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

 

{Excerpt}

Situation at a glance

    -- On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare, Democratic Republic of the Congo (DRC), and the Ministry of Health of Uganda declared an outbreak of Ebola Disease following the confirmation of Bundibugyo virus disease (BVD) in both countries. 

    -- On 16 May 2026, the World Health Organization (WHO) Director-General 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. 

    -- On 19 May 2026, the Director-General of WHO convened the first meeting of the IHR Emergency Committee, and temporary recommendations were issued to State Parties. 

    -- As of 21 May, 746 suspected cases and 176 deaths among suspected cases were reported in DRC. 

    -- So far 85 confirmed cases, including two in Uganda, and ten deaths, with one in Uganda, among confirmed cases were reported across both countries. 

    -- In DRC, transmission is concentrated in Ituri, North Kivu and South Kivu provinces, with challenges in contact follow-up, insecure conditions, and inadequate isolation and referral systems complicating response efforts. 

    -- Uganda has reported two imported cases with no confirmed local transmission. 

    -- An American national who was working in DRC has also been confirmed positive and transferred to Germany for care. 

    -- National authorities, in collaboration with WHO and partners, are implementing response measures including deployment of rapid response teams, delivery of medical supplies, strengthened surveillance, laboratory confirmation, infection prevention and control assessments, the set-up of safe and optimized treatment centers, and community engagement.

Description of the situation

    -- On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare of Democratic Republic of the Congo (DRC) officially declared the 17th Ebola disease outbreak following the laboratory confirmation of Bundibugyo virus disease (BVD) in eight samples. 

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

    -- On 16 May 2026, the 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 International Health Regulation (IHR)

    -- Since the last Disease Outbreak News was published on 16 May 2026, the number of suspected and confirmed cases has increased rapidly in DRC, with geographical expansion into North Kivu and South Kivu. 

    -- In total, 746 suspected cases, including 176 deaths among suspected cases have been reported from DRC as of 21 May 2026; and 85 confirmed cases (two in Uganda), including ten deaths (one in Uganda) (CFR 12%) have been reported from both countries.

    (...)

    -- As of 21 May 2026, a total of 83 confirmed cases including nine deaths (CFR 11%); and 746 suspected cases including 176 deaths have been reported from 15 health zones (HZ) in Ituri, North Kivu and South Kivu Provinces, DRC. 

    -- Four health worker deaths have been reported to date. 

    -- Epidemiological and laboratory investigations are ongoing to reclassify all suspected cases and deaths reported in DRC.

    -- The most affected HZ are Mongbwalu, Rwampara and Bunia, which all account for 96% of suspected cases and 79% of confirmed cases.  

    -- As of 21 May, 1603 contacts have been listed in Ituri province and one contact became a suspected case. However, follow-up remains weak due to insecurity and movement restrictions. 

    -- The follow-up rate as of 21 May is 21%. On 21 May, 84 new alerts were reported, and 77 alerts were investigated, all of which were validated.

    -- An American national, who was working in DRC as a surgeon, has also been identified as a confirmed case. Exposure is thought to have occurred during a medical procedure on 11 May. Onset of symptoms was reported on 16 May and laboratory confirmation was received on 20 May. The case is currently at a High-Level isolation unit in Berlin, Germany undergoing treatment.

(...)

    -- Response efforts continue to face a number of challenges, including:

        ° absence of standardized isolation and treatment facilities and weak screening and referral pathways;

        ° inconsistent implementation of safe and dignified burial measures further underscores the significant risk of healthcare-associated transmission;

        ° cross-border transmission risks remain elevated due to insecurity, humanitarian crises, high population mobility, urban/semi-urban transmission hotspots, and porous borders, requiring intensified surveillance and information sharing;

        ° deeply challenging situation for affected communities, with growing concerns over access to free and supportive healthcare services, the ability to ensure respectful and dignified burials, and the spread of misinformation and rumour;

        ° ongoing conflict in Ituri province restricting the movement of surveillance teams, the deployment of Rapid Response Teams, and the transporting of laboratory samples.

    -- 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 with Bunia HZ being 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.

Uganda

    -- As of 20 May 2026, a total of two confirmed cases including one death have been reported in Kampala, Uganda. Both cases were imported from the DRC. The first case was admitted to a private hospital on 11 May and died on 14 May. The transfer of the body to DRC was completed the same day. The second case was confirmed on 16 May in Kampala, in an individual returning from DRC with no apparent links to the first case. The case is currently admitted in Uganda at the Mulago Isolation Treatment Unit. At the time of reporting, no local transmission has been identified in Uganda.

    -- As of 18 May, a total of 127 contacts, linked to both confirmed imported cases, have been identified and under follow-up. These include close household contacts and hospital contacts where the cases were hospitalized.

    -- Exposure risks are associated with healthcare settings and cross-border movements. Eighteen alerts were reported on 18 May and investigated. Four active cross-border exposure clusters identified in Ntoroko District are under investigation. 

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 or items. 

    -- 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, in collaboration with WHO and partners are implementing public health measures, including but not limited to the following:

Coordination

    ° The Incident Management System has been activated to coordinate response to the outbreak, with technical support from WHO and health partners

    ° Subnational coordination structures are being activated at the provincial and health zones level to coordinate operational activities. Daily provincial coordination meetings involving all response pillars and operational partners are ongoing.

    ° Rapid response teams from MoH and WHO have been deployed to Bunia, Mongbwalu, and Rwampara HZ.

Surveillance

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

    ° Alert management and case investigations are being scaled up. Investigation teams have been deployed to Bunia and Rwampara, with alerts under investigation in Ituri, North Kivu, South Kivu, and Tshopo provinces.

