Showing posts with label viral hemorrhagic fever. Show all posts
Showing posts with label viral hemorrhagic fever. Show all posts

Wednesday, June 10, 2026

Regional #Signals Preceding the 2026 #Bundibugyo Virus Disease #Outbreak

 


Highlights

    • Bundibugyo virus circulated undetected for months prior to outbreak declaration.

    • Four earlier regional hemorrhagic fever clusters flagged by open surveillance are unresolved.

    • These clusters warrant urgent reanalysis due to concern for regional spread.


Abstract

Background

The May 2026 Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo was declared a Public Health Emergency of International Concern after substantial undetected community transmission. We describe regional surveillance signals detected by the Biothreats Emergence, Analysis, and Communications Network (BEACON), our open access event based surveillance program, in the weeks preceding outbreak declaration.

Methods

We reviewed BEACON reports of VHF-compatible illness clusters detected in the transboundary DRC-Uganda-Burundi-South Sudan region during March–April 2026, prior to the May 15 laboratory confirmation of BDBV.

Results

BEACON detected four temporally proximal VHF-compatible illness signals: (1) March 9, North Kivu Province—suspected Ebola case under investigation with unresolved laboratory results; (2) March 10, Kasaï Province—fatal hemorrhagic illness with secondary cases and negative Ebola PCR; (3) March 30, Burundi—35-case undiagnosed cluster near the DRC border with 5 deaths, negative testing for major filoviruses and >200 pathogens, pending metagenomic sequencing; (4) April 22, South Sudan—three suspected VHF cases with negative initial testing. All four signals shared a similar diagnostic phenotype: VHF-compatible presentation, mobilization of investigation teams, negative initial testing, and no publicly reported confirmed etiology. None were formally reported to have been resolved.

Conclusions

Our detection of four unresolved VHF signals preceding the confirmed BDBV outbreak highlights gaps in formal follow-up mechanisms for negative cases and fragmented regional diagnostic coordination. In light of confirmed BDBV circulation and Africa CDC's identification of 10 countries at high risk for spread, these preceding signals warrant urgent retrospective investigation and laboratory.

Source: 


Link: https://www.ijidonline.com/article/S1201-9712(26)00497-2/fulltext

____

Tuesday, May 19, 2026

#DRC #Ebola #outbreak: hundreds of suspected cases, no vaccine (UN News Centre, May 19 '26)

 


By Dominika Tomaszewska-Mortimer, Geneva | 19 May 2026 Health


    A fast-spreading Ebola outbreak in the Democratic Republic of the Congo (DRC) has health workers rushing to stop transmission while the roll out of any potential vaccine is months away, the UN World Health Organization (WHO) said on Tuesday. 

    WHO’s representative in DRC, Dr Anne Ancia, told reporters in Geneva that there are more than 500 suspected cases including 130 suspected deaths, but that only 30 cases have been confirmed in the country so far.

    The agency is working closely with the authorities and rushing more testing kits to eastern DRC to identify cases of infection of Bundibugyo virus, a species of Ebola virus for which there are no vaccines or therapeutics.

    “We have significant uncertainty about the number of infections and how far the virus has spread,” Dr Ancia said.

    Speaking from Bunia in Ituri province, where cases were initially detected, Dr Ancia said that the outbreak has also reached North Kivu, with confirmed cases in Butembo and Goma. Uganda has also confirmed two imported cases.

    WHO chief Tedros Adhanom Ghebreyesus declared the outbreak a public health emergency of international concern on Sunday morning. He has expressed concern about the “scale and speed of the epidemic”.

    Uncertainty still surrounds how and where outbreak started

    “I don't think that we have the ‘patient zero’ for now,” said Dr Ancia. “What we know for now is that on 5 May, there was…a person who died in Bunia. The body was brought back [to] Mongbwalu…and put in a coffin. And then the family decided that the coffin was not worth the person. And therefore…they changed the coffin. And then there was the funeral, and it's from where it started.”

    Detection of the initial cases was slowed down by the fact that local tests in Bunia showed negative results for the Zaire strain of Ebola. The wide range of symptoms - fever, fatigue, diarrhoea and vomiting - also complicated the task of making a swift diagnosis, with the additional difficulty that the nosebleeds that are also associated with the disease did not begin until day five of infection, the WHO official explained.


Kinshasa breakthrough

    In the end, it was only through tests in Kinshasa that the presence of Bundibugyo virus was finally revealed. 

    Dr Ancia said that there is a focus on the international level on potential candidate vaccines or treatments which could help fight the outbreak. A WHO technical advisory group was scheduled to meet on Tuesday afternoon “to provide further recommendation to the WHO and its Member States on which potential vaccine should be prioritized”, she explained.

    Ervebo, a vaccine against the Zaire Ebola virus, is under consideration, the WHO representative said, but “it would take two months for it to be available”.

    While a vaccine could bring additional prevention and protection to the affected populations, the key to containing transmission lies in grassroots work within the communities to raise awareness, fight misinformation and ensure adherence to sanitary measures, especially around funerals.

    “If we use coercive measures and the population does not agree, we will see bodies disappear. We will see suspected cases refusing to come to the hospitals and health facilities,” Dr Ancia warned, underscoring health workers’ continuing engagement with schools, churches and community leaders. 

    WHO is supporting the Government-led response with more than 40 health professionals on the ground and through the deployment of supplies and extra diagnostic capacity, in what remains a “highly complex epidemiological, operational and humanitarian context”, characterized by insecurity and displacement, the WHO representative said.


IDP vulnerability

    The UN Refugee Agency (UNHCR) said on Tuesday that the affected provinces of Ituri and North Kivu are home to more than two million internally displaced people and returnees, while healthcare capacity remains weakened by conflict. 

    There is also concern for refugees living in the affected areas. In Ituri some 11,000 South Sudanese refugees require preventive assistance while in North Kivu’s capital, the rebel-held city of Goma, more than 2,000 Rwandan and Burundian refugees need sanitary supplies.

    The most recent outbreak of the Ebola Zaire virus in DRC ended in December 2025, and the trauma of a major epidemic in North Kivu and Ituri in 2018-19 persists among the population.

    Dr Ancia stressed that while it may be two months until a vaccine is available, “it is not two months before the outbreak will be done”. 

