#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

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#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.

(...)

Source: 

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

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#Nigeria, Ministry of Health confirmed the first imported case of #Bundibugyo Virus Disease in a traveler from #Uganda (Min. Health, Oct. 21 '26)

{Ministry of Health of Nigeria Instagram Page}

PRESS STATEMENT  | FG CONFIRMS EBOLA DISEASE CASE IN FCT, ACTIVATES PUBLIC HEALTH RESPONSE

Abuja, Nigeria | 20 October 2026

    The Federal Government of Nigeria confirm one case of Ebola disease in the  Federal Capital Territory (FCT), following laboratory confirmation today, 20  October 2026. 

    The patient, a woman who recently arrived in Nigeria on an international flight  from Uganda, was admitted to a private hospital in the FCT, where she received  care for several days before the diagnosis was confirmed. She is currently in  isolation and receiving medical care.

    The Federal Minister of Health and Social Welfare and NCDC are working closely with the FCT Health Services Secretariat and other relevant authorities to  contain the infection and prevent further spread.

    Contact tracing has commenced with 44 close contacts identified  presently, with public health teams identifying and monitoring people who may  have been exposed, including healthcare workers, patients, caregivers and travel contacts. Surveillance has been intensified, and the hospital is receiving  immediate support to strengthen infection prevention and control measures.

    The FG calls on all public and private healthcare facilities nationwide to be on high alert. Healthcare workers must maintain a high index of suspicion,  promptly identify and isolate suspected cases, observe strict infection prevention  and control measures, and immediately report suspected cases to public health  authorities.

What Nigerians Should Know and Do

    Ebola spreads through direct contact with the blood or body fluids of someone  who is sick with the disease or has died from it, or through contact with contaminated materials. A person with Ebola cannot spread the disease  before symptoms begin.

    We advise everyone to:

        1. Remain calm but vigilant. There is no need for panic.

        2. Practise regular hand hygiene and avoid contact with the body fluids  of anyone suspected to have Ebola.

        3. Watch for symptoms, including fever, severe weakness, headache,  vomiting and diarrhoea, particularly following possible exposure.

        4. Report any possible exposure immediately, even if you feel well. If  you develop symptoms, avoid close contact with others and call public health  authorities for guidance before visiting a healthcare facility.

        5. Cooperate with public health teams. Anyone contacted during contact  tracing, including relevant airline passengers, should provide the  necessary information and follow public health advice.

        6. Avoid rumours and stigma. Share only verified information from official  health authorities.

Our Assurance to Nigerians

    Nigeria successfully contained Ebola in 2014, and we have the experience  and public health systems to respond to this case. However, containing Ebola  requires everyone to play their part.

    The Federal Government, FCT authorities and other partners are working  together to protect healthcare workers, patients and the wider public.  Investigations are ongoing, and we will continue to provide accurate and timely  information. We urge Nigerians to remain calm, stay vigilant and cooperate with  public health authorities. Early detection, prompt reporting and everyone's  cooperation are critical to preventing further spread.

    The Government of Nigeria through the Presidential Taskforce on EVD  and NCDC will continue to provide updates.

    NCDC free call centre is available 24 hours a day, seven days a week. For  information or to report a suspected case, please call NCDC toll-free number  6232. 

Prof. Muhammad Ali Pate, CON | Coordinating Minister | Strategic Communications 

health.gov.ng

Source: 

Link: https://www.instagram.com/p/DeuendPDfyn/?utm_source=ig_web_copy_link&obrf=MzRlODBiNWFlZA==&srtk=MzRlODBiNWFlZA==

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#Kenya confirms first imported #Bundibugyo virus disease case; #WHO supports control efforts (Oct. 7 '26)

 

    Nairobi—Following the confirmation by Kenyan authorities of the country's first imported case of Bundibugyo virus disease (BVD), the World Health Organization (WHO) is working closely with the Government of Kenya to intensify key control measures to prevent further spread of the virus.

    The government is strengthening its response coordination and case investigation, while monitoring and listing contacts for enhanced disease surveillance. 

    At the core of the response efforts are screening at high-risk points of entry, and clear risk communication, while engaging communities to help prevent infection. These measures are rapidly being deployed to ensure the identification of cases and help contain further transmission.

    The patient, a Kenyan citizen, fell ill in the Democratic Republic of the Congo, where they had been living, and was treated at several health facilities there. 

    The patient then travelled by road to Kampala, Uganda through Beni on 2 October 2026, and flew to Nairobi, arriving on 3 October 2026. 