    ° Contact tracing has been initiated with 541 contacts identified, although major operational challenges persist due to insecurity.

    ° Data managers have been trained on the DHIS2 tracker, and a surveillance and digital health coordination meeting is being implemented to improve harmonization across digital platforms.

    ° The International Organization for Migration (IOM) is supporting points-of-entry (PoEs) surveillance; however, informal crossings and weak alert management at PoEs remain significant gaps.

Case Management

    ° WHO and partners are supporting the ongoing establishment and operationalization of isolation and treatment facilities in affected areas

    ° WHO and partners are working to maintain access to essential health and other services.

Laboratory

    ° Laboratory surge capacity is being scaled-up. The Institut National de la Recherche Biomédicale (INRB) teams are deploying to Bunia to establish and scale-up testing. A decentralization strategy is being developed to add additional field laboratories to Mongbwalu and Mahagi (Ituri – Uganda border). Goma laboratory is activated and provide testing capacities for North Kivu.

    ° PCR kits have been sourced, while WHO Regional Emergency Hub in Dakar is deploying reagents, Piccolo machines, and cold-chain modules to strengthen field laboratory operations.

    ° Genomic and epidemiological analyses are underway, and sequences have been uploaded through a joint publication (by DRC and Uganda) on virological.org.

Risk Communication and Community Engagement (RCCE)

    ° Community mobilization has started in Mongbwalu, while social listening activities and deployment of UNICEF digital platforms (U-Report and I-Hear-You) are underway to improve community feedback and information sharing.

    ° WHO is supporting engagement interventions with community and religious leaders

    ° WHO shared a multi-country infodemic management report providing an initial analysis of community perceptions, including key questions, concerns, rumours, misinformation, and disinformation, to guide targeted risk communication and community engagement interventions.

    ° WHO and partners have developed a shared RCCE message repository to harmonize risk communication content

Infection Prevention and Control (IPC)

    ° Coordination mechanism for IPC response is being established under the leadership of the Division of Provincial Health  and the Public Health Emergency Operations Centre.

    ° Local human resources are being scaled-up to enable required key intervention.

    ° More than 150 health workers have been trained on basic IPC and Ebola-specific measures, with an ongoing cascade training plan targeting an additional 500 health workers.

    ° Operational teams are being established and briefed for decontamination, safe and dignified burials and health facility assessments.

    ° IPC supplies including PPE are being donated to priority health facilities.

Operational support and Logistics

    ° Over 17 tons of emergency supplies were shipped to DRC, including personal protective equipment (PPE), Viral Haemorrhagic Fever supplies, tents, body bags, infection prevention and control materials, stretchers, medicines and other case management supplies.

    ° Deployment of EpiShuttle patient isolation transport systems, vehicles, telecommunications equipment, laboratory consumables, portable point-of-care diagnostic machines, reagents, cold-chain modules, and Ebola polymerase chain reaction (PCR) testing kits to strengthen clinical transport, laboratory diagnostics, and field response operations are ongoing.

    ° Coordination is underway to mobilize one helicopter, three ambulances, and two armored vehicles to support cargo and personnel movement. Human resource deployment structures are being finalized and United Nations Humanitarian Air Service (UNHAS) is supporting staff movement to Bunia.

Global Logistics 

    ° Cluster partners briefed on situation and work is under way for planning WFP/Logistics Cluster support for common partner services.

    ° Efforts are ongoing with partners to provide subsidized air cargo into the region, and into Bunia

    ° A four-week forecast of critical PPE requirements across case management, infection, prevention and control, and burial operations has been finalized to support sustained response activities.

    ° A high priority items list has been finalized to facilitate collective monitoring. Item-needs calculator being finalized for sharing.

Border Health, Travel and Mass Gatherings

    ° WHO travel and border health guidance has been disseminated across countries and transport sectors, emphasizing that suspected, probable and confirmed cases and their contacts should avoid travel unless medically evacuated, and advising against travel or trade restrictions and border closures.

    ° Affected and neighbouring countries are strengthening their preparedness to detect, investigate, refer, isolate and care for any suspected cases, including activation of health emergency plans, enhanced screening at airports, seaports, land crossings and major internal transit routes.

    -- Health authorities in Uganda, in collaboration with WHO and partners, are implementing public health measures, including but not limited to the following:

Coordination

    ° The Incident Management System has been activated to coordinate response to the outbreak, with technical support from WHO and health partners

    ° The National Public Health Emergency Operations Centre and regional Emergency Operations Centres (EOCs) were activated in Fort Portal, Arua, Yumbe, Kampala Capital City Authority, Kabale, and Hoima, with the national response plan and rapid risk assessment finalized.

Surveillance and Laboratory

    ° Field teams are utilizing Go.Data for contact tracing, benefiting from experience in implementing the tool during previous mpox, cholera and Sudan virus disease outbreaks.

    ° Screening is being strengthened at official and informal border crossings, major transit routes, and pilgrimage corridors.

Case Management

    ° Isolation facilities in high-risk districts have been activated and the Uganda National Emergency Medical Team deployed to support clinical management.

Laboratory

    ° Sequencing and sample transport systems are being strengthened

    ° A mobile laboratory is being deployed to Kasese near the DRC border, with a virtual diagnostics coordination meeting supporting cross-country laboratory operations.

Risk Communication and Community Engagement (RCCE)

    ° Risk communication systems have been activated with community messaging and public awareness campaigns ongoing through District Health Officer networks, with health workers receiving guidance on standard precautions and public health messaging.

