{ "license": "CC-BY-4.0", "attribution": "EbolaIntel (https://ebolaintel.com)", "apiVersion": "v1", "generatedAt": "2026-10-15T08:11:42.238Z", "outbreak": { "id": "2026-drc-uganda", "yearStart": 2026, "yearEnd": 2026, "countries": [ "DRC", "Uganda" ], "location": "Ituri Province - Bunia, Rwampara, Mongbwalu, Nizi, Nyankunde, Mambasa, Fataki, Drodro, Mandima, Niania and other affected zones; North Kivu Province - Beni, Butembo, Katwa, Kayna, Alimbongo, Goma, Musienene and other zones; South Kivu Province - Miti-Murhesa; Haut-Uele Province - Wamba, Isiro, Pawa, Rungu, Boma Mangbetu, Dungu; Tshopo Province - Kisangani and six further zones; Bas-Uele Province - Buta, Viadana, Ganga, Dakwa; Sud-Ubangi Province - Bulu; Uganda - Kampala, Wakiso (outbreak declared over 28 July 2026); Kenya - Nairobi (one imported fatal case, October 2026, outside the headline)", "strain": "BDBV", "cases": 9086, "deaths": 4383, "cfrPct": 48.2, "active": true, "notable": "WHO declared a Public Health Emergency of International Concern on 17 May 2026. Third recognised Bundibugyo virus outbreak; no approved vaccines or therapeutics target this strain, though the Zaire-licensed vaccine Ervebo began going into frontline workers on 27 August, alongside a trial of it against this strain, with no evidence of Bundibugyo efficacy. The Director-General told the second IHR Emergency Committee on 18 August that this is the second-largest Ebola outbreak ever recorded and the fastest-moving, and UN News reported on 17 August that it had become the deadliest Ebola outbreak in DRC's history. DRC passed 9,000 confirmed cases on 11 October. INSP SitRep N°150, with data as of 11 October and published 13 October, puts DRC at 9,066 confirmed cases and 4,381 confirmed deaths, a case-fatality rate of 48.3%; the health ministry released the same figures to AP on 13 October. Adding Uganda's final 20 confirmed cases and 2 deaths takes the combined headline to 9,086 and 4,383, a crude case-fatality rate of 48.2%. Five days have landed since the 6 October SitRep N°145 figure this site last carried: 338 confirmed cases and 176 deaths, about 68 cases and 35 deaths a day, against 72 cases and about 32 deaths a day over the week before. Daily confirmations ran between 58 and 69 from 7 to 10 October, then rose to 88 on 11 October, the most since 3 October: 56 in Ituri, 28 in North Kivu and 4 in Haut-Uele. That day's 45 deaths include 37 in the community, 82.2% of the total, and test positivity rose to 20.8% from 14.3% the day before. Bunia (20 cases), Mandima (18) and Beni (16) took 61.4% of the day's confirmations. INSP reads the jump as a call to strengthen early detection and community work. WHO's latest Ebola Disease Outbreak News is still DON619 of 8 October, which carried the 6 October cut. Isolation stood at 895 patients on 11 October, down from 1,066 on 6 October. Recoveries in DRC reached 2,389, from 2,269. Contact follow-up was 79.5% of contacts under follow-up (21,512 of 27,043), down from 82.0% on 6 October and still well below the 95% the SitRep sets; North Kivu was lowest at 76.9%. North Kivu's treatment and transit centres were 88.2% full on 11 October, with another 107 patients, 22.7% of those hospitalised in the province, held in facilities that are not treatment centres; a treatment centre at Musienene is due to open on 15 October. SitRep N°150 counts 269 frontline health workers infected since the start of the outbreak, 180 of them in Ituri. Twelve zones have gone at least 42 days without a new confirmed case, and 57 of the 65 zones ever affected are counted as currently affected. Seven provinces remain in the official count, now 65 of 167 health zones. The 65th is Dakwa, in Bas-Uele, added in SitRep N°147 for 8 October with one confirmed case, isolated at Dakwa general hospital; Bas-Uele now counts 13 cases and 4 deaths across four zones and still has no standard treatment centre. The 11 October province table sums exactly: Ituri 6,695 / 3,099, North Kivu 1,911 / 1,092, Haut-Uele 383 / 162, Tshopo 59 / 22, Bas-Uele 13 / 4, South Kivu 3 / 1 and Sud-Ubangi 2 / 1, totalling 9,066 / 4,381. Ituri holds 73.8% of cumulative cases and took 182 of the 338 new confirmations since 6 October; North Kivu took 126, 37.3%, a smaller share than the week before, and its case-fatality ratio is 57.1%. Mandima, in Ituri, grew fastest, to 258 cases and 132 deaths from 198 and 98, and SitRep N°150 names it the response's priority hotspot, with teams deployed there despite security, access and community-acceptance constraints. Beni reached 458 cases and 309 deaths, from 409 and 268, and Bunia 1,832 and 612. Tshopo, South Kivu, Bas-Uele and Sud-Ubangi reported no new case on 11 October. Kenya confirmed its first imported case on 6 October. According to the Kenyan Ministry of Health, the patient, a Kenyan citizen who had been living in DRC, fell ill about a month earlier and was treated at several hospitals there, then travelled by road to Kampala and flew to Nairobi, landing on Saturday 3 October. He passed airport screening, was taken by a relative to Nairobi Hospital and isolated; the National Virology Reference Laboratory and the Kenya Medical Research Institute each confirmed Bundibugyo virus in a sample taken on 5 October, and he died after supportive care. WHO's DON619 reads the month-long course as atypical for Bundibugyo disease and presumes he was infected in a health facility or in the community in DRC while seeking care for another illness. By 7 October the ministry had identified 57 contacts, 10 of them quarantined at the National Police Service Hospital in Nairobi, and was tracing 23 passengers and four crew from the flight. By 11 October the list had grown to 122, and the health cabinet secretary said 108 of them were in quarantine without symptoms, according to ECDC. Preliminary tests on a suspected case in Wajir County were negative, the county governor said on 8 October. WHO says contact tracing has started in Kenya and in Uganda, and that a rapid risk assessment for Kenya is under way. AP notes that Uganda has kept its border with DRC closed since May; how the patient crossed has not been explained. AP counts Kenya as the fourth country to record a case linked to this outbreak, after DRC, Uganda and France. EbolaIntel keeps the Kenyan case outside the DRC-plus-Uganda headline, like the exported and evacuated cases in Europe. WHO continues to advise against any restriction of travel to or trade with affected countries. WHO's DON619 of 8 October, its first since 25 September, gives a mixed national reading: transmission remains intense but unevenly distributed, with clear signs of slowing in some areas while others continue to grow. Over the last three completed epidemiological weeks weekly cases rose 2.5%, from 475 to 487, and weekly deaths held at 224 against 222. Of the 372 deaths reported since its previous edition, 264 occurred in the community and 108 in treatment centres, which WHO reads as continuing delays in recognising illness and reaching care. Forty-eight of the 64 affected zones reported at least one case in the preceding 21 days. It names Beni and Katwa in North Kivu and Rwampara, Bunia and Mandima in Ituri as the most affected zones. The risk assessment is unchanged: very high in DRC, high for countries sharing a land border with it, low for the rest of the region and globally. The Ervebo campaign has stalled in Ituri. SitRep N°139 for 30 September reports that a temporary stockout of the vaccine halted vaccination and the associated research in the province after 817 people had been vaccinated there, and SitRep N°145 for 6 October still lists frontline-worker vaccination and the study of cross-immunity against Bundibugyo virus as suspended pending supply from the national immunisation programme. Tshopo received 600 doses on 4 October with 9,400 more announced for the week, and Bas-Uele has reached 1,412 of 13,202 targeted frontline workers, 10.7%. SitRep N°149 for 10 October still lists both as suspended in Ituri. Africa CDC said at its 8 October briefing, as relayed by Xinhua, that 7,775 frontline workers had been vaccinated under the compassionate-use protocol as of 7 October and 848 under the research protocol, which is on hold for lack of supply; Haut-Uele has vaccinated 399 of 858 pre-registered frontline workers. Ervebo is licensed for Zaire ebolavirus only; whether it protects against Bundibugyo virus is what the trial is meant to establish. Two Bundibugyo-specific vaccine candidates are now moving into Uganda. On 6 October the MRC/UVRI and LSHTM Uganda Research Unit vaccinated the first participants in Masaka City in a Phase I study of the Oxford ChAdOx1 BDBV candidate, sponsored by the University of Oxford and funded by CEPI; it measures safety and immune response in healthy adults, not protection, and the Serum Institute of India supplied about 3,000 investigational doses for it. Africa CDC said on 8 October that Moderna's candidate received ethical approval on 7 October for a Phase Ib trial in Uganda. That candidate, mRNA-1469, entered its first-in-human Phase 1 trial in Canada on 3 August, at three sites with about 80 healthy adults, also with CEPI funding. Neither is approved, and neither has shown protection against Bundibugyo virus. Getting patients into care remains the weak point. On 11 October four of the five validated suspected cases at Ituri checkpoints refused transfer to a treatment centre; the day before, two could not be referred to Mambasa for lack of beds and two more refused. SitRep N°149 reports that two confirmed patients escaped from the Pawa treatment centre in Haut-Uele. Of 334 suspected cases investigated on 11 October, 143, or 42.8%, were transferred to a treatment or transit centre. In Ituri on 10 October, safe-burial and swab teams recorded 23 failures linked to community resistance