Middle East respiratory syndrome ( #MERS ) – #Qatar (WHO D.O.N., Nov. 14 '26)

 

Situation at a glance

    On 29 October 2026, the National International Health Regulations (IHR) Focal Point of the State of Qatar notified the World Health Organization (WHO) of two laboratory-confirmed cases of Middle East respiratory syndrome (MERS). 

    The cases were confirmed on 5 and 25 August 2026 and are the first MERS cases reported from Qatar since 2022. 

    MERS is a viral zoonotic infection, principally transmitted to humans through direct or indirect contact with infected dromedary camels. 

    Both patients were men aged over 50 years with underlying medical conditions and occupational exposure to dromedary camels. 

    Both were hospitalized and subsequently discharged in a stable condition. 

    A total of 99 contacts from both cases were identified, tested, and monitored for 14 days following their last exposure. 

    All contacts tested negative for MERS-CoV, and no secondary cases were identified. 

    The two cases reported exposure to dromedary camels at geographically separate farms, with no epidemiological link identified between them. 

    The cases appear to represent sporadic infections associated with zoonotic transmission from dromedary camels rather than human-to-human transmission.

Description of the situation

    On 29 October 2026, the National IHR Focal Point of Qatar notified WHO of two laboratory-confirmed cases of Middle East respiratory syndrome (MERS). 

    The cases were confirmed on 5 and 25 August 2026. 

    These are the first MERS-CoV cases reported by the State of Qatar since 2022. 

    The first case was a man aged over 50 years who worked with dromedary camels and had chronic medical conditions. 

    He developed symptoms on 22 July 2026 and was admitted to hospital on 25 July. 

    Real-time reverse transcription-polymerase chain reaction (RT-PCR) on an upper-respiratory tract specimen initially tested negative for MERS-CoV. 

    A subsequent lower-respiratory tract specimen tested positive by RT-PCR, and infection was laboratory-confirmed on 5 August. 

    He reported longstanding occupational exposure to dromedary camels, including during the 14 days before symptom onset. 

    He did not report consuming raw camel milk or any recent travel. 

    He recovered and was discharged in a stable condition after two consecutive negative PCR test results. 

    A total of 73 contacts were identified for this case, comprising 11 close contacts and 62 health and care workers. 

    All contacts were tested and monitored for 14 days following their last exposure. 

    All tested negative for MERS-CoV, and no secondary cases were identified. 

    The second case was a man aged over 50 years who was involved in camel breeding and rearing and had underlying chronic medical conditions. 

    He developed symptoms on 23 August 2026. Two nasopharyngeal specimens tested positive for MERS-CoV by RT-PCR on 25 August. 

    He reported sustained occupational exposure to dromedary camels, including directly caring for recently ill young camels during the 14 days preceding symptom onset. 

    He also reported consuming raw camel milk during this period but had no recent travel history. 

    He developed severe MERS-CoV pneumonia complicated by acute hypoxemic respiratory failure and required high-flow nasal oxygen and non-invasive ventilatory support. 

    He subsequently recovered and was discharged in a stable condition after two consecutive negative PCR test results. 

    A total of 26 contacts were identified for this case, comprising four close contacts and 22 health and care workers. 

    All contacts were tested and monitored for 14 days following their last exposure and tested negative for MERS-CoV. 

    One high-risk contact who was a health and care worker developed respiratory symptoms but tested negative for MERS-CoV on two specimens. 

    No secondary cases were identified. 

    The two cases reported occupational exposure at geographically separate camel farms, with no epidemiological link identified between the farms or the cases. 

    The precise sources of infection remain undetermined. However, their sustained occupational exposure to dromedary camels, including direct contact with recently ill camels in one case and the consumption of raw camel milk by the same case, suggest probable zoonotic acquisition. 

Epidemiology

    Middle East respiratory syndrome (MERS) is a respiratory illness caused by a coronavirus (MERS-CoV). The case fatality ratio (CFR) among confirmed cases is around 37%. The CFR is calculated based solely on laboratory-confirmed infections and may overestimate the actual mortality rate since milder cases often go undetected or unreported.

    Humans can contract MERS-CoV through multiple transmission pathways; the primary route being through direct or indirect contact with dromedary camels, which serve as the virus’s natural host and primary zoonotic reservoir. Additionally, human-to-human transmission can occur via infectious respiratory particles primarily in close-contact situations and can also occur through direct or indirect contact; this is especially prominent in health-care settings. Human-to-human transmission of the virus has occurred in health care facilities in several countries, including transmission from patients to health care providers and transmission between patients before MERS-CoV was diagnosed. It is not always possible to identify patients with MERS‐CoV early or without testing because symptoms and other clinical features may be non‐specific. Outside these environments, there has been limited documented human-to-human transmission. 

    MERS can present with no symptoms (asymptomatic), mild symptoms (including mild respiratory issues), or severe illness leading to acute respiratory distress and death. Common symptoms include fever, cough, and breathing difficulties, with pneumonia frequently observed, though not always present. Some patients also experience gastrointestinal symptoms such as diarrhoea. Severe cases may require intensive care, including mechanical ventilation. Those at higher risk of severe outcomes include older adults, individuals with weakened immune systems, and those with chronic conditions like diabetes, kidney disease, cancer, or lung disorders.

Public health response

    The national authorities undertook clinical management, laboratory testing, case investigation and contact tracing. All 99 identified contacts, including close contacts and health and care workers, were tested and monitored for 14 days following their last exposure. All tested negative for MERS-CoV, and no secondary infections were identified. 

    The national authorities also implemented infection prevention and control measures, enhanced vigilance within health care facilities and circulated a national advisory to health care providers. Animal health investigations and targeted risk communication activities for populations with frequent exposure to dromedary camels are ongoing. 

