haut-Uélé: Decreased from 89 to 72 (−19.1%)

    Despite the overall 21-day decline, daily incidence continues to fluctuate, with repeated rebounds, particularly in Ituri and Nord-Kivu.  

    Consequently, these reductions should be interpreted cautiously and do  not yet indicate a sustained contraction of the epidemic (Figure 2).

(...)

    During the same period, 649 confirmed deaths were reported nationally, compared with 782 deaths during the preceding 21 days, representing a decrease of 133 deaths (−17%). 

    Deaths declined from 448 to 377 (−15.8%) in Ituri and from 296 to 230  (−22.3%) in Nord-Kivu. 

    In contrast, deaths increased from 31 to 34 (+9.7%) in Haut-Uélé and  from five to eight (+60.0%) in Tshopo. 

    Consequently, Ituri accounted for 58.1% of deaths during the latest  period and Nord-Kivu for 35.4%, compared with 57.3% and 37.9%, respectively,  during the preceding period. However, as with cases, the overall 21-day decline  masks continued fluctuations in mortality and should be interpreted cautiously, as  it does not yet indicate a sustained downward trajectory (Figure 3).

(...)

    Transmission remained active in more than three-quarters of all health  zones affected since the start of the outbreak.

    Of the 65 health zones affected to date, 50 reported at least one new  confirmed case in the last 21 days. Case incidence increased in 23 health zones  (Figure 4), decreased in 26 and remained unchanged in one, highlighting  substantial heterogeneity in local transmission. The most pronounced increase  occurred in Mandima, Ituri (23 to 199 cases; +765.2%), while substantial  increases were also observed in Mambasa and several health zones in Nord-Kivu, particularly Beni, Mabalako and Oicha.

(...)

    Declines were widespread across Ituri and Nord-Kivu, including several  major transmission hotspots such as Bunia, Katwa, Mangala, Mongbwalu and  Komanda, while particularly marked reductions were observed in Tchomia  (−94.4%) and Isiro (−83.3%).

    The number of health zones with no reported confirmed cases during  the latest 21-day period decreased from 18 to 15.

    These include Ariwara, Aungba, Boga, Damas, Drodro, Kambala and Mahagi  in Ituri; Goma in Nord-Kivu; Dungu and Gombari in Haut-Uélé; Bafwasende,  Lubunga and Wanie-Rukula in Tshopo; Miti-Murhesa in Sud-Kivu; and Buta in  BasUélé.

(...)

    Weekly confirmed deaths ( Figure 5) increased for the second consecutive  week, from 192 during 21 – 27 September to 224 during 28  September – 4 October and 233 during 5 – 11 October. In the latest week, deaths  increased by 4.0%, with community deaths rising from 150 to 157  (+4.7%) and deaths in treatment facilities from 74 to 76 (+2.7%). 

    Community deaths continued to account for approximately two-thirds of all  confirmed deaths, increasing slightly from 67.0% to 67.4%. The sustained  increase in deaths over the past two weeks, particularly the persistently high  proportion occurring in the community, remains a key concern.

(...)

Kenya

    As of 12 October 2026, no new confirmed BVD cases or deaths have been  reported in Kenya since the detection of the imported case, and the  cumulative total remains one confirmed case with one death (CFR 100%).

    The imported case was a 40-year-old Kenyan male who travelled from the  Democratic Republic of the Congo through Uganda before arriving in Nairobi  on 3 October 2026. He presented for care and was isolated on the day of arrival, with laboratory testing confirming Bundibugyo virus infection. He died on 5  October and received a safe and dignified burial on 6 October 2026.

    Contact tracing and monitoring remain ongoing, with 128 contacts  currently listed, comprising 26 passengers, four flight crew, 43  Jomo Kenyatta International Airport staff, 10 relatives and 45 healthcare  workers. 

    Of these, 108 (84.4%) are in quarantine and were successfully followed up,  while 20 remain outside quarantine. The latter group includes seven passengers  who have not yet been located, seven newly identified healthcare workers and  one immigration officer who remains unreachable. 

    

    The remaining five contacts are passengers who had onward travels their  respective destination countries have been notified.

    A total of 289 alerts have so far been investigated, generating 293  laboratory tests, with all 292 results other than the index case testing negative. 

(...)

Situation interpretation

    The fluctuating national trajectory reflects uneven interruption of  transmission across a complex, geographically dispersed and increasingly cross-border outbreak. 

    Although response capacity has expanded substantially, persistent gaps  in early detection, contact follow-up, timely isolation and referral, together with  population mobility, insecurity and variable access to affected communities,  continue to allow transmission chains to persist or re-emerge. 

    The imported case detected in Kenya, following travel from the DRC  through Uganda, underscores the risk of further international spread, although no  secondary transmission has been detected in Kenya to date. 

    Bringing the outbreak under control will require rapid interruption of remaining transmission chains through earlier case detection and isolation,  ≥95% contact follow-up, investigation of community deaths, strengthened IPC  and safe burials, intensified surveillance in emerging hotspots, and rapid  management of unlinked cases, alongside strengthened cross-border surveillance,  information sharing and coordinated contact tracing. 

    Without consistent implementation of these measures across all affected  and at-risk areas, localized gains are likely to continue being offset by renewed  transmission and further geographic spread.