    On arrival, the patient was transported to a hospital in Nairobi and was quickly isolated. 

    Samples tested positive for Bundibugyo virus at both the National Virology Reference Laboratory and the Kenya Medical Research Institute. 

    Despite supportive care, the patient died on the night of 5 October 2026 and was buried on 6 October 2026 in line with the country’s Ebola safe and dignified burial protocol.

    The Government of Kenya notified WHO of the case in line with the International Health Regulations (2005) on 6 October 2026. 

    Kenya is the fourth country to confirm BVD. 

    The Democratic Republic of the Congo is responding to an ongoing BVD outbreak, while Uganda, where the Bundibugyo virus species was first detected in 2007, ended the latest outbreak in August 2026. 

    Most cases in Uganda were imported from the Democratic Republic of the Congo and the remaining few were locally acquired among contacts and health workers linked to imported cases. 

    France reported a travel-related case of BVD in June 2026.

    Health authorities in Kenya have so far listed 28 contacts, including family members and health workers who cared for the patient. They are also tracing 23 passengers and four crew members from the same flight, with arrangements underway for appropriate follow-up and quarantine of people assessed to be at risk.

    "Health emergency preparedness gives us a head start. Kenya has put important outbreak control measures in place. The priority now is to move swiftly to detect any further cases before the virus has an opportunity to spread. We're supporting the ongoing efforts to strengthen the response, and with rapid and coordinated action, we can prevent the virus from gaining a foothold and stop a potential larger outbreak," said Dr Mohamed Janabi, WHO Regional Director for Africa.

    Kenya has been on high alert since May 2026, when outbreaks were declared in the Democratic Republic of the Congo and Uganda. As of 6 October 2026, Kenya has screened over 652 000 travellers entering the country, tested 267 suspected samples and trained around 5000 health workers on Ebola prevention and management.

    WHO and partners have supported Kenya’s Ministry of Health and National Public Health Institute in these efforts. 

    This includes: 

        § Ebola simulation exercises and training a national pool of rapid response trainers, among them responders who served during the 2014–2016 West Africa outbreak. 

        § Isolation units across 27 high-risk counties in Kenya have been identified and assessed, case managers trained, and Ebola surveillance tools have been updated so that suspected cases can be quickly identified, reported and investigated. 

        § Risk communication and community engagement activities have also been strengthened through public messaging, media and community engagement, call centre support, and monitoring and responding to rumours and misinformation.

    WHO has also delivered about 1000 Ebola tests and 1000 personal protective equipment kits to high-risk counties in Kenya.

    Kenya's Ebola preparedness score, which tracks progress on key readiness measures such as surveillance, laboratory testing, isolation and treatment facilities and trained response teams, rose from 66% in May to 82% in July 2026.

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

    WHO calls for continued support to the response in affected countries. Global solidarity, along with government-led responses with engaged communities, is the best route to ending the outbreak.

Source: 

Link: https://www.afro.who.int/countries/kenya/news/kenya-confirms-first-imported-bundibugyo-virus-disease-case-who-supports-control-efforts

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Estimated #Transmissibility and #CFR of #Bundibugyo Virus, #Uganda, 2007

 

Abstract

Because the epidemiology of Bundibugyo virus remains unclear, we reanalyzed the first recognized outbreak (Uganda, 2007). Adjusting for case under-ascertainment and the effect of control measures, we estimated the effective reproduction number (1.55, falling to <1 after intervention) and case-fatality rate (31%, declining to 25%). The underascertainment rate was 15%.

Source: 

Link: https://doi.org/10.3201/eid3210.261175

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The First 100 Days of Five #Ebola #Outbreaks — #DRC, #Uganda, and West #Africa, 2007–2026 (MMWR, Sept. 15 '26)

 

Summary

    ° What is already known about this topic?

        § The Democratic Republic of the Congo (DRC) is experiencing its largest and deadliest Ebola disease outbreak, which is also the largest Ebola outbreak caused by Bundibugyo virus and the second largest Ebola outbreak worldwide.

    ° What is added by this report?

        § The 2026 Ebola outbreak resulted in 5,458 confirmed cases and 2,606 deaths in DRC in the first 100 days after initial detection, indicating rapid growth. No previous Ebola outbreak caused >800 cases during the first 100 days.

    ° What are the implications for public health practice?

