#Ebola disease caused by #Bundibugyo virus, #DRC & #Uganda (WHO D.O.N., July 17 '26): 2124 cases & 828 deaths in DRC

 

Situation at a glance

    ° The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo remains active, with sustained transmission driving increases in reported cases and deaths. 

    ° As of 15 July 2026, a cumulative total of 2124 confirmed cases, including 828 deaths, have been reported from the Democratic Republic of the Congo. 

    ° On 13 July 2026, German authorities informed WHO of a laboratory-confirmed case of Ebola disease caused by Bundibugyo virus in a humanitarian worker from the United States of America who was medically evacuated from the Democratic Republic of the Congo. 

    ° This is the second United States citizen to be treated in Germany, reflecting the ongoing international response efforts. 

    ° In Uganda no new cases have been reported since 21 June 2026. The most recent case was discharged from the treatment centre on 16 July after two negative tests results. 

    ° The country has therefore begun the 42-day period of enhanced surveillance required before the end of the outbreak can be declared. 

    ° National authorities in Uganda and the Democratic Republic of the Congo, in collaboration with WHO and partners, continue to implement extensive response measures. 

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

Description of the situation

    ° Since the previous  Disease Outbreak News was published on 3 July 2026, the number of confirmed cases and deaths has increased substantially in the Democratic Republic of the Congo. 

    ° In total, 2145 confirmed cases have been reported:  2124 in the Democratic Republic of the Congo (including two cases with diagnosis in the Democratic Republic of the Congo and subsequent treatment in Germany), 20 in Uganda and one in France. 

    ° A total of 830 deaths has been reported, including two in Uganda.  

    ° To date, at least 410 patients have recovered, including 390 in the Democratic Republic of the Congo, 18 in Uganda, one in France, and one in Germany.  

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Democratic Republic of the Congo

    ° Since 3 July 2026, an additional 664 confirmed cases, including 376 confirmed deaths, have been reported in the Democratic Republic of the Congo. 

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

    ° As of 15 July 2026, a total of 2124 confirmed cases, including 828 deaths (crude case fatality ratio [CFR] 39%) have been reported in the Democratic Republic of Congo. 

    ° So far, 390 patients have recovered. 

    ° Cases have been reported from 46 health zones (HZ) across five provinces:  Ituri (27/36 HZ), North Kivu (11/34 HZ), South Kivu (1/34 HZ), Haut-Uele (4/13 HZ) and Tshopo (3/23 HZ).

    ° Of the 46 affected health zones, the outbreak remains active in 38 health zones, which have reported cases within the past 21 days. The remaining health zones have not reported any new cases during this period. In the past 21 days, 969 confirmed cases, including 524 confirmed deaths, have been reported.  

    ° Ituri  remains the most affected province, accounting for 89.6% (1904/2124) of all confirmed cases and 83.6% (692/828) of all reported deaths nationwide. Within the province, the highest number of confirmed cases have been reported from Bunia (570 cases), Rwampara (418 cases), Mongbwalu (347 cases), Nizi (148 cases), and Nyankunde (99 cases) health zones.  

    ° As of 15 July, 12 693 contacts have been identified and are under follow-up across Ituri (10 183), North Kivu (2360) and Tshopo (150). Of these, 10 195 contacts have been followed up, corresponding to follow-up rates of 78.1% in Ituri, 50.0% in Tshopo and 91.7% in North Kivu. Previously listed contacts in South Kivu have completed their 21-day followup. In addition, 107 contacts of the case reported in France have been listed and are under follow-up in Kinshasa.  

    ° Infections among health workers continued to increase, with 119 confirmed cases, 61 recoveries and 36 deaths reported among health workers, corresponding to a CFR of 30.3%. This highlights persistent occupational exposure risks, inadequate infection prevention and control (IPC) implementation in health facilities, and exposure risk in the community. 

    ° The outbreak continues in a complex humanitarian and conflict-affected environment, characterized by highly mobile and often displaced populations, many of whom have limited access to basic services, including food, clean water, shelter, health care and protection.  These conditions increase the risk of transmission, particularly in overcrowded sites for internally displaced people. 

    ° Security incidents affecting health facilities, have created additional operational challenges in affected provinces, including restricted access for response teams, disruption of surveillance and response activities and an increased risk of undetected transmission. These conditions underscore the need for response efforts to be led by local leaders and anchored in communities.  

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Figure 2: Number of confirmed cases (n = 2124), in the Democratic Republic of the Congo, by date of reporting and as of 15 July 2026 

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Figure 3: Number of deaths among confirmed cases (n = 828), in the Democratic Republic of the Congo, by date of reporting and as of 15 July 2026.  