    “Remember the previous one, it took two years,” she warned.


Link: https://news.un.org/en/story/2026/05/1167542

____

Sunday, May 17, 2026

#Ebola disease caused by #Bundibugyo virus, #DRC & #Uganda (WHO D.O.N., May 17 '26)

 


Situation at a glance

    -- On 5 May 2026, the World Health Organization (WHO) was alerted of a high-mortality outbreak of unknown illness in Mongbwalu Health Zone, Ituri Province, Democratic Republic of the Congo (DRC), including deaths among health workers

    -- On 14 May 2026, the Institut national de recherche biomédicale (INRB) Kinshasa analyzed 13 blood samples from Rwampara Health Zone, Ituri Province. 

    -- Laboratory analysis confirmed Bundibugyo virus disease (BVD) in eight of these samples on 15 May, a species of Ebola. 

    -- The case fatality rates in the past two BVD outbreaks have ranged from 30% to 50%. 

    -- Unlike Ebola virus disease, there is no licensed vaccine or specific therapeutics against Bundibugyo virus, though early supportive care is lifesaving. 

    -- On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare, DRC, officially declared the 17th Ebola Disease outbreak in DRC

    -- Concurrently, the Uganda Ministry of Health confirmed an outbreak of BVD following the identification of one imported case from DRC, a Congolese man who died in the capital city of Kampala

    -- On 16 May 2026, WHO Director-General, after having consulted the States Parties where the event is known to be currently occurring, determined that the Ebola disease caused by Bundibugyo virus in DRC and Uganda constitutes a public health emergency of international concern (PHEIC), as defined in the provisions of IHR. 

    -- Response measures include deployment of rapid response teams, delivery of medical supplies, strengthened surveillance, laboratory confirmation, infection prevention and control assessments, the set-up of safe treatment centers, and community engagement. 

    -- WHO is supporting the coordination of the response, case management, and cross-border preparedness. 

    -- WHO advice has been issued to countries.


Description of the situation

    -- On 5 May 2026, WHO received an alert regarding an unknown illness with high mortality reported in Mongbwalu Health Zone, Ituri Province, including four health workers who died within four days

    -- Following an in-depth investigation by the rapid response team in Mongbwalu and Rwampara health zones (HZ) on 13 May, the outbreak was subsequently confirmed as Bundibugyo virus disease (BVD) due to Bundibugyo virus (BDBV) (Orthoebolavirus bundibugyoense, species) on 15 May.

    -- On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare officially declared the 17th Ebola Disease outbreak in the DRC, occurring in Rwampara, Mongwalu and Bunia HZ.

    -- The first currently known suspected case, a health worker, reported onset of symptoms including fever, hemorrhaging, vomiting and intense malaise on 24 April 2026. The case died at a medical centre in Bunia.

    -- As of 15 May, a total of 246 suspected cases and 80 deaths (four deaths among confirmed cases) have been reported from three HZ: Rwampara (six health areas affected), Mongbwalu (three health areas affected), and Bunia .  

    -- Twenty four suspected cases are currently in isolation facilities across the three HZ.  

    -- In addition, unusual clusters of community deaths with symptoms compatible with Bundibugyo virus disease (BVD) are being investigated across other HZ in Ituri and North Kivu.

    -- A further case reported on 16 May, an individual returning from Ituri to Kinshasa, has tested NEGATIVE for Bundibugyo virus on confirmatory testing by the Institut National de la Recherche Biomédicale (INRB) of DRC, and is therefore not considered a confirmed case.

    -- Most of the suspected cases are between 20 and 39 years old, with females accounting for over 60%, suggesting significant risks associated with household and caregiver transmission.

    -- Initial testing of 20 samples collected in Rwampara HZ and analysed at the Provincial Public Health Laboratory in Bunia using standard Ebola Xpert were negative for Ebola virus. 

    -- Samples were sent to INRB for further analysis, of which eight samples analysed were confirmed as Orthoebolavirus by polymerase chain reaction (PCR) on 15 May. Genomic sequencing confirmed the virus species as Bundibugyo virus (BDBV).

    -- As of 15 May, 65 contacts have been listed, with 15 identified as high-risk. However, follow-up remains weak due to insecurity and movement restrictions. Several listed contacts became symptomatic and died before they could be isolated.

    -- On 15 May 2026, the Ministry of Health of Uganda confirmed an outbreak of BVD following the identification of an imported case from the DRC. 

    -- The case is an elderly man who was admitted to a private hospital on 11 May with severe symptoms and died on 14 May

    -- The post-mortem transfer of the body to DRC was completed the same day. 

    -- A clinical sample collected when the case was admitted on 11 May was tested at the Central Emergency Surveillance and Response Support Laboratory, Wandegeya, and was confirmed as Bundibugyo virus on 15 May 2026. 

    -- A second imported case was confirmed on 16 May in Kampala, in an individual returning from DRC with no apparent links to the first case. 

    -- At the time of reporting, no local transmission has been identified in Uganda.

    -- On 16 May 2026, the Director-General of WHO, after having consulted the States Parties where the event is known to be currently occurring as defined in the provisions of the International Health Regulations (2005) (IHR), determined that the Ebola disease caused by Bundibugyo virus in DRC and Uganda constitutes a PHEIC.

    -- It is currently thought that the event originated in the Mongbwalu HZ, DRC, a high-traffic mining area, with cases subsequently migrating to Rwampara and Bunia to seek medical care. 

    -- Ituri province borders South Sudan and Uganda (and Bunia HZ is less than 500km from Uganda). 

    -- A full epidemiological investigation and trace back exercise is ongoing.

    -- Ituri’s role as a commercial and migratory hub and proximity to Uganda and South Sudan increases the risk of regional exportation and cross-border transmission.


Epidemiology

    -- Bundibugyo virus disease (BVD) is a severe and often fatal form of Ebola disease caused by the Bundibugyo virus, one of the Orthoebolavirus species. 

    -- It is a zoonotic disease, with fruit bats suspected to be the natural reservoir. 

    -- Human infection occurs through close contact with the blood or secretions of infected wildlife, such as bats or non-human primates, and subsequently spreads from person to person through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals or contaminated surfaces. 

