#Influenza at #human - #animal #interface - #Summary and #risk #assessment, 7 Sept. - 7 Oct. '26 (WHO, Oct. 28 '26): 1 New H5N1 case in #Cambodia, 4 #H9N2 in #China, 1 #H1N1v in #Brazil

• New human cases {2}: 

        ° From 7 September to 7 October 2026, based on reporting date,  detections of influenza A(H5N1) in one human, influenza A(H9N2) in four  humans and influenza A(H1N1) variant (A(H1N1)v) 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 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. Whilst human infections with viruses of animal  origin are infrequent, they are not unexpected at the human-animal interface.

• Risk management: 

    ° Candidate vaccine viruses (CVVs) for zoonotic influenza viruses  intended for pandemic preparedness purposes, were reviewed and updated at the  September 2026 WHO consultation on influenza vaccine composition for use in the  Southern Hemisphere 2027 influenza season. A detailed summary of zoonotic  influenza viruses characterized since February 2026 is published and updated CVVs lists are published.

• 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(H5N1), Cambodia

        § On 27 September 2026, Cambodia notified WHO of a laboratory- confirmed human infection with an avian influenza A(H5N1) virus in an adult  male, from Oddar Meanchey Province. He developed a runny nose on 24  September, and respiratory swabs collected that day tested positive for influenza A(H5N1) at the National Institute of Public Health on 26 September.  Institut Pasteur du Cambodge, a WHO H5 Reference Laboratory, confirmed the  result on 27 September. The patient was admitted to a referral Hospital for isolation, clinical monitoring and oseltamivir treatment. Genomic sequencing of  the virus from this case could not be done due to a low viral load.

    § The national and provincial Rapid Response Teams, in collaboration  with animal health and local authorities, are conducting epidemiological,  environmental and animal health investigations. The  patient frequently visited a family member’s poultry farm. At the farm, chickens began becoming ill and  dying around 13 September. Poultry specimens collected from remaining birds on 22 September tested positive for avian influenza.

    § Additional specimens were collected for testing from five direct contacts  with the case and three persons with poultry exposure and all were negative for  influenza A(H5N1). All identified contacts are being monitored for symptoms 14 days.

    § This is the sixth case reported in Cambodia in 2026.

    § According to reports received by WOAH, various influenza A(H5)  subtypes continue to be detected in wild and domestic birds in Africa, the  Americas, Asia, Europe and Oceania. Infections in non-human mammals are also reported, including in marine and land mammals.{7} A list of bird and mammalian species affected by HPAI A(H5) viruses is maintained by FAO.{8}

    ° Risk assessment for avian influenza A(H5N1) viruses:

        1. What is the current global public health risk of additional human cases of  infection with avian influenza A(H5N1) viruses?

            § Most human infections so far have been reported in people exposed to A(H5N1) 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(H5N1) 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(H5N1) viruses. There has been no reported human-tohuman transmission of  A(H5N1) viruses since 2007, although there may be gaps in investigations. In 2007 and the years prior, small clusters of A(H5N1) 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(H5N1) 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(H5N1) 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 these viruses have  not acquired the ability to transmit easily among humans.  

    ° A(H9N2), China

        § Between 9 and 30 September 2026, China notified WHO of four  laboratory-confirmed human cases of A(H9N2) virus infection.

        [Age - Province - Symptom onset]

        1} < 5-year-old - Henan - 30 August 2026

        2} < 5-year-old - Guangdong - 7 September 2026

        3} Adult - Henan - 17 September 2026

        4)} < 5-year-old - Guizhou - 20 September 2026

        § Three of the cases with mild symptoms were detected in influenza-like  illness surveillance and have recovered. The adult has underlying chronic conditions and was still in hospital at the time of reporting. 

        § All cases had direct or indirect exposure to poultry and/or local live  bird markets. Samples from environments associated with the likely area of  exposure of some 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(H1N1)v, Brazil

        § On 30 September 2026, Brazil notified PAHO/WHO of a laboratory- confirmed human infection with an influenza A(H1N1)v virus in an adult woman, with pre-existing chronic conditions, residing in the state of Santa  Catarina. She developed symptoms of influenza-like illness on 16 July 2026 and  sought medical attention on 20 July. Her husband and three adult children,  who live in the same household, also experienced symptoms of an influenza-like illness; at that time, all were diagnosed, based solely on clinical  examination, with a viral infection and received treatment. The woman,  however, did not recover. On 27 July, the patient was hospitalized due to worsening respiratory symptoms. She received treatment, including the  antiviral oseltamivir, and required intensive care, including ventilatory support. Despite intensive care, the patient passed away on 28 August.