WHO risk assessment

    MERS is a viral respiratory infection caused by a coronavirus. Humans can become infected through direct or indirect contact with infected dromedary camels, which are the natural host and zoonotic source of MERS-CoV infection. Human-to-human transmission can occur, particularly in health care settings and among close contacts, but sustained transmission between people has not been documented. The disease can be severe, particularly among people with underlying chronic medical conditions and immunocompromised people.  

    These are the first MERS cases reported from Qatar since 2022. Both cases had occupational exposure to dromedary camels, and one reported tending to sick camels and consuming raw camel milk during the 14 days before symptom onset. The cases were exposed at geographically separate farms, with no epidemiological link identified between them. All 99 identified contacts tested negative for MERS-CoV, and no secondary cases were identified. The available information therefore suggests that these were sporadic infections associated with zoonotic transmission rather than human-to-human transmission. 

    The occurrence of two apparently unlinked cases highlights the continued risk of zoonotic spillover among people with frequent or occupational exposure to dromedary camels, particularly those with underlying medical conditions. 

    As per WHO’s rapid risk assessment of 29 January 2026, the overall risk associated with MERS-CoV remains moderate at both the regional and global levels. 

    This assessment reflects continued sporadic zoonotic spillover into the human population and the potential for subsequent health care-associated transmission and international importation into countries where the disease is not endemic. 

    Based on the information reported by the State of Qatar, there is no evidence of sustained human-to-human transmission associated with these cases. Continued surveillance and animal health investigations remain important to detect and assess any potential further transmission.

WHO advice

    The importance of maintaining strong surveillance for acute respiratory infections in all Member States is re-emphasised. Where warranted by the epidemiological or clinical context, MERS-CoV should be included in diagnostic testing algorithms. This includes patients with compatible acute respiratory illness and recent exposure to dromedary camels, their products or secretions, or recent health care visits in or travel to countries where MERS-CoV is endemic. Testing should also be considered for patients with unexplained severe acute respiratory infection, particularly when tests for other respiratory pathogens are negative, and when unusual patterns or clusters of severe respiratory illness, including health care-associated clusters, are identified. 

    Human-to-human transmission of MERS-CoV in health care settings has been associated with delays in recognizing early symptoms, triaging suspected cases and implementing infection prevention and control measures. Early identification, appropriate case management, prompt isolation, contact tracing, infection prevention and control measures, and public health awareness can reduce the risk of human-to-human transmission. 

    Health and care workers should apply standard precautions consistently for all patients at every interaction in health care settings. Transmission-based precautions should be implemented when caring for patients with symptoms of acute respiratory infection who are suspected of having a viral infection, including suspected, probable or confirmed MERS-CoV infection. Contact and droplet precautions should be applied, and airborne precautions should be implemented when performing aerosol-generating procedures. 

    MERS-CoV can cause severe disease in people with underlying chronic medical conditions, such as diabetes, renal failure and chronic lung disease, and in immunocompromised people. People with underlying medical conditions or those who are immunocompromised should avoid close contact with dromedary camels or their products, particularly when visiting farms, markets, barns or other places where the virus may be circulating among dromedary camels. 

    Anyone interacting with animals or animal products should follow general hygiene measures, including regular handwashing before and after touching animals and avoiding contact with sick animals. Appropriate food hygiene should be observed when handling or consuming camel products. People should avoid drinking raw camel milk or camel urine and should not consume meat that has not been properly cooked. 

    WHO emphasizes the importance of collaboration between human and animal health sectors through a One Health approach. This includes coordinated epidemiological investigations, animal health and environmental assessments, enhanced surveillance in camel-related settings, and timely sharing of important epidemiological, genomic, cross-border or secondary-transmission findings. 

    Under the IHR (2005), States Parties are required to assess public health events using the decision instrument in Annex 2 and to notify WHO, within 24 hours of assessment of events that meet the criteria for notification. 

    Based on the currently available information, WHO advises against any restriction of travel to, or trade with, States Parties experiencing / responding to the public health event. 

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Source: World Health Organization, https://www/who.int/emergencies/disease-outbreak.news.item/2026-DON626

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Weekly #US #Influenza #Surveillance #Report: Key Updates for Week 44, ending November 7, 2026 (CDC, summary): #H1N1pdm09 is predominant strain so far

 

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Key Points

    ° Multiple seasonal influenza surveillance indicators continue to increase in many parts of the country.

    ° This early-season influenza activity is currently higher than typically observed at this time of year, but an earlier increase in activity does not necessarily lead to a higher seasonal peak or greater overall severity.

    ° During Week 44 (the week ending November 7, 2026), of the 680 influenza viruses reported by public health laboratories, 670 were influenza A and 10 were influenza B. 

        § Of the 460 influenza A viruses subtyped, 455 (98.9%) were influenza A(H1N1)pdm09 and 5 (1.1%) were A(H3N2).

    ° Since Week 21 (the week ending May 30, 2026), 83.4% of the influenza A viruses reported have been A(H1N1)pdm09 and among these, the majority have been D.3.1.1 HA subclade.

    ° The influenza A(H1N1) viruses detected this season are still A(H1N1)pdm09 viruses, which emerged in 2009 and have caused seasonal epidemics globally since then. Influenza viruses are constantly changing, often requiring updates to influenza vaccine viruses each season.

    ° Historically, influenza A(H1N1)pdm09 viruses have changed less often than A(H3N2) viruses. Recently circulating influenza A(H1N1)pdm09 viruses (which are in an HA subclade called "D.3.1.1") have divided into distinct groups with different genetic changes in their HA genes. We are seeing more genetic diversity among co-circulating A(H1N1)pdm09 viruses than we have before.

    ° It is too early to know what viruses may predominate or to say whether there might be implications on flu vaccine effectiveness this season.

    ° Two pediatric deaths associated with season influenza virus infection occurring during the 2026-2027 influenza season were reported to CDC this week for a total of five deaths this season.

    ° Because case investigation takes time, flu-associated deaths in children may be reported to CDC weeks after they occur; counts are preliminary and may increase. All reported cases meet the influenza-associated pediatric mortality case definition.