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

Uganda

    ° The last confirmed case was reported to be identified on 21 June 2026.  As of 14 July 2026, a cumulative total of 20 confirmed cases have been reported, including two deaths in imported cases (reported on 15 May and 5 June) and one probable case resulting in death. 

    ° Of the confirmed cases, 15 were imported cases and five were secondary cases among contacts and health workers linked to imported cases from the Democratic Republic of the Congo.  All cases were reported in Kampala District. To date, no community transmission has been in Uganda. Exposure risks have been associated with health-care settings and cross-border movements.  

    ° Following case reclassification, the number of affected healthcare workers was revised from five to four. In total, 18 recoveries have been reported. 

    ° Of the 831 contacts listed as of 28 June, 821 contacts have completed their 21-day follow-up period as of 14 July.  

    ° The most recent case was discharged from the treatment centre on 16 July after two negative tests results. This marks the start of the 42-day countdown period (twice the maximum incubation period) to ensure surveillance activities continue to be implemented and detect any cases that were missed before the declaration of the end of the outbreak. Given the ongoing outbreak in the Democratic Republic of the Congo, the risk of importation still exists.   

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Figure 4: Number of confirmed cases (n = 20), in Uganda by date of reporting and as of 17 July 2026 

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France

    ° No additional BVD cases have been reported in France since the previous update. 

    ° The imported confirmed BVD case reported on 24 June recovered and was discharged from the healthcare facility on 4 July after two negative PCR test results. No secondary transmission has been identified among the five low-risk flight contacts  placed under precautionary quarantine. These contacts  completed their follow-up period on 14 July. 

    ° French authorities have been monitoring  these individuals in coordination with relevant regional public health authorities as well as with the National IHR Focal Points of Belgium and the Netherlands who conducted an individual risk assessment. None of the contacts developed symptoms, and no addtional  at-risk individuals have been identified. 

Germany

    ° A  physician from the United States  working in the Democratic Republic of the Congo, was medically evacuated and treated in Germany in May 2026. The patient recovered and was discharged. No secondary cases were reported. 

    ° A second United States citizen, a humanitarian worker, tested positive for Bundibugyo virus in the Democratic Republic of Congo in July 2026 and was medically evacuated to a university hospital in Frankfurt/Main, Germany. The patient  is reported to be in stable condition.

Epidemiology

    ° Bundibugyo virus disease (BVD) is a severe Ebola disease caused by the Bundibugyo virus, one of the Orthoebolavirus species. It is a zoonotic disease, with fruit bats suspected to be the natural reservoir. 

    ° Human infection is thought to occur through close contact with the blood or secretions of infected wildlife, such as bats or non-human primates, and it subsequently spreads from person-to-person through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals or contaminated surfaces and materials. Transmission is particularly amplified in health-care settings when IPC measures are inadequate and during unsafe burial practices involving direct contact with deceased persons. 

    ° The incubation period for BVD ranges from 2 to 21 days, and infected individuals are not infectious until symptom onset. Early symptoms such as fever, fatigue, muscle pain, headache, and sore throat, are non-specific, which complicates clinical diagnosis and can delay detection. These symptoms then progress to gastrointestinal symptoms, organ dysfunction, and, in some cases, haemorrhagic manifestations. 

    ° CFRs in the past two BVD outbreaks, reported in Uganda and in the Democratic Republic of the Congo in 2007 and 2012 were 30% and 50%, respectively. 

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

Public health response

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

    ° For further information about public health response actions by the respective Ministry of Health, WHO and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa: Ebola Bundibugyo Virus Disease Outbreak Democratic Republic of the Congo | Uganda Weekly External Situation Report | WHO | Regional Office for Africa  

WHO risk assessment

    ° On 6 June 2026, WHO reassessed the risk of the outbreak of BVD to incorporate newly available information and align with the WHO Temporary Recommendations. The risk for countries sharing land borders with countries with documented Bundibugyo virus detection, the Democratic Republic of the Congo and Uganda at the time of assessment, has been separated from the risk for other countries in the African Region. 

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

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

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

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

    ° For further information, please see the WHO Rapid Risk Assessment – Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo, Uganda and countries with land borders adjoining countries with documented BDBV detection v3. 

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Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON613

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#USA, #Wastewater Data for Avian #Influenza #H5 (US CDC, July 17 '26)

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A(H5) detections in the past week: Time Period: July 05, 2026 - July 11, 2026

    - A(H5) Detection: 4 site(s) (0.9%)

    - No Detection: 442 site(s) (99.1%)

    - No samples: 46 site(s)

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Source: 

Link: https://www.cdc.gov/wastewater/emerging-viruses/h5.html?

