Showing posts with label risk assessment. Show all posts
Showing posts with label risk assessment. Show all posts

Thursday, July 9, 2026

# Influenza at #human - #animal #interface - Summary and #risk #assessment, from 13 June to 7 July 2026 (WHO): 1 new case of #H5 virus, 2 of #H9N2 and one of #H3N2v

 


Influenza at the human-animal interface - Summary and risk assessment, from 13 June to 7 July 2026 {1} 


    New human cases {2}

        ° From 13 June to 7 July 2026, based on reporting date, detections of influenza A(H5) in one human, influenza A(H9N2) in two humans, and an influenza A(H3N2) variant ((H3N2)v) virus in one human were officially reported. 

    Circulation of influenza viruses with zoonotic potential in animals

        ° High pathogenicity avian influenza (HPAI) events in poultry and non-poultry animal species continue to be reported to the World Organisation for Animal Health (WOAH).{3} 

        ° The Food and Agriculture Organization of the United Nations (FAO) also provides a global update on avian influenza viruses with pandemic potential.{4} 

        ° Additionally, low pathogenicity avian influenza viruses as well as swine influenza viruses continue to circulate in animal populations. 

    Risk assessment {5}: 

        ° There have been no reports of sustained human-to-human transmission associated with the above-mentioned human infection events. 

        ° Based on information available at the time of this risk assessment update, the overall public health risk from currently known influenza A viruses detected at the human-animal interface has not changed and - At present, these viruses are not thought to be capable of sustained human-to-human transmission, although this could change as they evolve. 

        ° Although human infections with viruses of animal origin are infrequent, they are not unexpected at the human-animal interface.  

    IHR compliance {6}: 

        ° This includes any influenza A virus that has demonstrated the capacity to infect a human and its haemagglutinin (HA) gene (or protein) is not a mutated form of those, i.e. A(H1) or A(H3), circulating widely in the human population. 

        ° Information from these notifications is critical to inform risk assessments for influenza at the human-animal interface.  


Avian influenza viruses in humans 

A(H5), Bangladesh   

    ° On 15 June 2026, Bangladesh notified WHO of one laboratory-confirmed human case of avian influenza A(H5) infection in Bangladesh in a child from Sylhet Division

    ° The case was detected notified through the National Influenza Surveillance, Bangladesh (NISB) platform as an influenza likeillness (ILI) case.    

    ° The patient developed respiratory symptoms on 17 May 2026, received outpatient healthcare on 20 May. 

    ° A clinical sample was collected that day and was received by the Institute of Epidemiology, Disease Control and Research (IEDCR) on 4 June as part of routine surveillance. 

    ° The sample tested positive for influenza A(H5) virus by real-time reverse transcription polymerase chain reaction (RTPCR) on 11 June.    

    ° The patient is now in good health and reported no travel history and no history of exposure to poultry

    ° However, poultry deaths were reported in the area surrounding the patient’s residence. 

    ° The outbreak investigation team identified and followed close and possible contacts

    ° Samples from some of the close contacts as well as animal and environmental samples were collected for testing for influenza. 

    ° All contacts remained asymptomatic and all samples tested negative for influenza.    

    ° This is the third laboratory-confirmed human case of avian influenza A(H5) reported in Bangladesh in 2026, and the 15th human case of avian influenza A(H5) reported to WHO from Bangladesh since 2008, including two fatal cases, one reported in 2013 and one in 2026.  


Risk assessment for avian influenza A(H5) viruses:

  1. What is the current global public health risk of additional human cases of infection with avian influenza A(H5) viruses?    
    • Most human infections so far have been reported in people exposed to A(H5) viruses, for example, through contact with infected poultry or contaminated environments, including live poultry markets, and occasionally infected mammals and contaminated environments. 
    • As long as the viruses continue to be detected in animals and related environments humans are exposed to, further human cases associated with such exposures are expected but remain unusual. 
    • The impact for public health if additional sporadic cases are detected is minimal
    • The current overall global public health risk is low.  
  2. What is the likelihood of sustained human-to-human transmission of avian influenza A(H5) viruses related to the events above?    
    • No sustained human-to-human transmission  has  been identified associated with the recent reported human infections with avian influenza A(H5) viruses.
    •  There has been no reported human-to-human transmission of A(H5N1) viruses since 2007, although there may be gaps in investigations.
    •  In 2007 and the years prior, small clusters of A(H5) virus infections in humans were reported, including some involving health care workers, where limited human-to-human transmission could not be excluded; however, sustained human-to-human transmission was not reported.
    •  Current evidence suggests that influenza A(H5) viruses related to these events did not acquire the ability to efficiently transmit between people.    
  3. What is the likelihood of international spread of avian influenza A(H5) viruses by travellers?    
    • Should infected individuals from affected areas travel internationally, their infection may be detected in another country during travel or after arrival. 
    • If this were to occur, further communitylevel spread is considered unlikely as current evidence suggests these viruses have not acquired the ability to transmit easily among humans.    