in Bambu, Mangala and Mandima. AP, reporting the 9,000 mark on 13 October, notes that a large share of deaths occur outside treatment centres. Médecins Sans Frontières said on 6 October that spread in North Kivu is out of control. Stephanie Hoffmann, who coordinates its Ebola treatment centre in Butembo, told AP that most new cases come from unknown chains of transmission, that 75% of Ebola deaths are community deaths, and that the virus is moving from the city into rural areas with no support; MSF is calling for more treatment capacity. Attacks on the response continue. SitRep N°145 reports that the surveillance focal point of Kabondo health zone in Kisangani was seriously wounded in the head with a machete during an investigation, and that a response team was attacked by residents while tracing contacts around the community death of a patient who had absconded. In North Kivu the Butuhe checkpoint in Kalunguta zone has stayed closed since a security incident on 26 September in which a health worker was killed. WHO's DON618 of 25 September, with data to 23 September (7,890 / 3,799), reads the curve province by province: in Ituri incidence continues to decline gradually from the mid-August peak although transmission remains elevated; North Kivu reached its highest reported level in mid-September, followed by a decline in recent reporting days; Haut-Uele shows sustained transmission below its late-August peak; and Tshopo shows renewed activity after a period of low incidence. WHO assesses the risk as very high in DRC, high for countries sharing a land border, and low for the rest of the African region and globally. The slower daily average since 16 September fits that reading; it is not control. Contact follow-up on 29 September was 78.7% of identified contacts (24,206 of 30,751), down from 82.0% the day before and below the 95% level the SitRep sets; North Kivu was the weakest province at 71.4%. On the vaccine side, SitRep N°138 counts 731 people vaccinated in Ituri with MSF support and 1,022 frontline workers in Bas-Uele, both with the Zaire-licensed Ervebo, while the trial of its efficacy against Bundibugyo virus continues. The last week of September brought violence around the response. On Sunday 27 September a local official of the ruling UDPS party was beaten to death at his home in Butembo, and the house set alight, after he defended the Ebola response and urged prevention on a radio programme, his party said, as reported by Reuters and AP. On the evening of Tuesday 29 September the Ebola transit centre in the Kigonze displacement camp on the outskirts of Bunia burned down. UN News reported the loss on 1 October without naming a cause; the UN senior Ebola coordinator, Julien Harneis, told AP that soldiers searching for weapons had burned the camp, forcing about 19,000 residents to flee. \"When we lose a center, that means we lose capacity, we lose investment, and we have to start again,\" he said. AP also reports surveillance workers in Bunia protesting months of unpaid wages under the slogan \"No money, no data\", and puts health-worker deaths from the virus above 50. A health worker from Europe working for Médecins Sans Frontières in DRC tested positive for Bundibugyo virus on 29 September and was flown to the Netherlands on the night of 1 October, to the high-level isolation unit at Leiden University Medical Center. ECDC describes it as the fourth case linked to this outbreak imported into Europe, all among people doing medical or humanitarian work in the affected areas, and says the risk to the general population in Europe remains very low. EbolaIntel keeps evacuated and exported cases outside the DRC-plus-Uganda headline. Money moved again at a ministerial meeting convened on 30 September under the US G20 presidency: donors announced more than US$470 million in new funding, taking global commitments to the response past US$2 billion. The United States added US$267 million, bringing its direct contribution since May to US$887 million, according to figures reported by Actualite.cd on 1 October. North Kivu's cumulative case-fatality ratio on 16 September is 61.3%, still the worst of the seven provinces. SitRep N°125 records 376 patients hospitalised in the province, 221 of them in normed structures with 228 beds, a 96.9% occupancy of those beds, with 42.1% of hospitalised patients treated outside an Ebola treatment unit and no beds left in Butembo or Katwa. That is a different occupancy arithmetic from SitRep N°122's 145.6%, which measured patients against a smaller bed count; the shortage in Butembo and Katwa has not eased. Katwa leads the province at 536 cases and 339 deaths as of 16 September, then Beni at 255 and 183, a case-fatality ratio of 71.8%, and Butembo at 244 and 157. Beni took 14 of North Kivu's 27 new confirmations that day. WHO's Olivier le Polain told a Geneva briefing on 15 September that North Kivu weekly cases had doubled from about 100 to more than 200, about 45% of the previous week's national total, and that he was particularly worried about Butembo and Katwa. He reported no confirmed case in South Kivu since the end of May, sporadic mainly imported cases in Tshopo, and more established local transmission in Haut-Uele at about 30 to 40 new cases a week. Katwa's health-zone chief told a 14 September briefing in Butembo that 16 health workers in the zone have been infected since May and that three have died; those health-worker figures are his, and they do not replace the last national count of 158 infected and 45 dead as of 21 August. The DRC government said on Friday 11 September that the 17th Ebola outbreak is under control and that the peak was reached in the third week of August, with 10 of the then 61 affected health zones reporting no new cases for at least 21 days. WHO's latest weekly assessment, as reported by Xinhua via the Independent on 14 September, is the opposite: the outbreak remains uncontrolled and increasingly heterogeneous, easing in some areas while intensifying or spreading elsewhere. Former health minister Jean-Jacques Mbungani cautioned that a downward trend in some foci is not control everywhere, and that the curve reflects detected cases. EbolaIntel does not treat the government claim as a turning point. Africa CDC said on 3 September it was too early to declare the outbreak under control; nothing in the 16 September operational numbers reverses that. On 15 September, at a Geneva briefing, WHO's Olivier le Polain said it is too early to confidently say a peak has been passed, and that bringing the outbreak fully under control will take many months. Julien Harneis, the UN senior Ebola coordinator, called it still a deadly and massive epidemic, with progress in some areas and growth in others, and said the Humanitarian Needs and Response Plan is only 49% funded. INRB director general Jean-Jacques Muyembe, briefing in Kinshasa on 15 September after a visit to Bunia, said a national peak is hard to read because the provinces are on different slopes: Ituri, he said, is descending, while North Kivu has not yet reached a plateau. He told partners not to hear 'under control' as the end of the outbreak, and said the response has to continue until the last positive contact. Those are his readings, alongside WHO's caution the same day; they do not replace SitRep N°125. On 15 September Kamba repeated the peak claim, putting daily confirmations at about 80 against about 120 at the height, daily deaths at about 30 against about 50, and the reproduction number at 0.9. Those last three figures are the minister's. SitRep N°125's 16 September window is 71 new confirmations, with North Kivu taking 38% of them. Tedros said on 16 September that the fight is far from over. Bunia MP Iracan Gratien de Saint-Nicolas, speaking to the Guardian on 15 September, warned against triumphalism. On 16 September North Kivu's 228 normed beds ran at 96.9% occupancy, with no beds in Butembo or Katwa, while Ituri sat at 43.5% of 1,015 beds. The operational numbers have recovered on contact tracing after the 13 September dip. SitRep N°125, carried by ECDC on 18 September, records 905 patients hospitalised in isolation, unchanged from 13 September, and 87.6% of identified contacts under follow-up (26,181 of 29,873), up from 78.6% three days earlier and back above INSP's own 85% threshold. Completeness is still uneven: Ituri 90.7% (13,535 of 14,926), North Kivu 85.6% (11,604 of 13,556), Tshopo 82.2%, Haut-Uele 69.3%, Sud-Ubangi 41.0%, against Bas-Uele at 95.6%. Recoveries in DRC reached 1,798, from 1,726 on 13 September. That contact figure remains a share of identified contacts rather than of the contacts that exist, and remains below the 95% operational target Africa CDC and WHO set: Africa CDC director general Jean Kaseya said on 4 August, in remarks to the Associated Press published by STAT News, that \"contact tracing is not working\", putting 60 to 70% of new cases outside traced chains. On 13 September Radio Okapi reported three confirmed cases at the Savo displacement site in Djugu territory, Ituri, a camp of more than 70,000 people in overcrowded shelters; the three patients were transferred to Fataki hospital about 20 kilometres away and contact tracing had begun. On 14 September Radio Okapi reported that response work in Damas health zone, also in Djugu, had been suspended since 13 September, with health workers demanding three months of unpaid risk bonuses and a regular supply of protective equipment, stopping patient care, contact follow-up, safe burials and awareness. The same day, health officials in Bule, in Fataki health zone, said community deaths continue daily, a single ambulance cannot run after dark, and they have asked for a transit or treatment site in Bule itself. WHO Africa Region reported on 7 September that treatment capacity had grown from