Source: 

Link: https://www.afro.who.int/countries/kenya/publication/ebola-bundibugyo-virus-disease-outbreak-democratic-republic-congo-weekly-external-situation-report

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#HK CHP closely monitors case of #pneumonia of undetermined etiology that resulted in death in #Russia (Dept. of Health, Oct. 12 '26)

 

    Regarding the death of a laboratory worker in Irkutsk Oblast of Siberia, Russia, due to severe pneumonia of undetermined etiology, the Centre for Health Protection (CHP) of the Department of Health (DH) said today (October 12) that, according to the World Health Organization (WHO)'s latest announcement, information obtained from the Russian authorities indicated that no evidence of ongoing transmission associated with the event had been identified. 

    Nevertheless, for the sake of prudence, the CHP has implemented a series of control and prevention measures. 

    The CHP will continue to closely monitor the latest developments, respond swiftly, and strictly guard against imported cases in order to safeguard public health.

      After noticing media reports of the above-mentioned death case in Russia in early October, the CHP immediately and proactively sought further information from the WHO and the Russian health authorities. 

    According to the latest information from the WHO, citing data provided by Russian authorities, no case of plague had been recorded recently in Irkutsk Oblast, the laboratory testing of the deceased's contacts detected no high-threat pathogens, and that there were no further cases of severe pneumonia linked to this case. 

    The Russian authorities reported that no biosecurity incidents had occurred in the laboratory, and quarantine measures were instituted in the hospital where the patient was being treated. 

    According to the WHO's assessment, no evidence of ongoing transmission associated with this event has been identified so far. 

    Nevertheless, a key uncertainty remains the absence of a confirmed diagnosis in the deceased laboratory worker. 

    The WHO will continue to monitor the situation and assess any potential public health implications as further information becomes available.

      In recent months, the CHP has not received any reports of residents or travellers arriving in Hong Kong from Russia with cases of pneumonia of undetermined etiology. 

    Based on current information, there is no evidence indicating ongoing transmission. 

    The CHP assesses that the immediate public health impact to Hong Kong is low. 

    For the sake of prudence, the CHP has implemented a series of control and prevention measures to guard against imported cases, including:

          (i) strengthening health surveillance for passengers arriving on relevant flights from Russia at the airport, including arranging for Port Health Division officers to conduct temperature checks at the relevant flight gates, and conducting health assessments for passengers exhibiting symptoms;

          (ii) displaying signages and broadcasting announcements in the airport arrival area and through airlines to urge passengers who have visited Irkutsk Oblast of Siberia, Russia, within the past 14 days to proactively declare their travel history to the on-site staff of the DH for further health assessment;

          (iii) if an inbound traveller exhibits symptoms of pneumonia, after assessment by Port Health Division officers, arrangements will be made immediately to transfer the individual to a public hospital for further testing; and

          (iv) providing the Airport Authority Hong Kong and airlines with the latest information regarding the case in Russia, and urging airlines to remind their flight crews to strictly enforce established prevention and control measures if they identify suspected cases on their flights.

      Through existing mechanisms, Hong Kong has the capacity to detect cases of unexplained infections and emerging infectious diseases at boundary control points and in hospitals.

      In addition, the CHP will send letters to all doctors and hospitals in Hong Kong, reminding them to remain highly vigilant and to strengthen surveillance. Any patient who has visited Irkutsk Oblast of Siberia, Russia, within 14 days prior to the onset of symptoms and has developed pneumonia of undetermined etiology must immediately report to the CHP so that further testing can be arranged.

     　The CHP reminds travellers that if they develop respiratory symptoms after returning to Hong Kong, they should wear a face mask, seek medical attention and report their travel history to a doctor. The CHP will continue to maintain close liaison with the WHO and other relevant health authorities, closely monitor developments, and adjust disease prevention strategies as necessary to safeguard public health.

 

Ends/Monday, October 12, 2026 | Issued at HKT 16:25

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Source: 

Link: https://www.info.gov.hk/gia/general/202610/12/P2026101200466.htm?fontSize=1

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#Pneumonia of undetermined etiology - #Russia (#WHO D.O.N., Oct. 10 '26)

 

Situation at a glance

    On 2 October 2026, WHO became aware through media reports of the death of an employee of the Irkutsk Antiplague Research Institute (APRI) of Siberia and the Far East, the Russian Federation. 

    According to these reports, the individual died on 2 October following hospitalization for severe pneumonia on 29 September, and pneumonic plague was suspected as the cause of death, following occupational exposure in laboratory settings. 

    Following requests for verification from WHO, the National Focal Point for the International Health Regulations (2005) (NFP) of the Russian Federation confirmed the death and informed WHO that no case of plague had been registered recently in Irkutsk Oblast, that preventive and control measures had been implemented in accordance with national sanitary legislation, and that the laboratory testing of contacts detected no high-threat pathogens. 

    The authorities also reported that no biosecurity incidents had occurred in the laboratory, contrary to reports in the media, and that there were no further case of severe pneumonia linked to this case. 

    The NFP informed WHO that the case and all contacts had been tested for a range of microorganisms, including high-threat pathogens. 

    Test results were negative for the tested high-threat pathogens. 

    All contacts had been medically followed up in healthcare facilities or at home, and all remained asymptomatic throughout. 

    Quarantine measures were instituted in the hospital where the patient was being treated. 