Infection Prevention and Control (IPC)

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

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.

    -- This is the 17th Ebola disease outbreak in the DRC since 1976. The last Ebola disease outbreak in the country was an outbreak and Ebola virus disease which 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. In Uganda, the last outbreak reported was an outbreak of Sudan ebolavirus in 2022. The last BVD outbreak was recorded in the country in 2007.

    -- 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 assessed the risk of the outbreak of BVD to be very high at the national level in DRC, high at the regional level, and low at the global level.

(...)

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON603

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#Canada, Speaking #Remarks for the Chief Public Health Officer on #Ebola Disease and #Hantavirus Technical #Briefing (May 22 '26)

 

May 22, 2026 | 1:00pm EST

    Thank you for joining us today.

    Before we begin, I want to acknowledge that we are gathered on the unceded traditional territory of the Anishinaabe Algonquin Nation. I would like to take this moment to reflect on the history of Indigenous people and to honour the original stewards of the lands where we live and work.

Situation Update – Ebola Disease

    I will begin today with an update on the Ebola situation in Africa and what it means for Canada. And then, I will provide an update on Andes hantavirus.

    On May 15, Africa's Centres for Disease Control and Prevention declared an outbreak of Ebola disease in the eastern Democratic Republic of the Congo. Cases linked to this outbreak have also been reported in Uganda, including an imported case that was confirmed to be the Bundibugyo virus strain.

    On May 17, the Director General of the World Health Organization declared this outbreak a Public Health Emergency of International Concern due to the evidence of cross-border spread, uncertainty around the true size of the outbreak, the potential for wider regional and global impacts, and the need for global collaboration.

    It is important to be clear: while this is a serious and evolving situation, cases remain localized, and the global risk is low.

    This outbreak is occurring in an area with complex challenges, including proximity to urban centres, security concerns and high levels of population movement associated with mining activity. These factors can increase the potential for spread locally and across borders.

    We recognize the risk for people in the region is high, and our thoughts are with the individuals, families, communities and health workers who are directly bearing the brunt of this challenging outbreak.

    Canada stands ready to assist.

Risk to Canadians

    Based on the Public Health Agency of Canada's rapid risk assessment and in alignment with the World Health Organization, the risk to people in Canada is considered to be low at this time.

    There has never been a case of Ebola disease imported into Canada despite numerous Ebola outbreaks in the affected region.

    I do want to be transparent that, out of an abundance of caution, one individual in Ontario underwent precautionary testing. This individual recently returned from Ethiopia and reported symptoms consistent with a range of illnesses.

    Both initial testing conducted in Ontario and confirmatory testing at the National Microbiology Laboratory were both negative.

    This is a good example of how quickly measures are activated, even when the likelihood of Ebola is very low.

    Ebola disease is transmitted through direct contact with the body fluids of an infected individual who is showing symptoms, or through contact with infected animals or contaminated materials. It is not spread through casual contact, and it does not spread through the air like respiratory viruses.

    Those at highest risk are individuals providing care to patients with Ebola disease, participating in burial practices involving direct contact, or working in healthcare or laboratory settings where the virus is present.

Public Health Response

    While the risk in Canada remains low, we are taking this situation very seriously and are taking a precautionary approach.

    The Public Health Agency of Canada is actively monitoring the outbreak in close collaboration with international partners, including the World Health Organization, as well as provincial and territorial public health authorities.

    At our borders, we have strengthened screening measures. As of May 20, enhanced screening questions have been implemented at airport kiosks for travellers who have been in the Democratic Republic of the Congo or Uganda within the past 21 days.

    Travellers are now asked whether they have been in these countries and whether they are experiencing symptoms or may have been in contact with someone with Ebola disease.

    We have also deployed additional quarantine and screening officers at key airports, and we are maintaining a 24/7 centralized monitoring approach. Signage has been deployed at major airports across the country to ensure travellers know what to do if they feel unwell.

    These measures are supported under the Quarantine Act and are designed to identify potential risks early and ensure that appropriate follow-up actions are taken.

    On Wednesday, a flight was redirected to Montréal due to a passenger of concern. PHAC quarantine officers assessed the individual, determined they were asymptomatic, and appropriate border procedures were followed.

    For travellers, I want to emphasize the importance of checking the Government of Canada's Travel Advice and Advisories before departure.

    Individuals returning from affected regions should monitor their health for 21 days. If symptoms develop, it is critical that they isolate immediately, away from others and contact local public health authorities before seeking in-person care.

Laboratory and Preparedness Capacity

    Canada has strong laboratory and surveillance systems in place.

    Any suspected case in Canada would be immediately reported, with samples sent to the National Microbiology Laboratory in Winnipeg for confirmatory testing. Results are typically available within 24 hours once samples arrive at the lab.

    Our National Microbiology Laboratory continues to play a leading role globally in Ebola research, including work on vaccines, therapeutics, and diagnostics. Canadian scientists were instrumental in the development of the world's first Ebola vaccine, and they continue to contribute to preparedness and response efforts internationally.

International Collaboration

    This outbreak underscores the importance of global collaboration.

    Canada continues to work closely with international partners through established mechanisms such as the World Health Organization and the Global Outbreak Alert and Response Network.

    We stand ready to provide technical expertise and support if requested, as we have done in previous outbreaks. Our shared goal is to contain this outbreak at its source and reduce the risk of further spread.

Hantavirus Update

    I will now turn briefly to the situation regarding Andes hantavirus.