    -- Transmission is particularly amplified in health-care settings when infection prevention and control (IPC) measures are inadequate, and during unsafe burial practices involving direct contact with the deceased.

    -- The incubation period for BVD ranges from 2 to 21 days, and individuals are usually not infectious until symptom onset

    -- Early symptoms are non-specific, including fever, fatigue, muscle pain, headache, and sore throat, which complicates clinical diagnosis and can delay detection. 

    -- These progress to gastrointestinal symptoms, organ dysfunction, and in some cases haemorrhagic manifestations. 

    -- Case fatality rates in the past two BVD outbreaks, reported in Uganda and in DRC in 2007 and 2012, have ranged from approximately 30% to 50%.

    -- Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. 

    -- Control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.


Public health response

    -- Health authorities in DRC are implementing public health measures, including but not limited to the following:


Coordination

    ° Rapid response teams have been deployed to Rwampara and Mongbwalu HZ.

    ° Provincial coordination and emergency meetings by le centre d’operation des urgences en sante publique (COUSP) have been held.


Surveillance and Laboratory

    ° Surveillance for suspected and probable cases is ongoing (including at relevant Points of Entry and borders).

    ° Operational case definitions have been elaborated in Ituri.

    ° Sequencing confirmed Bundibugyo virus in positive RT-PCR samples.


Risk Communication and Community Engagement (RCCE)

    ° Social mobilization meeting was held with community leaders in the Rural commune of Mongbwalu under the leadership of the Mayor.


Infection Prevention and Control (IPC)

    ° IPC assessment in key health facilities is ongoing: Bunia Hospital Centre of the Evangelical Medical Centre (CME), Mongbwalu General Referral Hospital and Abelkozo Health Centre.

    ° CME Bunia is maintaining isolation protocols. Healthcare workers have been briefed on the specific diagnostic profile of this strain.


Logistics

    ° Logistical support has been provided for investigations in Mongbwalu and Rwampara Health Zones.

    ° Support has been provided for the transportation of samples to INRB Kinshasa.

    ° Health authorities in Uganda are implementing public health measures, including but not limited to the following:

    -- Activating national and district-level emergency measures, including enhanced surveillance, screening at borders, deployment of rapid response teams, isolation of a high-risk contact, and quarantine of all identified contacts.

    -- Strengthening of preparedness activities such as mobile laboratory deployment, infection prevention, and risk communication.

    -- Rapid response readiness teams have been deployed at all official and informal points of entry along the western border, major transit routes, and pilgrimage corridors.

    -- Advising health workers to remain vigilant and adhere strictly to infection prevention measures.

    -- WHO is supporting the national authorities, including through:

        - Deployment of technical expertise and rapid response teams to support response efforts.

        - Deployment of IPC, clinical management and sample collection kits.

        - Identification of isolation facilities for case management in Bunia, Rwampara, and Mongbwalu HZ .

        - Dissemination of WHO case management protocol.

        - In-depth investigations and listing of contacts of suspected/probable cases.

        - Strengthening epidemiological surveillance, IPC and RCCE at all points of entry.

        - Strengthening Point of Entry (PoE) screening and cross border coordination, including mass gatherings.

        - Supporting the Ministry of Health in implementation of the Response Plan and WHO internal Response Plan.

        - Following up with the IHR National Focal Points (IHR NFP) in DRC and Uganda on the official IHR notification while concurrently managing communication across the IHR NFP network to ensure timely coordination.

        - Coordinating the delivery of key supplies.

        - Engaging experts on research and development priorities. 


WHO risk assessment

    -- On 16 May 2026, WHO Director-General, after having consulted the States Parties where the event is known to be currently occurring, determined that the Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern (PHEIC), as per the provisions of the IHR. Temporary recommendations for State Parties will be issued.  In the meantime, WHO issued advice to countries, as stated below.

    -- This is the 17th Ebola disease outbreak in the DRC since 1976. The last Ebola disease outbreak in the country was declared on 4 September 2025 with total of 64 cases (53 confirmed, 11 probable), including 45 deaths (CFR 70.3%), reported from six health areas in Bulape Health Zone, Kasai Province. 

    -- The end of outbreak was declared on 1 December 2025. 

    -- The last BVD outbreak was reported on 17 August 2012 by the DRC Ministry of Health in Province Orientale.  A total of 59 cases, 38 confirmed and 21 probable cases, including 34 deaths were reported. The outbreak was declared over on 26 November 2012 by the MOH.

    -- This outbreak is occurring in a complex epidemiological and humanitarian context

    -- A critical four-week detection gap between the onset of symptoms of the presumed index case (25 April 2026) and the laboratory confirmation of the outbreak (14 May 2025) suggests a low clinical index of suspicion among healthcare providers. This is compounded by the presence of co-circulating arboviruses and influenza-like illnesses, masking the initial index of suspicion for Ebola disease and exacerbating community transmission. 

    -- Furthermore, the infection and death of four healthcare workers within a four-day span at Mongbwalu General Referral Hospital underscores critical breaches in IPC protocols. A large number of community deaths has been reported potentially associated with unsafe burial practices.

    -- Ongoing conflict in Ituri province restricts the movement of surveillance teams, limits the deployment of Rapid Response Teams, and hinders the secure transport of laboratory samples. Contact tracing is challenging due to difficult access and highly mobile populations, increasing the risk of high-risk contacts being lost to follow up or never identified.

    -- Ituri’s role as a commercial and migratory hub increases the risk of regional exportation. The proximity to Uganda and South Sudan increases the risk of cross-border transmission if PoE screening and cross border coordination and information sharing are not immediately reinforced. On 15 May 2026, the Ministry of Health of Uganda reported an imported case of BVD.

    -- Humanitarian needs in the area are dire. Ituri has 273 403 displaced people, with a total of 1.9 million people in need according to the Humanitarian Response Plan 2026 for DRC. From January to March 2026, 32 600 newly displaced and 30 200 returnees were recorded. The province recorded 5800 protection incidents and 11 incidents against humanitarian actors.