    ° The preliminary in-season severity assessment has classified the severity of influenza activity at this point in the season as low across all ages and for children (0-17 years), adults (18-64 years) and older adults (65+ years). The severity assessment for the season may change as flu activity is currently increasing.

    ° CDC estimates that there have been at least 2,600,000 illnesses, 36,000 hospitalizations, and 2,100 deaths associated with flu so far this season.

    ° CDC's FluSight forecasts predict a likely increase nationally in both flu hospital admissions and the percentage of emergency department visits due to flu for the week ending November 28. The number of new flu hospital admissions is forecast to range from 8,300 to 34,400 admissions, while the national percentage of emergency department visits due to flu is forecast to range from 1.8% to 7.7%.

    ° Annual seasonal influenza (flu) vaccination is recommended. Influenza vaccines are available for persons aged 6 months and older. People who are recommended for influenza vaccination but have not been vaccinated yet this season are encouraged to be vaccinated now.

    ° There are prescription flu antiviral drugs that can treat flu illness; those should be started as early as possible and are especially important for patients at higher risk for influenza complications.

    ° Influenza viruses are among several viruses contributing to respiratory disease activity. CDC is providing updated, integrated information about COVID-19, flu, and respiratory syncytial virus (RSV) activity on a weekly basis.

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Source: US Centers for Disease Control and Prevention, https://www.cdc.gov/fluview/surveillance/2026-week-44.html

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#Bundibugyo Virus Disease #Outbreak in #DRC, #Kenya, #Nigeria - Weekly Report No. 25, Data as of 7 November 2026 (WHO, summary): 10,920 cases & 5,323 deaths in DRC

 

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Event description

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic  of the Congo continues at a high, sustained level of transmission, with no sign of decline: close to 390 confirmed cases were added during the reporting  period and the national seven-day average has stayed between 65 and 67 cases per day. 

    Nord-Kivu now contributes almost as many cases as Ituri and accounts for the  entire increase observed over the last 21 days, while contact follow-up fell to  its lowest level in weeks at the end of the period. 

    The importation events in Kenya and Nigeria remain contained: no new case has been reported in Kenya since 19 October, six of the seven surviving  patients have been discharged and the last contacts will complete monitoring on  11 November, while no secondary case has been identified in Nigeria, where contact monitoring is expected to end on 13 November. 

    In the Democratic Republic of the Congo, insecurity in Beni health zone in  North Kivu and Bafwasende in Tshopo, health-worker strikes in Bas-Uélé and  Tshopo and the continued suspension of response activities in Bafwasende  constrain surveillance and response operations. 

Democratic Republic of the Congo

    As of 7 November 2026, the BVD outbreak in the Democratic Republic of the Congo has affected 67 health zones and 247 health areas across eight provinces; no new health zone was affected during the reporting period. 

    Since  External Situation Report #24, an additional 388 confirmed cases and 197 confirmed deaths have been reported, bringing the cumulative total to 10 920 confirmed cases, including 5 323 confirmed deaths [crude case fatality ratio (CFR) 48.7%].

    Transmission remains highly heterogeneous across affected areas. Ituri  continues to account for the largest proportion of cumulative confirmed cases  (69.7%), although its relative contribution is declining, while Nord-Kivu (24.7% of  cumulative cases; CFR 54.8%) accounted for 46.1% of the cases reported  since the previous report, almost as many as Ituri (47.2%). 

    Transmission persists at lower levels in Haut-Uélé (4.9% of new cases),  Tshopo and Nord-Ubangi. 

    National daily incidence rose steadily from May to its highest levels in late July and mid-August, declined through late September and has fluctuated at  a high plateau since early October. 

    The seven-day moving average ranged between 65 and 67 confirmed cases  per day during the reporting period (64.7 on 7 November, compared with 67.0 on  1 November and a late-October high of 76), still well below the mid-August peak  of 94. 

    Provincial trends continue to diverge. Ituri continues its slow decline from  the late-July peak (seven-day average of 29 cases per day on 7 November, down  from 31 on 1 November and 38 on 19 October), while Nord-Kivu has risen to 31  cases per day (up from 30 on 1 November and 26 on 19 October) and exceeded  Ituri on several days of the period. Haut-Uélé remains stable at three to four cases per day, Tshopo reports sporadic cases (last case on 5 November) and Nord- Ubangi reported three further cases in Yakoma and Wapinda. Bas-Uélé, Sud-Kivu and Sud-Ubangi have reported no case in the last 21 days (Figures 1 and 2).

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Kenya

    Since the previous report, Kenya has reported no new confirmed case of BVD. The cumulative total remains nine confirmed cases, including two deaths  (CFR 22.2%): the imported index case, who died on 5 October, and a 65-year-old family member who died on 23 October. 

    All eight secondary cases (four family members and four hospital staff)  belong to a single known chain of transmission, were epidemiologically linked to  the index case and were already under quarantine when they developed symptoms; no community spread has been detected. 

    The last confirmed case was reported on 19 October 2026. 

    On 6 November, day 32 since the first case was confirmed, the Ministry of  Health announced that a sixth patient had recovered and was being discharged  after testing negative and meeting all discharge criteria.; only one patient remains  under care and continues to be closely monitored. 

    The 42-day countdown to the end of the outbreak will start once this last  patient has recovered and been discharged.

    Of the nine confirmed cases, seven were male and two were female, with  ages ranging from 24 to 65 years. Designated isolation facilities have 211 isolation  beds (scalable to 241).

    A total of 135 contacts have been listed since the index case was  confirmed, comprising 46 airport staff, 45 hospital staff, 26 passengers, 14  relatives and four flight crew members. Of these, eight (5.9%) tested positive  for BVD during quarantine (four relatives and four hospital staff), one of  whom has died.