A(H9N2), China  

    ° Between 12 and 23 June 2026, two laboratory-confirmed cases of A(H9N2) virus infection were detected in China. 

    ° Both cases had mild illness and were hospitalized in isolation wards at the time of reporting. 


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    ° Both cases had exposure to local live bird markets

    ° Samples from environments associated with the likely area of exposure of the cases tested positive for A(H9) viruses. 

    ° No further cases were detected among contacts of these cases.   


Risk assessment for avian influenza A(H9N2):  

  1. What is the global public health risk of additional human cases of infection with avian influenza A(H9N2) viruses?  
    • Most human cases follow exposure to the A(H9N2) virus through contact with infected poultry or contaminated environments. 
    • Most human infections of A(H9N2) to date have resulted in mild clinical illness
    • Since the virus is endemic in poultry in multiple countries in Africa and Asia, additional human cases associated with exposure to infected poultry or contaminated environments are expected but remain unusual. 
    • The impact to public health if additional sporadic cases are detected is minimal
    • The overall global public health risk is low.  
  2. What is the likelihood of sustained human-to-human transmission of avian influenza A(H9N2) viruses related to these events?  
    • At the present time, no sustained human-to-human transmission has been identified associated with the recently reported human infections with A(H9N2) viruses. 
    • Current evidence suggests that A(H9N2) viruses from these cases did not acquire the ability of sustained transmission among humans.  
  3. What is the likelihood of international spread of avian influenza A(H9N2) virus by travellers?  
    • Should infected individuals from affected areas travel internationally, their infection may be detected in another country during travel or after arrival. 
    • If this were to occur, further community level spread is considered unlikely as current evidence suggests the A(H9N2) virus subtype has not acquired the ability to transmit easily among humans.  


Swine influenza viruses in humans 

Influenza A(H3N2)v, Brazil  

    ° On 25 June 2026, Brazil notified PAHO/WHO of a laboratory-confirmed human infection with an influenza A(H3N2)v virus detected in a child in Santa Catarina state

    ° The patient had symptom onset on 12 June 2026 and due to worsening respiratory symptoms, healthcare was sought on 16 June. 

    ° The patient was referred for hospital admission with a diagnosis of Severe Acute Respiratory Infection (SARI). 

    ° Upon admission, an antigen test confirmed influenza A and the patient was placed in a private respiratory isolation room and antiviral treatment was initiated. 

    ° The patient was discharged on 19 June.  

    ° A nasopharyngeal swab sample was collected on 16 June and sent to the State public health laboratory for real-time RT-PCR. 

    ° On 18 June, a swine-origin influenza H3 variant was suspected, and the sample was sent to the Laboratory of Respiratory Viruses, Exanthems, Enteroviruses, and Viral Emergencies (LVRE) at the Oswaldo Cruz Institute (Fiocruz/Rio de Janeiro) on 19 June. 

    ° Analyses confirmed the presence of an influenza A(H3N2)v virus via molecular testing and genomic sequencing. 

    ° An investigation by the state and municipality epidemiological surveillance team found that all contacts were asymptomatic before, during and after the child’s illness. 

    ° The child's grandfather worked at a swine nursery housing approximately 5,000 animals, though he noted that sanitary barriers were in place. 

    ° The child frequently visited the grandfather's home and had contact with him several days a week.  

    ° This is the first human A(H3N2)v infection detected in the Brazil in 2026 and the first case reported in the state of Santa Catarina. 