    -- Unlike Ebola virus disease, there is no licensed vaccine or specific therapeutics against BDBV. Research and development activities are activated to coordinate efforts to advance potential candidate medical countermeasures. Response and outbreak control relies entirely on a range of interventions and public health measures that will need to be thoroughly implemented, including supportive care, early detection, adequate IPC, rigorous contact tracing, safe burials, and community engagement.


WHO advice

    -- For countries where the event is occurring (the Democratic Republic of the Congo and Uganda)


Coordination and high-level engagement

    ° Activate their national disaster/emergency management mechanisms and establish an emergency operation centre, under the authority of the Head of State and relevant government authority, to coordinate response activities across partners and sectors to ensure efficient and effective implementation and monitoring of comprehensive Bundibugyo virus disease control measures. These measures must include enhanced surveillance including contact tracing, infection prevention and control (IPC), risk communication and community engagement, laboratory diagnostic testing, and case management. Coordination and response mechanisms should be established at national level, as well as at subnational level in affected areas and at-risk areas.

    ° Should national capacities be overwhelmed, collaboration with partners should be enhanced to strengthen operations and ensure the ability to implement control measures in all affected and neighbouring areas. 


Risk communication and community engagement 

    ° Ensure that there is a large-scale and sustained effort to fully engage the community – through local, religious and traditional leaders and healers – so communities play a central role in case identification, contact tracing and risk education; the population should be made fully aware of the benefits of early treatment.

    ° Strengthen community awareness, engagement, and participation in particular to identify and address cultural norms and beliefs that serve as barriers to their full participation in the response, and integrate the response within the wider response required to address the needs of the population, particularly in contexts of the protracted humanitarian crisis in Eastern DRC.


Surveillance and laboratory  

    ° Strengthening surveillance and laboratory capacity across affected provinces and neighbouring provinces, through the establishment of (1) dedicated surveillance and response cells within affected health zones and across key at-risk neighbouring health zones; (2) enhanced community surveillance, particularly focused on community deaths; and (3) decentralized laboratory capacity for testing of Bundibugyo virus. 


Infection prevention and control in health facilities and in the context of care

    ° Strengthen measures to prevent nosocomial infections, including systematic mapping of health facilities, triage, targeted IPC interventions and sustained monitoring and sustained supervision.

    ° Ensure healthcare workers receive adequate training on IPC, including the proper use of PPE, and that health facilities have appropriate equipment to ensure the safety and protection of their staff, their timely payment of salaries and, as appropriate, hazard pay.

    ° Patients’ referral pathway and access to safe and optimized intensive care

    ° Ensure that suspected cases can be safely transferred to specialized clinical units for their isolation and management in a human and patient-centred approach.

    ° Establish specialized treatment centers or units, located close to outbreak epicenter(s), with staff trained and equipped to implement optimized intensive supportive care. 


Research and development of medical countermeasures

    ° Implement clinical trials to advance the development and use of candidate therapeutics and vaccine, supported by partners. 


Border health, travels and mass-gathering events 

    ° Undertake cross-border screening and screening at main internal roads to ensure that no suspected case is missed and enhance the quality of screening through improved sharing of information with surveillance teams.

    ° There should be no international travel of Bundibugyo virus disease contacts or cases, unless the travel is part of an appropriate medical evacuation. To minimize the risk of international spread of Bundibugyo virus disease:

    ° Confirmed cases should immediately be isolated and treated in a Bundibugyo virus disease Treatment Centre with no national or international travel until two Bundibugyo virus-specific diagnostic tests conducted at least 48 hours apart are negative;

    ° Contacts (which do not include properly protected health workers and laboratory staff who have had no unprotected exposure) should be monitored daily, with restricted national travel and no international travel until 21 days after exposure;

    ° Probable and suspect cases should immediately be isolated and their travel should be restricted in accordance with their classification as either a confirmed case or contact.

    ° Implement exit screening of all persons at international airports, seaports and major land crossings, for unexplained febrile illness consistent with potential Bundibugyo virus disease. The exit screening should consist of, at a minimum, a questionnaire, a temperature measurement and, if there is a fever, an assessment of the risk that the fever is caused by Bundibugyo virus disease. Any person with an illness consistent with Bundibugyo virus disease should not be allowed to travel unless the travel is part of an appropriate medical evacuation.

    ° Consider postponing mass gatherings until BVD transmission is interrupted.


Safe and dignified burials 

    ° Ensure funerals and burials are conducted by well-trained personnel, with provision made for the presence of the family and cultural practices, and in accordance with national health regulations, to reduce the risk of Bundibugyo virus infection. The cross-border movement of the human remains of deceased suspect, probable or confirmed Bundibugyo virus disease cases should be prohibited unless authorized in accordance with recognized international biosafety provisions.


Operations, supplies and logistics

    ° Strong supply pipeline needs to be established to ensure that sufficient medical and laboratory commodities and other critical items, especially personal protective equipment (PPE), are available to those who appropriately need them. WHO advises against any restrictions on travel and/or trade to DRC or Uganda based on available information for the current outbreak.


For countries with land borders adjoining countries with documented Bundibugyo virus disease 

    ° Unaffected States Parties with land borders adjoining States Parties with documented Bundibugyo virus disease  transmission should urgently enhance their preparedness and readiness capacity, including active surveillance across health facilities with active zero reporting, enhancement of community surveillance for clusters of unexplained deaths; establish access to a qualified diagnostic laboratory; ensure that health workers are aware of and trained in appropriate IPC procedures; and establish rapid response teams with the capacity to investigate and manage BVD cases and their contacts.

    ° Dedicated coordination mechanisms should be in place at national and subnational level in all Unaffected States Parties with land borders adjoining States Parties with documented cases of Bundibugyo virus disease. States should be prepared to detect, investigate, and manage Bundibugyo virus disease cases; this should include assured access to a qualified diagnostic laboratory for Bundibugyo virus disease, isolation and case management capacity and activation of rapid response teams. 

    ° Any State Parties newly detecting a suspected or confirmed Bundibugyo virus disease case or contact, or clusters of unexplained deaths should treat this as a health emergency, take immediate steps in the first 24 hours to investigate and stop a potential outbreak by instituting case isolation, case management, establishing a definitive diagnosis, and undertaking contact tracing and monitoring as required.