        § This Ebola outbreak appears to be expanding faster than any previously documented Ebola outbreak, with seven times as many cases 100 days after initial detection than the 2014 Ebola outbreak in West Africa, the largest outbreak worldwide. Urgent implementation of public health interventions to identify cases, trace contacts, and limit transmission are needed to bring the outbreak under control.

Abstract

The first 100 days after identification of an outbreak are important to understanding transmission dynamics, impact of early public health interventions, and trajectory of potential future cases and deaths. A large Ebola disease outbreak in the Democratic Republic of the Congo (DRC), which has become the country’s largest and deadliest, is ongoing. To better understand the current outbreak, this report compared metrics from the first 100 days of this outbreak with those of four past Ebola outbreaks. The historic outbreaks of Ebola disease selected for this comparison include the two largest (the 2014 outbreak in West Africa and a 2018 outbreak in DRC), and the only two previous outbreaks caused by Bundibugyo virus (the 2007 outbreak in Uganda and the 2012 outbreak in DRC). This activity was reviewed by CDC, deemed not research, and conducted consistent with applicable federal law and CDC policy.*

Source: 

Link: http://dx.doi.org/10.15585/mmwr.mm7537e1

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Notes from the Field: #Clinical Characteristics of Patients with #Ebola Disease Caused by #Bundibugyo Virus — #Uganda, 2026

 

Summary

    ° What is already known about this topic?

        § Clinical and epidemiologic descriptions of Bundibugyo virus disease (BVD) are rare; case-fatality rates in previous outbreaks have ranged from 32% to 55%. Effective treatments have not been described.

    ° What is added by this report?

        § Among the first 21 cases (20 confirmed; one probable) in the 2026 Uganda BVD outbreak, 18 were admitted to the Mulago National Referral Hospital Ebola Treatment Unit (ETU). Among these 18, all had elevated liver enzymes, hypoalbuminemia, and hyponatremia on ETU admission. All 18 received treatment with remdesivir through an off-label, compassionate-use protocol. Among 20 confirmed cases, 18 (90%) patients survived; two deaths occurred among patients with confirmed cases whose infections were recognized late. Seeking care promptly might have reduced the number of deaths.

    ° What are the implications for public health practice?

        § Communicating with the public about the benefits of seeking health care promptly when BVD is suspected might improve patient outcomes. Clinical trials of remdesivir for patients with BVD might be warranted.

Abstract

    Ebola disease is a viral hemorrhagic fever caused by viruses of the genus Orthoebolavirus. Bundibugyo virus (Orthoebolavirus bundibugyoense), first identified in 2007 in Bundibugyo District, Uganda, is one of four orthoebolaviruses known to cause Ebola disease in humans; only two previous Bundibugyo virus disease (BVD) outbreaks have been documented. Transmission occurs through direct contact with infectious blood or other body fluids. Common signs and symptoms include fever, abdominal pain, diarrhea, vomiting, weakness, and bleeding from orifices and injection sites. Case-fatality rates (CFRs) among confirmed cases in the two previous outbreaks ranged from 32% to 55% (1,4). No licensed vaccine or specific treatment is available for BVD; clinical management is primarily supportive. On May 15, 2026, the Uganda Ministry of Health confirmed an outbreak of BVD imported from the neighboring Democratic Republic of the Congo (DRC). On August 26, 2026, the outbreak was declared over in Uganda with 20 confirmed BVD cases and one probable case reported, although the outbreak in DRC is ongoing. This report describes the clinical and epidemiologic characteristics of all 21 cases. This activity was reviewed by CDC, deemed not research, and conducted consistent with applicable federal law and CDC policy.*

Source: 

Link: http://dx.doi.org/10.15585/mmwr.mm7535a2

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Early Action #Review of #Detection, Notification, and #Response Timeliness during Cross-Border #Bundibugyo Virus Disease #Outbreak, #Uganda, 2026

 

Abstract

Bundibugyo virus disease (BVD), an Ebola virus species with no licensed vaccine or therapeutic, reemerged in May 2026 as a cross-border outbreak in Uganda and the Democratic Republic of the Congo. During a 2-day workshop, July 8–9, 2026, we conducted an early action review of the outbreak response using the 7-1-7 framework (7 days to detect, 1 day to notify, 7 days to complete early response actions) to assess timeliness and identify bottlenecks and enablers across 9 response pillars. Uganda declared its outbreak on May 15, 2026; by July 8, the country had recorded 20 confirmed cases (15 imported, 5 locally transmitted) and a case-fatality rate of 15%. Uganda met all 3 targets: detection in 6 days, notification in <1 day, and response completion in 2 days. Low clinical suspicion, cross-border data-sharing gaps, fragmented digital systems, and delayed community engagement were common bottlenecks; strong leadership and coordination structures were most cited enablers.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/10/26-1411_article