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#WNV in #humans, the European Region, Weekly #Report (ECDC, July 17 '26): #Italy (21), #Greece (7), North #Macedonia (2), #Romania (2) & #Spain (2) cases so far

 

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Week 29, 2026 | Produced on 17 July 2026 at 08:30, based on data submitted up until and including 15 July 2026.

Current situation

    ° Since the beginning of the 2026 transmission season, and as at 15 July, 28 areas affected by West Nile virus (WNV) have been identified in five countries across Europe {1}.

    ° These areas are located in: 

        § Italy (17), 

        § Greece (five), 

        § North Macedonia (two), 

       § Romania (two) and 

        § Spain (two).

    ° The five countries have reported 34 locally acquired {2} human cases of WNV infection: 

        § Italy has reported 21, 

        § Greece seven,     

        § North Macedonia two, 

        § Romania two and 

        § Spain two cases.

    ° This week, 17 areas are reported as affected for the first time this season. The affected areas identified as at 15 July 2026 are listed in Table 1 and shown in Map 1 below.

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Table 1. Areas affected by West Nile virus during the 2026 transmission season at 15 July, by country and NUTS3 or GAUL1 area

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* ‘First reported this week’ indicates that the affected area was not included in the previous weekly overview.

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Source: 

Link: https://wnv-weekly.ecdc.europa.eu/

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#Nirmatrelvir for acute #COVID19 to prevent #longCOVID (PANORAMIC Norway): a double-blind, randomised, placebo-controlled trial

 

Summary

Background

Long-term symptoms are common after acute COVID-19, particularly fatigue, cognitive problems, and dyspnoea. Cohort studies have suggested that antiviral treatment of acute COVID-19 might prevent development of post-COVID-19 condition (also known as long COVID), but the efficacy of antivirals has yet to be verified in prospective studies. We aimed to investigate whether treatment of acute SARS-CoV-2 infection with nirmatrelvir–ritonavir would reduce the risk of long COVID.

Methods

In this double-blind, randomised, placebo-controlled trial, participants were recruited from the municipal health-care service at three sites in Norway (Bergen, Oslo, and Ålesund). Non-hospitalised adults aged 18–65 years with SARS-CoV-2 infection confirmed by PCR or lateral flow test and symptoms for 5 days or fewer were eligible for inclusion. Key exclusion criteria included pregnancy or lactation, chronic renal impairment or chronic liver dysfunction, and any person judged by the investigator to need nirmatrelvir–ritonavir treatment due to increased risk of hospitalisation or death. Participants were allocated in a 1:1 ratio to receive oral 300 mg nirmatrelvir and 100 mg ritonavir, or placebo, twice a day for 5 days using a pre-generated randomisation list without stratification or block adjustment. Participants, clinicians, and the study team were masked to treatment allocation. The primary outcome was long COVID, defined as patient-reported fatigue, dyspnoea, and/or cognitive symptoms at 3 months’ follow-up. Safety was analysed as a secondary outcome, and included adverse events, hospital admissions, and deaths. Both the primary outcome and safety were assessed in the intention-to-treat population. The trial is registered with ClinicalTrials.gov (NCT05852873) and is now closed to new participants.

Findings

Between May 12, 2023, and June 11, 2025, we enrolled 144 participants, of whom 66 were assigned to nirmatrelvir–ritonavir and 78 to placebo. In the protocol we planned to enrol 2000 participants, but the trial was stopped prematurely by the steering committee due to insufficient recruitment. Among the 143 participants who completed follow-up, the risk of long COVID at 3 months was significantly reduced in the nirmatrelvir–ritonavir group (17 [26%] of 66) compared with the placebo group (33 [43%] of 77), corresponding to a relative risk after imputation of data for the single missing value in the placebo group of 0·60 (95% CI 0·37–0·98; p=0·039). In the nirmatrelvir–ritonavir group, five patients discontinued treatment due to adverse events. The most common adverse events in the nirmatrelvir–ritonavir group were change in taste or smell (57 [86%] of 66 in the nirmatrelvir–ritonavir group vs 14 [18%] of 78 in the placebo group) and nausea or vomiting (19 [29%] vs eight [10%]). Inversely, palpitations were more common in the placebo group (ten [13%] of 78) than in the nirmatrelvir-ritonavir group (two [3%] of 66). No severe adverse events were reported.

Interpretation

Treatment with nirmatrelvir–ritonavir for acute COVID-19 was associated with a significant reduction in the risk of long COVID at 3 months’ follow-up. The limited sample size precludes firm conclusions, and further clinical trials are warranted.

Funding

National Health Authorities’ KlinBeForsk programme, Western Norway Regional Health Authority, Helse Møre og Romsdal Hospital Trust, and The Influenza Centre, Haukeland University Hospital and University of Bergen, Bergen, Norway.