    Based on the information provided by NFP, WHO has not identified evidence of ongoing transmission associated with this event. 

    A key uncertainty remains the absence of a confirmed diagnosis in the deceased laboratory worker. 

    WHO will continue to monitor the situation and assess any potential public health implications as further information becomes available.

Description of the situation

    On 2 October 2026, WHO became aware through media reports of the death of an employee of the Irkutsk APRI of Siberia and the Far East, Russian Federation. 

    The individual died on 2 October following hospitalization for severe pneumonia on 29 September.

    On 3 October, 5 October, 6 October and 7 October, WHO contacted the Russian Federation health authorities to verify the information reported by media including a purported second case and in accordance with Articles 9 and 10 of the International Health Regulations (2005) (IHR), WHO also asked for further information to assess the potential international public health implications in accordance with Article 6 of the IHR. 

    On 2 October, a public statement issued by the Irkutsk branch of Rospotrebnadzor (RPN), a federal agency that works to provide oversight and control of wellbeing and consumer rights and protection in the Russian Federation, indicated that a “special sanitary-epidemiological expert commission” had been convened for the suspected case of high-threat pathogen. 

    Sanitary and epidemic control measures were put in place, including identifying contacts who were placed under medical observation. 

    Russian Federation authorities stated at the time that all contacts were without symptoms and with negative laboratory results for high-threat pathogens.

    On 6 October, WHO received a response to its verification request from the NFP of the Russian Federation, stating that no case of plague has been registered recently in Irkutsk Oblast, and confirming that an epidemiological investigation had been conducted following the identification of a case of severe pneumonia in an employee of the Irkutsk APRI. 

    According to authorities, the individual initially presented with symptoms compatible with an acute respiratory viral infection. 

    After testing negative for a number of high-threat pathogens, the patient was determined to have died from pneumonia of undetermined etiology.

    Russian authorities informed WHO of the following: 

        § that preventive and control measures had been implemented in accordance with national sanitary legislation; 

        § that the widest possible range of contacts were identified, placed under medical observation and tested for high-threat pathogens, and 

        § that as of 9 October, no high-threat pathogens within the laboratory’s research portfolio had been detected in any of the contacts, and 

        § their medical observation has been discontinued. 

    The authorities further reported that no laboratory biosafety or biosecurity incidents had occurred at the institute, as determined by two independent investigations and stated that media reports suggesting otherwise were inaccurate.

    According to the Russian Federation authorities, the situation continues to be monitored.

    Following subsequent requests for information from WHO on 7 and 8 October, the NFP of the Russian Federation provided further information. 

    According to their official report, the patient and all identified contacts were tested for a broad range of pathogens, including influenza, SARS-CoV-2, other respiratory infections, and bacterial infections (including plague and streptococcus). 

    All results were reportedly negative for high-threat pathogens, and only two cases of COVID-19, three cases of rhinovirus, one case of Haemophilus spp., and other opportunistic infections were identified among contacts. 

    The authorities further reported that the fatality was not due to plague infection, had been vaccinated against the high-threat pathogens with which the employee had worked occupationally. 

    The report also stated that the individual had not travelled outside of Irkutsk Oblast during the two weeks prior to symptom onset.  

    WHO has offered support in the areas of high-threat pathogens and laboratory biosafety and biosecurity to the public health authorities in the Russian Federation.

    In response to further information about the public health measures put in place, Russian Federation authorities reported that given the patient’s occupation, precautionary public health measures were implemented, and a broad range of contacts were identified and placed under medical observation either in healthcare facilities or at home. 

    Medical observation, including daily laboratory testing, was conducted for seven days and has been completed for all identified contacts. 

    All contacts remained asymptomatic and tested negative for the pathogens under investigation.

    The Russian Federation authorities informed WHO that, apart from the hospital where the case was admitted, no other healthcare facility was placed under quarantine or subjected to additional public health measures, contrary to media reports.

Public health response

    The NFP of the Russian Federation publicly announced that the regional sanitary and anti-epidemic commission convened an extraordinary meeting on 2 October. 

    RPN, the responsible agency, approved an operational action plan of sanitary and anti-epidemic measures, in accordance with national legislation, including contact tracing and medical follow-up, laboratory testing of identified contacts, enhanced epidemiological investigation and risk assessment and implementation of precautionary infection prevention and control measures. 

    Five Rospotrebnadzor organizations, including three research institutions, were involved in the measures. 

    The preventive and anti-epidemic measures were implemented in accordance with the patient's professional activities. 

    No infectious disease-related health concerns were identified. 

    More than 5500 laboratory tests were conducted, and none detected high-consequence or dangerous pathogenic microorganisms. 

    Testing was performed using a broad range of established laboratory methods, including bacteriological, biological, mass spectrometric, and molecular genetic techniques. 

    No high-threat pathogens were detected among contacts, and all follow-up activities were completed without identifying additional cases.

WHO risk assessment

    WHO’s rapid risk assessment is a systematic and continuous process that characterizes the risk posed by a public health event and informs measures to reduce its impact and prevent international spread.

    A key uncertainty for this event is the absence of a confirmed diagnosis in the deceased laboratory worker. 

    According to information provided by the national authorities, testing did not identify plague or other tested high-threat pathogens, and the death has been classified as pneumonia of undetermined etiology. 