        § A nasopharyngeal sample, collected on 29 July, tested positive for  influenza A on 30 July and was subsequently subtyped as influenza A(H1N1) on 31  July. The sample was sent to the reference laboratory for respiratory viruses  at the Oswaldo Cruz Institute (IOC/Fiocruz) in Rio de Janeiro for further  characterization. On 4 September, genomic analysis identified an influenza  A(H1N1)v virus. 

        § According to information gathered during an epidemiological investigation conducted by municipal and state teams between 5 and 9  September, the patient had no history of travel or direct contact with  swine. However, a possible indirect exposure to swine was identified through  a neighbour who raises these animals for personal consumption.

        § Since 2015, twelve cases of human infection with swine-origin virus  variants, including this one, have been detected within Brazil’s respiratory virus  surveillance workflow. 

    ° Risk Assessment:

        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 but remain unusual. The impact  for public health if additional cases are detected is minimal. The overall risk of additional 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, therefore sustained human-to-human transmission  is thus currently considered unlikely.

        3. What is the likelihood of international spread of swine influenza viruses by  travelers?  

            § 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 suggest that these viruses have not acquired the ability to transmit easily among humans.

    For more information on zoonotic influenza viruses, see the report from  the WHO Consultation on the Composition of Influenza Virus Vaccines for Use in  the Southern Hemisphere Influenza Season that was held on 21-24 September 2026 at this link. 

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.

        • 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 must be maintained at all times, including during a non- influenza emergency. To maximize the value of influenza surveillance platform for  other respiratory threats, 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)

    ° Global framework to accelerate action on avian  influenza https://iris.who.int/handle/10665/387613

    ° 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/

____

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

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

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

{6} Case definitions for the four diseases requiring notification in all  circumstances under the International Health Regulations (2005). World Health  Organization; 2009 (https://www.who.int/publications/m/item/casedefinitions-for-the-four-diseases-requiring-notification-to-who-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_2014-2022-2024-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-october-2026

____

#Ebola disease caused by #Bundibugyo virus - #DRC, #Kenya and #Nigeria (#WHO D.O.N., Oct. 23 '26)

{Extracts}

Situation at a glance

    Since the publication of the previous Disease Outbreak News on 8 October 2026, the Bundibugyo virus disease (BVD) outbreak has expanded geographically in the Democratic Republic of the Congo, as well as in the African Region, with Kenya and Nigeria reporting imported cases. 

    Sustained, high-level transmission continues in the Democratic Republic of the Congo. 

    As of 20 October 2026, a total of 9704 confirmed cases, including 4687 deaths (crude case fatality ratio: 48.3%), have been reported across 66 health zones in eight provinces. 

    The high proportion of deaths occurring in communities continues to highlight challenges in early case detection and timely access to appropriate care. 

    Of the 482 deaths reported since the previous update, 307 occurred in communities and 175 in treatment centres. 

    On 6 October 2026, the Ministry of Health of Kenya reported the first laboratory-confirmed imported case of BVD in Kenya in an individual who had travelled from the Democratic Republic of the Congo to Kenya via Uganda. 

    As of 20 October 2026, a total of nine cases of BVD including one death, has been reported in Kenya. 

    The eight additional cases are all known contacts of the first imported case. 

    There is currently no evidence of wider community transmission. 

    On 20 October 2026, Nigeria confirmed an imported case in the Federal Capital Territory Abuja in a patient who had travelled from Uganda to the country. 

    The patient is currently in isolation and receiving medical care. Further investigations are ongoing to better understand the complete travel history and the possible source of exposure. 

    These developments underscore the need for sustained readiness in the region, including cross-border surveillance, points of entry monitoring, timely case detection and coordinated preparedness and response measures. 

    WHO advises against any restriction of travel to, or trade with, affected countries.

Description of the situation

    Since the previous Disease Outbreak News was published on 8 October 2026, additional confirmed cases and deaths have been reported in the Democratic Republic of the Congo.

    Cases have been reported in five countries since the declaration of the outbreak on 15 May 2026: the Democratic Republic of the Congo, Uganda, France, and more recently, Kenya and Nigeria. 