a single 9-bed centre on 19 May to 59 facilities with 1,346 beds as of 1 September, 974 of them in Ituri, where overall occupancy sits around 62% while some Bunia centres run at 90 to 100%; the agency says more than 6,200 additional staff and 2,071 extra beds will be needed over the next three months. At an online briefing on 3 September, Africa CDC official Wessam Mankoula said it remains too early to declare the outbreak under control: four health zones had gone more than 42 days without a new case and five more sat between 21 and 42 days, but transmission remained active in 51 of the then 60 affected zones, more than 60% of deaths in the preceding week occurred in the community, and a two-week easing of the notification curve was, he said, not yet a sustained decline. A CDC MMWR Notes from the Field published 1 September, covering the 21 days to 21 August, puts numbers on the same gap: only 15 to 20% of new confirmed cases had been identified as contacts (target above 90%), 59% of confirmed deaths occurred outside a treatment unit, an average of 10.6 contacts were listed per case against a target of 20, and only 49% of affected health zones had a safe-burial team. CDC calls that uncontrolled expansion. At an online briefing on 20 August, Yap Boum II, head of emergency preparedness and response at Africa CDC, estimated the official count may capture only 30 to 40% of actual infections, implying an outbreak up to three times the reported size; director general Jean Kaseya has said the epidemic is not under control, could eventually surpass the West African death toll unless the response changes, and has pointed to evidence suggesting transmission may have begun around February, months before the 15 May declaration. The agency has also outlined a plan to block transmission toward major riverside population centres, above all Kinshasa, a megacity of nearly 20 million where no case has been confirmed. Africa CDC and WHO issued a joint call on 6 August, after a senior delegation visited the affected provinces, for an urgent scale-up of community-led response. They reported DRC at 3,973 confirmed cases, 1,801 deaths and 776 recoveries across 51 health zones in five provinces as of 4 August, with 99 new confirmed cases and 52 deaths in the preceding 24 hours, and named resistance to some response activities, misinformation and population movement as the barriers holding the response back. The prescription is the one Kaseya has repeated since June: communities directly involved in surveillance, referrals, treatment, safe and dignified burials and decisions affecting their families, testing and treatment brought closer to where people live, treatment capacity expanded, and frontline health workers protected, equipped, supported and paid on time. The last of those remains unsettled in the official record more than three weeks after the Rwampara and Bunia strikes began. Money has moved, and from the government whose withdrawal from global health aid this page has tracked as a constraint on the response. The US Department of State announced on 5 August that it intends, working with Congress, to provide an additional US$242 million for Ebola response and preparedness in DRC and Uganda and for related humanitarian assistance. That brings total direct State Department assistance for this outbreak to more than US$512 million and makes the United States the largest single financial contributor to the response. The announcement is aligned with the commitment of up to a further US$500 million the US government made at the G7 leaders summit on 16 June. The release describes the money as covering emergency operations, surveillance and early detection, isolation and treatment, laboratory strengthening, community engagement and screening at points of entry, and reports nearly 300 metric tonnes of medical and infection-prevention supplies distributed, support to more than 180 health facilities and more than 8.6 million health screenings conducted. Set against Africa CDC's estimate that the combined humanitarian and health response needs about US$1.4 billion, it is the largest single movement on the funding gap this outbreak has produced, and it sits alongside entry restrictions from the same government that organisations running treatment beds have said impede staffing. Treatment capacity has grown with it: UN News reported on 3 August that the International Medical Corps had opened a 100-bed Ebola treatment centre at the Kigonze displacement camp on the outskirts of Bunia, described as the largest in the country, with US support. Marking one hundred days of the outbreak on 23 August, Kaseya told AFP partners have promised about US$1 billion with roughly US$700 million already counted as committed, and he pressed for the money to reach the organisations working on the ground. Tedros posted on X on 22 August that all actors must do more to end the epidemic. The vaccine story of this outbreak broke in the week of 17 August. The DRC government requested a release of Ervebo from the global Ebola virus disease vaccine stockpile managed by the International Coordinating Group on Vaccine Provision; on Monday 17 August the ICG informed Kinshasa of an immediate initial release of 70,000 doses, and WHO and Africa CDC welcomed the allocation in a joint release on 20 August. The split is the story: 20,000 doses are earmarked for a Phase 3 randomised clinical trial of the vaccine against Bundibugyo virus, and 50,000 are for frontline and health workers under current SAGE recommendations, which means some people at risk will receive it outside any trial. WHO states plainly that it is not known whether Ervebo protects against Bundibugyo virus in humans, that early laboratory and animal data suggest it may provide some protection, and that people offered the vaccine must be informed of the risks, potential benefits and limitations and give informed consent. The recommendation to study Ervebo in a randomised trial came from the third meeting of WHO's Technical Advisory Group on Candidate Vaccine Prioritization, convened 31 July with the report published 7 August. For calibration: since the stockpile mechanism was established in January 2021 through July 2026, just over 56,000 Ervebo doses had been allocated for outbreaks in DRC and a further 167,000 used in preventive campaigns across five countries, so this single release is larger than every outbreak response allocation combined. What this does not change: Ervebo is licensed for Zaire ebolavirus only. It remains unapproved for Bundibugyo, its use here is an emergency deployment wrapped around a trial rather than a licence extension, and no efficacy data against this strain exists yet. The first tranche has landed: newsrooms reported more than 16,000 doses arriving in the country by Saturday 22 August. The campaign itself began on Thursday 27 August, when health minister Roger Kamba gave the first dose to a health worker in Kisangani, the Tshopo provincial capital, more than three months into the emergency. More than 50,000 of the released doses had reached the country by then. The rollout runs first through Tshopo, Bas-Uele and Haut-Uele, the three least affected of the six counted provinces, and works inward: \"We will cover all the provinces that are around Ituri, moving in the ring towards the centre\", Kamba said, having framed the priority as protecting \"first those who are on the front line\". Officials describe the frontline-worker component as compassionate use, the route that allows an unapproved product to be given in a serious disease, and their stated rationale is that the two viruses are related closely enough that Ervebo may offer some cross-protection. That is a hypothesis, not a finding. It is precisely what the 20,000-dose trial is designed to test, and until it reports there is no human efficacy data for Ervebo against Bundibugyo virus. WHO convened the second IHR Emergency Committee meeting on 18 August, three months to the day after the PHEIC declaration. The Director-General's opening remarks set the frame: the epidemic is far from under control, fueled by insecurity, displacement and intense population movement along roads, rivers and mining routes, and what concerns him most is where people are dying, at home and outside treatment centres and known contact lists, each such death pointing to a chain of transmission not yet found. Representatives of DRC, Uganda and France attended. As we checked on 21 August no statement from the committee had been published; the statement then landed on Monday 24 August, six days after the meeting, and resolves what this page had been tracking: the Director-General, acting on the Committee's advice, has issued an updated set of temporary recommendations under the IHR, the instrument that governs an ongoing determination, and nothing in the document terminates the PHEIC. Two structural changes stand out. First, the community-transmission group now contains only the DRC: Uganda, whose outbreak was declared over on 28 July, moves into the neighbouring-country group alongside Angola, Burundi, the Central African Republic, the Republic of the Congo, Rwanda, South Sudan, Tanzania and Zambia, at a risk level WHO assesses as high against very high for DRC. Second, a wholly new section on social measures, mass gatherings and domestic mobility instructs DRC to postpone mass gatherings in transmission zones, reduce crowding in bars, restaurants and nightclubs, limit motorbikes to one passenger, plan safe school openings, run 24/7 health checkpoints on roads connecting affected areas to those at high risk of introduction, and place Bundibugyo surveillance aboard vessels navigating inland waterways toward major urban centres including Kinshasa: the river-corridor shielding Africa CDC sketched last week is now written into the