    However, WHO has not received information identifying the causative agent responsible for the fatal illness. 

    Given the absence of a confirmed diagnosis, WHO is not in a position to independently assess whether the duration of the reported monitoring period for contacts was sufficient to exclude all plausible causes of the fatal illness.

    The occupational setting of the case remains an important consideration. 

    The deceased individual worked at an institution that handles high-consequence pathogens, and precautionary public health measures were reportedly implemented because of the individual's professional activities. 

    While the information provided by the authorities does not indicate infection with tested high-threat pathogens or identify additional linked cases, the source of the fatal illness remains undetermined. 

    A laboratory-associated exposure therefore cannot be fully excluded at this stage.

    Based on the information provided by NFP, WHO has not identified evidence of ongoing transmission associated with this event. 

    However, confidence in the assessment remains limited by the absence of a confirmed etiological diagnosis, and the remaining uncertainty regarding the source and mode of exposure. 

    Additional clinical, epidemiological and laboratory information, including confirmation of the diagnosis in the deceased laboratory worker, is required to improve confidence in the assessment. 

    WHO will continue monitoring the situation and assess any potential public health implications as further information becomes available. 

WHO advice

    WHO encourages all States Parties to the IHR to actively engage with the WHO IHR Contact Points in their respective WHO Regional Office for timely event-related communications, including by applying, to that effect, the decision instrument contained in Annex 2 of the IHR, intended to inform the decision by national authorities to notify WHO (Article 6) or to consult with WHO (Article 8).

    As the etiology of the fatal illness remains undetermined, further investigation of available clinical specimens and epidemiological information should continue, as appropriate. 

    Additional laboratory testing, including confirmatory testing by reference laboratories where needed, may assist in establishing the causative agent and refining the public health risk assessment.

    Depending on seasonality and local epidemiology, States Parties may consider enhancing or strengthening community-based, event-based or sentinel surveillance for respiratory infections and strengthening testing capacities for respiratory pathogens. 

    Public health authorities may also encourage uptake of recommended vaccinations against seasonal influenza, COVID-19, pneumococcal diseases and other vaccine-preventable respiratory infections as appropriate.

    Given that the reported event involved a laboratory worker and that initial media reports suggested a possible occupational exposure or laboratory-related incident, WHO recalls the importance of maintaining robust biosafety, biosecurity, and infection prevention and control practices in laboratories handling potentially hazardous biological agents. This recommendation is precautionary in nature and does not imply that a laboratory-associated infection or incident has been confirmed in this event.

    Should an occupational exposure to biological hazards occur among personnel working in laboratory settings, regardless of the specific role or the nature of the clinical outcome, WHO recommends strict adherence to appropriate biosafety, biosecurity and infection prevention and control measures in accordance with established protocols. 

    These measures are intended to minimize the risk of occupational exposure to and unintended release of infectious agents and should be applied consistently as part of routine laboratory practice, without implying that a particular infection or clinical condition was necessarily acquired as a result of occupational exposure in the laboratory setting.

    Based on the information currently available, WHO does not advise any restrictions on travel or trade related to this event. 

    WHO will continue monitoring the situation and updating its recommendations as additional information becomes available.

Further information

    ° Rospotrebnadzor: a full range of preventive measures has been completed in Irkutsk. Available here:  https://www.rospotrebnadzor.ru/deyatelnost/epidemiological-surveillance/?ELEMENT_ID=33189

    ° Shelekhovsky District official website, Extraordinary meeting of the Regional Sanitary and Anti-Epidemic Commission. Available here: https://www.sheladm.ru/p/044cd85d94814bb99845ef58826e6adc

    ° Irkutsk region Governor. Available here:  https://web.max.ru/-68185301813993

    ° Irkutsk Anti-Plague Research Institute of Siberia and Far East. Available here: https://irknipchi.ru/index_eng.htm

    ° World Health Organization (2020). Laboratory biosafety manual, 4th ed. World Health Organization. Available here: https://iris.who.int/handle/10665/337956.

    ° World Health Organization (2021). WHO guidelines for plague management: revised recommendations for the use of rapid diagnostic tests, fluoroquinolones for case management and personal protective equipment for prevention of post-mortem transmission. Available here: https://iris.who.int/handle/10665/341505.

    ° World Health Organization. Fact Sheet Plague. Available here: https://www.who.int/news-room/fact-sheets/detail/plague

Citable reference: World Health Organization (10 October 2026). Disease Outbreak News; Pneumonia of undetermined etiology in the Russian Federation. Available at:  https://www/who.int/emergencies/disease-outbreak.news.item/2026-DON620 

Source: 

Link: https://www/who.int/emergencies/disease-outbreak.news.item/2026-DON620

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#Bundibugyo Virus Disease #Outbreak in #DRC - Weekly Situation #Report No. 21, as of 4 Oct. '26 (#WHO, summary): 8,603 cases and 4,148 deaths in DRC

 

{Summary}

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Event description

    The ongoing Bundibugyo virus disease (BVD) outbreak in the Democratic  Republic of the Congo has now extended to Kenya, the fourth country affected during the current outbreak, following earlier detections in  Uganda and France, where the events have since been controlled. 

    Kenya has reported its first confirmed case and associated death in a traveller arriving from the Democratic Republic of the Congo. This latest  development further underscores the regional and international dimensions of the outbreak and the continuing risk of cross-border spread.