Risk assessment for swine influenza viruses:    

  1. What is the public health risk of additional human cases of infection with swine influenza viruses?    
    • Swine influenza viruses circulate in swine populations in many regions of the world. 
    • Depending on geographic location, the genetic characteristics of these viruses differ. 
    • Most human cases are exposed to swine influenza viruses through contact with infected animals or contaminated environments. 
    • Human infection tends to result in mild clinical illness in most cases. 
    • Since these viruses continue to be detected in swine populations, further human cases are expected.
    •  The impact to public health if additional sporadic cases are detected is minimal
    • The overall risk of additional sporadic human cases is low.    
  2. What is the likelihood of sustained human-to-human transmission of swine influenza viruses?     
    • No sustained human-to-human transmission was identified associated with the event described above. 
    • Current evidence suggests that contemporary swine influenza viruses have not acquired the ability of sustained transmission among humans.   
  3. What is the likelihood of international spread of swine influenza viruses by travellers?     
    • Should infected individuals from affected areas travel internationally, their infection may be detected in another country during travel or after arrival. 
    • If this were to occur, further community level spread is considered unlikely as current evidence suggests that these viruses have not acquired the ability to transmit easily among humans.   


Overall risk management recommendations

    ° Surveillance and investigations 

        Due to the constantly evolving nature of influenza viruses, WHO continues to stress the importance of global strategic surveillance in animals and humans to detect virologic, epidemiologic and clinical changes associated with circulating influenza viruses that may affect human (or animal) health. 

            Continued vigilance is needed within affected and neighbouring areas to detect infections in animals and humans. 

            Close collaboration with the animal health and environment sectors is essential to understand the extent of the risk of human exposure and to prevent and control the spread of animal influenza. 

            WHO has published guidance on surveillance for human infections with avian influenza A(H5) viruses. 

        As the extent of influenza virus circulation in animals is not clear, epidemiologic and virologic surveillance and the follow-up of suspected human cases should continue systematically. 

            Guidance on investigation of non-seasonal influenza and other emerging acute respiratory diseases has been published on the WHO website. 

        Countries should: 

            - increase avian influenza surveillance in domestic and wild birds, 

            - enhance surveillance for early detection in cattle populations in countries where HPAI is known to be circulating, include HPAI as a differential diagnosis in non-avian species, including cattle and other livestock populations, with high risk of exposure to HPAI viruses; 

            - monitor and investigate cases in non-avian species, including livestock, 

            - report cases of HPAI in all animal species, including unusual hosts, to WOAH and other international organizations, 

            - share genetic sequences of avian influenza viruses in publicly available databases, 

            - implement preventive and early response measures to break the HPAI transmission cycle among animals through movement restrictions of infected livestock holdings and strict biosecurity measures in all holdings, 

            - employ good production and hygiene practices when handing animal products, and protect persons in contact with suspected/infected animals.{7} 

            - More guidance can be found from WOAH and FAO. 

        When there has been human exposure to a known outbreak of an influenza A virus in domestic poultry, wild birds or other animals – or when there has been an identified human case of infection with such a virus – enhanced surveillance in potentially exposed human populations becomes necessary. 

            - Enhanced surveillance should consider the health care seeking behaviour of the population, and could include a range of active and passive health care and/or communitybased approaches, including: enhanced surveillance in local influenza-like illness (ILI)/SARI systems, active screening in hospitals and of groups that may be at higher occupational risk of exposure, and inclusion of other sources such as traditional healers, private practitioners and private diagnostic laboratories. 

        Vigilance for the emergence of novel influenza viruses with pandemic potential should be maintained at all times including during a non-influenza emergency. In the context of the cocirculation of SARS-CoV-2 and influenza viruses, WHO has updated and published practical guidance for integrated surveillance. 

    ° Notifying WHO 

        All human infections caused by a new subtype of influenza virus are notifiable under the International Health Regulations (IHR, 2005).{8,9} State Parties to the IHR (2005) are required to immediately notify WHO of any laboratory-confirmed {10} case of a recent human infection caused by an influenza A virus with the potential to cause a pandemic {11}. Evidence of illness is not required for this report. Evidence of illness is not required for this report. 