    Nigeria is the fifth country affected by the ongoing outbreak, highlighting the continued risk of cross-border transmission.  

Democratic Republic of the Congo

    An additional 976 confirmed cases, including 482 confirmed deaths, have been reported in the Democratic Republic of the Congo since the previous Disease Outbreak News was published.

    In the most recent 24-hour period, as of 20 October, 67 new confirmed cases were reported, with Ituri accounting for 37 cases, Nord Kivu for 29, and Tshopo for one case. No new cases were reported in Bas-Uélé, Haut-Uélé, Nord Ubangi, Sud Kivu or Sud-Ubangi during that period.

    As of 20 October, cumulative confirmed cases have reached 9704, including 4687 deaths and 2595 recoveries. The overall crude CFR is 48.3%.

    Confirmed cases have now been identified in 66 health zones across eight provinces. Fifty of the 66 affected zones reported at least one new case during the preceding 21 days, while 16 reported no recent cases. Mandima, Beni and Bunia have reported the highest number of cases and deaths in the preceding 21 days. 

    Ituri remains the most extensively affected province, with 28 of 36 health zones reporting cases during this outbreak, followed by Nord Kivu (17/34), Haut-Uélé (7/13), Tshopo (7/23), Bas-Uélé (4/11), Sud Kivu (1/34), Sud-Ubangi (1/16) and Nord-Ubangi (1/11). Nord-Ubangi is the most recently affected province reporting three confirmed cases including one death and Dakwa in Haut-Uélé is the most recently affected health zone.

(...)

    Ituri remains the epicentre, with 7040 cumulative confirmed cases and 3271 deaths. 

    Nord Kivu follows with 2146 confirmed cases and 1199 deaths, and continues to record the highest provincial CFR, at 55.9%. 

    Haut-Uélé has reported 421 cases and 183 deaths, while Tshopo has recorded 76 cases and 27 deaths. 

    The less-affected provinces continue to report substantially fewer cases, but transmission persists in several of them. 

    The continued occurrence of cases across multiple provinces shows that the outbreak remains geographically active even as intensity varies between health zones.

    Out of 30 130 contacts under follow-up across six provinces, 24 017 were seen in the last 24 hours corresponding to a follow-up rate of 79.7%, up from 77.8% the previous day, but remaining below the required threshold of 95.0%. Two provinces were at or above the 95.0% threshold: Bas-Uélé (98.9%; 740/748) and Sud-Ubangi (97.3%; 109/112). Four provinces were below the threshold: Haut-Uélé (89.9%; 1286/1430), Ituri (92.8% (6382/6879), with 7 contacts becoming suspected cases, Tshopo (83.7%; 1077/12 086) and Nord-Kivu (73.3%; 14 423/19 675), with performance in Nord-Kivu remaining insufficient. Strengthened contact follow-up is required, particularly in provinces below the target, to achieve the minimum threshold of 95%.

(...)

Kenya

    On 6 October 2026, the Ministry of Health of Kenya reported its first laboratory-confirmed imported case of BVD in an adult male who had travelled from the Democratic Republic of the Congo via Uganda by road and arrived in Nairobi on 3 October by air. The case had been ill with other comorbidities for approximately one month and received care at several hospitals in the Democratic Republic of the Congo. He was isolated upon arrival at a hospital in Nairobi. Samples collected on 5 October tested positive for Bundibugyo virus at two national laboratories. Despite supportive care, the patient died on 5 October and was given a safe and dignified burial on 6 October.

    As of 20 October 2026, a total of nine cases, including one death, has been reported in Kenya.  All eight secondary cases are epidemiologically linked to the imported index case and associated with one cluster. They include four family members and four health and care workers. All new cases were under quarantine at the time of symptom onset and are currently in isolation and receiving appropriate supportive care and treatment at two designated facilities.

    There is currently no evidence of transmission outside this cluster.

    As of 20 October, all of the 135 contacts have been traced and quarantined.

(...)

Nigeria

    On 20 October 2026, Nigeria reported one laboratory-confirmed imported case of BVD in the Federal Capital Territory Abuja, becoming the fifth country to detect the virus since the outbreak was declared in the Democratic Republic of the Congo on 15 May 2026. The case developed symptoms on 7 October, four days after arriving in Nigeria, sought care in Abuja on 11 October and tested positive for Bundibugyo virus on 20 October 2026. The case is currently in isolation and receiving medical care.