    Of the remaining 118 contacts, 66 had completed their 21 days of  monitoring and returned home by 6 November and the remaining 52 are expected  to complete quarantine by 11 November 2026.

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Nigeria

    Nigeria has reported a single confirmed case of BVD, announced by the  Federal Ministry of Health on 20 October 2026 in the Federal Capital Territory,  Abuja. 

    The case, a 42-year-old woman, arrived in Abuja from Uganda via Addis  Ababa on 3 October, developed symptoms on 7 October and was admitted to a  private health facility on 11 October; the Nigeria Centre for Disease Control and  Prevention (NCDC) was notified on 19 October and the National Reference  Laboratory confirmed the infection on 20 October. The patient was clinically stable  and, at the request of her country and with clearance from the Nigerian  authorities, was medically evacuated to Switzerland on 26 October 2026,  where she remains in isolation and under medical care in Geneva. 

    No additional confirmed case has been reported. As of 5 November 2026, a  cumulative 62 contacts linked to the index case had been identified,  categorized and followed up; none had developed symptoms, no new contact had  been identified, and seven contacts had completed the mandatory 21-day follow- up and left the quarantine facility, with the remaining contacts due to complete  follow-up on a staggered basis between 31 October and 13 November 2026. 

    Exposure remains confined to a single epidemiological cluster directly linked  to the index case. The 12-day interval between symptom onset and notification,  eight days of which were spent in private-facility care, remains the main concern for undetected exposures.

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Situation interpretation

    The BVD outbreak remains at a critical juncture. In the Democratic  Republic of the Congo, transmission is not declining: close to 390 confirmed cases  and 200 deaths were added in one week, the national seven-day average has held  between 65 and 76 cases per day for five weeks, and the epicentre  continues to shift towards Nord-Kivu, which accounted for the entire 21-day  increase in cases (513 to 661) and deaths (250 to 322) and now reports as many  cases as Ituri each day. Beni, Mutwanga, Oicha, Mabalako and Kalunguta are the  health zones where transmission is intensifying most. At the same time, the  performance of the response weakened at the end of the period: contact follow-up  fell to 69.8% on 7 November, safe burial completion dropped to 85%, refusals  increased, and only half of investigated suspected cases are isolated within 24  hours. Insecurity in Beni, the suspension of activities in Bafwasende and health- worker strikes in Bas-Uélé and Tshopo further increase the risk of undetected  transmission. 

    The absence of new cases in Kenya since 19  October, the discharge of six  of the seven surviving patients and the imminent end of contact monitoring in  Kenya (11 November) and Nigeria (13 November) indicate that the exported  chains have been contained, although surveillance must be sustained until the  end-of-outbreak criteria are met. Priorities should focus on reinforcing response  capacity in Nord-Kivu, particularly in Beni, Mutwanga, Oicha and Mabalako, restoring contact follow-up and safe burial.

Source: World Health Organization, Regional Office for Africa, https://www.afro.who.int/countries/kenya/publication/bundibugyo-virus-disease-outbreak-democratic-republic-congo-kenya-nigeria-weekly-external-situation

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Yellow fever - #WHO #African Region, 6 November 2026 (WHO D.O.N., summary)

 

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Situation at a glance

    Yellow fever transmission continues in the WHO African Region, with recent outbreak activity concentrated in parts of West Africa. 

    Between 1 January and 12 October 2026, 67 confirmed cases, including 18 deaths, were recorded in nine countries in the Region: Burkina Faso, Cameroon, the Central African Republic, Côte d’Ivoire, Ghana, Guinea, Liberia, Nigeria and Togo. 

    The most recent outbreak activity has been concentrated in Burkina Faso, Côte d’Ivoire, Ghana and Liberia, including in areas close to international borders. 

    Occupational and environmental exposures, including work in or near forested areas, mining activities, and other outdoor occupations, are important risk factors for yellow fever infection. 

    Frequent cross-border population movement, the presence of competent mosquito vectors, and uneven vaccination coverage increase the risk of further transmission and geographic spread. 

    Countries in the Region, supported by WHO and partners, are implementing response activities including enhanced surveillance and case investigation, laboratory testing, active case finding, risk communication and community engagement, and vaccination activities in affected and at-risk areas. 

    On 27 October 2026, WHO assessed the overall public health risk associated with the current yellow fever situation as moderate at the regional level. 

    The global risk remains low.

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Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON624

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#Ebola disease caused by #Bundibugyo virus - #DRC, #Kenya and #Nigeria, 6 November 2026 (WHO D.O.N., Summary)

 

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Situation at a glance

    Since the publication of the previous Disease Outbreak News on 23 October 2026, the Bundibugyo virus disease (BVD) outbreak has expanded geographically in the Democratic Republic of the Congo. 

    While some areas have seen a slight decline in cases, sustained, high-level transmission continues overall in the Democratic Republic of the Congo. 

    As of 3 November 2026, a total of 10 668 confirmed cases, including 5198 deaths (crude case fatality ratio: 48.7%), have been reported across 67 health zones in eight provinces, with active transmission ongoing in 51 health zones. 

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

    Of the 512 deaths reported since 21 October, 335 occurred in communities and 177 in treatment centres. 

    Since the last Disease Outbreak News, no new cases have been reported from Kenya or Nigeria. 

    However, the high-level transmission in the Democratic Republic of the Congo indicates a continued need for readiness in the region, including cross-border surveillance, points of entry monitoring, timely case detection and coordinated preparedness and response measures. 

    No new country has reported cases since the last Disease Outbreak News was published, however, two countries have medically evacuated confirmed cases among citizens: Switzerland and the United Kingdom of Great Britain and Northern Ireland. 

    Based on the currently available information, WHO advises against any restriction of travel to, or trade with, States Parties experiencing and/or responding to the public health event.