        WHO published the case definition for human infections with avian influenza A(H5) virus requiring notification under IHR (2005): https://www.who.int/teams/global-influenzaprogramme/avian-influenza/case-definitions

    ° Virus sharing and risk assessment 

        It is critical that these influenza viruses from animals or from humans are fully characterized in appropriate animal or human health influenza reference laboratories. Under WHO’s Pandemic Influenza Preparedness (PIP) Framework, Member States are expected to share influenza viruses with pandemic potential on a timely basis {12} with a WHO Collaborating Centre for influenza of GISRS. The viruses are used by the public health laboratories to assess the risk of pandemic influenza and to develop candidate vaccine viruses.  

        The Tool for Influenza Pandemic Risk Assessment (TIPRA) provides an in-depth assessment of risk associated with some zoonotic influenza viruses – notably the likelihood of the virus gaining human-to-human transmissibility, and the impact should the virus gain such transmissibility. TIPRA maps relative risk amongst viruses assessed using multiple risk elements. The results of TIPRA complement those of the risk assessment provided here, and those of prior TIPRA risk assessments are published at http://www.who.int/teams/global-influenza-programme/avianinfluenza/tool-for-influenza-pandemic-risk-assessment-(tipra).  

    ° Risk reduction 

        Given the observed extent and frequency of avian influenza in poultry, wild birds and some wild and domestic mammals, the public should avoid contact with animals that are sick or dead from unknown causes, including wild animals, and should report dead birds and mammals or request their removal by contacting local wildlife or veterinary authorities.  

        Eggs, poultry meat and other poultry food products should be properly cooked and properly handled during food preparation. Due to the potential health risks to consumers, raw milk should be avoided. WHO advises consuming pasteurized milk. If pasteurized milk isn’t available, heating raw milk until it boils makes it safer for consumption. 

        WHO has published practical interim guidance to reduce the risk of infection in people exposed to avian influenza viruses. 

    ° Trade and travellers 

        WHO advises that travellers to countries with known outbreaks of animal influenza should avoid farms, contact with animals in live animal markets, entering areas where animals may be slaughtered, or contact with any surfaces that appear to be contaminated with animal excreta. Travelers should also wash their hands often with soap and water. All individuals should follow good food safety and hygiene practices.  

        WHO does not advise special traveller screening at points of entry or restrictions with regards to the current situation of influenza viruses at the human-animal interface. For recommendations on safe trade in animals and related products from countries affected by these influenza viruses, refer to WOAH guidance.  


Links:  

° WHO Human-Animal Interface web page https://www.who.int/teams/global-influenza-programme/avian-influenza 

° WHO Influenza (Avian and other zoonotic) fact sheet https://www.who.int/news-room/fact-sheets/detail/influenza-(avian-and-other-zoonotic) 

° WHO Protocol to investigate non-seasonal influenza and other emerging acute respiratory diseases https://www.who.int/publications/i/item/WHO-WHE-IHM-GIP-2018.2 

° WHO Public health resource pack for countries experiencing outbreaks of influenza in animals:  https://www.who.int/publications/i/item/9789240076884 

° Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) Reported to WHO  https://www.who.int/teams/global-influenza-programme/avian-influenza/avian-a-h5n1-virus 

° Avian Influenza A(H7N9) Information https://www.who.int/teams/global-influenza-programme/avian-influenza/avian-influenza-a-(h7n9)virus 

° World Organisation of Animal Health (WOAH) web page: Avian Influenza  https://www.woah.org/en/home/ 

° Food and Agriculture Organization of the United Nations (FAO) webpage: Avian Influenza https://www.fao.org/animal-health/avian-flu-qa/en/ 

° WOAH/FAO Network of Expertise on Animal Influenza (OFFLU) http://www.offlu.org/ 

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{1} This summary and assessment covers information confirmed during this period and may include information received outside of this period. 

{2} For epidemiological and virological features of human infections with animal influenza viruses not reported in this assessment, see the reports on human cases of influenza at the human-animal interface published in the Weekly Epidemiological Record here.  