    As of 20 October, 44 contacts had been identified and are being monitored. National authorities, with support from WHO and partners, have intensified contact tracing, case investigation and infection prevention and control measures, including the provision of essential supplies and personal protective equipment for health workers. Investigations are ongoing to establish the likely source of infection and reconstruct the travel and exposure history. WHO has urged countries across the region to strengthen surveillance, laboratory diagnostic capacity, rapid response readiness and cross-border preparedness to mitigate the risk of further transmission.

(...)

WHO risk assessment

    On 14 August 2026, WHO reassessed the risk of the outbreak of BVD. The risk for countries sharing land borders with the Democratic Republic of the Congo was separated from the risk for other countries in the African Region.

    The risk in the Democratic Republic of the Congo was assessed as very high, the risk for countries sharing land borders with the Democratic Republic of the Congo was assessed as high, and the risks for the rest of the African region and at the global level was again assessed as low. For further information, please see WHO Rapid Risk Assessment-Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo v4.

    In light of the evolving situation and newly available information, the rapid risk assessment is currently being revised to reassess the risk in affected countries, the African region and globally.  

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON622

____

#Threat #assessment brief – Importation of #Ebola disease cases caused by #Bundibugyo virus to #Kenya and #Nigeria – 23 October 2026 (ECDC, edited)

 

{Extract}

23 October 2026

Kenya and Nigeria have recently reported imported Ebola disease cases in their countries. In Kenya, the detection of an imported case was reported in Nairobi, where secondary cases were also reported. In Nigeria, a case in a person with travel history to Uganda was detected in Abuja. This has occurred in the context of the ongoing outbreak of Ebola disease caused by Bundibugyo virus (BDBV) in the Democratic Republic of the Congo (DRC), and cases reported in Uganda this spring. 

    This Threat Assessment Brief assesses the risk for people from the EU/EEA living in or travelling to the newly affected areas, and the overall risk for the general EU/EEA population. It is intended for public health authorities in the EU/EEA.

Epidemiological situation

    On 20 October 2026, Nigeria reported one confirmed Ebola disease case caused by BDBV in a person who travelled from Uganda via an international flight on 3 October 2026. 

    Symptom onset was on 7 October and the person was admitted to hospital on 11 October. 

    The confirmation of Ebola disease caused by BDBV was made on 20 October. 

    Contact tracing is currently under way, with 44 contacts being followed up.

    As of 23 October 2026, Kenya has reported nine confirmed Ebola disease cases caused by BDBV, including one death. 

    The first individual, reported on 6 October, developed symptoms while in DRC and travelled to Kenya via Uganda on 3 October. 

    All eight secondary cases (four relatives and four healthcare workers) were linked to the first imported case and were in quarantine when they developed symptoms. 

    Contact tracing activities are ongoing in Kenya, with all listed contacts (135 people) being followed up as of 22 October 2026.

    As of 21 October 2026, 9 704 confirmed Ebola disease cases caused by BDBV, including 4 687 deaths, have been reported from eight provinces in DRC (data until 20 October 2026), where community transmission is still ongoing. 

    In Uganda, a total of 20 cases, including two deaths were reported since 15 May 2026. 

    The last confirmed case in Uganda was reported on 21 June 2026.

Risk assessment

    The likelihood of infection for people from the EU/EEA living in or travelling to affected areas in Kenya and Nigeria is assessed as low, providing they adhere to recommended precautionary measures. 

    Although infection with BDBV leads to severe disease at an individual level, the impact for people from the EU/EEA living in and travelling to affected areas in Kenya and Nigeria is considered low at the population level. 

    Therefore, overall, the current risk for people from the EU/EEA living or travelling to affected areas in Kenya and Nigeria is considered low.

    Based on the experience from the current and previous Ebola disease outbreaks in Africa, it is expected that the importation of cases to Europe will remain rare events and will mainly concern medical evacuations for treatment. 

    The likelihood of secondary transmission of BDBV and sustained transmission within the EU/EEA following an imported case is considered very low, as cases are likely to be promptly identified and isolated, and recommended control measures would be implemented. 

    The population-level public health impact in the EU/EEA is expected to be very low as only very few cases are expected. 