    Canada confirmed a case of Andes hantavirus linked to the MV Hondius cruise ship earlier this month. At this time, there have been no additional cases identified in Canada beyond the initial confirmed case in British Columbia, and all high-risk contacts continue to be monitored by local public health authorities.

    The overall risk to the general population in Canada remains low at this time.

    We continue to take a precautionary approach given the severity of this virus, while recognizing that person-to-person transmission of Andes hantavirus is rare and typically requires close, prolonged contact with someone who is symptomatic.

    Our thoughts are with the individual in hospital in British Columbia and their family. We thank our public health colleagues and the clinical team for the excellent care and support they are providing.

World Health Assembly and International Coordination

    This week, I had the opportunity to attend the World Health Assembly in Geneva, where I met with a number of my global counterparts, to discuss the public health challenges we all face.

    I also met Dr. Ghebreyesus, Director-General of the World Health Organization and members of his senior leadership team who are leading emergency response, including the Ebola response in DRC.

    These discussions reinforced the importance of transparency, timely information sharing, and coordination in responding effectively to emerging public health threats.

    The events of the past several weeks have demonstrated that strong global relationships are not only valuable, they are essential.

Conclusion

    In closing, we have robust systems in place for detection, prevention, and response. We are working in close collaboration with provincial and territorial partners, as well as with international organizations and governments, to ensure a coordinated and effective approach.

    We will continue to provide timely updates and clear guidance as new information becomes available.

    I would like to thank our public health partners across the country, our frontline healthcare workers, laboratory scientists, and our international colleagues for their dedication, expertise, and collaboration.

    Together, we are working to protect the health and safety of people in Canada and around the world.

    Thank you. Merci. Miigwetch.

Source: 

Link: https://www.canada.ca/en/public-health/news/2026/05/speaking-remarks-for-the-chief-public-health-officer0.html

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Molecular Characterization of #H5N1 Clade 2.3.4.4B Virus in Vaccinated Layer #Chickens

 

Abstract

The global emergence of the avian influenza virus (AIV) H5N1 clade 2.3.4.4B since 2016 has caused substantial losses in wild bird and poultry populations, along with heightened risks of transmission to humans and other mammals. Vaccination of poultry has been a key strategy to curb the virus’s spread and mitigate its socioeconomic impact. This report describes an outbreak of high pathogenicity avian influenza virus (HPAIV) H5N1 clade 2.3.4.4B in a flock of 15,000 brown layer chickens (170 days old), all of which had received a four-dose vaccination regimen with H5N1/H5N8 commercial vaccines at 17, 50, 100, and 125 days of age. Despite this vaccination history, H5N1 infection was confirmed approximately seven weeks post-vaccination. H5N1 infection was confirmed by RT-qPCR, virus isolation, and full genome sequencing covering all eight gene segments, followed by phylogenetic and molecular analyses. Clinical signs included reduced feed intake, decreased egg production, and a cumulative mortality rate of 35% over 52 days. Hemagglutination inhibition (HI) testing with various H5 antigens revealed inconsistent antibody titers (geometric mean: 4.0 to 9.1 log2). Genetic analysis of the full-length HA and NA gene sequences further revealed strong similarity to contemporaneous H5N1 clade 2.3.4.4B strains circulating in Egypt, with multiple mutations in the HA head domain, particularly near immunogenic epitopes and receptor binding sites. These findings highlight the limitations of current vaccination strategies under conditions of antigenic mismatch and complex immunization schedules, emphasizing the need for improved vaccine matching and continuous molecular surveillance. To improve outbreak management in poultry, enhanced vaccination protocols, stringent biosecurity measures, and rigorous monitoring practices are critical.

Source: 

Link: https://www.mdpi.com/1999-4915/18/6/589

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Epidemiological #surveillance against the #Andes virus: have we learned anything after #COVID19?

 

Summary

Recent outbreaks associated with Andes hantavirus have reignited the international debate on healthcare preparedness for hantaviruses with documented human-to-human transmission. Unlike other orthohantaviruses, Andes hantavirus has demonstrated human-to-human transmission in certain epidemiological contexts, including household and hospital settings. The recent emergence of cases linked to multinational outbreaks has prompted new assessments and recommendations from international public health organizations.

This manuscript presents an epidemiological reflection on the current challenges of surveillance against emerging hantaviruses, drawing on the experience gained during the COVID-19 pandemic. It also reviews aspects related to zoonotic surveillance, molecular monitoring, early detection, and integrated One Health approaches applied to preparedness for future emerging threats.

The available evidence suggests the need to strengthen surveillance systems capable of integrating human, environmental, and animal information to improve the response to complex epidemiological scenarios associated with emerging hantaviruses.

Source: 

Link: https://ojs.sanidad.gob.es/index.php/resp/article/view/1824

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#WHO DG's opening #remarks at Member State #information #session on outbreaks of #Ebola and #hantavirus – 22 May 2026 (edited): 1 new Andes virus case confirmed

 

    Excellencies, Honourable Ministers,

    Heads of delegation, colleagues and friends,

    Good afternoon to all Member States in the room, and good morning, good afternoon and good evening to those joining us online.

    As you know, in the early hours of Sunday morning Geneva time, I declared a public health emergency of international concern over the Ebola outbreak in the Democratic Republic of the Congo, with so far two imported cases to Uganda.

    I’m conscious that this is the first time a Director-General has declared a PHEIC before convening an Emergency Committee.

    It’s not a decision I took lightly, but it’s one I took in accordance with the International Health Regulations, after speaking with the Ministers of Health of both countries, and in light of the need for an urgent response.