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Source: World Health Organization, https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON625

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#Bundibugyo Virus Disease #Outbreak - #DRC, #Kenya, #Nigeria - Sit. #Report No. 24, Data as of 1 Nov. '26 (WHO, summary): 10,532 cases & 5,126 deaths in DRC

  

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Event description

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic  of the Congo passed 10 000 confirmed cases during the reporting period and  continues at a high, sustained level of transmission, driven increasingly by  Nord-Kivu while Ituri remains the largest contributor. 

    The importation events in Kenya and Nigeria have so far remained  contained: no new case has been reported in Kenya since 19 October and all  secondary cases occurred among contacts already in quarantine, while no  secondary case has been identified in Nigeria. 

    However, a one new death was reported in Kenya, bring the total number of  deaths to two. 

    In the Democratic Republic of the Congo, insecurity, health-worker strikes  in Bas-Uélé and Tshopo and the suspension of response activities in Bafwasende  Health Zone continue to constrain surveillance and response operations.

Democratic Republic of the Congo

    As of 1 November 2026, the BVD outbreak in the Democratic Republic of  the Congo has affected 67 health zones across eight provinces; Yakoma  Health Zone in Nord-Ubangi Province was added to the list of affected zones on 28  October.

    Since External Situation Report #23, an additional 895 confirmed cases and 480 confirmed deaths have been reported, bringing the cumulative total to  10 532 confirmed cases, including 5 126 confirmed deaths [crude case fatality  ratio (CFR) 48.7%]. 

    Transmission remains highly heterogeneous across affected areas. Ituri  continues to account for the largest proportion of cumulative confirmed cases  (70.6%), although its relative contribution is declining, while Nord-Kivu (23.9% of cumulative cases; CFR 55.4%) accounted for 60.0% of the cases reported on 1 November. 

    Transmission persists at lower levels in Haut-Uélé and Tshopo.

    National daily incidence rose steadily from May to its highest levels in late  July and mid-August, declined through late September and has fluctuated at  a high plateau since early October. 

    The seven-day moving average ranged between 67 and 76 confirmed  cases per day during the reporting period, peaking at 76 cases per day on 29–30  October before easing to 67 on 1 November, still below the mid-August peak of  94. 

    Provincial trends diverge. Ituri continues its gradual decline from the late- July peak (seven-day average of 31 cases per day on 1 November, down from 38  on 19 October), while Nord-Kivu is rising again (30 cases per day, up from 26)  and now reports almost as many cases as Ituri each day. HautUélé remains stable  at four to five cases per day, Tshopo shows low-level but sustained transmission,  and Nord-Ubangi reported its first cases in October. Bas-Uélé, Sud-Kivu and Sud-Ubangi have reported no case in the last 21 days (Figures 1 and 2).

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Trend Analysis (21-day comparison):

    During the most recent 21-day period (12 October – 1 November 2026), a  total of 1 466 confirmed cases were reported nationally, compared with 1 333  cases during the preceding 21 days (21 September – 11 October), representing  an increase of 133 cases (+10.0%). 

    Provincial trends remain heterogeneous. Cases in Ituri decreased slightly  from 748 to 736 (−1.6%), accounting for 50.2% of national cases during the  latest period. 

    In Nord-Kivu, cases increased from 486 to 607 (+24.9%), accounting for  41.4% of national cases, while in Haut-Uélé cases increased from 72 to 84  (+16.7%), accounting for 5.7% of national cases. Tshopo reported 33 cases  compared with 20 in the preceding period (+65.0%), and Nord-Ubangi reported  its first six cases. Bas-Uélé and Sud-Ubangi, which reported six and one cases  respectively in the preceding period, reported none.

    During the same period, a total of 745 confirmed deaths were reported  nationally, compared with 649 deaths during the preceding 21 days (21  September – 11 October), representing an increase of 96 deaths (+14.8%). 

    Deaths increased from 377 to 393 (+4.2%) in Ituri, from 230 to 303  (+31.7%) in Nord-Kivu and from 34 to 43 (+26.5%) in Haut-Uélé and decreased  from eight to five in Tshopo; Nord-Ubangi reported its first death. The rise in  deaths, concentrated in NordKivu, outpaced the rise in cases, reflecting a  worsening mortality burden in the province where transmission is now intensifying.

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    Transmission remained active in two-thirds of all health zones affected  since the start of the outbreak. Of the 67 health zones affected to date,  45 (67.2%) reported at least one new confirmed case during the most recent 21  days(12 October – 1 November 2026). 

    Case incidence increased in 26 health zones, decreased in 27 and was  unchanged in one when the two periods are compared. 

    

    The largest absolute increase occurred in Beni, Nord-Kivu (177 to 262  cases; +48.0%), followed by Mambasa, Ituri (22 to 62; +181.8%), Mandima,  Ituri (199 to 233; +17.1%), Mutwanga, Nord-Kivu (14 to 43; +207.1%), Oicha,  Nord-Kivu (28 to 51; +82.1%) and Wamba, Haut-Uélé (26 to 49; +88.5%).  Bafwasende in Tshopo (11 cases), Wapinda and Yakoma in Nord-Ubangi (three  cases each) and Damas and Mahagi in Ituri (one case each) reported cases after  none in the preceding period (Figure 4).

    There were also 22 health zones without a new case in the last 21 days.  These include Adja, Ariwara, Aungba, Boga, Drodro, Fataki, Gety, Kambala and  Logo in Ituri; Goma and Kayna in Nord-Kivu; Dungu and Gombari in Haut-Uélé;  Lubunga, Mangobo and Wanie-Rukula in Tshopo; Miti-Murhesa in Sud-Kivu; Buta, Dakwa, Ganga and Viadana in BasUélé; and Bulu in Sud-Ubangi.

(...)

    Weekly confirmed deaths (Figure 6) rose to 286 during 19–25 October 2026,  the highest weekly total since late August, before declining by 16.4% to  239 during 26 October – 1 November. Community deaths decreased from 184 to  155 (−15.8%) and deaths in treatment facilities from 102 to 84 (−17.6%), so  that the proportion of deaths occurring in the community was essentially  unchanged at 64.9% (64.3% the previous week). 