    ° If Bundibugyo virus disease is confirmed to be occurring in the State Party, the full recommendations for State Parties with Bundibugyo virus disease transmission should be implemented, on either a national or subnational level, depending on the epidemiologic and risk context. State Parties should immediately report the confirmation of Bundibugyo virus disease to WHO.

    ° Risk communications and community engagement, especially at points of entry, should be increased.

    ° At-risk countries should put in place approvals for investigational therapeutics as an immediate priority for preparedness.


For all other countries

    ° No country should close its borders or place any restrictions on travel and trade. Such measures are usually implemented out of fear and have no basis in science. They push the movement of people and goods to informal border crossings that are not monitored, thus increasing the chances of the spread of disease. Most critically, these restrictions can also compromise local economies and negatively affect response operations from a security and logistics perspective.

    ° National authorities should work with airlines and other transport and tourism industries to ensure that they do not exceed WHO’s advice on international traffic.

    ° States Parties should provide travelers to Bundibugyo virus disease affected and at-risk areas with relevant information on risks, measures to minimize those risks, and advice for managing a potential exposure.

    ° The general public should be provided with accurate and relevant information on the Bundibugyo virus disease outbreak and measures to reduce the risk of exposure.

    ° State Parties should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to Bundibugyo virus disease.

    ° Entry screening at airports or other ports of entry outside the affected region are not considered needed for passengers returning from areas at risk.


Further information

-- Epidemic of Ebola Disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda determined a public health emergency of international concern.  https://www.who.int/news/item/17-05-2026-epidemic-of-ebola-disease-in-the-democratic-republic-of-the-congo-and-uganda-determined-a-public-health-emergency-of-international-concern

-- The Ministry of Public Health, Hygiene and Social Welfare, DRC, officially declares the 17th Ebola Disease outbreak. https://administration.sante.gouv.cd/wp-content/uploads/2026/05/Declaration-de-la-17e-Epidemie-de-la-maladie-a-virus-Ebola-dans-les-zones-de-sante-de-Rwampara-Mongwalu-et-Bunia-dans-la-province-dIturi.pdf

-- WHO Democratic Republic of Congo confirms new Ebola outbreak.  https://www.afro.who.int/countries/democratic-republic-of-congo/news/democratic-republic-congo-confirms-new-ebola-outbreak-who-scales-upsupport

-- Ebola  disease fact sheet: http://www.who.int/en/news-room/fact-sheets/detail/ebola-virus-disease

-- Disease Outbreak News. Ebola outbreak in Democratic Republic of Congo – update. WHO. 14 September 2012: Ebola outbreak in Democratic Republic of Congo – update

-- Disease Outbreak News. Ebola outbreak in Democratic Republic of Congo – update. WHO. 26 October 2012: Ebola outbreak in Democratic Republic of Congo – update

-- WHO Launches Online Training to Strengthen Filovirus Outbreak Response. https://www.who.int/news/item/26-03-2025-who-launches-online-training-to-strengthen-filovirus-outbreak-response#

-- Infection prevention and control guideline for Ebola and Marburg disease. WHO. August 2023: https://www.who.int/publications/i/item/WHO-WPE-CRS-HCR-2023.1

-- Infection prevention and control and water, sanitation and hygiene in health facilities during Ebola or Marburg disease outbreaks: rapid assessment tool, user guide https://www.who.int/publications/i/item/9789240107205

-- Assessment and management of health and care workers with possible occupational exposures to Orthoebolavirus or Orthomarburgvirus: implementation guidance https://www.who.int/publications/i/item/9789240107328

-- Optimized Supportive Care for Ebola Virus Disease. Clinical management standard operating procedures. WHO. 2019. https://www.who.int/publications/i/item/9789241515894 

-- Ebola clinical management. https://www.who.int/teams/health-care-readiness/ebola-clinical-management 

-- Framework and toolkit for infection prevention and control in outbreak preparedness, readiness and response at the national level. https://www.who.int/publications/i/item/framework-and-toolkit-for-infection-prevention-and-control-in-outbreak-preparedness--readiness-and-response-at-the-health-care-facility-level

-- Considerations for border health and points of entry for filovirus disease outbreaks: https://www.who.int/publications/m/item/considerations-for-border-health-and-points-of-entry-for-filovirus-disease-outbreaks

-- Diagnostic testing for Ebola and Marburg virus diseases: interim guidance, 20 December 2024: https://www.who.int/publications/i/item/B09221 

Citable reference: World Health Organization (17 May 2026). Disease Outbreak News; Bundibugyo Virus Disease, Democratic Republic of the Congo (The) and Uganda. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON602 

Source: 


Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON602

____

Saturday, May 16, 2026

#Africa #CDC Calls for Urgent Regional Coordination Following #Ebola Virus Disease #Outbreak in #Ituri Province, #DRC, and Imported Ebola #Bundibugyo Case Reported by #Uganda (May 16 '26)

 


    Addis Ababa, Ethiopia / Kinshasa, Democratic Republic of the Congo / Kampala, Uganda, 15 May 2026 — The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring the confirmed Ebola Virus Disease outbreak in Ituri Province, Democratic Republic of the Congo (DRC), and the imported Ebola Bundibugyo case reported by the Uganda Ministry of Health. 

    Africa CDC is working with national authorities and partners to support a rapid, coordinated regional response aimed at interrupting transmission, protecting communities and reducing the risk of cross-border spread.

    Following consultations with the DRC Ministry of Health and national public health institutions, preliminary laboratory results from the Institut National de Recherche Biomedicale (INRB) detected Ebola virus in 13 of 20 samples tested with the Bundibugyo Virus.

    As of the latest update from DRC, approximately 246 suspected cases and 65 deaths have been reported, mainly in Mongwalu and Rwampara health zones

    Four deaths have been reported among laboratory-confirmed cases

    Suspected cases have also been reported in Bunia and are pending confirmation. 

    These figures remain provisional and are being validated through laboratory confirmation, line-list harmonization, contact identification and epidemiological investigation.

    In a statement issued on 15 May 2026, Uganda’s Ministry of Health reported a confirmed Ebola Bundibugyo Virus Disease case in a 59-year-old Congolese male who was admitted to Kibuli Muslim Hospital on 11 May 2026 and died on 14 May 2026

    Uganda has reported the case as imported from DRC and has indicated that no local case has yet been confirmed

    Africa CDC is supporting coordination to align laboratory information, contact management and cross-border risk assessment across affected and at-risk settings.