Democratic Republic of the Congo

    The BVD outbreak in the Democratic Republic of the Congo continues to expand geographically, with Alimbongo Health Zone in Nord-Kivu Province  becoming the latest affected health zone, bringing the total number affected since  the start of the outbreak to 64 health zones across seven provinces. 

    Transmission remains increasingly heterogeneous across affected  provinces and health zones. 

    In the last week ending 4 October 2026, a further 487 confirmed cases and 224 confirmed deaths were reported, increasing the cumulative total to  8603 confirmed cases, including 4148 deaths [crude case fatality ratio (CFR): 48.2%]. 

    Ituri remains the principal focus, although its relative contribution  continues to decline, accounting for 75.0% of cumulative confirmed cases, while  substantial transmission continues in Nord-Kivu and persists in Haut-Uélé.

    At the national level, daily incidence remains high and fluctuating, with  the seven-day moving average rising again in early October following a decline  through the second half of September. This pattern continues to mask divergent provincial trajectories. 

    Ituri has declined substantially from its late-July/early-August peak but shows a recent upturn, while Nord-Kivu has rebounded sharply after a  temporary decline from its mid-September peak. 

    Transmission in HautUélé remains sustained but below its August peak,  while Tshopo continues to report intermittent activity from a low baseline. 

    Bas-Uélé and Sud-Ubangi report sporadic cases, with no recent  transmission evident in Sud-KivuOverall, the epidemic remains geographically  heterogeneous, with the recent national rebound driven particularly by renewed transmission in parts of Ituri and Nortrd-Kivu.

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    During the most recent 21 days (14 September – 4 October 2026), a total  of 1345 confirmed cases were reported nationally, compared with 1674 cases  during the preceding 21 days (24 August – 13 September), representing a  decrease of 329 cases (−19.7%). 

    

    Cases declined in the three principal transmission provinces: from 1004  to 791 (−21.2%) in Ituri, 553 to 448 (−19.0%) in Nord-Kivu, and 100 to 78  (−22.0%) in Haut-Uélé. 

    Consequently, Ituri accounted for 58.8% of cases reported during the  latest period and Nord-Kivu for 33.3%, compared with 60.0% and 33.0%,  respectively, during the preceding period. 

    However, the overall 21-day decline masks a recent reversal in  trajectory, with cases increasing again during the latest week, particularly in Ituri  and Nord-Kivu. The decline over the longer comparison period should therefore be interpreted cautiously and does not yet indicate sustained epidemic contraction.

(...)

    During the same period, 638 confirmed deaths were reported nationally,    compared with 830 deaths during the preceding 21 days, representing a decrease  of 192 deaths (−23.1%). 

    

    Deaths declined from 495 to 385 (−22.2%) in Ituri and from 299 to 208  (−30.4%) in Nord-Kivu. In contrast, deaths increased from 31 to 37 (+19.4%) in  Haut-Uélé, while Tshopo reported seven deaths compared with two during the preceding period. 

    Consequently, Ituri accounted for 60.3% of deaths during the latest period  and Nord-Kivu for 32.6%, compared with 59.6% and 36.0%, respectively,  during the preceding period. However, as with cases, the overall 21-day decline  masks a recent reversal in trajectory, with reported deaths increasing again during the latest week.

(...)

    Transmission remained active in nearly three-quarters of all health zones affected since the start of the outbreak. 

    

    Of the 64 health zones affected to date, 46 reported at least one new  confirmed case in the last 21 days. 

    

    Encouragingly, 18 health zones have not reported a new confirmed case  in the last 21 days. These include Adja, Aru, Ariwara, Aungba, Boga, Drodro,  Kambala, Logo and Mahagi in Ituri; Goma in Nord-Kivu; Gombari in Haut-Uélé;  Bafwasende, Lubunga, Tshopo and Wanie-Rukula in Tshopo; Miti-Murhesa in Sud- Kivu; and Buta and Ganga in Bas-Uélé. 

    Provincial trends continue to mask important differences between health  zones. 

    In Ituri, the most pronounced increase  occurred in Mandima, where cases  rose from 15 to 129 (+760.0%), while Mambasa increased from 3 to 20 and Nia- Nia from 46 to 72 (+56.5%). 

    In contrast, cases declined in several established transmission hotspots, including Bunia, from 285 to 196 (−31.2%), Nizi, from 120 to 54  (−55.0%), Mangala, from 116 to 52 (−55.2%), Lita, from 65 to 32 (−50.8%),  and Komanda, from 76 to 40 (−47.4%). 

    Rwampara remained a major focus despite a more modest decline, from  106 to 95 cases (−10.4%).

    Nord-Kivu showed continued broad-based intensification, with Beni  increasingly driving transmission. Cases in Beni increased from 111 during the  preceding 21 days to 165 during the most recent period (+48.6%), while  Butembo declined from 101 to 41 (−59.4%) and Musienene from 46 to 22  (−52.2%). Katwa also declined substantially, from 175 to 77 cases (−56.0%),  although it remained an important focus of transmission. Haut-Uélé declined  overall, driven largely by a sharp reduction in Isiro (−82.8%), while transmission  remained relatively stable in Wamba and Pawa. However, the first case in Dungu  indicates continued geographic expansion despite the provincial decline.