    On 1 November alone, 20 of the 23 confirmed deaths (87.0%) occurred in  the community. Close to two-thirds of confirmed deaths continue to occur outside treatment facilities, highlighting persistent challenges in early case  detection, timely referral and access to treatment.

(...)

Kenya

    Since the previous report, Kenya has reported no new confirmed case of BVD. The cumulative total remains nine confirmed cases, including two deaths (CFR 22.2%): the imported index case, who died on 5 October, and a  65-year-old family member who died on 23 October. All eight secondary cases  (four family members and four hospital staff) were epidemiologically linked to the  index case and were already under quarantine when they developed symptoms. 

    The last confirmed case was reported on 19 October 2026; the 42-day  countdown to the end of the outbreak will start once the last confirmed patient  has been discharged after two negative tests.

    Of the nine confirmed cases, seven were male and two were female, with  ages ranging from 24 to 65 years. Seven patients remain under treatment in  isolation at designated facilities, which have 211 isolation beds (scalable to 241), 

corresponding to a bed occupancy of 3.3%.

    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 (5.9%) tested positive for BVD during quarantine (four relatives and  four hospital staff), one of whom has died. 

    As of 28 October, 98 contacts remained  in quarantine in Kenya (41 hospital staff, 33 airport staff, 14 passengers  and 10 family members), all of whom were followed up in the  previous 24 hours (100%); 20 contacts (13 airport staff, four flight crew and three  passengers) had completed follow-up and been discharged from quarantine; and nine passengers who travelled outside Kenya are being  followed up through bilateral engagement with their Countries of destination.

(...)

Nigeria

    Nigeria reported a single confirmed case of BVD, announced by the  Federal Ministry of Health on 20 October 2026 in the Federal Capital Territory,  Abuja. The case, a 42-year-old woman, arrived in Abuja from Uganda via Addis  Ababa on 3 October, developed symptoms on 7 October and was admitted to a  private health facility on 11October. 

    The patient was clinically stable and received supportive care before  being medically evacuated to Switzerland on 26 October 2026. 

    As of 31 October, no additional confirmed cases had been reported. As of  29 October, 62 contacts had been identified in Abuja Municipal Area Council, none  of whom had developed symptoms, and 18 samples had been tested, of which one  was positive. 

    No secondary transmission has been detected; the 12-day  interval  between symptom onset and notification, eight days of which were spent in  private-facility care, remains the main concern for undetected exposures.

(...)

Situation interpretation

    The BVD outbreak remains at a critical juncture. In the Democratic  Republic of the Congo, transmission is not declining:  the cumulative count  passed 10 000 confirmed cases, the national seven-day average has held between  67 and 76 cases per day for three weeks, and the epicentre is shifting  towards Nord-Kivu, where cases rose by a quarter and deaths by a third over the  last 21-day period, where one in three patients is managed outside dedicated  treatment centres, and where contact follow-up and safe burial performance are  the weakest. 

    Health-worker strikes in Bas-Uélé and Tshopo, insecurity in Beni and Nizi and  the suspension of activities in Bafwasende further increase the risk of  undetected transmission. 

    The absence of new cases in Kenya since 19 October and of secondary  transmission in Nigeria is encouraging and indicates that the exported chains have  so far been contained, although continued surveillance is essential until the  end-of-outbreak criteria are met. 

    Priorities should focus on reinforcing response capacity in NordKivu,  particularly in Beni, Mutwanga, Oicha and Mabalako, restoring operational access  in insecure and strike-affected areas, improving the timeliness of isolation of  suspected cases and the completion of safe burials, and maintaining coordinated  cross-border surveillance and information sharing to prevent further international  spread.

Source: World Health Organization, https://www.afro.who.int/countries/nigeria/publication/bundibugyo-virus-disease-outbreak-democratic-republic-congo-kenya-nigeria-weekly-external-situation

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#Shamonda virus in #human - #France (#WHO D.O.N., November 5 '26)

 

Situation at a glance

    On 20 October 2026, the National IHR Focal Point (NFP) of France notified WHO regarding the first documented human infection with Shamonda virus (SHAV). 

    The case was an immunocompromised older man from eastern France with no travel history during the preceding year. 

    He developed severe neurological illness on 23 September 2026 and was diagnosed with severe encephalitis (brain inflammation). 

    The patient died on 8 October 2026. 

    SHAV is recognized primarily as an animal-associated virus, like the closely related Schmallenberg virus circulating in Europe, with no previously documented human infections. 

    SHAV was confirmed by metagenomic sequencing and reverse transcription polymerase chain reaction (RT-PCR), with high viral loads detected in tissue samples collected after death and other causes of encephalitis excluded. 

    There is currently widespread SHAV circulation in animals in Europe, including outbreaks across much of France. 

    The source and route of human infection remain unknown. 

    While vector-borne transmission is most likely, food-borne transmission is under investigation. 

    As this is the first documented laboratory confirmed human infection, WHO considers that the public health risk cannot yet be reliably assessed and recommends continued One Health surveillance and investigation.

Description of the situation

    On 20 October 2026, the National IHR Focal Point of France notified WHO of a laboratory-confirmed human infection with Shamonda virus. 

    The case was an immunocompromised older adult male who was hospitalized on 18 August 2026 for his underlying illness. 

    He developed neurological signs on 23 September, including visual disturbances, confusion, loss of consciousness and seizures. 

    A diagnosis of severe encephalitis was made on 25 September, and cerebrospinal fluid (CSF) samples were collected. He died on 8 October.

    Virological findings of SHAV were identified by metagenomics on the CSF samples from 25 September, and the French health authorities were notified on 7 October. 

    The sequence belonged to the SHAV-EU1 genotype and is 99% genomically identical to a virus circulating in neighbouring Switzerland, and the sequence retrieved covered approximately 90% of the genome. 