    The confirmation of an imported case reported by Uganda underscores the importance of rapid regional coordination

    Africa CDC remains concerned by the urban context of Bunia and Rwampara, with insecurity intense population movement, mining-related mobility in Mongwalu, gaps in contact listing, infection prevention and control challenges, and the proximity of affected areas to Uganda and South Sudan.

    Due to the cabinet meeting in DRC to discuss this outbreak, Africa CDC agreed to postpone the meeting that was planned and convene this urgent high-level regional coordination meeting today 16 May 2026 with health authorities from DRC, Uganda and South Sudan, together with the WHO, UNICEF, the Pandemic Fund, African Medicines Agency (AMA), U.S. CDC and other response partners. 

    The meeting will focus on immediate response priorities, cross-border surveillance and alert management, laboratory support and sequencing, infection prevention and control, case management, risk communication and community engagement, safe and dignified burials, contact management, logistics and resource mobilization.

    “Africa CDC stands in solidarity with the Governments and people of the Democratic Republic of the Congo and Uganda as they respond to this outbreak,” said H.E. Dr Jean Kaseya, Director General of Africa CDC. 

    “The situation requires speed, scientific rigour and regional solidarity. We are working with DRC, Uganda, South Sudan and partners to strengthen surveillance, preparedness and response, and to help contain transmission as quickly as possible.”

    To respond in a more coherent and holistic way to this regional outbreak, Africa CDC took the following immediate actions:

        ° Activate the Incident management Support Team (IMST) including all partners as the regional coordinating mechanism for the 3 countries and approve a 72-hour Incident Action Plan covering DRC and Uganda responses and South Sudan preparedness.

        ° Deploy multidisciplinary surge teams to support DRC and Uganda where the disease is cleared, with parallel readiness support for neighboring countries.

        ° Establish a medical countermeasures workstream to assess diagnostics, PPE, therapeutics, vaccines and cold chain needs, pending final sequencing.

        ° Mandate the Science, Innovation and R&D team, to coordinate sequencing follow-up, evidence review, product options, research protocols and partner engagement.

        ° Convene the regional partner coordination meeting on 16 May at 3pm Geneva time with DRC, Uganda, South Sudan, WHO, AMA and key technical and financing partners,

        ° Hold an evening press briefing on 16 May at 6pm Geneva time to brief the media on this outbreak

        ° Escalate political engagement through President Ramaphosa as the AU PPPR Champion, the AU Commission Chairperson and AU Bureau to secure high-level support for access and coordination.

    Africa CDC urges communities in affected and at-risk areas to follow guidance from national health authorities, report symptoms promptly, avoid direct physical contact with suspected cases, avoid contact with body fluids or contaminated materials, maintain hand hygiene, and support response teams working to protect communities. 

    Health facilities and health workers should maintain a high index of suspicion, apply infection prevention and control measures, and immediately report suspected cases through national reporting channels.

    Ebola Virus Disease is a severe and often fatal illness. It spreads through direct contact with the bodily fluids of infected persons, contaminated materials, or the bodies of persons who have died from the disease. Early detection, prompt isolation and care, contact tracing, infection prevention and control, community engagement, and safe and dignified burials are critical to stopping transmission.

    Africa CDC will continue to provide updates as additional information becomes available, including sequencing results, updates from national health authorities and outcomes of the regional coordination meeting.

###


About Africa CDC

    The Africa Centres for Disease Control and Prevention (Africa CDC) is the public health agency of the African Union. As an autonomous institution, Africa CDC supports AU Member States to strengthen health systems, improve disease surveillance, and enhance emergency preparedness and response. For more information, visit: http://www.africacdc.org and follow Africa CDC on LinkedIn, X, Facebook, and YouTube.

Media ContactWilson Johwa, Senior Communications Officer, Directorate of Communication & Public Information | JohwaW@africacdc.org

Source: 


Link: https://africacdc.org/news-item/africa-cdc-calls-for-urgent-regional-coordination-following-ebola-virus-disease-outbreak-in-ituri-province-drc-and-imported-ebola-bundibugyo-case-reported-by-uganda/

____

Friday, May 15, 2026

#DRC confirms new #Ebola #outbreak, #WHO scales up support (#WHO Regional Office for Africa, May 15 '26)

 


    Kinshasa/Brazzaville — The World Health Organization (WHO) is rapidly scaling up support to the Government of the Democratic Republic of the Congo following confirmation of an outbreak of Ebola Bundibugyo in the country’s north-eastern Ituri Province.  

    Laboratory analysis conducted by the National Institute of Biomedical Research (INRB), the country’s reference laboratory in the capital Kinshasa, confirmed the Ebola outbreak caused by the Bundibugyo species in 13 of 20 samples collected from suspected cases linked to a cluster of severe illness and deaths reported in  Mongbwalu  and  Rwampara health zones in Ituri  Province.

     The Bundibugyo species was first identified in 2007 in Bundibugyo district in western Uganda, during which 131 cases were reported with 42 deaths (case fatality rate of 32%).  

    In the current outbreak in the Democratic Republic of the Congo, a total of 67 community deaths suspected to be due to Ebola Bundibugyo have been reported so far. 

    Patients presented with symptoms including fever, generalized body pain, weakness, vomiting and, in some cases, bleeding

    Several cases deteriorated rapidly and died

    Given the uncertainties and severity of the illness, there is  concern about the scale of transmission in affected communities.  

    A WHO mission including the WHO representative, the emergency preparedness and response team had already been deployed in Ituri  to support the provincial authorities with investigations that led to the confirmation of the outbreak in the two health zones.

     The team is also working with the national and provincial health authorities to strengthen outbreak control measures and prevent further spread of the virus.

     National authorities have activated emergency coordination mechanisms and deployed additional multidisciplinary rapid response teams to affected areas.  

    Additional WHO experts in epidemiology, infection prevention and control, laboratory diagnostics, clinical care, logistics, risk communication and community engagement are being mobilized to reinforce the frontline response. 