(...)

    Weekly confirmed deaths generally declined after peaking at 364 in mid-August, reaching 192 during 21–27 September.

    However, this trend reversed in the latest week, with deaths increasing  by 16.7% to 224 during 28 September–4 October. 

    The latest increase occurred in both settings, with community deaths  rising from 123 to 150 (+22.0%) and deaths in treatment facilities increasing  from 69 to 74 (+7.2%). 

    Consequently, the proportion of deaths occurring in the community  increased from 64.1% to 67.0%, continuing an upward trend from 61.3% during  14 – 20 September. The latest increase in both community and facility deaths  indicates a reversal of the declining mortality trend observed during the preceding  weeks, with two-thirds of confirmed deaths continuing to occur in the  community.

(...)

Kenya

    A confirmed case of BVD has been reported in Kenya. The case is a 40-year-old Kenyan male and resident of the Democratic Republic of the Congo.  

    Preliminary investigations indicate that he travelled from Buta in Bas-Uélé  Province to Kisangani, Tshopo Province, arriving on 20 September 2026, where symptom onset was reportedly noted. 

    He subsequently travelled to Beni, Nord-Kivu Province, on 1 October,  stayed overnight, and continued by road to Kampala, Uganda, on 2 October. 

    After an overnight stay in Kampala, he travelled by air from Entebbe,  Uganda to Nairobi, Kenya on 3 October 2026, arriving at approximately 13:10,  and proceeded directly to a healthcare facility accompanied by family members,  where he was isolated. 

    He presented with fever, chills, intense fatigue and weakness, muscle  pain, painful swallowing, sore throat, and bleeding under the skin at injection  sites. 

    Samples collected on 3 October tested positive for Bundibugyo virus at the  National Virology Reference Laboratory of the Kenya Medical Research Institute 

(KEMRI), with laboratory confirmation reported on 5 October 2026. 

    He died later that day while undergoing care. Safe and dignified burial has  been conducted.

    A total of 28 contacts, including family members and healthcare workers,  have so far been listed. An additional 23 passengers and crew members who  travelled on the same flight as the case from Kampala, Uganda, to Nairobi, Kenya, are being traced. 

    Contacts already identified are being quarantined while further  investigations are ongoing to establish the detailed travel itinerary of the case and  identify all persons who may have been exposed in the Democratic Republic  

of the Congo, Uganda, and Kenya.

Risk Assessment

    The risk of further spread remains very high within the Democratic Republic of the Congo, reflecting sustained transmission, continued geographic  expansion, high mortality, population mobility, insecurity and persistent response 

challenges. 

    The risk is considered high for neighbouring countries sharing land  borders with the Democratic Republic of the Congo and 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.

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Situation interpretation

    The outbreak of BVD remains uncontrolled despite expanded response capacity. 

    

    Recent increases in cases and deaths, shifting transmission hotspots,  persistent community deaths, suboptimal contact follow-up and delayed isolation 

indicate continuing gaps in breaking transmission chains. 

    The confirmed exportation to Kenya following travel through Uganda  further demonstrates the growing cross-border risk and its associated regional  consequences. 

    The immediate priorities should be to improve response performance across the different response pillars while strengthening crossborder coordination and preparedness.

Source: 

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

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Avian #influenza #overview June–August 2026 (ECDC/EFSA, September 22 '26, Summary)

 

{Summary}

Abstract

    Between 5 June and 28 August 2026, 110 highly pathogenic avian  influenza (HPAI) A(H5N1) virus detections were reported in domestic (7)  and wild (103) birds in 12 countries in Europe. The number of detections  remained at a seasonal low throughout the summer, continuing the decline  observed since spring. In contrast to previous years, fewer colony-breeding  seabirds were affected, and the geographical range of detections was more  limited. Further sporadic detections of HPAI A(H5) virus were reported in wild  terrestrial carnivores and pinnipeds. Outside Europe, the epidemic continued  in the Americas, where also the HPAI A(H7N3) subtype was detected in Mexico.  Following its first introduction to mainland Australia, HPAI A(H5N1) virus spread within local wild bird populations and spilled over to terrestrial  carnivores and marine mammals. In the US, the number of dairy  cattle farms reportedly affected by HPAI A(H5N1) increased, while detections in  captive American minks were reported for the first time. Between 5 June and  31 August 2026, 15 cases of avian influenza virus infection were publicly  reported in humans (no fatal cases) in three countries and territories:  Bangladesh (one A(H5N1) case), Cambodia (one A(H5N1) case) and China (13 A(H9N2) cases). All human cases reported exposure to poultry or a poultry  environment prior to detection or onset of illness. Human infections with avian  influenza viruses remain rare and no sustained human-to-human transmission has  been documented. The risk posed by avian influenza A(H5N1) clade  2.3.4.4b viruses currently circulating in Europe remains low for the general  public in the European Union/European Economic Area (EU/EEA) and low-to- moderate for those occupationally or otherwise exposed to infected animals or  contaminated environments.