    Therefore, the overall risk of BDBV for the general population in the EU/EEA is assessed as very low.

Recommendations

    EU/EEA countries should remain vigilant, strengthen their preparedness and response capabilities for detecting and managing potential imported Ebola disease cases, and provide travel advice to people living in and travelling to/from affected areas.

    ECDC does not recommend any travel restrictions for travellers to or from Kenya and Nigeria. Exit screening from the affected areas and countries, including symptom checks and exposure assessments is an important measure that contributes to reducing the risk by identifying symptomatic travellers before they board, and preventing them travelling while symptomatic.

    Entry screening of incoming travellers from areas affected in the current outbreak is not proven to be an efficient measure to detect imported cases, and is also a highly complex public health intervention.

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Source: 

Link: https://www.ecdc.europa.eu/en/publications-data/threat-assessment-brief-importation-ebola-disease-cases-caused-bundibugyo-virus

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#Bundibugyo Virus Disease #Outbreak in #DRC, #Kenya, #Nigeria - Weekly #Report No. 23, Data as of 19 Oct. '26 (WHO, summary)

 

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Event description

    The Bundibugyo virus disease (BVD) outbreak is becoming increasingly  challenging, marked by an expanding cluster of cases linked  to the imported index case in Kenya, further geographic expansion into a new  province of the Democratic Republic of the Congo, and the confirmation of a case  in Nigeria. 

    These developments highlight the widening international dimension  and the growing complexity of the outbreak, particularly in the  Democratic Republic of the Congo, where escalating insecurity, population  displacement and restricted humanitarian access threaten to further undermine  surveillance and response operations.

Democratic Republic of the Congo

    As of 19 October 2026, the BVD outbreak in the Democratic Republic of  the Congo has affected 66 health zones across eight provinces, following  the recent expansion into Wapinda Health Zone in Nord-Ubangi Province. 

    Since External Situation Report #22, an additional 572 confirmed cases and 265 confirmed deaths have been reported, bringing the cumulative total to  9637 confirmed cases, including 4646 confirmed deaths [crude case fatality ratio (CFR) 48.2%].

    Transmission remains highly heterogeneous across affected areas. Ituri  continues to account for the largest proportion of cumulative confirmed  cases (72.7%), although its relative contribution is declining, while substantial  transmission persists in Nord-Kivu and Haut-Uélé.

    National daily incidence increased steadily from May, reaching its highest  levels in late July and mid-August, before fluctuating at persistently high  levels through September. Following a decline in late September,  incidence rebounded in early October. 

    The most recent seven-day moving average indicates a modest upward trend, suggesting renewed intensification of transmission. Provincial trends  remain heterogeneous. Ituri shows a slight recent rebound despite an overall  decline from its August peak, while Nord-Kivu continues to experience elevated  but fluctuating transmission. 

    Haut-Uélé remains relatively stable with a slight increase, and Tshopo  shows renewed upward activity. Transmission remains sporadic in Bas-Uélé, with  newly reported cases in Nord-Ubangi, while Sud-Kivu and Sud-Ubangi report no recent transmission in the last 21 days (Figures 1 and 2).

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 19 October 2026

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Trend Analysis (21-day comparison):

    During the most recent 21-day period (29 September – 19 October 2026),  a total of 1466 confirmed cases were reported nationally, compared with 1328  cases during the preceding 21 days (8 – 28 September), representing an increase  of 138 cases (+10.4%). 

    Provincial trends remain heterogeneous. Cases increased in Ituri from 757  to 785 (+3.7%), accounting for 53.5% of national cases during the latest  period. In Nord-Kivu, cases increased from 460 to 564 (+22.6%), accounting for  38.5% of national cases while in Haut-Uélé cases decreased slightly from 82 to 81  (−1.2%), accounting for 5.5% of national cases.

    During the same period, a total of 692 confirmed deaths were reported  nationally, compared with 644 deaths during the preceding 21 days (8 – 28  September), representing an increase of 48 deaths (+7.5%). Deaths increased  from 302 to 374 (+23.8%) in Ituri, from 213 to 269 (+26.3%) in Nord-Kivu, from  35 to 38 (+8.6%) in Haut-Uélé, and from seven to ten (+42.9%) in Tshopo.  The increase in confirmed deaths, particularly in Ituri and Nord-Kivu,  reflects a worsening mortality burden alongside rising national case incidence.