emergency framework. Elsewhere the updated set asks for security corridors so responders can reach communities, immigration and customs fast-tracking for responders and supplies, investigation of every death occurring outside treatment structures, and health-workforce management that names timely payment of salaries and, as appropriate, hazard pay, the exact demand the Bunia and Rwampara strikers have made since July. The meeting sat alongside other August outputs: a high-level cross-border consultative meeting on 17 August, WHO operational guidance on protecting health care during the response published the same day, and Rapid Risk Assessment version 4 published 20 August. The heads of WHO, the WHO African Region and Africa CDC published a joint commentary on 25 August, under a title that argues the deadliest Bundibugyo Ebola outbreak can be stopped. Tedros Adhanom Ghebreyesus, Mohamed Yakub Janabi and Jean Kaseya write that DRC's seventeenth Ebola outbreak is the second largest ever recorded and is moving faster than any previous one, fuelled by insecurity from decades of armed conflict, and they put it at 5,290 confirmed cases and 2,516 deaths across 56 health zones as of 21 August. Their health-worker figure is the freshest we hold from a primary source: 158 infected, 45 dead. Their ask is arithmetic rather than rhetoric, that surveillance, treatment centres, infection prevention and community engagement all be scaled to two or three times current capacity. The commentary makes no mention of vaccines or therapeutics anywhere in its prescription, which is the shape of this outbreak in one detail: the case for stopping it rests entirely on response infrastructure, because no licensed medical countermeasure targets the strain causing it. WHO's flagship products have begun catching up but remain behind national reporting. A Disease Outbreak News published on 14 August is the first in that series since DON614 of 1 August, which remains the reference for the operational detail it carried: epidemiological week 30 was then the worst of the outbreak on both counts at 567 confirmed cases and 296 deaths, health-worker infections stood at 151 confirmed including 44 deaths with a 29% case-fatality ratio, and contact tracing had scaled without tightening, 13,455 of 17,863 identified contacts under follow-up. The weekly external situation report has been stale since number 11 carried data to 26 July. This cut is taken from the INSP SitRep N°114 PDF itself, data as of 5 September, and matches the ECDC outbreak page updated 7 September. ReliefWeb still refuses automated requests, but insp.cd served the source PDF for this refresh. Both rankings now carry the Director-General's own authority, and both have moved. On 18 August Tedros told the second IHR Emergency Committee this is the second-largest Ebola outbreak ever recorded and the fastest-moving any response has faced. The case ranking was settled on 1 August, when DON614 stated the outbreak had surpassed the 2018-2020 Kivu epidemic, which WHO puts at 3,317 confirmed cases in its own account; the combined headline of 6,624 clears every version of that comparison by more than 3,300 cases. The death ranking resolved during the week ending 17 August, when UN News reported WHO describing the outbreak as the deadliest in DRC's history: the combined toll of 3,177 has passed Kivu's 2,299 deaths, at crude case-fatality ratios of roughly 48% against Kivu's 66%. The 2013-2016 West Africa epidemic, with 28,616 cases and more than 11,300 deaths across Guinea, Liberia and Sierra Leone, remains the largest and deadliest by a wide margin. At a WHO briefing in Geneva on 14 July, after returning from Bunia, Dr Chikwe Ihekweazu, Executive Director of WHO's Health Emergencies Programme, put a name and an attribution to the under-detection thesis EbolaIntel had previously carried only as an unnamed official: \"We think, with some of our support and modelling, the scale of the outbreak is at least 2-4 times the number of cases we are finding.\" He said 80% of new cases are turning up outside contact lists, from transmission chains nobody has traced, and that over the preceding few days the outbreak had produced some of its highest single-day counts, including more than 80 cases confirmed in one 24-hour period. WHO characterises this as the fastest-growing Ebola outbreak it has managed and, at close to 2,000 confirmed cases and more than 700 deaths across five provinces, the third-largest Ebola outbreak on record. Ihekweazu described the response as running behind the virus: \"You have to imagine that this is a fire. There is something driving the fire in its heart, and it is also expanding at the same time.\" He reported treatment capacity in Bunia now close to 800 beds and rising weekly, and laboratory capacity grown from 1 laboratory to 14, while naming four constraints that continue to hold the response back: a funding gap, attacks on health centres, the armed conflict in eastern DRC, and community mistrust. A figure carried by ECDC from the WHO Africa Region situation report quantifies how much of the epidemic is happening out of sight: 92.3% of 430 deaths investigated up to 5 July occurred in the community or before admission to a health facility, which ECDC attributes to delays in detection, referral, isolation and access to care. Africa CDC director general Jean Kaseya put a fresher number on the same problem alongside the 30 July ministry update: 63% of confirmed deaths over the preceding two weeks occurred outside treatment centres, which he attributed largely to unsafe handling of bodies by relatives and neighbours, including touching the dead. Reporting of the same Africa CDC briefing by CIDRAP adds two measures this page had not carried. The first is a pace comparison: Africa CDC puts the case count at about seven times what the 2013-2016 West Africa epidemic had recorded at the equivalent point in its own course, which is the arithmetic behind the fastest-growing description rather than a separate claim. The second is diagnostic yield: national test positivity is running above 40%, against the 38.1% Ituri figure the 18 July situation report recorded, and a positivity rate that high is itself evidence of under-testing rather than of a well-characterised epidemic, because a surveillance system finding most of its cases would be testing far more people who turn out negative. Kaseya said he would travel to Bunia the following week to meet DRC health officials, and framed the way out in the same terms he has used since June: \"We need to rethink the way to work with the community if we really want to stop this outbreak. There is no magical solution unless we really work with communities.\" He put the unlinked-case share specifically at over 80% in Ituri. That is a lower share than the 92.3% ECDC recorded for deaths investigated to 5 July, but the two figures are not directly comparable, covering different windows and different denominators, and both point the same way: most transmission-relevant deaths are still happening where the response is not. WHO Disease Outbreak News DON613, published 17 July, reports 119 health-worker infections in DRC including 36 deaths and 61 recoveries, up from the 112 infections and 35 deaths INSP reported earlier. The 80% figure has not improved. Coverage of the second-largest milestone on 31 July put it the same way Ihekweazu had a fortnight earlier: four in five new confirmed cases have no traceable connection to any known patient, which is why response officials have been unable to say whether the epidemic has peaked or when existing tools would bring it under control. Africa CDC assessed the outbreak as still uncontrolled the same day. Two field descriptions from 31 July capture what that looks like on the ground. Carl Skau of the UN World Food Programme said, \"It is the fastest spreading Ebola epidemic that we have ever seen. The world needs to pay much more attention.\" Angele Gapio of Caritas in Bunia described the shift from an importable outbreak to an endemic one: \"The disease has now settled in the community. People continue to seek treatment from traditional healers, and the chain of transmission continues.\" Staff at Bunia General Hospital and the Rwampara treatment centre were reported still on strike over unpaid wages and working conditions at the end of July, the dispute that first closed Rwampara on 13 July now in its third week without a published settlement. The response is also being disrupted from inside. On Monday 13 July, dozens of staff at the Rwampara Ebola treatment centre in Bunia, Ituri, including epidemiologists, case investigators, drivers and gravediggers, stopped work over salaries and bonuses unpaid since the outbreak was declared, closing the facility and blocking its access road; strikers said suspending care and clinical surveillance would leave hospitalised patients with almost no chance. Health workers at Bunia General Hospital also walked out, and DRC's INSP confirmed that continuity of essential health services in Bunia and Rwampara had been compromised. Staff agreed on 14 July to resume work on condition the government paid within 72 hours. Health minister Roger Kamba said the delay came from verifying the response payroll after unrelated names were added to it. Work resumed at Bunia and Rwampara after the intervention of Ituri's military governor, Major-General Gaby Kasongo Mulumba, who met the response's strategic coordination at the governorate on 15 July, but the 72-hour deadline passed without payment. At a press briefing in Bunia on Saturday 18 July, response officials committed to paying the arrears and announced corrective measures rather than a date: validation of personnel lists, digitalisation of the payment system, and a progressive shift to digital payments. They attributed