©2026 European Food Safety Authority, European Centre for Disease Prevention  and Control, European Union Reference Laboratory for Avian Influenza. EFSA  Journal published by WileyVCH GmbH on behalf of European Food Safety Authority

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Source: 

Link: https://doi.org/10.2903/j.efsa.2026

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#Bundibugyo Virus Disease #Outbreak, #DRC - Situation #Report 19, Data as of 20 September 2026 (WHO, summary): 7,733 cases & 3,732 deaths so far

 

{Summary}

{Click on Image to Enlarge}

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Event description

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of  the Congo has expanded further, with Dungu Health Zone in Haut-Uélé  Province, bordering South Sudan, being the latest affected, bringing the total  number of health zones affected to 63 since the start of the outbreak. 

    This latest geographic expansion heightens concern about further spread  towards international borders, while transmission within the country remains  increasingly heterogeneous across affected provinces and health zones. 

    Since External Situation Report #18, a further 475 confirmed cases and  222 confirmed deaths have been reported, bringing the cumulative total  to 7733 confirmed cases, including 3732 deaths [crude case fatality ratio (CFR 48.3%)], as of 20 September 2026. 

    Ituri remains the principal focus, although its relative contribution  continues to decline, accounting for 76.9% of cumulative confirmed cases, while substantial transmission continues in Nord-Kivu and persists in Haut-Uélé.

    At the national level, daily incidence remains high and fluctuating, with the  seven-day moving average rebounding in early September before declining in the  most recent days. This national pattern masks divergent provincial trajectories. 

    Ituri continues a gradual decline from its late-July peak but remains at a  high level, while Nord-Kivu experienced a marked increase, reaching its highest  incidence in mid-September, followed by an apparent decline in recent days.

    Transmission in Haut-Uélé remains sustained but below its August peak,  while Tshopo shows renewed activity from a low baseline. Bas-Uélé continues to  report sporadic transmission, with no recent transmission evident in Sud-Kivu.

    Overall, the epidemic remains geographically heterogeneous, with  recent declines in the principal transmission areas occurring alongside persistent  low-level transmission and continued geographic expansion to new areas.

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 20 September 2026

{Click on Image to Enlarge}

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    During the most recent 21 days (31 August – 20 September 2026), a total of 1633 confirmed cases were reported nationally. 

    

    Compared with 1719 cases during the preceding 21-day period (10 – 30  August 2026), this represents a decrease of 86 cases (−5.0%). 

    Reported cases declined by 25.8% in Ituri, from 1255 to 931, and by  18.3% in Haut-Uélé, from 109 to 89. 

    

    In contrast, cases increased sharply by 72.7% in Nord-Kivu, from 341 to  589, while Tshopo increased from 10 to 20 cases. 

    Bas-Uélé reported three cases compared with four during the preceding  period, while one case was reported in Sud-Ubangi. 

    Consequently, Ituri’s contribution to newly reported cases fell markedly  from 73.0% to 57.0%, while Nord-Kivu’s contribution increased from 19.8% to  36.1%; Haut-Uélé’s contribution declined from 6.3% to 5.5%. 

    Overall, the modest 5.0% national decline masks a pronounced geographic  redistribution of transmission, with the substantial decline in Ituri  increasingly offset by continued high transmission in Nord-Kivu and geographic  expansion to new areas.

    During the same period, 782 confirmed deaths were reported nationally,  compared with 939 deaths during the preceding 21 days, representing a decrease of 157 deaths (−16.7%). 

    The national decline was driven largely by Ituri, where reported deaths  decreased from 654 to 448 (−31.5%), while deaths also declined in Haut-Uélé,  from 50 to 31 (−38.0%). 

    In contrast, deaths increased substantially in Nord-Kivu, from 228 to  296 (+29.8%). Consequently, Ituri’s contribution to newly reported deaths fell  from 69.6% to 57.3%, while Nord-Kivu’s contribution increased from 24.3% 

to 37.9%; Haut-Uélé’s contribution declined from 5.3% to 4.0%. 

    Tshopo reported five deaths, Bas-Uélé one, and SudUbangi one during the  latest period. 

    Overall, the decline in national mortality was driven predominantly by  the substantial reduction in Ituri and masks the continued concentration of  mortality in Nord-Kivu, which now accounts for more than one-third of newly reported cases and deaths nationally.

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    Additionally, during the most recent 21 days (31 August–20 September  2026), 49 of the 63 affected health zones (77.8%) reported at least one new  confirmed case, while 14 (22.2%) reported no new cases. Health zones reporting  no cases were Adja, Aru, Ariwara, Aungba, Boga, Kambala and Mahagi in Ituri;  Goma in Nord-Kivu; Gombari in Haut-Uélé; Lubunga, Tshopo and Wanie-Rukula in  Tshopo; Miti-Murhesa in Sud-Kivu; and Buta in Bas-Uélé.

    Provincial trends continue to mask important differences between health  zones. In Ituri, where cases declined overall between the two consecutive  21-day periods, several health zones showed increasing or sustained transmission.  

    Cases nearly doubled in Komanda, from 36 to 69 (+91.7%), and increased  substantially in Mongbwalu, from 44 to 79 (+79.5%), while remaining broadly  stable in Lita, from 55 to 57 (+3.6%). In contrast, transmission declined  substantially in several major hotspots, including Bunia, from 376 to 265  (−29.5%), Nizi, from 183 to 94 (−48.6%), Rwampara, from 190 to 104 (−45.3%), and Nia-Nia, from 77 to 54 (−29.9%). Mangala also declined from  130 to 91 cases (−30.0%). 