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

    Of the 66 health zones affected to date, 50 (75.8%) reported at least one  new confirmed case during the most recent 21 days (29 September – 19 October  2026). Case incidence increased in 31 health zones while 21 health zones reported a decreased in cases comparing the two periods. The largest absolute  increase occurred in Mandima, Ituri (87 to 216 cases; +148.3%), while  substantial increases were also observed in Mambasa (12 to 45; +275.0%) and  several health zones in Nord-Kivu, particularly Mabalako (22 to 47; +113.6%),  Oicha (17 to 28; +64.7%) and Beni (158 to 194; +22.8%) (Figure 4).

    There were also 16 health zones without a new case in the last 21 days.  These include Adja, Ariwara, Aungba, Boga, Drodro, Kambala and Mahagi in Ituri;  Goma in Nord-Kivu; Dungu and Gombari in Haut-Uélé; Lubunga and Wanie-Rukula in Tshopo; Miti-Murhesa in Sud-Kivu; Buta and Viadana in Bas-Uélé; and Bulu in Sud-Ubangi.

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    Weekly confirmed deaths (Figure 6) declined by 5.2%, from 233 during  5–11 October to 221 during 12–18 October 2026, reversing the upward trend  observed over the preceding two weeks. Community deaths decreased from 157  to 135 (−14.0%), while deaths in treatment facilities increased from 76 to 86  (+13.2%). Consequently, the proportion of deaths occurring in the community  declined from 67.4% to 61.1%. Despite the overall reduction, more than six in ten  confirmed deaths continued to occur in the community, highlighting persistent  challenges in early case detection, timely referral and access to treatment.

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Kenya

    Since the previous report, Kenya has confirmed eight additional cases of BVD, bringing the cumulative total to nine cases, including one death (CFR: 11.1%). 

    

    All eight new cases were epidemiologically linked to the imported index  case and were already under quarantine when they developed symptoms. 

    The secondary cases included four family members and four hospital  staff.

    Of the nine confirmed cases, seven were male and two were female,  with ages ranging from 24 to 65 years. 

    Eight patients are currently in isolation and receiving treatment at two  designated facilities. All are reportedly in stable condition.

    A total of 135 contacts have been listed, comprising 46 airport staff, 45  hospital staff, 26 passengers, 14 relatives and four flight crew members. 

    Of these, eight have tested positive for BVD (four relatives and four  hospital staff). 

    Eight passengers travelled outside Kenya, and the authorities in their  destination countries were notified. Among the 119 contacts remaining under  follow-up in Kenya, 118 (99.2%) are in quarantine, while one passenger remains  outside quarantine.

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Nigeria

    On 20 October 2026, the Federal Ministry of Health of Nigeria announced a confirmed case of BVD in the Federal Capital Territory, Abuja. 

    The case involved a woman who reportedly travel from Uganda to  Nigeria on 3 October 2026. She developed symptoms on 7 October 2026 and  sought care at a private health facility on 11 October 2026. 

    Following clinical deterioration, laboratory testing confirmed BVD on 20  October 2026. The patient is currently in isolation and receiving treatment. 

    A total of 44 close contacts have so far been identified, including  healthcare workers, patients, caregivers and travel contacts. Additional  investigation is underway to establish her travel itinerary, including all those who may have been potentially exposed while the case was symptomatic. 

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Situation interpretation

    The BVD outbreak remains at a critical juncture, with sustained  transmission in the Democratic Republic of the Congo and international  spread highlighting persistent gaps in outbreak containment. 

    In the Democratic Republic of the Congo, escalating insecurity,  displacement and restricted humanitarian access are further challenging response  operations and increasing the risk of undetected transmission. 

    In Kenya, the identification of all secondary cases among known, quarantined contacts is encouraging, suggesting that transmission  chains remain traceable, although continued surveillance is essential to detect any  unrecognized spread. 

    In Nigeria, the prolonged period between symptom onset and confirmation  raises concern about potentially undetected exposures and secondary  transmission, requiring urgent retrospective investigation and intensified  surveillance. 

    Priorities should focus on targeted interventions in transmission hotspots, restoring operational access in insecure areas,  strengthening early detection and rapid containment, and intensifying coordinated  cross-border surveillance and information sharing to prevent further  international spread.

Source: 

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

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#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

 

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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).

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    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).

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    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.

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    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.

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    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.

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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. 

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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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