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00244-6/fulltext?rss=yes

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#Safety and efficacy of #mRNA #vaccines: a mechanistic and public health perspective

 

Summary

mRNA vaccines represent a transformative advance in vaccinology, combining rapid development timelines, scalable manufacturing, and strong immunogenicity with a favourable safety profile. Global deployment of mRNA vaccines during the COVID-19 pandemic provided an unprecedented real-world evaluation of this platform, with billions of doses administered across diverse populations. In this Review, we critically examine the safety and efficacy of mRNA vaccines from mechanistic, preclinical, clinical, and public health perspectives. We outline the biological basis of mRNA vaccines, including their transient cytoplasmic expression, lack of genomic integration, and rapid clearance, distinguishing them clearly from other gene therapies. We synthesise evidence on vaccine components, manufacturing quality controls, and regulatory standards that underpin safety, alongside data from randomised trials, post-authorisation surveillance, and active pharmacovigilance systems. We also review real-world effectiveness across age groups, pregnancy, and populations that are immunocompromised, along with the effects on transmission. Last, we address public perception and vaccine confidence, and discuss implications for next-generation mRNA vaccines, including strategies to reduce reactogenicity, improve breadth and durability of immunity, enhance global access, and support sustainable public trust. Together, the accumulated evidence affirms mRNA vaccines as a safe, effective, and adaptable platform with enduring relevance for future infectious disease prevention and public health preparedness, and for the treatment of cancer and autoimmunity.

Source: 

Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00512-X/abstract?rss=yes

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#Autoantibodies against type I #interferons in patients with #zoonotic #H7N9 #influenza: an observational case–control study

 

Summary

Background

The determinants of the species barrier preventing human infections with avian influenza A viruses (IAV) are incompletely understood. We previously identified loss-of-function variants of the interferon-regulated antiviral factor MxA as a genetic factor for increased susceptibility to infections with the H7N9 subtype. Given the central role of type I IFNs (IFN-I) in antiviral defence, we hypothesised that IFN-I-neutralising autoantibodies may similarly predispose to zoonotic H7N9 infection.

Methods

In this observational case–control study, serum samples collected between 2013 and 2017 from 199 Chinese patients with laboratory-confirmed H7N9 infection and 531 healthy, uninfected controls (269 poultry workers, 262 close contacts) were screened for IgG autoantibodies binding IFNα2, IFNβ1b, or IFNω using a multiplex bead-based assay. Positive samples were tested for IFN-neutralising activity in a luciferase-based reporter assay. To confirm their ability to block IFNα2-mediated antiviral activity, selected samples (n = 19) were analysed in IAV infection experiments. Associations between age, sex, H7N9 case status, case fatality, and the presence of neutralising autoantibodies were evaluated by logistic regression. Available whole-genome sequencing data from 26 individuals with neutralising autoantibodies were screened for variants in genes linked to IFN-I autoimmunity.

Findings

Neutralising autoantibodies against at least one IFN-I were detected in 19.1% (38/199) of patients but in only 1.1% (6/531) of controls, consistent with published general population data. Most patient sera targeted IFNα2 and/or IFNω (35/199), and 18.1% (36/199) neutralised even high IFN-I concentrations of 1–10 ng/ml. The presence of neutralising autoantibodies was associated with 8.2- to 25.3-fold higher odds of H7N9 infection (p < 0.0001), depending on antibody specificity and reference group. Autoantibody prevalence increased significantly with age in patients (44.8% ≥70 years; OR = 1.05; 95% CI 1.02–1.07; p = 0.0001), but was not associated with sex (OR for males vs. females = 0.52; 95% CI 0.23–1.14; p = 0.106). All selected sera containing neutralising autoantibodies blocked IFNα2-induced antiviral activity in cell culture. No known genetic predisposition for IFN-I autoimmunity was identified.

Interpretation

Our findings suggest that IFN-I-targeting autoimmunity is associated with susceptibility to zoonotic IAV infection with the H7N9 subtype, and possibly also other subtypes, including panzootic H5N1. Given the ease of implementation, screening for anti-IFN-I autoantibodies could be readily integrated into surveillance or targeted testing. This could be relevant in environments with increased exposure to zoonotic IAVs.

Funding

Shenzhen Medical Research Fund, National Natural Science Foundation of China, Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences, Guangdong Provincial Science and Technology Program, Program for Youzuzhikeyan of Shenzhen University, German Research Foundation, Swiss National Science Foundation.

Source: 

Link: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(26)00271-9/fulltext

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#Hantavirus cardiopulmonary syndrome in #children: a systematic scoping #review of presentation, critical care management, and outcomes

 

Abstract

Background

Pediatric hantavirus cardiopulmonary syndrome/hantavirus pulmonary syndrome (HCPS/HPS) is rare but can progress rapidly from a nonspecific febrile prodrome to respiratory failure, shock, and multiorgan dysfunction. Pediatric-specific evidence is limited, and a comprehensive map of the clinical literature is lacking.