    Preparations began immediately to convene an Emergency Committee, which met on Tuesday and concurred that in its view the situation is a public health emergency of international concern, but not a pandemic emergency.

    Previously, WHO assessed the risk as high at the national and regional levels and low at the global level.

    We are now revising our risk assessment to very high at the national level, high at the regional level, and low at the global level.

    So far, 82 cases have been confirmed in DRC, with seven confirmed deaths.

    But we know the epidemic in DRC is much larger. There are now almost 750 suspected cases and 177 suspected deaths.

    In Uganda, two cases have been confirmed in people who travelled from DRC, with one death.

    The measures taken in Uganda, including intense contact tracing and cancelling the Martyrs’ Day commemoration, appear to have been effective in preventing the further spread of the virus.

    An American national who was working in DRC has also been confirmed positive, and transferred to Germany for care.

    We are also aware of media reports today about another American national who is a high-risk contact who has been transferred to the Czech Republic.

    I thank the governments of DRC and Uganda for their leadership in coordinating the response, as well as the National Institute for Biomedical Research and the National Institute of Public Health in DRC, and the local health authorities.

    WHO is supporting the response, in close cooperation with partners.

    In addition to national staff in DRC, so far we have deployed 22 international staff to the field, including some of our most experienced people;

    And we have released US$ 3.9 million from the Contingency Fund for Emergencies.

    We’re also in touch with the Under Secretary-General of OCHA, who has allocated US$ 60 million.

    On the ground, we’re supporting national authorities with every pillar of the response, including contact tracing, establishing treatment centres, risk communication and community engagement, and more.

    Together with the Africa CDC, WHO is also establishing a continental Incident Management Support Team.

    In the coming days we will publish a multi-agency Strategic Preparedness and Response Plan, aligned with the national plans of both DRC and Uganda, and with our partners.

    There are several dimensions to this outbreak that make it especially challenging.

    First, as you know, unlike many previous Ebola outbreaks, which were caused by Zaire virus, this outbreak is caused by the Bundibugyo virus, for which there are no approved vaccines or therapeutics.

    There have only been two previous outbreaks of Bundibugyo, in Uganda and 2007 and DRC in 2012.

    Part of the reason the outbreak went undetected was because the tests that are used to detect Zaire virus do not detect Bundibugyo.

    Yesterday, WHO convened the leaders of several partner organizations under the interim Medical Countermeasures Network, to review the pipeline of vaccines, therapeutics and diagnostics.

    The WHO R&D Blueprint is also coordinating several advisory groups on therapeutics, vaccines, clinical trial design and more.

    Second, the provinces of Ituri and North Kivu in which the outbreak is occurring are highly insecure, with intensified fighting in recent months, causing more than 100 000 people to be newly displaced.

    Across both provinces, around 4 million people need urgent humanitarian assistance, 2 million are displaced, and 10 million face acute hunger.

    The area is also rich in minerals, with a transient population of miners, increasing the risk for the spread of the virus.

    Third, there is significant distrust of outside authorities among the local population.

    Just yesterday, there was a security incident at a hospital in Ituri, where tents and medical supplies were set on fire.

    Building trust in the affected communities is critical to a successful response, and is one of our highest priorities.

    We are also committed to ensuring that essential health services for the affected communities are maintained and strengthened, based on their needs.

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    Now a brief update on the hantavirus outbreak among passengers and crew on board the cruise ship MV Hondius.

    Today, the Netherlands confirmed an additional case among a crew member who disembarked in Tenerife, was repatriated to the Netherlands and has been isolating since then.

    There are now 12 reported cases and 3 reported deaths.

    No deaths have been reported since the 2nd of May, when the outbreak was first reported to WHO.

    We continue to urge affected countries to monitor all passengers and crew carefully for the remainder of the quarantine period.

    More than 600 contacts continue to be followed in 30 countries, and a small number of high-risk contacts are still being located.

    Once again, I thank the many countries that have cooperated in the response, and the epidemiological investigation: Argentina, Cabo Verde, Chile, Netherlands, South Africa, Spain and the United Kingdom.

    The sharing of information under the International Health Regulations for this response has been very effective, with almost 800 communications with national focal points and WHO in the first two weeks alone.

    Thank you all once again for your support, and we look forward to your questions and advice.

    I thank you.

Source: 

Link: https://www.who.int/news-room/speeches/item/who-director-general-s-opening-remarks-at-the-member-state-information-session-on-outbreaks-of-ebola-and-hantavirus-22-may-2026

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1rst #meeting of #IHR EC regarding #epidemic of #Ebola #Bundibugyo in #DRC and #Uganda 2026 – Temporary #recommendations (WHO, May 22 '26)

 

{Edited, please visit original page to view in full}

    On 17 May 2026, pursuant to paragraph 2 of Article 12 - Determination of a public health emergency of international concern, including a pandemic emergency of the International Health Regulations (2005) (IHR), the Director-General (DG) of the World Health Organization (WHO), after having consulted the States Parties where the event was known to be occurring, determined that the epidemic of Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern (PHEIC), but did not meet the criteria of pandemic emergency, as defined in the IHR. The DG statement issued on 17 May 2026 also contained “WHO advice” to States Parties to respond to and prepare for the event.

    On 19 May 2026, the DG convened the first meeting of the IHR Emergency Committee regarding the epidemic of Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda (hereafter “Committee”). 

    The Committee’s advice aligned with the determination by the DG that the event constitutes a PHEIC, but does not meet the criteria for pandemic emergency. 

    The Committee acknowledged that the epidemic is occurring in one of the most challenging operational environments possible, therefore, any response must incorporate key contextual information to improve the chances of a successful response. 