{3} World Organisation for Animal Health (WOAH). Avian influenza. Global situation. Available at: https://www.woah.org/en/disease/avian-influenza/#ui-id-2

{4} Food and Agriculture Organization of the United Nations (FAO). Global Avian Influenza Viruses with Zoonotic Potential situation update. Available at: https://www.fao.org/animal-health/situation-updates/global-aiv-withzoonotic-potential

{5} World Health Organization (2012). Rapid risk assessment of acute public health events. World Health Organization. Available at: https://iris.who.int/handle/10665/70810

{6} World Health Organization. Case definitions for the four diseases requiring notification in all circumstances under the International Health Regulations (2005). Available at: https://www.who.int/publications/m/item/case-definitions-for-the-four-diseases-requiring-notification-towho-in-all-circumstances-under-the-ihr-(2005).  

{7} World Organisation for Animal Health. Statement on High Pathogenicity Avian Influenza in Cattle, 6 December 2024 (https://www.woah.org/en/high-pathogenicity-avian-influenza-hpai-in-cattle/). 

{8} World Health Organization. International Health Regulations (2005), as amended through resolutions WHA67.13 (2014), WHA75.12 (2022), and WHA77.17 (2024) (https://apps.who.int/gb/bd/pdf_files/IHR_20142022-2024-en.pdf). 

{9} World Health Organization. Case definitions for the four diseases requiring notification in all circumstances under the International Health Regulations (2005) (https://www.who.int/publications/m/item/casedefinitions-for-the-four-diseases-requiring-notification-to-who-in-all-circumstances-under-the-ihr-(2005)). 

{10} World Health Organization. Manual for the laboratory diagnosis and virological surveillance of influenza (2011) (https://apps.who.int/iris/handle/10665/44518). 

{11} World Health Organization. Pandemic influenza preparedness framework for the sharing of influenza viruses and access to vaccines and other benefits, 2nd edition (https://iris.who.int/handle/10665/341850). 

{12} World Health Organization. Operational guidance on sharing influenza viruses with human pandemic potential (IVPP) under the Pandemic Influenza Preparedness (PIP) Framework (2017) (https://apps.who.int/iris/handle/10665/259402). 


Source: 


Link: https://www.who.int/publications/m/item/influenza-at-the-human-animal-interface-summary-and-assessment--7-july-2026

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Friday, July 3, 2026

#Assessment of #influenza virus and #coronavirus #tropism, #replication competence and disease severity in ex vivo and in vitro cultures of the #human respiratory tract



ABSTRACT

The emergence of animal influenza viruses circulating in poultry and human populations poses a significant public health threat, yet current risk assessment tools that connect surveillance data to human transmission risk and disease severity are lacking. To address this, we employed a semi-quantitative approach to analyze virus tropism and replication competence, conducting risk assessments of influenza and coronavirus adaptation to human transmission in an ex vivo model, and evaluating virus-induced impairment of alveolar fluid clearance (AFC) in vitro as a correlation of disease severity. Our results showed that seasonal influenza A H1N1, H3N2, influenza B, MERS-CoV, and SARS-CoV exhibited productive viral replication and tissue infection in bronchial tissues, whereas wild bird surveillance isolates such as H5N3 and H7N1 showed minimal replication when compared to pandemic H1N1 and highly pathogenic avian influenza (HPAI) H5N1. Notably, differential lung viral replication and tissue tropism were detected for H5N6 and H9N2. HPAI H5N1, H7N9, MERS-CoV, and SARS-CoV caused more severe AFC impairment than seasonal H1N1, H3N2, and influenza B viruses, correlating with their clinical severity. Overall, these findings revealed an important association between viral tropism and human transmissibility in ex vivo explants, as well as the impairment of AFC in vitro, which aligns with the clinical manifestations of disease severity across different viral strains.

Source: 


Link: https://www.microbiologyresearch.org/content/journal/jgv/10.1099/jgv.0.002281

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

 


Situation at a glance

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

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

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

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

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

    Uganda has not reported any new cases since 21 June 2026

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

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


Description of the situation

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

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

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

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(...)

Democratic Republic of the Congo

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

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

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

    So far, 213 patients have recovered

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

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

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

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

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

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

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

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

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


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


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

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Uganda

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

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

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

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

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

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

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

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

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


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France:

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

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

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

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


Epidemiology

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

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

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


Public health response

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

(...)


WHO risk assessment

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

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

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

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

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

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

(...)