Methods

We conducted a systematic scoping review per Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidance (protocol registered at DOI:10.17605/OSF.IO/MZDN4). PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane CENTRAL were searched from inception to May 2026. Eligible reports described children or adolescents (age ≤18 years) with HCPS/HPS and extractable pediatric clinical data. Two reviewers independently screened records, assessed overlap, extracted data, and appraised reporting quality using Joanna Briggs Institute tools.

Results

Of 2208 database records, 20 reports were included in the core pediatric synthesis after removal of 976 duplicates and screening. Reports were concentrated in the Americas. Recurrent features included fever, gastrointestinal symptoms, myalgia, thrombocytopenia, hemoconcentration, pulmonary edema, respiratory failure, and shock. Severe cases required mechanical ventilation, vasoactive support, extracorporeal membrane oxygenation, and in some cases renal replacement therapy. Larger pediatric case series and surveillance-level reports reported mortality of approximately 33% to 37%. Evidence was predominantly case-based with variable reporting completeness.

Conclusions

Pediatric HCPS/HPS is rare but potentially rapidly fatal. Early suspicion in endemic regions or after rodent exposure, with prompt supportive critical care and timely consideration of advanced cardiopulmonary support, is central to management.

Source: 

Link: https://www.tandfonline.com/doi/full/10.1080/08998280.2026.2698359

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#Ribavirin post-exposure #prophylaxis for #Andes virus #exposure: a viewpoint

 

Summary

Andes virus (ANDV) is unique among hantaviruses because person-to-person transmission is possible. This raises questions on the relevance of post-exposure prophylaxis (PEP), particularly following high-risk household, healthcare-associated, or laboratory exposures, considering its high case fatality rate. Ribavirin has demonstrated antiviral activity against hantaviruses in vitro and in animal models, although clinical evidence supporting its use for ANDV remains extremely limited. This viewpoint summarises the currently available evidence regarding ribavirin as PEP after potential ANDV exposure. We discuss the knowledge gaps that may limit the applicability of ribavirin PEP, to make informed decisions on the use of ribavirin in the setting of PEP. Potential dosing strategies are visualised by modelling and simulation, and potential dose and duration are discussed. Although the biological rationale for ribavirin PEP appears compelling, absence of controlled human studies and potential toxicity currently limit its role to highly selected exposure scenarios and use shortly after exposure.

Source: 

Link: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(26)00270-7/fulltext

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Pan-continental #spillover #risk: integrated spatiotemporal, transmissibility and #surveillance analysis of avian #influenza #H5N1 in #Africa

 

Abstract

Background: 

The HPAI H5N1 panzootic represents a critical threat to human health in Africa, where traditional poultry systems and dense human-animal interfaces facilitate frequent zoonotic spillover. While sporadic human cases raise pandemic concerns, continent-wide integration of spatial dynamics, transmissibility indicators, and surveillance performance has been lacking. This study quantifies avian influenza transmission over two decades across Africa, identifies geographical hotspots, and evaluates the responsiveness of current surveillance systems.

Methods: 

We analysed 8,037 avian influenza outbreak events and 369 laboratory-confirmed human cases, predominantly caused by HPAI H5N1 (2004–2025), using harmonised data from FAO (EMPRES-i+), WHO, and WOAH. A Bayesian Besag-York-Mollié (BYM) spatiotemporal model estimated residual transmission risks and Incidence Rate Ratios (IRR) by subtype. The basic reproduction number (R₀) was derived via an exponential growth model applied to human outbreak phases across infectious durations of 7–30 days. Surveillance responsiveness was assessed by quantifying notification delays between clinical observation and official reporting.

Results: 

Risk of infection in animals: HPAI H5N1 was the dominant strain, representing 87.8% of animal cases, with Egypt acting as the primary epidemiological epicentre (66% of total records). The spatiotemporal model revealed that H5N1 is associated with a significantly higher risk of animal infection (IRR = 8.37; 95% CI: 6.65–10.53). Although 71% of outbreaks were reported within 5 days of detection, significant delays (≥15 days) occurred in 12% of cases, with notable regional disparities. Risk of infection in human: H5N1 was associated with a 67-fold increase in the incidence of human cases compared to other subtypes (IRR = 66.78; 95% CI: 25.29–176.37). Sensitivity analyses yielded R0 estimates ranging from 1.05 (95% CI: 0.91–1.31) to 1.23 (95% CI: 0.60–2.33), indicating localised epidemic potential.