    Retrospective testing of serum samples collected in early July through October, as well as faecal, urine, saliva and respiratory samples, confirmed the presence of SHAV RNA by RT-PCR. 

    Post-mortem biopsies of the brain, liver and spleen showed very high viral genomic loads. 

    A wide panel of tests for other encephalitis pathogens returned negative results. 

    The patient lived in rural eastern France, where animal SHAV transmission has been documented since July 2026, and had not travelled in the preceding year. 

    The patient received multiple blood transfusions between February and October 2026 for his underlying illness.

    Testing performed by the French Blood Establishment (EFS) and the National Reference Center for Arboviruses (CNR) on blood donors linked to transfused red blood cell units was negative for Shamonda virus, making transfusion-associated transmission unlikely, although it cannot be completely excluded at this stage. 

    Epidemiological investigations around the case have not identified a specific source of exposure, although mosquito exposure was reported. 

    Serological investigations are also being conducted among close contacts of the patient.

    Although foodborne transmission is currently considered unlikely, investigations are ongoing to assess the potential excretion of Shamonda virus in the milk of infected cattle and to better characterize any potential implications for food safety. 

    In parallel, veterinary and entomological investigations are continuing to further clarify the vector(s), the ecology, transmission pathways, and public health significance of the virus.

    This is the first laboratory confirmed human case of Shamonda virus disease reported globally. 

    No additional human cases have been detected to date.

Epidemiology

    SHAV belongs to the family Peribunyaviridae, genus Orthobunyavirus, within the Simbu serogroup. It belongs to the same species as Schmallenberg virus (ie Orthobunyavirus schmallenbergense). It was first isolated from cattle in Nigeria in the 1960s and has subsequently been identified in animals in parts of Africa, Japan and Europe. 

    Until the recently reported human case, SHAV was recognized primarily as an animal-associated virus, like the closely related Schmallenberg virus circulating in Europe, with no documented human infections. 

    As this is the first confirmed human infection reported globally, there is currently insufficient evidence to assess the extent to which SHAV infects humans or causes disease.

    SHAV was detected for the first time in Europe during the summer of 2026 with confirmed or suspected infections reported in cattle, horses and alpacas in Belgium, France, Germany, the Netherlands and Switzerland. 

    As of 21 October 2026, additional European countries and territories have reported SHAV detections in animals: Austria, Ireland, Jersey, Liechtenstein, Portugal, Slovenia and Spain. 

    In metropolitan France, as of 20 October, the available reports indicate animal detections in 54 departments, predominantly in cattle.

    Two distinct variants of SHAV have been identified in animals in Europe: SHAV-EU1, reported in Germany, Austria, France and Switzerland, and SHAV-EU2, identified in Belgium, the Netherlands, northern Germany and northwestern France. 

    Based on current knowledge, SHAV is a vector-borne disease and it is not considered to spread directly between animals. 

    It appears to be transmitted primarily by biting midges of the genus Culicoides, although the main vector species remain unknown. 

    Culicoides (midges) are widespread, and climate change may alter their geographical distribution and abundance, potentially affecting the transmission of vector-borne pathogens in Europe, including Simbu serogroup orthobunyaviruses such as Schmallenberg virus, as well as orbiviruses like bluetongue and African horse sickness viruses. 

    Furthermore, wind-assisted dispersal of infected Culicoides over long distances may also contribute to the introduction and spread of midge-borne viruses into previously unaffected areas, although its role in SHAV transmission requires further investigation. Vertical transmission from mother to fetus during gestation in animals can also occur.  

    In cattle, reported signs include acute systemic illness, such as fever, diarrhoea, reduced activity or appetite, and reduced milk production. 

    Neurological disease has been observed in horses with SHAV-positive brain tissue. 

    Congenital malformations have occurred during gestational infection with related Simbu serogroup orthobunyaviruses in animals. However, the full effects of SHAV, including recently detected European strains, on pregnancy, reproduction and fetal development in animals require further investigation. 

    Given the concurrent circulation of bluetongue virus in Europe and the overlap in clinical signs, veterinary surveillance and laboratory-based differential diagnosis are important. 

    Laboratory confirmation relies on molecular methods, such as RT-PCR, with sequencing or further testing where indicated. 

    No specific antiviral treatment or vaccine is currently available for SHAV; animal-health prevention measures focus on reducing exposure to biting midges, livestock management practices and routine farm biosecurity. 

    Given the potential for overlapping neurological or systemic clinical presentations in animals with other viral infections, such as West Nile virus (WNV), retrospective investigations may be warranted among equine cases presenting with clinical signs compatible with SHAV infection that tested negative for WNV. 

    In addition, testing of samples from WNV-positive horses could help assess the occurrence of possible co-infections and better characterize the contribution of SHAV to equine disease. 

    Such investigations would support a more accurate assessment of the epidemiology, clinical impact and geographical distribution of SHAV in the European equine population.

    The emergence of SHAV in Europe warrants continued epidemiological surveillance and assessment by national veterinary authorities and the public health authorities in Europe using a coordinated One Health approach.  

    As of October 2026, SHAV was not included in the World Organisation for Animal Health (WOAH) list of reportable diseases; however, where SHAV meets the definition of an emerging disease, veterinary authorities are required to notify WOAH in accordance with Article 1.1.5 of the Terrestrial Health Code. 

Public health response

Notification by authorities to WHO and regional bodies.

    Clinical, biological and epidemiological investigations are continuing in conjunction with experts in human, animal and environmental health.

WHO risk assessment

    This first documented human infection with SHAV in 2026 demonstrates that human infection is possible. However, a single case is insufficient to assess the risk to the general population, including immunocompetent individuals, or to determine the frequency, clinical spectrum or severity of human infection. The route of infection and possible sources of exposure are unknown, though vector-borne transmission is a plausible hypothesis.