WHO advice

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

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

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

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


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


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

Source: 


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

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#Influenza at the #human - #animal #interface - Summary and #risk #assessment, from 9 May to 12 June 2026 (WHO, July 3 '26): 4 new human #H9N2 cases in #China

 


Influenza at the human-animal interface -  Summary and risk assessment, from 9 May to 12 June 2026 {1} 

    New human cases {2}: 

        ° From 9 May to 12 June 2026, based on reporting date, detections of influenza A(H9N2) in four humans were reported officially. 

    Circulation of influenza viruses with zoonotic potential in animals

        ° High pathogenicity avian influenza (HPAI) events in poultry and non-poultry animal species continue to be reported to the World Organisation for Animal Health (WOAH).{3} 

        ° The Food and Agriculture Organization of the United Nations (FAO) also provides a global update on avian influenza viruses with pandemic potential.{4} 

    ° Additionally, low pathogenicity avian influenza viruses as well as swine influenza viruses continue to circulate in animal populations. 

    Risk assessment {5}: 

        ° Sustained human to human transmission has not been reported associated with the above-mentioned human infection events. 

        ° Based on information available at the time of this risk assessment update, the overall public health risk from currently known influenza A viruses detected at the human-animal interface has not changed and remains low

        ° At present, these viruses are not thought to be capable of sustained human-to-human transmission, although this could change as they evolve.  

        ° Although human infections with viruses of animal origin are infrequent, they are not unexpected at the human-animal interface.  

    IHR compliance {6}: 

        ° This includes any influenza A virus that has demonstrated the capacity to infect a human and its haemagglutinin (HA) gene (or protein) is not a mutated form of those, i.e. A(H1) or A(H3), circulating widely in the human population. 

        ° Information from these notifications is critical to inform risk assessments for influenza at the human-animal interface.  


Avian influenza viruses in humans 

A(H9N2), China  

    ° Between 13 May and 11 June 2026, China notified WHO of four laboratory-confirmed cases of A(H9N2) virus infection detected through influenza-like illness surveillance. 

    ° All cases recovered from illness. 

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    ° The child with onset in April was admitted to hospital with pneumonia

    ° The adult case had comorbidities and was hospitalized

    ° All the cases had exposure to live bird markets or household poultry. 

    ° Samples from environments associated with the likely area of exposure of all but one of these cases tested positive for A(H9) viruses. 

    ° No further cases were detected among contacts of these cases.   


Risk assessment for avian influenza A(H9N2):  

  1. What is the global public health risk of additional human cases of infection with avian influenza A(H9N2) viruses?  
    • Most human cases follow exposure to the A(H9N2) virus through contact with infected poultry or contaminated environments
    • Most human infections of A(H9N2) to date have resulted in mild clinical illness
    • Since the virus is endemic in poultry in multiple countries in Africa and Asia, additional human cases associated with exposure to infected poultry or contaminated environments are expected but remain unusual. 
    • The impact to public health if additional sporadic cases are detected is minimal
    • The overall global public health risk is low.  
  2. What is the likelihood of sustained human-to-human transmission of avian influenza A(H9N2) viruses related to these events?  
    • At the present time, no sustained human-to-human transmission has been identified associated with the recently reported human infections with A(H9N2) viruses. 
    • Current evidence suggests that A(H9N2) viruses from these cases did not acquire the ability of sustained transmission among humans.  
  3. What is the likelihood of international spread of avian influenza A(H9N2) virus by travellers?  
    • Should infected individuals from affected areas travel internationally, their infection may be detected in another country during travel or after arrival. 
    • If this were to occur, further community level spread is considered unlikely as current evidence suggests the A(H9N2) virus subtype has not acquired the ability to transmit easily among humans.  

Overall risk management recommendations
    
    ° Surveillance and investigations 
    
        Due to the constantly evolving nature of influenza viruses, WHO continues to stress the importance of global strategic surveillance in animals and humans to detect virologic, epidemiologic and clinical changes associated with circulating influenza viruses that may affect human (or animal) health. 
        
            Continued vigilance is needed within affected and neighbouring areas to detect infections in animals and humans. 
        
            Close collaboration with the animal health and environment sectors is essential to understand the extent of the risk of human exposure and to prevent and control the spread of animal influenza. 
    
            WHO has published guidance on surveillance for human infections with avian influenza A(H5) viruses. 