Conclusion: 

Our findings highlight a persistent and geographically heterogeneous H5N1 reservoir in Africa with high zoonotic affinity. Although sustained human-to-human transmission remains limited, the identification of dual poultry-human hotspots and localised R0 peaks underscores the urgent need for geographically targeted One Health interventions. Strengthening real-time reporting systems and improving biosecurity in high-risk poultry value chains are critical to mitigating future pandemic threats on the continent.

Source: 

Link: https://www.frontiersin.org/journals/epidemiology/articles/10.3389/fepid.2026.1813211/full

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#Camel #Prion Disease, Tataouine, #Tunisia, 2019–2021

 

Abstract

We report 6 cases of camel prion disease in dromedaries in Tunisia, confirming widespread occurrence in North Africa. Affected animals showed neurologic signs and scrape prion protein accumulation in brain and lymphoid tissues. These findings highlight the importance of active surveillance and investigation of the epidemiology, transmission, and public health implications.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/8/25-1474_article

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Identification of #Contacts With High Rates of Missed and #Asymptomatic Infection Following an #Outbreak of #Ebola Virus Disease: A Seroepidemiological Study in Likati Health Zone, #DRC

 

Abstract

Background

Ebola virus disease (EVD) is often regarded as severe and highly fatal, but growing evidence suggests that subclinical or minimally symptomatic infections occur and frequently go undetected. During the 2017 outbreak in Likati Health Zone, only 8 cases were confirmed despite many reported exposures. We evaluated the extent of asymptomatic or unrecognized Ebola virus infection and associated factors among contacts of reported cases.

Methods

In November 2017, we conducted a cross-sectional community-based serosurvey among contacts originally identified through Ministry of Health records and newly identified through additional post-outbreak investigations. Participants provided blood samples and completed questionnaires on demographics, exposures, and symptoms within 4 weeks of symptom onset of the EVD case with whom contact was reported. Sera were tested for anti-EBOV nucleoprotein IgG by ELISA. Seropositive individuals were classified as asymptomatic (no symptoms) or unrecognized (≥1 symptom). Secondary attack rate (SAR) was estimated, and logistic regression assessed associations with sociodemographic factors, exposure level, and symptoms.

Results

Among 180 participants (79 originally identified; 101 newly identified), 33 (18.3%) were seropositive. Of these, 19 (58%) reported symptoms, and 14 (42%) were asymptomatic. Any EVD-related symptom was associated with higher odds of seropositivity (OR 2.48, P = .021), though no specific symptom was significant. Asymptomatic individuals had higher antibody titers than symptomatic seropositive contacts (P = .009). The overall SAR was 19.1% (95% CI: 15.9–23.0). High exposure level strongly predicted seropositivity (OR 11.2, 95% CI: 3.8–33.3).

Conclusions

Asymptomatic infections occurred, including among contacts missed during the response, highlighting the need for exposure-based serologic assessments in EVD investigations and raising questions about immune responses and the true disease burden in outbreak-affected settings.

Source: 

Link: https://academic.oup.com/ofid/article/13/7/ofag397/8725922

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#Spain, Ministry of Health is strengthening #prevention, #preparedness and response to #animal-borne #influenza with a national plan (Min. Health, July 16 '26)

 

    Madrid, July 16, 2026.- The Public Health Commission has approved the State Plan against infections by influenza viruses of zoonotic origin: Prevention, Surveillance and Control, which establishes a common framework for prevention, surveillance, early detection and response to influenza viruses that circulate in animals and can be transmitted to people.

    The Plan adopts the "One Health" approach and establishes a joint response across the fields of human health, animal health, and the environment. Its objective is to improve coordination among the different sectors at the national, regional, and local levels, and to ensure that epidemiological, microbiological, and environmental information is integrated, up-to-date, and readily available to facilitate the early implementation of control measures.

    The document has been coordinated by the Center for Coordination of Health Alerts and Emergencies (CCAES) of the Ministry of Health and prepared jointly with the Ministries of Agriculture, Fisheries and Food and for Ecological Transition and the Demographic Challenge, the Carlos III Health Institute, the Spanish Agency for Food Safety and Nutrition and other units involved in the prevention and management of these risks.

    Zoonotic influenza viruses circulate among animals. Transmission to humans remains infrequent and is usually linked to direct contact with infected animals, their secretions, or contaminated environments. However, their ability to mutate and exchange genetic material necessitates continuous surveillance, especially given the increased detection of these viruses in various mammal species.

    The Plan organizes the actions into four scenarios , which allow the measures to be progressively adapted to the epidemiological situation of each territory.

    Scenario 0 corresponds to a situation with no detected infections in animals or people and focuses on ordinary actions of prevention, surveillance, training and maintenance of diagnostic capabilities.