the arrears to administrative and logistical problems rather than to a lack of money. Radio Okapi reported on 19 July that no payment date had been given. The dispute is still unresolved in the official record: the DRC situation report for 18 July continues to list non-payment of response workers among its principal challenges, noting the strike in the Bunia and Rwampara health zones and a resumption announced after the military governor's intervention, recording the impact as an interruption of response activities including safe and dignified burials, and calling for payments to be regularised and dedicated funding secured. SOS Medias Burundi reported on 18 July that the industrial action has spread beyond Ituri, with doctors, nurses, laboratory technicians and community health agents in the Butembo and Beni health zones of North Kivu and in Kisangani, Tshopo, on indefinite strike over unpaid salaries and hazard pay, disrupting surveillance, contact tracing and community awareness work; that report rests on a single outlet and EbolaIntel has not been able to corroborate it against a second source. Rwampara and Bunia are the same two sites hosting the new EBO-PEP prophylaxis trial. On 18 July, the Associated Press reported that at least a dozen attacks on health facilities and health workers have been recorded during this outbreak, a count attributed to Pierre Akilimali, incident manager for the Ebola response, speaking at a briefing in Bunia. Response team members have been held captive in some health zones and safe-burial teams threatened in cemeteries, and AP reported that safety fears are pushing health and aid workers to withdraw from remote communities into Bunia, which shrinks the surveillance footprint precisely where undetected chains are suspected. The most recent incident was at Nyankunde in Ituri on Wednesday 15 July, where a crowd attacked the hospital and the adjacent Ebola treatment centre after a woman who had come to give birth died of severe anaemia when the hospital declined a blood transfusion offered by her family, transfusions being restricted under outbreak protocol. Stones were thrown, the perimeter fence was damaged, several of the Ebola patients under treatment escaped, the medical team left and the facility generator stopped working; Samaritan's Purse evacuated staff from the adjacent treatment centre and treatment resumed on 16 July. UN News reported on 24 July that MONUSCO, the UN peacekeeping mission, had deployed a mobile operating base near Nyankunde on 16 July to protect the treatment centre and the referral hospital, after which daily admissions the medical director had seen fall away began to recover. The DRC situation report separately records an attack on safe-burial teams at the Muchanga bridge and community resistance at Komanda and Mandima, and formally attributes access constraints to the armed groups CODECO and ADF. UN OCHA has recorded 76 security incidents affecting Ebola response and other aid workers across Ituri, North Kivu and South Kivu since the outbreak began, with 45 response and aid workers wounded; on 7 July, attackers raided an Ebola treatment centre in Butembo, North Kivu, and set part of it alight. Africa CDC director general Jean Kaseya has said the combined humanitarian and health response now requires about US$1.4 billion, roughly triple the US$518 million continental plan launched on 5 June, with about US$910 million pledged at the African Union high-level meeting of 17 June but only around 13% of that released to affected countries. At a health summit in Ghana on 22 July, as the outbreak passed 1,000 deaths, Kaseya put the Africa CDC death count at 1,031 and framed the toll bluntly: \"These are people dying. They are dying because we don't have vaccines, we don't have medicine, we don't have funding.\" Outlets covering the milestone, among them Al Jazeera and Euronews, noted this outbreak has reached 1,000 deaths faster than any previous Ebola outbreak, against roughly eight months for the 2013-2016 West Africa epidemic that remains the deadliest on record at more than 11,000 deaths, and Africa CDC renewed its call for stronger protection of frontline health workers through reliable protective equipment, infection-prevention systems, training and psychosocial support. At the WHO media briefing on 16 July, Tedros said the joint WHO and Africa CDC continental plan still faces a shortfall of more than US$400 million, and framed closing it as an investment in security rather than charity. He reported treatment capacity above 800 beds, laboratory capacity grown from one facility to 16, contact follow-up near 80%, and more than 21,000 community health workers in training, while repeating that the outbreak continues to outpace the response. UNICEF said on 15 July that only 25% of the funding it requires for its Ebola response is available, a figure its regional director Gilles Fagninou gave on returning from a mission to Ituri. On 16 July the Global Fund approved US$4.6 million in emergency funding for an intensified malaria response across four Ituri health zones, covering mass drug administration, insecticide-treated nets and spatial repellents, explicitly to protect the Ebola response by reducing the number of febrile patients who present as suspected Ebola cases and consume isolation beds; the Global Fund had already approved US$8.2 million in emergency support in May and June, US$6.4 million for DRC and US$1.8 million for Uganda. On 15 July, two months into the outbreak, Medecins Sans Frontieres appealed for an urgent scale-up of the international medical response in Ituri, reporting that its 90-bed Elikiya treatment centre in Bunia is almost always at full capacity, so patients keep arriving late and critically ill and deaths that earlier diagnosis and care might have prevented continue. The DRC situation reports put numbers on constraints the response has described qualitatively for weeks. As of 18 July, 724 patients were in isolation, 272 confirmed and 452 suspected, against 857 beds nationally, an occupancy rate of 84.5%. North Kivu is the province in deficit, at 123.1% occupancy with 181 patients against 141 beds, while Ituri ran at 76.3% with 539 patients against 706 beds and Tshopo at 40%. The report lists insufficient treatment-centre capacity among its principal challenges, warning of admission delays and a raised risk of transmission inside health facilities. The Musienene health zone in North Kivu, which has no Ebola treatment centre or transit centre at all, recorded four of the province's 16 new confirmed cases that day. Infection prevention remains thin: only 175 of 1,170 triage units in Ituri were functional, and shortages of personal protective equipment and chlorine are listed as drivers of the 119 frontline infections recorded in the province. Four patients absconded from treatment structures in 24 hours. Surveillance volume is high and improving: 872 alerts were logged in a single day, 825 of them investigated within 24 hours, a 94.6% investigation rate, validating 192 suspected cases of whom 80 were community deaths. Laboratory positivity on 18 July was 38.1% in Ituri, 67 of 167 samples, against 12.6% in North Kivu, 16 of 127. Decentralised laboratories are being installed at Butembo, Mambasa and Logo, with diagnostic kits and equipment deployed to Mahagi for a further laboratory. Only 9 of 33 points of entry and control were operational in Haut-Uele, where the report calls for 23 priority points to be activated. Ten additional ambulances were handed over to the response in Bunia on 16 July, and a further ambulance was received by the points-of-entry pillar on 18 July, to improve patient evacuation and sample transport from remote and insecure areas. Alongside the epidemiological pillars, a prevention of sexual exploitation and abuse workstream has begun training focal points for the Bunia-area health zones with support from WHO, Save the Children and UNFPA, with briefings planned for responders deploying to Tshopo and Haut-Uele, and UNAIDS has joined the response on Ebola and HIV co-infection in Ituri and Tshopo. France reported one imported confirmed Ebola case on 24 June in a doctor who had returned from a humanitarian mission in one of the DRC transmission zones. The DRC government said the doctor worked from 22 May to 19 June at an Ebola treatment centre in Rwampara, Ituri province, then travelled through Kinshasa before flying to France on 23 June. France has isolated five possible flight contacts. EbolaIntel notes France separately and does not fold it into the DRC-plus-Uganda headline total unless WHO or ECDC include France in affected-country totals. On 30 June, Reuters reported that DRC health authorities were tracing possible Ebola spread to two provinces not previously in the case count, Haut-Uele and Tshopo, both linked to Ituri's Niania health zone. In Tshopo, the body of a pregnant woman who fell ill in Niania on 18 June and died on 27 June was carried about 300 kilometres by motorcycle to Kisangani, where a sample taken at a morgue tested positive; the body had passed through several health zones before diagnosis, and authorities launched contact tracing across the province. In Haut-Uele, two contacts of Niania cases who had been placed in isolation for testing fled to the province, one testing positive and the other awaiting confirmatory testing, before both were located and returned to Niania; DRC's National Institute of Biomedical Research had earlier confirmed a Haut-Uele case to Agence France-Presse. Haut-Uele borders South Sudan and the Central African Republic, and Tshopo, whose capital Kisangani is a major Congo River hub, lies west of Ituri; Haut-Uele's involvement means the whole of DRC's northeast, home to about 15 million people, is now affected. WHO DON612, published 3 July, now