    Priority actions include strengthening disease surveillance, active case finding, contact tracing, infection prevention and control in health facilities, expanding access to safe care, laboratory testing capacity, ensuring safe burials and community sensitization to prevent further spread of the disease.    

    “The Democratic Republic of the Congo has extensive experience responding to Ebola outbreaks, and WHO is rapidly scaling up support to the ongoing response,” said Dr Mohamed Janabi, WHO Regional Director for Africa. 

    "Working closely with national authorities and partners, we are mobilizing swiftly, deploying additional expertise and resources to halt the spread of the virus, protect and save lives.”  

    WHO is airlifting 5 metric tonnes of supplies, including infection prevention and control, materials, laboratory sample transportation equipment, case management, tents and other supplies currently available in Kinshasa to Bunia to support frontline health workers and treatment facilities.    

    The outbreak is affecting areas that present significant operational challenges, including urban areas with intense population movements associated with mining activities, insecurity, and frequent cross- border movement—all of which increase the risk of further transmission.  

    In neighbouring Uganda, the Ministry of Health confirmed Ebola Bundibugyo in a patient from the Democratic Republic of the Congo who was being treated at a health facility but later died

    Ugandan health authorities have activated outbreak control measures, including disease surveillance, screening and response readiness.  

    This marks the 17th recorded outbreak of Ebola disease in the Democratic Republic of the Congo since the virus was first identified in 1976 in Yambuku, in Equateur Province.

    The last one was an outbreak of Ebola virus disease that ended in December 2025.  

    Ebola disease is a severe and often fatal illness transmitted through direct contact with the blood, secretions, organs or other bodily fluids of infected people, as well as contaminated surfaces and materials. 

    Early detection, supportive treatment and rapid public health measures significantly improve survival and are critical to stopping transmission.

Source: 


Link: https://www.afro.who.int/countries/democratic-republic-of-congo/news/democratic-republic-congo-confirms-new-ebola-outbreak-who-scales-upsupport

____

Monday, May 4, 2026

Characterization of atypical #Ebola virus disease in #ferrets

 


Abstract

Ebola virus (EBOV) infection typically results in severe—and often lethal—acute disease. However, increasing evidence suggests that EBOV can persist in certain immune-privileged tissues, which may then serve as reservoirs for the later reemergence of EBOV and disease recrudescence. Here, we report atypical EVD recrudescence in a ferret model inoculated with an otherwise lethal dose of EBOV and treated with low doses of a highly potent monoclonal antibody cocktail. Among 32 antibody-treated ferrets, 14 animals survived, while 8 succumbed to acute EVD within about 5–8 days. The remaining 10 animals succumbed to atypical EVD between 12 and 18 days post-infection (DPI) despite having shown no, or very minor, signs of illness during the acute phase of disease. While viremia disappeared by 14 DPI in most animals that succumbed to atypical EVD, it rebounded modestly just prior to death. Unlike animals that died of acute EVD, those that died of atypical EVD showed only a moderate systemic inflammatory response and few signs of organ dysfunction, in line with low levels of virus in the liver and spleen. Interestingly, however, ferrets that died of atypical EVD showed high levels of virus in the brain, consistent with increased markers of inflammation in the central nervous system and significant pathological changes, including a breakdown in the blood-brain barrier and severe meningoencephalitis. Not only does this study shed important light on the atypical and underappreciated manifestations of EVD, but it also establishes the ferret as a valuable model of EBOV recrudescence.

Source: 


Link: https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1013916

____

Thursday, April 23, 2026

#Nosocomial #outbreak of #Lassa fever in Conakry, #Guinea, 2022

 


Abstract

Background

Lassa fever (LF) is endemic in Guinea, with high seroprevalence in the forest region. However, clinical cases have been only anecdotally reported. In August 2022, a nosocomial outbreak occurred at a private clinic in the capital Conakry, an area previously considered low risk.

Methods

Suspected cases were confirmed by real-time RT-PCR within 24 hours. Viremia was monitored during hospitalization, and whole-genome sequencing was performed in-country within 13 days of outbreak detection. Outbreak investigation involved rodent testing in the home village of the suspected primary case.

Results

Six cases were laboratory-confirmed, five of which were healthcare workers of the clinic. The case fatality rate was 16.7%. Viral RNA remained detectable in blood of survivors for a median of 26 days (IQR 24-41) post disease onset. Epidemiological investigations identified a suspected primary case, who had died of a febrile disease compatible with Lassa fever, had contact with all secondary cases, and had a travel history from Kissidougou area. Three near-complete and one partial Lassa virus genomes were recovered from the secondary cases, which phylogenetically clustered with genomes from central Guinea. Consistent with a common transmission source, the four genomes were almost identical. Rodent testing revealed a new reservoir area in eastern-central Guinea.

Discussion

This outbreak highlights the vulnerability of healthcare settings in low-prevalence areas of West Africa to nosocomial Lassa virus transmission due to human mobility. Facilitated by capacity building programs for viral hemorrhagic fevers, rapid diagnosis, genomic analysis, and ecological assessment enabled an efficient outbreak response and control.

Source: 


Link: https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiag229/8661158

____

Monday, March 23, 2026

Mapping #global emergence of #pathogens with #epidemic and #pandemic #potential to inform and accelerate pandemic #prevention, #preparedness, readiness and response

 


Abstract

Introduction 

Increasing occurrence of epidemics and pandemics and concurrent emergence of different pathogens calls for multi-sectoral, multi-pathogen preparedness actions. Data on various factors that drive emergence of diverse pathogens can inform evidence-based preparedness by identifying geographies at-risk. When leveraging evidence within a One Health approach, multiple pathogens can be addressed simultaneously, thereby strengthening countries pandemic preparedness efforts. 

Methods 

For seventeen priority pathogens (avian influenza viruses, zoonotic coronaviruses including COVID-19, hemorrhagic fever viruses including Ebola, Henipaviruses, and arboviruses including yellow fever and Zika), we identified global evidence on animal reservoirs, vectors, environmental suitability, and reported human cases. We discriminated geospatially recorded pathogen detections from a background sample and constructed maps using these datasets to generate an evidence-based assessment of emergence risk globally. 