    Scenario 1 is activated upon detection of outbreaks in wild or captive animals. It distinguishes between isolated outbreaks in birds, multiple outbreaks distributed across a territory, and detections in wild mammals.

    Scenario 2 considers outbreaks in domestic animals and also differentiates between isolated outbreaks in birds, multiple outbreaks, and detections in domestic mammals.

    Finally, scenario 3 applies when a human infection is identified. In this case, a distinction is made between cases with known exposure to animals or contaminated environments, those where no risk exposure is identified, and cases associated with contact with another infected person, which would imply possible limited human-to-human transmission.

    The scenarios are not mutually exclusive and may be applied simultaneously in the same territory. Each autonomous community will conduct its own risk assessment to determine the necessary measures in each affected province, community, or geographical area.

    The Plan envisions the creation of a Permanent State Committee for Coordination and Monitoring , chaired and technically coordinated by the CCAES, responsible for reviewing preparedness and response measures, promoting common protocols, conducting joint risk assessments, and evaluating the Plan's effectiveness. Furthermore, it recommends that the autonomous communities establish equivalent bodies to coordinate actions related to public health, animal health, the environment, food safety, and occupational health.

    This body will include representatives from the competent departments in public health, animal health, biodiversity, food safety, occupational health, medicines and health products and epidemiological and microbiological surveillance, as well as from the autonomous communities, the Spanish Federation of Municipalities and Provinces and experts.

    Human health measures focus especially on people who, due to their professional activity, may come into contact with infected animals, their secretions or contaminated materials, such as livestock farm personnel, veterinary professionals, environmental agents or zoo workers.

    Companies must assess the risk, provide the necessary protective equipment, and ensure health monitoring. Occupational risk prevention services will identify and monitor exposed personnel in the event of outbreaks in animals and, where appropriate, may recommend PCR tests, preventive antiviral treatment, or vaccination against zoonotic viruses.

    The Plan also maintains the recommendation for seasonal flu vaccination for those who work in direct contact with animals, with the aim of reducing the risk of coinfection by human and animal flu viruses.

    In the animal sector , the Plan strengthens surveillance of wild and domestic birds and mammals, as well as genomic analysis of viruses to detect changes that could increase their transmissibility. In the event of outbreaks on farms, biosecurity measures, movement controls, confinement, and, where appropriate, vaccination will be implemented.

    In parks and urban or peri-urban areas, protocols will be established to safely remove sick or dead animals, clean and disinfect affected areas, and inform the public. It is recommended not to touch or handle them and to report their presence to the appropriate authorities.

    The Plan incorporates risk communication and community participation as one of its five main components. To this end, an inter-institutional communication group will be established, websites with updated information will be created, and campaigns will be developed targeting both the general public and the professional sectors with the greatest exposure.

    Media and social media will also be monitored to detect and respond to rumors, false content, or unverified information. In higher-risk scenarios, an official spokesperson will be appointed, information will be updated daily, and, when necessary, a citizen hotline will be activated.

    The Permanent State Committee will develop the indicators that will allow the evaluation of preparedness and response, as well as compliance with the Plan in its various components and at the state and regional levels.

    In the last year, more than 150 outbreaks of avian influenza have been detected in Spain, mostly in wild birds, although outbreaks have also been recorded in poultry, leading to the culling of thousands of animals. Despite the increased circulation of the virus among birds, Spain has not registered any human cases of avian influenza to date. Regarding swine influenza, three human cases of infection have been identified in Spain since 2009.

    The new Plan will strengthen prevention, early detection and coordinated response to any changes in the epidemiological situation.

Source: 

Link: https://www.sanidad.gob.es/gabinete/notasPrensa.do?id=6965

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#Screening and #monitoring of #travellers returning from countries affected by #Bundibugyo virus: an overview of #European approaches, July 2026

 

Abstract

The 2026 Ebola outbreak caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda has prompted European countries and the United States to revise measures for travellers, healthcare workers and humanitarian personnel returning from affected areas. We compare current procedures and protocols with those implemented during the 2013–2016 Ebola outbreak. Despite some national differences, policies have largely converged towards risk-based management, early case detection, rapid isolation, exposure-based monitoring and healthcare preparedness, rather than routine border screening.

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.28.2600578?emailalert=true#abstract_content

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#NewZealand - #Influenza A #H5N1 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

 

Di Antoine Lamielle, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=128547540

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    ° This is the first detection of highly pathogenic avian influenza H5N1 clade 2.3.4.4b virus in New Zealand. 

    ° The detection is in a single subantarctic skua (Stercorarius antarcticus) found on Petone Beach, Lower Hutt. 

    ° The bird was found weak and emaciated and no neurological or respiratory clinical signs were observed. 