reports confirmed cases with travel history from Nia-Nia detected in Wamba health zone (Haut-Uele) and in Kisangani (Tshopo), so both provinces have confirmed detections, though transmission is still traced back to Ituri rather than established locally and their cases are counted within the national total. The same day as the Reuters report, the DRC Interior Ministry banned political rallies, public marches and other mass gatherings in Kinshasa and the northeastern provinces of Tshopo, Haut-Uele and Bas-Uele to limit physical contact, and President Tshisekedi announced a national response plan budgeted at US$319 million, with initial emergency funds already mobilised. DRC's reported contact follow-up stands at 83.2% in Ituri and 81% in North Kivu. The response is unfolding against deep cuts to global health aid. Reporting on 6 July by CNBC, and separately by PBS NewsHour and the Harvard T.H. Chan School of Public Health, quotes infectious-disease specialists and virologists who say the dismantling of USAID in 2025 has demonstrably worsened the outbreak: USAID had trained health workers to recognise Ebola, supplied testing kits and personal protective equipment, and helped move samples to laboratories, and its withdrawal has slowed contact tracing, eroded community trust, and left existing medical supplies harder to move into the worst-hit parts of Ituri. A Rockefeller Foundation and Echelon Insights poll published on 7 July, fielded 12-16 June among 2,022 US voters, found that 75% of Americans support restoring US disease-prevention aid for the DRC Ebola outbreak and 90% support funding overseas disease-prevention programmes generally. On 7 July, UN News reported WHO warning that the outbreak is still not under control. WHO's representative in DRC, Dr Anne Ancia, said, \"We would like to say it is stabilising, but frankly, we cannot say it yet.\" WHO said treatment centres are operating at saturation point with too few ambulances to move patients, while daily laboratory testing has risen from about 30 tests in Kinshasa to more than 2,000 across 10 decentralised laboratories, with a new laboratory opening in Bunia, and more than 1,200 treatment doses are now available for the PARTNERS trial. More than 10,000 contacts are being monitored, and insecurity from armed conflict in Ituri, North Kivu and South Kivu continues to constrain the response. Uganda declared its outbreak over on 28 July 2026, and EbolaIntel has corrected its own reporting to match. The Ministry of Health announced the end of the 2026 Ebola disease outbreak that day, closing a national epidemic of 20 confirmed cases, 18 recoveries and 2 deaths, a case-fatality rate of about 10%; 15 of the 20 were imported from DRC and five were Ugandans infected while caring for patients, four health workers and a driver. The declaration turns on which discharge started the clock, and the public record carries two answers. The Ministry counted 42 days, two maximum incubation periods for Bundibugyo virus, from the discharge of the last Ugandan national on 16 June, which lands on 28 July; wire coverage of the declaration described 16 June simply as the day the last patient was discharged. WHO Africa Region had announced on 16 July that Uganda was entering the 42-day countdown that day, after the last confirmed case tested negative a second time and was discharged from care, a clock that would have run to 27 August. Uganda's last confirmed case was reported on 21 June, five days after the day zero the Ministry used. The Ministry's stated rationale is that the 42-day rule remains an essential safeguard in outbreaks where transmission is uncertain, but that this one was fully characterised: a documented importation event, an identified source of infection, every confirmed case epidemiologically linked, genomic sequencing, and every identified contact through institutional quarantine and 21-day follow-up with no evidence of further transmission and no unexplained community spread. WHO concurred on 26 August, four weeks after the Ministry, declaring the Ugandan outbreak over after 42 days without a new confirmed case. The two declarations differ only in which discharge started the clock: WHO's own countdown, announced as beginning on 16 July, put the earliest end date in the last week of August, and that is where its declaration landed. Diana Atwine, permanent secretary at the Ministry of Health, said the country had assessed the risk and the whole chain of transmission. Until 26 August WHO had published no concurrence, and this page had tracked that gap: its weekly external situation report number 11, with data as of 26 July, carried no statement that Uganda's outbreak had ended, and on 16 July WHO representative Dr Kasonde Mwinga had cautioned that the last discharge was an encouraging moment rather than the end of the response. ECDC records the end date of 28 July on its outbreak page. EbolaIntel had reported on 29 July that Uganda was on day thirteen of a countdown running to 27 August, treating the first declaration reports as secondary overclaims; that was wrong, the Ministry had declared the outbreak over the previous day, and the correction is logged in our change log. Uganda's 20 cases and 2 deaths stay inside the cumulative headline, which counts the epidemic rather than the active caseload. Before the declaration Uganda's reported geography was the two districts of Kampala and Wakiso, both in the Kampala metropolitan area, with 2,482 people tested, 831 all-time contacts, 821 completed 21-day follow-ups and 5,465 travellers screened at points of entry. On 24 July Uganda extended cross-border solidarity in the other direction, handing five ambulances, 50 beds and mattresses and other equipment to the Aru health zone on the Ituri side of the border. Africa CDC has cited Uganda as evidence the outbreak can be controlled. The wider DRC outbreak is unaffected by Uganda's closure: it remains very active across six provinces and its own 42-day clock has not started. Xinhua reports WHO emergency official Abdirahman Mahamud saying this is the largest number of confirmed cases in the first month of an Ebola disease outbreak in Africa. Xinhua also reports Tedros saying treatment capacity has increased from fewer than 10 beds to more than 500 beds across 19 health centres, while laboratory capacity has expanded from about 30 tests per day in Kinshasa to more than 2,000 tests per day across nine laboratories in three provinces. ECDC reports an attack on a safe and dignified burial team in Mongbwalu health zone and reports that five workers were taken hostage at points of entry/control after false accusations that they were spreading Ebola disease through their work. AP reports the burial of a 6-month-old child in Bunia, the third child from an orphanage to die during the outbreak, and says the response is being complicated by clashes over disrupted burials and militarised response measures at times. NPR reported that residents attacked a health team in the territory of Aru on Monday 17 August after a suspected case was reported there, setting fire to an ambulance and damaging two other vehicles; RFI's 19 August account adds that a paramedic was wounded, that local youths sacked Kandoy hospital in the Biringi health zone as an ambulance collected two suspected cases, leaving the driver in a coma and the patients unaccounted for, and that on 15 August only 21 of 171 planned decontamination rings opened in Ituri, with only five ambulances operational in North Kivu. Save the Children estimates at least 180 Congolese children have lost both parents or caregivers since the outbreak began. WHO and Africa CDC launched a six-month US$518 million continental preparedness and response plan on 5 June, covering June-November 2026 and prioritising surveillance, laboratory testing, IPC, clinical care, community engagement, logistics, research, and essential health services in DRC, Uganda, and at-risk neighbouring countries. Uganda and Rwanda have both closed their borders with DRC. CDC said on 18 June that it had more than 125 staff working in DRC and Uganda and had accessed US$107 million in emergency funding to strengthen the international response and domestic readiness. WHO assesses DRC risk as very high, Uganda risk as high, countries sharing land borders with documented BDBV detection as high, and risk to the rest of the African Region and globally as low. WHO advises against travel or trade restrictions on DRC or Uganda. CDC says no Ebola cases have been confirmed within the United States and risk to the US public and travellers remains low, although on 10 July it reported that a US citizen working for a humanitarian organisation in DRC had tested positive for Bundibugyo virus, the second US national infected in this outbreak after one was evacuated to Germany in May. The US has nonetheless restricted entry, and tightened it in mid-July on two fronts. A CDC order suspends the entry of foreign nationals who have been in DRC, Uganda or South Sudan within the prior 21 days; it did not lapse on 21 July as previously scheduled, because a further order continuing the suspension was signed on 13 July 2026 by the Assistant Secretary for Health, took effect at 5:00pm EDT that day for 30 days; CDC's situation page now records a renewed order of 12 August continuing the restrictions under 42 CFR 71.40. US citizens and nationals remain exempt from that order, but from Monday 13 July they face a separate restriction: the US began barring US citizens who have been in DRC from boarding commercial flights home until they have spent at least 21 days in a third country, imposed through a do-not-board list under Title 49 transportation authority on guidance from the Secretary of Health and Human Services and published in a CDC website update on 14 July, with case-by-case