        As the extent of influenza virus circulation in animals is not clear, epidemiologic and virologic surveillance and the follow-up of suspected human cases should continue systematically. 
            
            Guidance on investigation of non-seasonal influenza and other emerging acute respiratory diseases has been published on the WHO website. 

            Countries should: 
            
                - increase avian influenza surveillance in domestic and wild birds, enhance surveillance for early detection in cattle populations in countries where HPAI is known to be circulating, include HPAI as a differential diagnosis in non-avian species, including cattle and other livestock populations, with high risk of exposure to HPAI viruses; 
                
                - monitor and investigate cases in non-avian species, including livestock, report cases of HPAI in all animal species, including unusual hosts, to WOAH and other international organizations, 

                - share genetic sequences of avian influenza viruses in publicly available databases, 

                - implement preventive and early response measures to break the HPAI transmission cycle among animals through movement restrictions of infected livestock holdings and strict biosecurity measures in all holdings, 

                - employ good production and hygiene practices when handing animal products, and 

                - protect persons in contact with suspected/infected animals.{7} 

            More guidance can be found from WOAH and FAO. 

        • When there has been human exposure to a known outbreak of an influenza A virus in domestic poultry, wild birds or other animals – or when there has been an identified human case of infection with such a virus – enhanced surveillance in potentially exposed human populations becomes necessary. 

            - Enhanced surveillance should consider the health care seeking behaviour of the population, and could include a range of active and passive health care and/or communitybased approaches, including: enhanced surveillance in local influenza-like illness (ILI)/SARI systems, active screening in hospitals and of groups that may be at higher occupational risk of exposure, and inclusion of other sources such as traditional healers, private practitioners and private diagnostic laboratories. 

        Vigilance for the emergence of novel influenza viruses with pandemic potential should be maintained at all times including during a non-influenza emergency. In the context of the cocirculation of SARS-CoV-2 and influenza viruses, WHO has updated and published practical guidance for integrated surveillance. 


    ° Notifying WHO 

        All human infections caused by a new subtype of influenza virus are notifiable under the International Health Regulations (IHR, 2005).{8,9} State Parties to the IHR (2005) are required to immediately notify WHO of any laboratory-confirmed {10} case of a recent human infection caused by an influenza A virus with the potential to cause a pandemic {11}. Evidence of illness is not required for this report. Evidence of illness is not required for this report. 

        WHO published the case definition for human infections with avian influenza A(H5) virus requiring notification under IHR (2005): https://www.who.int/teams/global-influenzaprogramme/avian-influenza/case-definitions


    ° Virus sharing and risk assessment 

        It is critical that these influenza viruses from animals or from humans are fully characterized in appropriate animal or human health influenza reference laboratories. Under WHO’s Pandemic Influenza Preparedness (PIP) Framework, Member States are expected to share influenza viruses with pandemic potential on a timely basis {12} with a WHO Collaborating Centre for influenza of GISRS. The viruses are used by the public health laboratories to assess the risk of pandemic influenza and to develop candidate vaccine viruses.  

        The Tool for Influenza Pandemic Risk Assessment (TIPRA) provides an in-depth assessment of risk associated with some zoonotic influenza viruses – notably the likelihood of the virus gaining human-to-human transmissibility, and the impact should the virus gain such transmissibility. TIPRA maps relative risk amongst viruses assessed using multiple risk elements. The results of TIPRA complement those of the risk assessment provided here, and those of prior TIPRA risk assessments are published at http://www.who.int/teams/global-influenza-programme/avianinfluenza/tool-for-influenza-pandemic-risk-assessment-(tipra).  


    ° Risk reduction 

        Given the observed extent and frequency of avian influenza in poultry, wild birds and some wild and domestic mammals, the public should avoid contact with animals that are sick or dead from unknown causes, including wild animals, and should report dead birds and mammals or request their removal by contacting local wildlife or veterinary authorities.  

        Eggs, poultry meat and other poultry food products should be properly cooked and properly handled during food preparation. Due to the potential health risks to consumers, raw milk should be avoided. WHO advises consuming pasteurized milk. If pasteurized milk isn’t available, heating raw milk until it boils makes it safer for consumption. 