    The DG, considering the advice of the Committee, he is hereby issuing the following temporary recommendations to all States Parties to respond to and prepare to respond to the PHEIC.

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Temporary recommendations

    These temporary recommendations are issued for subsets of States Parties according to the public health risk associated with the Bundibugyo virus disease epidemic they face.

    All current WHO interim technical guidance can be accessed on this page of the WHO website. WHO evidence-based guidance has been and will continue to be updated in line with the evolving situation, updated scientific evidence, and WHO risk assessment.

    The implementation of these temporary recommendations by States Parties shall be with full respect for the dignity, human rights and fundamental freedoms of persons, in accordance with the principles set out in Article 3 of the IHR.

For States Parties with documented detection of Bundibugyo virus (the Democratic Republic of the Congo and Uganda)

    As of 22 May 2026, the WHO Secretariat assessed the risk for these States Parties as “Very high” for the Democratic Republic of the Congo and as “High” for Uganda.

    It is noted that the epidemiological situation in the two States Parties differs in terms of magnitude of the epidemic and contexts where response efforts are being implemented.

    Specifically, as of 22 May 2026, Uganda has reported two confirmed cases of Bundibugyo virus disease (BVD), both with epidemiological link traceable to areas in the Democratic Republic of the Congo with documented BVD transmission. 

    In Uganda, as of the same date, no onwards transmission among contacts of the two confirmed BVD cases was documented.

    The epidemic is caused by Bundibugyo virus (BDBV), a virus belonging to the Orthoebolavirus genus. Unlike Ebola virus causing Ebola virus disease, there is no currently approved therapeutics or vaccines against Bundibugyo virus. While candidate therapeutics are considered for clinical trials and work in ongoing to fast-track candidate vaccines evaluation, the control of the epidemic relies on scaling-up public health interventions as outlined below.

Coordination and high-level engagement

    ° Declare the Bundibugyo virus disease (BVD) epidemic a health emergency, at national or sub-national level, in accordance with domestic laws, and as appropriate.

    ° Activate national disaster or health emergency management mechanisms and activate or establish an emergency operation centre, under the authority of the Head of State or relevant government authority, to coordinate response activities across Government sectors, administrative levels, and partners to ensure efficient and effective implementation and monitoring of comprehensive BVD control measures. 

        - These measures must include: 

            - enhanced surveillance, including case identification; 

            - contact tracing; 

            - infection prevention and control (IPC), 

            - risk communication and community engagement; 

            - laboratory diagnostic testing, 

            - case management, and 

            - safe and dignified burials. 

    ° Coordination and response mechanisms should be established at national level, as well as at subnational level in areas where BDBV has been detected and at-risk areas.

    ° Establish and maintain up to date a register of signals consistent with BVD (“alerts”), including status of their investigation.

    ° Establish and maintain up to date a line list of suspected cases – including identified through syndromic surveillance, probable cases, and confirmed BVD cases.  

    ° Establish and maintain up to date the list of contacts of all confirmed and probable BVD cases, and monitor each contact for 21 days after the date of last known exposure. Both the evolution of the epidemic and resources available may require risk-based prioritization of contacts requiring identification and monitoring.

    ° Negotiate, as applicable, and establish security corridors, including cross-border, to allow responders to safely reach affected communities, as well as to allow communities to seek appropriate health care.

    ° Notify WHO, through the relevant WHO IHR Contact Point in the WHO Regional Office, the detection of suspected, probable and confirmed BVD cases on a daily basis, as per WHO case definitions available here.

Risk communication and community engagement

    ° Implement large-scale trust building and community engagement interventions – using all trusted available communication channels, and working closely with local religious and traditional leaders, and traditional healers – so that communities are fully aware of the risk and benefits of control measures, and pro-actively contribute and support the early detection and early isolation of cases; the identification and monitoring of contacts; and safe and dignified burial practices.

    ° Strengthen community awareness, engagement and participation, to establish and strengthen trust, including by identifying and addressing cultural norms and beliefs that may serve as barriers to their full participation in the response; and by integrating interventions and community feedback, within the wider response, to address the needs of the population, particularly in contexts of the protracted humanitarian crisis in the Eastern provinces of the Democratic Republic of the Congo.

    ° Train community leaders on the rationale underpinning public health measures, including the isolation of cases, monitoring of contacts, and safe burials in a dignified, non-stigmatizing, and non-punitive manner.

    ° Activate local networks, including community health workers, Red Cross volunteers, and other trusted community actors to promote protective behaviours; facilitate early detection and referral of suspected BVD cases; support contact tracing activities; and collect and relay community feedback to enhance the acceptance of public health measures.

    ° Enable adherence to movement restrictions, associated with the application of control measures, by providing food, water, communication, financial and psychosocial support.

Surveillance and laboratory

    ° Strengthen surveillance and laboratory capacity, decentralized across first sub-national administrative levels (e.g., provinces) with documented BDBV detection, as well as in their neighbouring first sub-national administrative levels, through:

    ° Dedicated surveillance and response teams within each health zone and in neighbouring health zones determined to be at high risk for the introduction of BVD;

    ° Active case finding and enhanced community surveillance for clusters of unexplained illness or deaths;

    ° The investigation of “alerts” within 24 hours from detection;

    ° The scale-up and strengthen RT-PCR laboratory capacities for timely testing for BDBV, including the establishment of protocols for safe sample collection, sample referral pathways, biosafety training for laboratory workers;

    ° The decentralization of the laboratory capacities should be considered to allow for quick turn-around time and support patient care, as well as any clinical trials that may take place. Field laboratories should be set up in accordance with biosecurity and biosafety standards. A near point of care assay might be considered provided that its performance is validated against current RT-PCR standards.