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#Bundibugyo at the #Border: The 2026 #Ebola #Outbreak and the Case for Pre-emptive #Countermeasure #Equity

 

Abstract

The 2026 Ebola outbreak caused by Bundibugyo ebolavirus in the Democratic Republic of the Congo and Uganda exposes a persistent structural flaw in global health security: preparedness remains overwhelmingly reactive and pathogen-specific. Despite the $518 million Africa CDC-WHO joint continental plan, no licensed BDBV vaccine or therapeutic is available; a 21-day (three-week) detection delay and cross-border transmission expose inadequate inter-epidemic investment in non-Zaire ebolavirus countermeasures. We argue for sustained, ring-fenced financing, institutionalised cross-border coordination, species-inclusive diagnostics, and real-time genomic data sharing to move African Ebola preparedness from reactive to pre-emptive.

Source: 

Link: https://www.sciencedirect.com/science/article/pii/S1477893926000682?via%3Dihub

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Operational #epidemiology of the early phase of the 2026 #Bundibugyo virus disease #outbreak in the #DRC and #Uganda

 

Abstract

The 2026 Bundibugyo virus disease outbreak in the Democratic Republic of the Congo (DRC) and Uganda occurred in a fragile cross-border setting marked by delayed recognition, diagnostic uncertainty, insecurity, population mobility, community mistrust, and healthcare-worker exposure. We conducted a retrospective operational epidemiology study using official situation reports, public health declarations, ministry statements, WHO and Africa CDC updates, cross-border communiqués, and selected partner statements. This analysis reflects publicly available data from the early outbreak period, with the primary DRC data lock on 27 May 2026 and Uganda and regional triangulation through 29 May 2026. We reconstructed the early timeline, described epidemiological and geographic progression, quantified response indicators, and applied a transparent health-zone prioritization framework. The earliest documented symptom onset was 24 April 2026. The Institut National de Recherche Biomédicale (INRB) detected non-Zaire ebolavirus in eight of 13 samples on 14 May, giving a 20-day symptom-onset-to-first-laboratory-detection interval; species-level Bundibugyo virus confirmation and official declaration followed on 15 May. By the DRC data lock on 27 May, 125 confirmed cases and 17 confirmed deaths had been reported, giving a confirmed case fatality ratio of 13.6%. DRC also reported 906 suspected cases and 223 suspected deaths, giving a suspected fatality proportion of 24.6%. Confirmed cases expanded from three to 13 health zones across three provinces within 12 days. Ituri province accounted for 110 confirmed cases (88.0%); Bunia, Rwampara, and Mongbwalu health zones together contributed 90 cases (72.0%). Uganda reported nine confirmed cases and one death by 29 May. Operational pressure included 2,635 listed contacts in DRC, 436 contacts under follow-up in Uganda, and 126 of 774 collected samples (16.3%) pending testing in DRC. Healthcare workers represented 16 of 125 DRC confirmed cases (12.8%) and at least three of nine Uganda cases (33.3%). Applying the health-zone prioritization framework, Rwampara, Mongbwalu, and Bunia were classified as higher priority health zones. Excluding confirmed burden did not change any health-zone tier; data classification confidence was high for 10 zones and moderate for three. Within this early operational snapshot, outbreak visibility reflected both transmission and operational factors, particularly detection delay, laboratory backlog, cross-border movement, healthcare-linked exposure, and community trust or security incidents. The framework provides a transparent basis for rapid decision support during an outbreak’s early phase by directing surveillance, laboratory, case-management, infection prevention and control, contact-tracing, and community-engagement resources toward health zones where multiple operational risks converge.

Source: 

Link:https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006680

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#Ebola #Bundibugyo Virus Disease #Outbreak, #DRC, #Uganda - Situation #Report No. 14, Data as of 16 August '26 (WHO, edited): 5,021 cases & 2,378 deaths in DRC

 

{Click on Image to Enlarge}

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Event description

Democratic Republic of the Congo

    The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo has expanded to a sixth province, with the detection of a confirmed  case in Bas-Uélé province in the north-east, indicating further geographic  spread beyond the main transmission areas in the eastern part of the country. 

    Since External Situation Report #13, an additional 640 confirmed cases and 367 confirmed deaths have been reported, reflecting continued sustained  transmission and high mortality. 