    Nord-Kivu showed the opposite pattern, with continued broad-based  intensification, although trends varied between individual health zones. Cases  more than doubled in Beni, from 62 to 143 (+130.6%), and increased in  Butembo, from 64 to 87 (+35.9%) and Musienene, from 31 to 42 (+35.5%). In  contrast, Katwa remained at a very high level but declined slightly, from 161 to  154 cases (−4.3%). Haut-Uélé declined overall, but this similarly concealed  divergent health-zone trajectories: cases in Pawa more than doubled from 16 to  35 (+118.8%), while declining in Isiro from 50 to 18 (−64.0%) and Wamba from 35 to 25 (−28.6%).

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    Weekly confirmed deaths peaked at 364 during 10 – 16 August, before  declining to 302 and 270 over the following two weeks. Deaths subsequently  increased to 276 during 31 August – 6 September and 284 during 7 – 13  September, before declining to 222 during 14 – 20 September (−21.8%). This  latest decline occurred in both settings, with community deaths decreasing from  193 to 136 (−29.5%) and deaths in treatment facilities declining from 91 to 86  (−5.5%).

    Consequently, the proportion of deaths occurring in the community fell  from 68.0% to 61.3%, continuing the decline from the peak of 75.0% during  31 August – 6 September. Despite this improvement, nearly two-thirds of  confirmed deaths in the latest week continued to occur in the community.

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    The geographic distribution of confirmed BVD community deaths has  shifted substantially over time. Ituri remained the dominant contributor  throughout most of the outbreak, but its share declined markedly in recent weeks  as Nord-Kivu’s contribution increased, reaching near parity during 31 August – 13  September. In the latest week, 14 – 20 September, Ituri’s contribution increased  to 58.8%, while Nord-Kivu’s declined to 33.8%, with Haut-Uélé accounting for  4.4% and only small contributions from other affected provinces. 

    Overall, the  pattern indicates an important geographic redistribution of  community mortality, with Nord-Kivu now contributing a substantially greater  share than during the earlier phase of the outbreak, despite the recent decline.

    Overall, 2,241 community deaths with age and sex information available were analysed. 

    Children aged <5 years accounted for 554 (24.7%) of these deaths,  while 1,157 (51.6%) were male and 1,084 (48.4%) were female. During the most  recent 21 days, 482 community deaths with age and sex information  available were analysed. Of these, children aged <5 years accounted for 146  (30.3%), representing a greater proportional concentration than in the overall distribution. By sex, 251 (52.1%) were male and 231 (47.9%) were  female, broadly consistent with the overall sex distribution. The greater  representation of children under five among recent community deaths suggests  that this age group may be experiencing increasing vulnerability to death before  reaching appropriate care, warranting closer investigation of care-seeking,  detection and referral pathways among young children.

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    Available case investigation information suggests that community deaths may result from multiple barriers along the pathway to appropriate care,  including missed diagnosis at peripheral health facilities, self-medication, care- seeking from traditional healers or religious places, refusal of referral, and no prior  healthcare contact. Although their relative contribution cannot yet be  quantified, these pathways highlight the need to strengthen early case  identification, community detection, and timely referral to appropriate treatment.

Risk Assessment

    The risk of further spread remains very high within the Democratic Republic of the Congo, reflecting sustained transmission, continued geographic  expansion, high mortality, population mobility, insecurity and persistent response 

challenges. 

    A two-week invasion-risk forecast identified 20 previously unaffected  health zones at elevated risk of transmission. Dungu, which was among the health  zones identified as high risk, has since reported confirmed transmission.  The remaining 19 health zones are Rethy, Watsa, Nyarambé, Biringi, Makoro,  Karisimbi, Angumu, Rutshuru, Nyiragongo, Niangara, Linga, Kirotshe,  Bafwagbogbo, Alimbongo, Jiba, Poko, Rwanguba, Kamango and Kibirizi. 

    This development reinforces the value of risk-based preparedness and  readiness measures in health zones identified as being at elevated risk.

    The risk is considered high for neighbouring countries sharing land  borders with the Democratic Republic of the Congo and 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.

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Situation interpretation

    The outbreak remains uncontrolled and increasingly geographically dispersed, expanding the operational footprint of the response and placing  additional pressure on already stretched resources. The emergence of  transmission in Dungu, a health zone bordering South Sudan that was previously  identified as being at high risk, further heightens the potential for cross-border  spread and reinforces the need to accelerate readiness in areas where further  spread is anticipated. At the same time, community mortality remains a major  concern, with nearly two-thirds of recent deaths occurring in the community,  indicating persistent delays in detection, referral and access to appropriate care. 

    Children under five are disproportionately represented among  community deaths, suggesting particular vulnerabilities in early recognition of  illness and timely care-seeking and referral for young children. The multiple  pathways leading to community deaths, including missed recognition at health  facilities, self-medication, alternative care-seeking, refusal of referral and no prior  healthcare contact, indicate that reducing mortality will require interventions  across the entire pathway to care.

    Priorities should include stronger community detection, early recognition  at peripheral health facilities, rapid referral and improved community  trust and acceptance, alongside targeted investigation and interventions to  address the specific barriers contributing to community deaths among children under five.

Source: 

Link: https://www.afro.who.int/countries/democratic-republic-of-congo/publication/ebola-bundibugyo-virus-disease-outbreak-4

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