exceptions possible on humanitarian or law-enforcement grounds. It replaces the previous arrangement of direct return with enhanced airport screening. A US official said about two dozen Americans were due to board US-bound flights when the measure took effect and that the State Department is working with them through the waiting period, while CDC provides medical assessments to Americans in DRC. The measure has drawn the first significant pushback from an organisation running treatment beds in DRC: Samaritan's Purse, which Reuters reports has about 80 US citizens deployed in the country, has treated more than 270 patients and operates roughly 100 beds, said the requirement will impede staffing of Ebola treatment facilities. Its chief executive Franklin Graham said it will \"hurt us getting the staff that we need\" and compromise \"the level of care that we will be able to provide\", and objected to health workers being treated \"like they are damaged goods\". The US Department of Health and Human Services did not immediately respond to Reuters. Canada became the second G7 country to close its border to this outbreak. The Public Health Agency of Canada announced on 19 July that, as of 11:59pm EDT on Monday 20 July, foreign nationals who have been in DRC within the previous 21 days are prohibited from entering Canada, enforced through an Interim Order under the Aeronautics Act requiring commercial and private air carriers not to board them on Canada-bound flights. Canadian citizens, permanent residents and persons registered under the Indian Act are exempt from the entry ban: those who have been in DRC, Uganda or South Sudan within the previous 21 days may still travel, but receive a health assessment on arrival and must quarantine for 21 days, a requirement in force under the Quarantine Act since 30 May. The measures were due to expire on 29 August 2026, and on 28 August Ottawa extended them for a further 30 days to 28 September, keeping the entry bar, the hold on immigration and visa decisions for residents of DRC, Uganda and South Sudan, and the 21-day quarantine all in force. Ottawa described the step as taken out of an abundance of caution and said the health risk to Canadians remains low, and no Ebola case has been reported in Canada. Reuters noted the move runs against WHO advice: WHO has repeatedly asked countries not to impose travel or trade restrictions on DRC or Uganda during this outbreak, warning that blanket measures disrupt the supply chains and staffing the response depends on. US officials cited greater community spread into western DRC as the rationale; as of 10 September that characterisation is no longer only a stated basis, because Sud-Ubangi in the north-west is now in the official count, though still as a single imported case rather than established local transmission. Enhanced airport screening for returning travellers runs in parallel. On 2 July, the UN Development Programme estimated the outbreak could cut DRC economic output by about 1.6%, more than US$1 billion, eliminate about 55,000 jobs and push nearly one million more people into poverty, with Africa-wide losses of US$2.37 billion to US$3.6 billion depending on how far the outbreak spreads. On 3 July, South African President Cyril Ramaphosa visited Kinshasa and urged continental solidarity with DRC's Ebola response. On 17 June, WHO issued comprehensive filovirus clinical-management guidelines that cover Bundibugyo virus disease and stress early recognition, rapid referral, optimized supportive care, laboratory monitoring, careful rehydration, shock management, antibiotics when bacterial infection is present, and structured after-care for survivors. Following an expert consultation convened on 28 May, WHO advisory groups concluded that Ervebo, licensed only for Zaire ebolavirus, should not be used outside carefully designed research settings for Bundibugyo, because evidence of cross-protection to other Ebola virus species remains limited and inconclusive. That posture has since shifted in practice: the SAGE-recommended allocation of 50,000 doses to frontline and health workers puts Ervebo into arms outside trial settings, a step beyond the May position, while the licensing fact is unchanged. No vaccine or therapeutic has received Emergency Use Listing or prequalification for Bundibugyo virus. On 2 July, WHO announced that patient enrolment had begun in the PARTNERS trial, the Platform Adaptive Randomised Trial for New and Repurposed Filovirus TreatmentS, the first clinical trial of treatments for Bundibugyo virus disease. The first patient was enrolled in Bunia; the trial is sponsored by WHO and coordinated by the Congolese National Institute of Biomedical Research (INRB), the Institute of Tropical Medicine in Antwerp, and the University of Oxford, with support from Africa CDC. Patients of any age with confirmed disease are randomised to standard care alone, standard care plus MBP134, standard care plus remdesivir, or both drugs plus standard care, with mortality at 28 days as the primary endpoint; the trial aims to recruit 700 to 1,000 participants over six months. The United States and Gilead Sciences are donating the trial doses. On 18 August the Director-General reported that PARTNERS had enrolled 100 patients across three facilities in Ituri. On 14 July, recruitment opened for EBO-PEP, the first trial of a post-exposure prophylaxis against Bundibugyo virus, resolving the open question left by DRC health minister Samuel Roger Kamba's 10 July announcement that such a trial would start within the week. The trial coordinators and the International Pandemic Preparedness Secretariat describe recruitment as opening in both DRC and Uganda, with the first sites in Ituri. EBO-PEP tests obeldesivir, an investigational oral antiviral developed by Gilead Sciences with no Bundibugyo-specific human efficacy data, in nearly 1,000 participants aged over 12 who had direct contact with a confirmed case within the previous five days and are symptom-free at enrolment, with daily monitoring for 21 days and a final visit at day 42. The first PEP centres sit next to the ALIMA-run treatment centres in Bunia and Rwampara. It is coordinated by ALIMA with DRC's INRB and France's ANRS Emerging Infectious Diseases, supported by Medecins Sans Frontieres and Africa CDC, and funded by EUR 3.4 million from the Global Health EDCTP3 partnership, US$1 million from Africa CDC and US$5 million combined from DRC and South Africa; several newsrooms have framed it as a Gilead-run trial, which it is not. A secondary protocol offers compassionate-use remdesivir to children under 12 and to pregnant or breastfeeding women, who are excluded from the obeldesivir arm. The trial is designed as a platform intended to extend to Uganda and beyond. On 13 July, the Oxford Vaccine Group launched BD-Ebov, the world's first Phase 1 trial of a Bundibugyo vaccine candidate, testing ChAdOx1 BDBV for safety and immune response in 50 healthy adults aged 18-55 in Oxford; it vaccinated the first volunteer on 24 July, the first time any Bundibugyo vaccine candidate had been given to a human. The Serum Institute of India manufactured and stockpiled about 620,000 doses of the candidate in two weeks and supplied 4,000 investigational doses for the Phase 1 study. UN News reported on 4 August that a second Bundibugyo-specific vaccine trial had started in Canada that week, and on 18 August the Director-General stated that two vaccines designed specifically against Bundibugyo virus have entered human trials, with a separate vaccine that has shown cross-protection in animal studies, Ervebo, moving toward a Phase 3 trial; the second BDBV-specific candidate is Moderna's mRNA-1469, first dosed in Nova Scotia on 3 August in a Phase 1 trial at three Canadian sites, according to CEPI. On 30 July, CEPI announced up to US$8.5 million for Hilleman Laboratories, a Singapore-based joint venture of MSD and Wellcome, to develop and manufacture rVSV-platform Bundibugyo vaccine doses for clinical trials from master virus seed material generated by IAVI, with MSD advising. All of these products remain investigational: no vaccine or therapeutic is approved against Bundibugyo virus. On 1 June, CEPI committed up to US$62 million to accelerate three Bundibugyo vaccine candidates: up to US$50 million for a Moderna mRNA candidate, US$8.6 million for the Oxford ChAdOx1 BDBV candidate, and US$3.2 million for the IAVI rVSV-BDBV candidate. On 9 June it added US$1.9 million to Public Health Vaccines LLC of Cambridge, Massachusetts, to generate master viral seed stock for a second rVSV-based Bundibugyo candidate, a fourth developer alongside Moderna, Oxford and IAVI. The only regulatory milestone this outbreak has produced is diagnostic, not preventive or therapeutic: on 2 July WHO added the first Bundibugyo virus test to its Emergency Use Listing, an RT-qPCR kit from Shanghai ZJ Bio-Tech that detects and distinguishes pathogenic ebolavirus species.", "primarySource": "https://www.cdc.gov/wcms/vizdata/ebola/ebola-case-counts-web-updates.csv", "centroid": { "lat": 1.5601, "lng": 30.2473 }, "locations": [ { "name": "Bunia", "country": "DRC", "healthZone": "Bunia health zone, Ituri Province", "lat": 1.5601, "lng": 30.2473, "cases": 1832, "deaths": 612, "note": "Highest-count zone: 1,832 confirmed cases and 612 deaths as of 11 October, 20 of them new that day. Ituri stands at 6,695 / 3,099, 73.8% of the national total. Ervebo vaccination in Ituri remains suspended for lack of doses. Hosts PARTNERS and EBO-PEP trials.", "noteFr": "Zone la plus touchée : 1,832 cas confirmés et 612 décès au 11 octobre, dont 20 nouveaux ce jour-là. L'Ituri compte 6,695 cas et 3,099 décès, 73,8% du total national. Faute de doses, la vaccination Ervebo y reste suspendue." }, { "name": "Rwampara", "country": "DRC", "healthZone": "Rwampara