    ° NB: The GeneXpert platform cannot detect Bundibugyo virus (BDBV).

    ° Identify and monitor, for 21 days after the date of last known exposure, the health of contacts of suspected probable, and confirmed BVD cases. On a daily basis, the health status of contacts being monitored should be assessed and recorded. Any contact developing symptoms compatible with BVD should be assessed, isolated, tested and cared for.

    ° Establish a mechanism to monitor the evolution of indicators related to the performance of contact tracing activities.

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, the establishment and dissemination of protocols for triage, targeted IPC interventions and sustained monitoring and supervision.

    ° Provide continuous IPC training to health care workers, including the proper use of personal protective equipment (PPE).

    ° Provide health facilities with sufficient supplies of appropriate PPE equipment to ensure the safety and protection of their staff, resources for timely payment of their salaries and, as appropriate, hazard pay.

    ° Establish channels for health workers to report and be assessed following exposures, and have access to psychosocial support and, when possible post-exposure prophylaxis under compassionate use or clinical trial. All health worker occupational exposure must be investigated to allow for immediate corrective actions.

    ° Consider building community IPC capacity by training community leaders, and emphasizing that hand hygiene not only contributes to bring the BVD epidemic under control, but also reduces the risk of transmission of other communicable diseases present in the same areas. Hand hygiene shall be facilitated at critical spots, such as schools, churches, bars, markets, local gatherings sites, points of entry, etc.

Patient referral pathway and access to safe and optimized intensive care

    ° Establish dedicated BVD isolation and treatment centers or units for suspected, probable, and confirmed cases, located within, or close to, areas with documented BDBV detection, with sufficient staff who are specifically trained and equipped to implement optimized intensive supportive care.

    ° Establish protocols for transferring suspected BVD patients safely to dedicated health care facilities for their isolation, assessment and treatment in a humane and patient-centred approach. This includes trained ambulance teams, mechanisms to notify the receiving health care facility, the application of appropriate IPC precautions during transfer, and decontamination protocols for vehicles and equipment.

    ° Establish protocols for the handling and disposal of medical waste, in accordance with biosafety principles.

    ° Establish survivor follow-up programmes, including clinical care, counselling, semen testing and sexual health advice and condoms where appropriate, along with psychosocial support and stigma-reduction programmes.

    ° Maintain the package of essential health services, including by providing IPC equipment for them to operate safely. This includes, at minimum, malaria diagnosis and treatment, and maternal and child health services.

Safe and dignified burials

    ° Establish protocols ensuring 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 relevant national laws and regulations.

Operations, supplies and logistics

    ° Establish logistics support to maintain a robust supply pipeline for PPE, diagnostics, therapeutics, and other medical commodities, IPC materials, including for safe burial.

Border health, international travel and mass-gathering events

    ° Enhance, through arrangements between countries sharing borders, surveillance at ground crossings and border areas.

    ° Implement measures, in accordance with national laws and regulations, to prevent suspected, probable, and confirmed BVD cases, as well as their contacts from undertaking international travel, unless the travel is part of an appropriate medical evacuation.

    ° Prevent the cross-border movement of the human remains of deceased suspected, probable or confirmed BVD cases, unless authorized through bilateral arrangements.

    ° Implement exit screening at all points of entry – airports, ports and ground crossings – consisting of, at a minimum, a questionnaire encompassing history of potential exposure to BVD, a temperature measurement and, in case of fever, an in-depth assessment of the risk of BVD, by personnel trained and equipped with PPE. Any traveller determined to present with an illness consistent with BVD should not be allowed to travel unless the travel is part of an appropriate medical evacuation.

    ° Report to WHO, through the relevant WHO IHR Contact Point in the WHO Regional Office, the implementation of any international traffic related measure adopted.

    ° Consider postponing mass gatherings until BVD transmission is interrupted.

Research and development of medical countermeasures

    ° Engage, when feasible, with research partners and international institutions to:

    ° Define a robust laboratory strategy, urgently implement head-to-head comparison studies of PCR diagnostics to validate or invalidate the PCR platform (Radione ®) currently used in the field.

    ° Implement ethically approved, scientifically robust clinical trials to advance the development and use of candidate therapeutics for treatment and post-exposure prophylaxis and for vaccines.

    ° Establish, with a view to support research, expedited and efficient national regulatory and ethics reviews, community engagement, pharmacovigilance (where applicable), data sharing and equitable access arrangements.

For States Parties with land borders adjoining States Parties with documented BDBV detection

    ° As of 22 May 2026, the WHO Secretariat assessed the regional risk “High”.

    ° Establish a national coordination mechanism articulated with subnational levels.

    ° Enhance rapidly the status of readiness to respond to BVD cases, including establishing active surveillance across health facilities, with zero reporting; enhancing community-based surveillance for clusters of unexplained deaths; establishing access to laboratories qualified to test for BVD; raising the awareness of health workers regarding BVD; training health workers on IPC precautions; establishing rapid response teams for the investigation and management of BVD patients and their contacts; establishing a mechanism for the identification and monitoring of contacts.

    ° Establish the capacity at national reference laboratory(ies) to timely and safely perform testing for BDBV along with relevant differential testing. Considerations may be given to shipment to an international reference laboratory for inter-laboratory comparison as part of external quality assurance implementation.