    Although transmission to humans by Culicoides has been documented for Oropouche virus, another orthobunyavirus, currently, there is no evidence that SHAV is transmitted to humans by this route. 

    Although widespread animal infections in Europe justify further investigation of potential human exposure, they do not establish the likelihood of human infection or sustained transmission. 

    Seasonal declines in Culicoides activity may reduce vector-borne transmission in the short term in northern climates, but do not exclude other routes or future exposure. 

    Given the very limited data regarding the zoonotic potential of SHAV, the public health risk remains uncertain and cannot yet be reliably assessed or quantified. 

    Continued surveillance, investigation of potential transmission routes and potential new human cases, assessment of clinical outcomes across different population groups and retrospective studies in animal populations are warranted. 

    The risk assessment should be updated as further evidence becomes available. 

WHO advice

    In view of the limited evidence on the zoonotic potential of SHAV, the following actions are recommended:

        ° Strengthened surveillance and information sharing. 

            § Continue animal surveillance for SHAV and other orthobunyavirus and consider appropriate human surveillance such as serosurveys, with timely information sharing between veterinary and public health authorities. 

            § Suspected human infections should be investigated in accordance with national procedures and available diagnostic capacity.

        ° Further investigation of the circumstances surrounding the reported case should seek to clarify the source of infection, including the potential contribution of vector exposure.

        ° Assessment of the potential for infection across different population groups. Further analysis of viral genotype and phenotype is required to better understand its potential for transmission to humans.

        ° Should additional human cases be identified, investigations should aim to characterize clinical presentation and outcomes, taking account of immune status and relevant underlying conditions or treatments.

        ° Improved diagnostic and epidemiological understanding, including laboratory investigation and characterization of any suspected cases.  

            § SHAV should be considered and tested for in people with relevant symptoms when occupational and/or environmental exposure may be compatible, until the risk to humans is better understood. 

            § Collaboration between human and animal health services can help identify possible epidemiological links and improve understanding of the virus's transmission pathways.

        ° Strengthened entomological investigations. 

            § Entomological studies should be enhanced to identify the Culicoides species and potentially other vectors involved in SHAV transmission and assess their geographical distribution, seasonal dynamics and vector competence. 

            § Improved understanding of the vectors involved would support both animal and public health risk assessments and help inform surveillance prevention and control strategies.

        ° Promoting One Health investigations to better characterize SHAV circulation. 

            § Investigations in animal populations, including species that may serve as sentinels of viral circulation, can provide valuable information on the geographical spread, transmission dynamics and clinical impact of SHAV. 

            § Improved understanding of animal infections may help identify areas of possible human exposure and support public health risk assessment.

        ° Maintaining proportionate risk communication. Communication should clearly distinguish the established circulation of SHAV in animals from the still-limited evidence of human infection.

        ° Review the risk assessment as evidence evolves. The assessment should be updated if additional human infections are identified, the route of transmission is clarified, or new evidence emerges regarding the clinical consequences of infection in immunocompromised or immunocompetent individuals. 

        ° Continued surveillance, targeted investigation and coordination between human and animal health authorities are warranted to address uncertainties and inform any subsequent adjustment of public health risk assessment and guidance. 

Further information

    • Ministry of Health, Families, Autonomy and Disability Affairs, France: https://sante.gouv.fr/actualites-presse/presse/communiques-de-presse/article/virus-shamonda-une-premiere-detection-chez-l-etre-humain   

    • Fatal encephalitis caused by Shamonda virus Europe 1 (SHAV-EU1) in a patient with a severely weakened immune system, France, 2026. https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.42.2600883   

    • Ministry of agriculture, agri-food and food sovereignty, France: Shamonda virus: a first detection in humans. https://agriculture.gouv.fr/virus-shamonda-une-premiere-detection-chez-letre-humain    

    • Ministry of agriculture, agri-food and food sovereignty, France: Cases of orthobunyavirus infection in dairy cows. https://agriculture.gouv.fr/cas-dinfections-de-vaches-laitieres-par-un-orthobunyavirus     

    • Public Health Agency (Santé publique France) France. https://www.santepubliquefrance.fr/les-actualites/virus-shamonda-un-premier-cas-humain-detecte-en-france-que-sait  

    • Health Food chain safety environment, Belgium: Shamonda-like virus: information and frequently asked questions. https://www.health.belgium.be/fr/outils/shamonda-virus-informations-questions-frequentes   

    • Swiss federal authorities, Institute of virology and immunology: Shamonda virus in Switzerland. https://www.ivi.admin.ch/en/neues-orthobunyavirus-der-simbu-serogruppe-bei-rindern-entdeckte    

    • USCDC: Emergence of Shamonda Orthobunyavirus, Central Europe, 2026. https://wwwnc.cdc.gov/eid/article/32/12/26-1496_article    

    • Plateforme ESA, France. https://plateforme-esa.fr/fr/un-nouveau-virus-apparente-au-virus-schmallenberg-agent-causal-potentiel-de-cas-epizootiques-de  

    • European Food Safety Authority (EFSA): Identification and mapping of potential and highly likely vectors for selected vector-borne diseases in the EU and neighbouring countries. https://efsa.onlinelibrary.wiley.com/doi/10.2903/j.efsa.2026.10061   

    • WOAH, Schmallenberg virus. https://www.woah.org/app/uploads/2021/03/a-schmallenberg-virus.pdf    

    • WOAH, Bunyaviral disease of animals. https://www.woah.org/fileadmin/Home/eng/Health_standards/tahm/3.10.01_BUNYAVIRAL_DISEASES.pdf  

Citable reference: World Health Organization (1 November 2026). Disease Outbreak News; Shamonda virus in human, France. Available at:  https://www/who.int/emergencies/disease-outbreak.news.item/2026-DON623     

Source: World Health Organization, https://www/who.int/emergencies/disease-outbreak.news.item/2026-DON623

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