        WHO has published practical interim guidance to reduce the risk of infection in people exposed to avian influenza viruses. 


    ° Trade and travellers 

        WHO advises that travellers to countries with known outbreaks of animal influenza should avoid farms, contact with animals in live animal markets, entering areas where animals may be slaughtered, or contact with any surfaces that appear to be contaminated with animal excreta. Travelers should also wash their hands often with soap and water. All individuals should follow good food safety and hygiene practices.  

        WHO does not advise special traveller screening at points of entry or restrictions with regards to the current situation of influenza viruses at the human-animal interface. For recommendations on safe trade in animals and related products from countries affected by these influenza viruses, refer to WOAH guidance.  


Links:  


    WHO Influenza (Avian and other zoonotic) fact sheet https://www.who.int/news-room/fact-sheets/detail/influenza-(avian-and-other-zoonotic) 

    WHO Protocol to investigate non-seasonal influenza and other emerging acute respiratory diseases https://www.who.int/publications/i/item/WHO-WHE-IHM-GIP-2018.2 

    WHO Public health resource pack for countries experiencing outbreaks of influenza in animals:  https://www.who.int/publications/i/item/9789240076884 

    Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) Reported to WHO  https://www.who.int/teams/global-influenza-programme/avian-influenza/avian-a-h5n1-virus 


    World Organisation of Animal Health (WOAH) web page: Avian Influenza  https://www.woah.org/en/home/ 

    Food and Agriculture Organization of the United Nations (FAO) webpage: Avian Influenza https://www.fao.org/animal-health/avian-flu-qa/en/ 

    WOAH/FAO Network of Expertise on Animal Influenza (OFFLU) http://www.offlu.org/

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{1} This summary and assessment covers information confirmed during this period and may include information received outside of this period. 

{2} For epidemiological and virological features of human infections with animal influenza viruses not reported in this assessment, see the reports on human cases of influenza at the human-animal interface published in the Weekly Epidemiological Record here.  

{3} World Organisation for Animal Health (WOAH). Avian influenza. Global situation. Available at: https://www.woah.org/en/disease/avian-influenza/#ui-id-2

{4} Food and Agriculture Organization of the United Nations (FAO). Global Avian Influenza Viruses with Zoonotic Potential situation update. Available at: https://www.fao.org/animal-health/situation-updates/global-aiv-withzoonotic-potential

{5} World Health Organization (2012). Rapid risk assessment of acute public health events. World Health Organization. Available at: https://iris.who.int/handle/10665/70810

{6} World Health Organization. Case definitions for the four diseases requiring notification in all circumstances under the International Health Regulations (2005). Available at: https://www.who.int/publications/m/item/case-definitions-for-the-four-diseases-requiring-notification-towho-in-all-circumstances-under-the-ihr-(2005).  

{7} World Organisation for Animal Health. Statement on High Pathogenicity Avian Influenza in Cattle, 6 December 2024 (https://www.woah.org/en/high-pathogenicity-avian-influenza-hpai-in-cattle/). 

{8} World Health Organization. International Health Regulations (2005), as amended through resolutions WHA67.13 (2014), WHA75.12 (2022), and WHA77.17 (2024) (https://apps.who.int/gb/bd/pdf_files/IHR_20142022-2024-en.pdf). 

{9} World Health Organization. Case definitions for the four diseases requiring notification in all circumstances under the International Health Regulations (2005) (https://www.who.int/publications/m/item/casedefinitions-for-the-four-diseases-requiring-notification-to-who-in-all-circumstances-under-the-ihr-(2005)). 

{10} World Health Organization. Manual for the laboratory diagnosis and virological surveillance of influenza (2011) (https://apps.who.int/iris/handle/10665/44518). 

{11} World Health Organization. Pandemic influenza preparedness framework for the sharing of influenza viruses and access to vaccines and other benefits, 2nd edition (https://iris.who.int/handle/10665/341850). 

{12} World Health Organization. Operational guidance on sharing influenza viruses with human pandemic potential (IVPP) under the Pandemic Influenza Preparedness (PIP) Framework (2017) (https://apps.who.int/iris/handle/10665/259402). 


Source: 


Link: https://www.who.int/publications/m/item/influenza-at-the-human-animal-interface-summary-and-assessment--12-june-2026

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