Results 

Seventeen pathogen-specific assessments were combined into a global composite map. Sub-Saharan Africa and South Asia have evidence supporting emergence risk for the greatest number of pathogens (included areas at-risk of all pathogens) and scored highest when strength-of-evidence weightings were factored. The Americas had the lowest tally of considered pathogens. Environmental suitability analyses received the highest weights, reservoir ranges the lowest. 

Discussion 

Preparedness and readiness must consider the range of global biological threats. Our methodology is capable of incorporating changing evidence on emergence potential for multiple pathogens to identify geographies at higher risk with different pathogen combinations. Our maps can contribute to existing decision-support structures, guiding shared interventions and strategic allocation of resources for spillover prevention and pandemic preparedness, thereby enhancing local response capacities applying a multidisciplinary approach.


Competing Interest Statement

The authors have declared no competing interest.


Funding Statement

This work was concluded in 2024 and supported by the United States Agency for International Development (USAID) before January 22, 2025, the Germany Agency for International Cooperation (GIZ) and the Government of France.

Source: 


Link: https://www.medrxiv.org/content/10.64898/2026.03.20.26347940v1

____

Wednesday, March 11, 2026

Post-discharge #sequelae of #Lassa fever #survivors in #Nigeria: an analysis of the LASCOPE prospective cohort

 


Summary

Background

Lassa fever is one of the most important viral haemorrhagic fevers, yet post-discharge sequelae remain inadequately characterised. Previous studies have been limited by small sample sizes and unsystematic assessments. We aimed to describe post-discharge sequelae in Lassa fever survivors and explore the effect of disease severity on sequelae patterns.

Methods

LASCOPE was a prospective study of patients with PCR-confirmed Lassa fever hospitalised at Federal Medical Centre Owo, Owo, Nigeria, between April 23, 2018, and Feb 17, 2023. All patients who provided informed consent were included, with no age restriction. Severe disease was defined as the presence of at least one of the following during the acute phase: National Early Warning Score version 2 score of 7 or higher, Kidney Disease Improving Global Outcomes stage 2 or higher, or Lassa virus PCR Ct value of less than 25. At hospital discharge, follow-up of survivors was planned for day 60 after admission, or before that, based on medical need. A systematic symptom assessment was done at each visit. The main outcome was clinical remission, defined as complete absence of symptoms. Other outcomes were post-discharge death, symptom incidence, and prevalence of symptoms over time. Subgroup analyses were performed by age group (children aged <18 years or adults aged ≥18 years) and disease severity (severe or not severe).

Findings

Of 882 survivors (median age 32 years [IQR 22–46], 459 [52%] female and 423 [48%] male), post-discharge data were available for 807 (91%), with a total of 2603 person-months of follow-up. For three of 807 survivors with post-discharge information, only the vital status was collected. 736 (91%) of 807 reached clinical remission, with a median time to clinical remission of 19 days (95% CI 16–23) post discharge. The most frequently reported symptoms were asthenia (158 [20%] of 804), headache (148 [18%]), and post-exertional malaise (123 [15%]). Hearing symptoms were reported by only 17 (2%) of 804 survivors, which was substantially lower than previous studies. Disease severity did not affect time to remission. Six (1%) survivors died after hospital discharge.

Interpretation

Patient-reported symptoms suggest good recovery with few hearing or neurosensory disorders in most survivors of Lassa fever. Future research would benefit from extended follow-up periods and standardised diagnostic assessments, including objective audiometry, to further characterise the full spectrum of post-Lassa fever complications.

Funding

Institut National de la Santé et de la Recherche Médicale, University of Oxford, EU, UK Department for International Development, Wellcome Trust, French Ministry of Foreign Affairs, Agence Nationale de Recherches sur le SIDA et les Hépatites Virales, and French National Research Institute for Sustainable Development.

Source: 


Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00057-5/abstract?rss=yes

____

Monday, January 26, 2026

#Marburg virus disease - #Ethiopia [End of the Outbreak] (#WHO, Jan. 26 '26)

 


{Excerpt}

26 January 2026


Situation at a glance

On 26 January 2026, the Ministry of Health of Ethiopia declared the end of the Marburg virus disease (MVD) outbreak

This declaration came after two consecutive incubation periods (a total of 42 days) since the last person confirmed with MVD died and was given a safe and dignified burial, in accordance with WHO recommendations on 14 December 2025. 

As of 25 January 2026, a cumulative total of 19 cases, including 14 confirmed (including nine deaths) and five probable cases (all deaths), were reported. 

A total of 857 contacts listed for monitoring all had completed their 21-day follow-up as of 25 January 2026. 

WHO, through its country office and partners, provided technical, operational and financial support to the government to contain this outbreak.


Description of the situation

On 14 November 2025, after the laboratory confirmation of suspected viral hemorrhagic fever (VHF) cases in Jinka town, South Ethiopia Regional State, Ethiopia, the Ministry of Health of Ethiopia declared an outbreak of Marburg Virus Disease (MVD). 

Molecular testing conducted by the National Reference Laboratory at the Ethiopian Public Health Institute (EPHI) identified Marburg virus (MARV) in patient samples. 

This was the first time Ethiopia was reporting a MVD outbreak.

The first known case was an adult from Jinka town who developed symptoms on 23 October. 

The patient presented to the General Hospital the following day with vomiting, loss of appetite, and abdominal cramps. 

As of 25 January 2026, a cumulative total of 14 confirmed cases, including nine deaths (Case Fatality Rate (CFR) 64.3%) and five probable cases, all of whom had died, were reported by the Ministry of Health from Jinka, Malle and Dasench woredas in South Ethiopia Region and Hawassa in Sidama Region.

As of 25 January 2026, a total of 857 contacts were listed who completed 21 days of follow-up, 760 from the South Ethiopia Region and 97 from the Sidama Region. 

As of 5 January 2026, 3800 samples were tested for the virus.

On 26 January 2026, after two consecutive incubation periods (a total of 42 days), without a new confirmed case reported, after the last confirmed case died and was given a safe and dignified burial, on 14 December 2025, the Ministry of Health of Ethiopia declared the end of the MVD outbreak, as per WHO recommendations.

(...)

Source: 


Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON592

____

My New Space

Most Popular Posts