    The crude case fatality ratio (CFR) has increased from 45.9% to 47.4%,  continuing the upward trend observed over several weeks.

    As of 16 August 2026, a total of 5 021 confirmed cases, including 2 378 confirmed deaths have been reported across 55 health zones in six provinces. 

    Buta health zone in Bas-Uélé province and Tshopo health zone in Tshopo  province are the latest affected health zones. 

    Ituri remains the epicentre, accounting for 84.8% of cumulative confirmed  cases and 79.0% of cumulative confirmed deaths.

Figure 1. Daily growth trend in confirmed Bundibugyo virus disease cases in the Democratic Republic of the Congo, by date of report, as of 16 August 2026

{Click on Image to Enlarge}

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    During the most recent 21 days (27 July – 16 August 2026), a total of 1 759 confirmed cases and 941 confirmed deaths were reported nationally. 

    Transmission remained concentrated in Ituri, which accounted for 1 356  cases (77.1%) and 671 deaths (71.3%), followed by Nord-Kivu with 293 cases  (16.7%) and 224 deaths (23.8%), and Haut-Uélé with 101 cases (5.7%) and 42  deaths (4.5%). 

    Compared with the preceding 21-day period (6 – 26 July 2026), the  number of newly reported cases increased by 121 (+7.4%), and deaths by 25  (+2.7%). However, trends varied substantially between provinces. In Ituri, newly  reported cases and deaths declined by 68 (−4.8%) and 97 (−12.6%)  respectively. 

    In contrast Nord-Kivu reported an increase of 123 newly reported cases  (+72.4%) and 101 deaths (+82.1%). Haut-Uélé recorded the largest relative  increase, with 61 additional newly reported cases (+156.4%) and 21 additional  newly reported deaths (+100.0%). Tshopo remained a smaller transmission focus,  while the detection of a case and death in Bas-Uélé indicates further  geographic expansion.

    At the health-zone level, transmission remained geographically widespread. Of the 55 health zones affected since the start of the outbreak, 47  (85.5%) reported at least one confirmed case during the most recent 21 days.  

    Eight health zones reported no new confirmed cases during this period: Adja, Ariwara, Boga and Kambala in Ituri; Goma in NordKivu; Rungu in Haut-Uélé; Lubunga in Tshopo; and Miti-Murhesa in Sud-Kivu. 

    Seven health zones reported confirmed cases for the first time since the  beginning of the outbreak: Gombari in Haut-Uélé, Lubero in Nord-Kivu, Bafwasende, Kabondo, Tshopo and Wanie-Rukula in Tshopo, and Buta in Bas-Uélé.  This indicates continued geographic expansion, including into previously  unaffected health zones.

    Despite this expansion, transmission remains highly concentrated in a limited number of health zones. Bunia, Rwampara, Nizi, Katwa, Mongbwalu and  Nia-Nia together reported 1 186 cases during the most recent 21 days, accounting  for 67.4% of all cases reported nationally during this period. 

    The distribution of transmission is also changing. Cases increased  substantially in Bunia (+80; +24.9%), Rwampara (+69; +31.5%) and Katwa  (+63; +71.6%), while substantial relative increases were observed in Wamba  (+31; +281.8%), Beni (+34; +226.7%), Fataki (+37; +246.7%) and Isiro (+18;  +150.0%). Conversely, cases declined in established transmission foci such as Mongbwalu (−134; −61.5%) and Nizi (−97; −34.8%). Overall, the data indicate a redistribution of transmission, with declining activity in some established hotspots occurring alongside intensification in others and continued geographic expansion into new health zones.

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    Mortality remains high and varies substantial across affected areas. Ituri continues to account for the largest absolute burden, with 1 878 cumulative confirmed deaths, representing 79.0% of all deaths nationally.  However, the CFR is considerably higher in Nord-Kivu (70.5%), than in Ituri  (44.1%) and Haut-Uélé (45.3%). This disparity was also evident during the most  recent 21 days, when Nord-Kivu accounted for only 16.7% of reported cases but  24.0% of reported deaths nationally.

    At health-zone level, the largest numbers of deaths were reported from  major transmission foci in Ituri, particularly Bunia, Rwampara and Mongbwalu.  However, CFRs were substantially higher in several health zones in Nord-Kivu, including, Butembo (85.6%), Beni (75.8%) and Katwa (68.1%), compared  with Bunia (29.8%), Rwampara (38.9%), and Mongbwalu (49.9%). These marked  geographic variation indicate that mortality is not explained by  transmission intensity alone and warrants further assessment of differences in case detection, timeliness of presentation and referral, community  deaths, access to care and clinical management. 