    ° Subantarctic skua are an ocean-going species. 

    ° Genomic sequencing indicates that the virus is closely related to H5N1 HPAI clade 2.3.4.4b viruses recently detected in Western Australia. 

    ° An epidemiological investigation is underway, and general surveillance is continuing. At this time, there is no evidence of further spread. 

    ° Vaccination of specific populations of threatened avian species is being initiated.

    ° A single ocean-going subantarctic skua (Stercorarius antarcticus), also known as brown skua.

Source: 

Link: https://wahis.woah.org/#/in-review/7709

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Occupationally Exposed and General #Population #Antibody #Profiles to #Influenza A Viruses Circulating in #Swine as Indication of Zoonotic #Risk

 

Abstract

Persons with occupational exposure to swine might be at disproportionate risk for zoonotic swine influenza A virus. To evaluate human antibody responses, we tested serum or plasma from swine veterinarian, farm employee, and general population cohorts by hemagglutination inhibition assays against representative swine and human seasonal influenza vaccine strains. We analyzed hemagglutination inhibition data by antigenic cartography to assess strain relationships and reproduction number modeling to evaluate pandemic potential using age-stratified immunity profiles. Occupationally exposed groups had lower human seasonal vaccine uptake (45.5% vs. 70%) and lower odds of seropositivity to several H1 and H3 strains from swine than did general population cohorts. One swine strain exhibited significant antigenic drift (3.62 antigenic units) from its nearest vaccine strain. Multiple strains required lower reproduction number thresholds for pandemic spread (1.09–1.35) than recorded pandemic strains (1.46–1.80), demonstrating that population immunity gaps heighten zoonotic risk to circulating swine H1 and H3 strains.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/8/25-1995_article

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First nationwide full- #genome characterisation of #human-derived #Andes virus in #Chile: a retrospective genomic #epidemiology study

Summary

Background

Andes virus (ANDV) is the only hantavirus known to transmit between humans and causes hantavirus cardiopulmonary syndrome in Chile and Argentina. In Chile, ANDV genomic diversity remains incompletely characterised. This study aimed to characterise the genetic diversity, geographical structure, and molecular signatures of ANDV using human clinical samples collected over a 13-year period (2011–24).

Methods

We conducted a retrospective genomic epidemiology study of ANDV infections in Chile. Clinical samples from patients with confirmed ANDV, collected between March 9, 2011, and June 27, 2024, were analysed and sequenced. Clinical and epidemiological data were obtained from diagnostic laboratories and surveillance programmes. Consensus sequences for the S, M, and L segments were generated, and genetic clustering and divergence were assessed using phylogenetic inference and variant calling.

Findings

We analysed clinical samples from 58 infected individuals and identified two major genomic variants of ANDV with distinct geographical distributions, defined by regionally structured patterns of nucleotide and amino acid substitutions across the S, M, and L segments: ANDV Chi-North (central Chile) and ANDV-South (southern Chile). No consistent clustering by clinical severity was observed, and no recurrent non-synonymous substitutions were uniquely associated with severe disease. Substitutions previously associated with person-to-person transmission in outbreaks in Argentina were not consistently observed in Chilean sequences, including in four person-to-person transmission cases. Although some substitutions described in ANDV-like viruses were present in the Chi-North lineage, this lineage remained phylogenetically distinct and geographically restricted to central Chile.

Interpretation

To our knowledge, this study provides the first nationwide genomic characterisation of human-derived ANDV in Chile. The identification of geographically structured variants indicates that ANDV diversity in Chile is driven by regional diversification rather than clinical outcome. The absence of consistent amino acid signatures associated with disease severity or person-to-person transmission suggests that these phenotypes are unlikely to be explained by viral genetic variation alone. These findings refine current understanding of ANDV evolution and highlight the need for continued integrated genomic surveillance in endemic regions.

Funding

Agencia Nacional de Investigación y Desarrollo de Chile and National Institutes of Health.

Source: 

Link: https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(26)00109-6/fulltext

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#Bundibugyo #ebolavirus from the 2026 Ebola #outbreak in #Uganda and #DRC: a new #variant

 

{Excerpt}

(...)

In conclusion, we show that the BDBV variant identified in Uganda from a travel-related case linked to the ongoing outbreak in Ituri represents a new clade of BDBV. These findings underscore the diversity of the BDBV ecosystem and the urgent need for antiviral and vaccine countermeasures to reduce fatalities and for public health measures to limit the spread of the virus. Global efforts are immediately needed in this region. Continued genomic surveillance is required for in-depth monitoring to track emerging BDBV variants and adjust and employ BDBV countermeasures in a timely manner.

Source: 

Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01079-2/fulltext

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