    ° Conduct international contact tracing operations as necessary, including obtaining information from airlines and other conveyances operations; identifying contacts associated with conveyances on an international voyage, and communicate with States Parties known as final destination of those contacts.

    ° Intensify risk communication and community engagement activities, in communities residing in border areas and at points of entry, including airports and ports with direct connection with States Parties with documented BDBV detection, and provide the general public with accurate and up to date information regarding the BVD epidemic and measures to reduce the risk of exposure.

    ° Exercise arrangements in place to respond to BVD through simulation exercises relating to management of BVD ” alerts”, including cross-border; sample referral; activation of rapid response teams and mechanisms.

    ° Establish, with a view to support research, expedited and efficient national regulatory and ethics reviews, community engagement, pharmacovigilance (where applicable), data sharing and equitable access arrangements.

Border health and international travel

    ° Provide travelers with accurate and up to date information regarding the BVD epidemic and measures to reduce the risk of exposure, including discouraging travel to areas with documented BDBV detection.

    ° Enhance, through arrangements between countries sharing borders, surveillance at ground crossings. This includes establishing coordination mechanisms for the detection and assessment of travelers with unexplained febrile illness; and the timely sharing of information regarding contacts who have, or may have, crossed the border, thus enabling continuity of follow-up.

    ° Pre-position PPE, other IPC materials, sample collection kits, case investigation forms, and safe burial supplies in border areas adjacent to those with documented BDBV detection.

    ° Activate health contingency plans at airport and ports, involving conveyance operators, to detect, assess, and manage travellers from States Parties with documented BDBV detection, presenting with symptoms compatible with BVD, and the identification of their contacts, according to established protocols. This entails the availability of trained personnel, referral mechanisms, application of IPC measures.

    ° Coordinate with conveyance operators to facilitate timely communication, prior to arrival and to relevant authorities, of any suspected BVD cases on board conveyances, and to identify contacts associated with conveyances on an international voyage. The identification of such contacts entails, where applicable, the communication of personal details to the States Parties known as final destination of those contacts.

    ° At the time these temporary recommendations are issued, neither the suspension of flights or waterways routes with States Parties with documented BDBV detection, nor denial of entry to travellers and conveyances arriving from those States Parties, are recommended.

    ° Report to WHO, through the relevant WHO IHR Contact Point, the implementation of any international traffic related measure adopted.

    ° Treat as a health emergency, including through a formal declaration according to domestic laws, the detection of a suspected or confirmed BVD case, of a contact thereof, or of a cluster of unexplained deaths. This include investigating any of those events within 24 hours and, by instituting case isolation and management; establishing a definitive diagnosis; and undertaking the identification and monitoring of contacts.

    ° Notify to WHO immediately, through the relevant WHO IHR Contact Point in the WHO Regional Offices, any suspected, probable or confirmed BVD case, as per WHO case definitions available here.

    ° In the presence of a BVD case, temporary recommendations for State Parties States Parties with documented BDBV detection apply.

For all other States Parties

    ° As of 22 May 2026, the WHO Secretariat assessed the risk for these States Parties as “Low”.

    ° Make arrangements to detect, assess, report and manage travelers with unexplained febrile illness arriving from areas with documented BDBV tdetection. These include, but are not limited to, disseminating the definition of BVD cases to public and private health care facilities, including travel clinics, and general practitioners; identifying laboratories to conduct testing for BDBV; identifying isolation facilities allowing for safe assessment and clinical care.

    ° Provide no-governemntal organizations and other entities deploying personnel internationally to respond to the BVD epidemic with information on risk, measures to minimize the risk of exposure, and advice for managing a potential exposure.

    ° Prepare to facilitate the evacuation and repatriation of nationals (e.g., health workers) who have been exposed to BVD cases.

    ° Provide the general public with accurate and up to date information regarding the BVD epidemic and measures to reduce the risk of exposure, including discouraging travel to areas with documented BDBV detection.

Border health and international travel

    ° Provide accurate and up to date information regarding the BVD epidemic to travel clinics, other health facilities and professionals, and discourage travel to areas with documented BDBV detection.

    ° Provide incoming travelers, at points of entry, with information about measures to take should they develop symptoms compatible with BVD within 21 days after arrival.

    ° Coordinate with the transport sector, including conveyance and points of entry operators, for the timely management of suspected BVD cases, including communication prior to arrival if the individual is on board; as well as for the identification of their contacts on board conveyance. The identification of such contacts entails, where applicable, the communication of personal details to the States Parties known as final destination of those contacts.

    ° At the time these temporary recommendations are issued, neither the suspension of flights from States Parties with documented BDBV detection, nor denial of entry to travellers and conveyances arriving from those States Parties, are recommended.

    ° Report to WHO, through the relevant WHO IHR Contact Point, the implementation of any international traffic related measure adopted.

    ° Notify to WHO immediately, through the relevant WHO IHR Contact Point in the WHO Regional Offices, any suspected, probable or confirmed BVD case, as per WHO case definitions available here.

    ° In the presence of a BVD case, temporary recommendations for States Parties with documented BDBV detection apply.

All States Parties

    ° Reporting on the implementation of temporary recommendations

    ° Report quarterly to WHO on the status of, and challenges related to, the implementation of these temporary recommendations, using a standardized tool and channels that will be made available by WHO, also allowing for the monitoring of progress and the identification of gaps in the national response.

Source: 

Link: https://www.who.int/news/item/22-05-2026-first-meeting-of-the-ihr-emergency-committee-regarding-the-epidemic-of-ebola-bundibugyo-virus-disease-in-the-democratic-republic-of-the-congo-and-uganda-2026-temporary-recommendations

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