    Mortality remains high both in the community and among patients in treatment facilities. During the past six weeks, an average of approximately 162  community deaths and 98 treatment facility deaths were reported each week. 

    Community deaths accounted for approximately 60% of all confirmed  deaths during this period. The high proportion of community deaths highlights  persistent challenges in early case detection, referral and access to designated  treatment facilities. 

    Mortality among patients reaching treatment facilities may reflect late  presentation and severe disease at admission, while further assessment is needed  to determine the contribution of clinical management capacity, quality of  care and patient vulnerabilities, including age, malnutrition and comorbidities. For  the purposes of this report, community death refers to death occurring outside a  designated Ebola treatment facility, including at home, in the community, or in  another (non-Ebola) health facility.

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    The current BVD outbreak continues to follow a markedly different trajectory from previous major Ebola disease outbreaks. 

    

    During the first 95 days of reporting, the 7-day moving average increased  progressively, reaching more than 90 confirmed cases per day, substantially  higher than the levels observed during comparable period of the 2014 – 2016 

West Africa and 2018 – 2020 Democratic Republic of the Congo outbreaks. 

    With 5 021 confirmed cases reported as of 16 August 2026, this has  become the largest BVD outbreak ever recorded and the second-largest Ebola  disease outbreak on record. 

    The sustained high incidence and continued geographic expansion indicates  that transmission remains intense and that the outbreak has not yet entered a  clear declining phase.

Figure 5. Comparison of three major Ebola disease outbreak trajectories during the first 95 days of reporting using seven-day moving averages of the daily number of confirmed cases reported.

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Uganda and France

    Uganda has now recorded 31 consecutive days without a new confirmed  BVD case since the last patient was discharged on 16 July 2026. All identified  contacts have completed follow-up, with no further cases detected. The continued  high level of transmission in neighbouring eastern Democratic Republic of the  Congo, however, means that the risk of crossborder reintroduction remains.

    France has reported no new confirmed BVD cases for 43 consecutive days  since the imported case was discharged on 4 July 2026. This period is more  than twice the maximum 21-day incubation period for BVD. No secondary  transmission has been detected, and all five identified flight contacts completed  follow-up without developing symptoms.

Risk Assessment

    The risk of further geographic spread within the Democratic Republic of the Congo remains very high, while the risk of cross-border spread remains  elevated. 

    The detection of a case in Buta, Bas-Uélé and additional affected health  zones in Tshopo, together with sustained transmission in highly mobile areas of  Ituri, Nord-Kivu and Haut-Uélé, increases the potential for onward spread along major transport corridors. Tshopo, particularly the Kisangani transport hub, is of 

particular concern because of its connectivity with other parts of the country and  the potential for longer-distance dissemination towards Kinshasa. 

    Continued transmission in eastern and north-eastern Democratic  Republic of the Congo also increases the likelihood of cross-border movements of  infected persons. 

    Uganda, South Sudan and the Central African Republic remain at  particularly high risk of importation, given their geographic proximity to affected 

areas of the Democratic Republic of the Congo, established cross-border population movements and connectivity along major mobility corridors. 

    Enhanced surveillance, information sharing, preparedness and cross- border coordination should therefore be maintained along priority mobility corridors and at points of entry.

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Situation interpretation

    The BVD outbreak is evolving into a more geographically dispersed emergency, with persistent transmission in established hotspots occurring  alongside intensification in other areas and continued seeding of new locations. 

    The combination of very high mortality, substantial deaths outside  designated treatment facilities, increasing surveillance workload and  uneven response capacity suggests that current interventions are not yet  achieving sufficient speed, coverage or intensity to interrupt transmission. 

    The response should therefore be increasingly risk-informed and geographically differentiated, with the intensity and combination of  interventions adapted to local transmission patterns and operational gaps, while  simultaneously establishing sufficient response capacity ahead of transmission in 

newly affected and high-risk areas. 

    Given increasing connectivity between affected areas and major  populationmovement corridors, stronger interprovincial and cross-border  surveillance and preparedness are also critical to prevent further geographic spread.

Source: 

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

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

 

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Event description

Democratic Republic of the Congo

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

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

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

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

    

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

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

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

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

    

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

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

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

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

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

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

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

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

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

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

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

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

Uganda and France

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

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

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Situation interpretation

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

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

Source: 

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

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