health zone, Ituri Province", "lat": 1.585, "lng": 30.21, "cases": 1132, "deaths": 393, "note": "Peri-urban zone adjoining Bunia, second-highest count: 1,132 confirmed cases and 393 deaths as of 11 October. Hosts one of the first EBO-PEP prophylaxis centres. Site of the 13 July salary strike.", "noteFr": "Zone périurbaine voisine de Bunia, deuxième bilan : 1,132 cas confirmés et 393 décès au 11 octobre. Accueille l'un des premiers centres de prophylaxie EBO-PEP. Site de la grève salariale du 13 juillet." }, { "name": "Mongbwalu", "country": "DRC", "healthZone": "Mongbwalu health zone, Ituri Province", "lat": 1.945, "lng": 30.038, "cases": 712, "deaths": 341, "note": "Gold-mining area and early epicentre: 712 confirmed cases and 341 deaths as of 11 October, no new case that day. Informal healthcare, crowded mining camps and miner mobility still complicate contact tracing.", "noteFr": "Zone minière aurifère et premier épicentre : 712 cas confirmés et 341 décès au 11 octobre, sans nouveau cas ce jour-là. Soins informels, camps miniers surpeuplés et mobilité des mineurs compliquent le suivi des contacts." }, { "name": "Nizi", "country": "DRC", "healthZone": "Nizi health zone, Ituri Province", "lat": 1.8667, "lng": 30.15, "cases": 813, "deaths": 290, "note": "Gold-mining zone north of Bunia, third-highest count: 813 confirmed cases and 290 deaths as of 11 October, ahead of Mongbwalu.", "noteFr": "Zone minière aurifère au nord de Bunia, troisième bilan : 813 cas confirmés et 290 décès au 11 octobre, devant Mongbwalu." }, { "name": "Nyankunde", "country": "DRC", "healthZone": "Nyankunde health zone, Ituri Province", "lat": 1.4167, "lng": 30.0167, "cases": 133, "deaths": 39, "note": "Mission-hospital town south of Bunia: 133 confirmed cases and 39 deaths as of 11 October. On 15 July a crowd attacked the hospital and adjacent treatment centre after a maternal death; treatment resumed 16 July.", "noteFr": "Ville d'hôpital missionnaire au sud de Bunia : 133 cas confirmés et 39 décès au 11 octobre. Le 15 juillet, une foule a attaqué l'hôpital et le centre de traitement voisin après un décès maternel ; les soins ont repris le lendemain." }, { "name": "Tchomia", "country": "DRC", "healthZone": "Tchomia health zone, Ituri Province", "lat": 1.35, "lng": 30.86, "cases": 76, "deaths": 25, "note": "Lake Albert health zone: 76 confirmed cases and 25 deaths as of 11 October, unchanged since 29 September. Cross-border lake corridor with fishing and trade complicates surveillance.", "noteFr": "Zone de santé du lac Albert : 76 cas confirmés et 25 décès au 11 octobre, sans changement depuis le 29 septembre. Sur ce corridor lacustre transfrontalier, la pêche et le commerce compliquent la surveillance." }, { "name": "Fataki", "country": "DRC", "healthZone": "Fataki health zone, Ituri Province", "lat": 1.99137, "lng": 30.56845, "cases": 84, "deaths": 31, "note": "Ituri health zone: 84 confirmed cases and 31 deaths as of 11 October. On 13 September Radio Okapi reported three confirmed cases at the Savo displacement site in Djugu territory, which holds more than 70,000 displaced people.", "noteFr": "Zone de santé de l'Ituri : 84 cas confirmés et 31 décès au 11 octobre. Le 13 septembre, Radio Okapi a signalé trois cas confirmés sur le site de déplacés de Savo, en territoire de Djugu, qui accueille plus de 70,000 personnes." }, { "name": "Drodro", "country": "DRC", "healthZone": "Drodro health zone, Ituri Province", "lat": 1.75792, "lng": 30.54298, "cases": 15, "deaths": 7, "note": "Ituri health zone: 15 confirmed cases and 7 deaths as of 11 October, unchanged since 9 September.", "noteFr": "Zone de santé de l'Ituri : 15 cas confirmés et 7 décès au 11 octobre, sans changement depuis le 9 septembre." }, { "name": "Mandima", "country": "DRC", "healthZone": "Mandima health zone, Ituri Province", "lat": 1.0631, "lng": 29.0497, "cases": 258, "deaths": 132, "note": "Ituri's fastest-growing zone: 258 confirmed cases and 132 deaths as of 11 October, from 198 / 98 on 6 October, with 18 new cases that day. SitRep N°150 names it the response's priority hotspot and reports extra teams deployed.", "noteFr": "Zone de l'Ituri à la plus forte progression : 258 cas confirmés et 132 décès au 11 octobre, contre 198 et 98 le 6 octobre, dont 18 nouveaux cas ce jour-là. Le SitRep N°150 en fait le foyer prioritaire de la riposte." }, { "name": "Goma", "country": "DRC", "healthZone": "Goma health zone, Nord-Kivu Province", "lat": -1.6792, "lng": 29.2228, "cases": 1, "deaths": 0, "note": "Major urban centre (~1 million) on the Rwanda border. SitRep N°150 still lists a single confirmed case and no death in Goma. North Kivu as a whole has reached 1,911 cases and 1,092 deaths as of 11 October.", "noteFr": "Grande ville d'environ un million d'habitants à la frontière rwandaise. Le SitRep N°150 n'y recense toujours qu'un cas confirmé, sans décès. Le Nord-Kivu compte 1,911 cas et 1,092 décès au 11 octobre." }, { "name": "Musienene", "country": "DRC", "healthZone": "Musienene health zone, Nord-Kivu Province", "lat": -0.67195, "lng": 28.86673, "cases": 143, "deaths": 69, "note": "North Kivu: 143 confirmed cases and 69 deaths as of 11 October. A treatment centre in Musienene is due to open on 15 October; in July the zone had no treatment or transit centre, so patients were moved elsewhere to be isolated.", "noteFr": "Nord-Kivu : 143 cas confirmés et 69 décès au 11 octobre. Un centre de traitement doit y ouvrir le 15 octobre ; en juillet, la zone ne disposait ni de centre de traitement ni de centre de transit Ebola." }, { "name": "Katwa", "country": "DRC", "healthZone": "Katwa health zone, Nord-Kivu Province", "lat": 0.1268, "lng": 29.3167, "cases": 628, "deaths": 383, "note": "North Kivu's largest count: 628 confirmed cases and 383 deaths as of 11 October, a case-fatality ratio of 61.0%. SitRep N°150 flags secure access for teams in Katwa as a priority. 16 health workers infected there since May, three died.", "noteFr": "Premier bilan du Nord-Kivu : 628 cas confirmés et 383 décès au 11 octobre, une létalité de 61,0%. Le SitRep N°150 fait de l'accès sécurisé des équipes à Katwa une priorité. 16 agents de santé y ont été infectés depuis mai." }, { "name": "Butembo", "country": "DRC", "healthZone": "Butembo health zone, Nord-Kivu Province", "lat": 0.1414, "lng": 29.2911, "cases": 297, "deaths": 185, "note": "Trading city of roughly a million people: 297 confirmed cases and 185 deaths as of 11 October. MSF, which runs a treatment centre here, said on 6 October that spread in North Kivu is out of control, with most new cases from unknown chains.", "noteFr": "Ville commerçante d'environ un million d'habitants : 297 cas confirmés et 185 décès au 11 octobre. MSF, qui y gère un centre de traitement, a jugé le 6 octobre la propagation au Nord-Kivu « hors de contrôle »." }, { "name": "Beni", "country": "DRC", "healthZone": "Beni health zone, Nord-Kivu Province", "lat": 0.4972, "lng": 29.4722, "cases": 458, "deaths": 309, "note": "North Kivu: 458 confirmed cases and 309 deaths as of 11 October, from 409 / 268 on 6 October, a case-fatality ratio of 67.5%. 16 new cases on 11 October. Beni ranks sixth nationally and second in the province after Katwa.", "noteFr": "Nord-Kivu : 458 cas confirmés et 309 décès au 11 octobre, contre 409 et 268 le 6 octobre, une létalité de 67,5%. 16 nouveaux cas le 11 octobre. Beni est la sixième zone du pays et la deuxième de la province après Katwa." }, { "name": "Mabalako", "country": "DRC", "healthZone": "Mabalako health zone, Nord-Kivu Province", "lat": 0.5539, "lng": 29.2725, "cases": 63, "deaths": 22, "note": "63 confirmed cases and 22 deaths as of 11 October, from 51 / 20 on 6 October. Mabalako was the index zone of the 2018-2020 Kivu epidemic.", "noteFr": "63 cas confirmés et 22 décès au 11 octobre, contre 51 et 20 le 6 octobre. Mabalako était la zone index de l'épidémie du Kivu de 2018-2020." }, { "name": "Kayna", "country": "DRC", "healthZone": "Kayna health zone, Nord-Kivu Province", "lat": -0.60927, "lng": 29.17249, "cases": 3, "deaths": 2, "note": "Lubero territory, the 61st affected zone on 3 September with a single case identified at an AFC/M23 checkpoint. Two community deaths confirmed on 2 October took it to three cases and two deaths, the day neighbouring Alimbongo entered the count.", "noteFr": "Territoire de Lubero, 61e zone touchée le 3 septembre avec un cas identifié à un poste de contrôle de l'AFC/M23. Deux décès communautaires confirmés le 2 octobre portent le bilan à trois cas et deux décès." }, { "name": "Alimbongo", "country": "DRC", "healthZone": "Alimbongo health zone, Nord-Kivu Province", "lat": -0.36879, "lng": 29.15618, "cases": 5, "deaths": 3, "note": "Lubero territory, North Kivu: the 64th affected zone, added on 2 October with four confirmed cases including two deaths; five cases and three deaths as of 11 October, unchanged since 6 October.", "noteFr": "Territoire de Lubero, Nord-Kivu : 64e zone touchée, ajoutée le 2 octobre avec quatre cas confirmés dont deux décès ; cinq cas et trois décès au 11 octobre, sans changement depuis le 6 octobre." }, { "name": "Bulu", "country": "DRC", "healthZone": "Bulu health zone, Sud-Ubangi Province", "lat": 3.25, "lng": 19.77, "cases": 2, "deaths": 1, "note": "Seventh affected province: 2 confirmed cases and 1 death as of 11 October, the first detection west of the eastern cluster. The first patient fell ill in Kisangani after passing through Rwanda, Uganda and Ituri, then went on by river. Marker at Gemena.", "noteFr": "Septième province touchée : deux cas confirmés et un décès au 11 octobre, premier foyer à l'ouest du bloc oriental. Le premier patient avait développé des symptômes à Kisangani avant de poursuivre par voie fluviale. Position approximative (Gemena)." }, { "name": "Miti-Murhesa", "country": "DRC", "healthZone": "Miti-Murhesa health zone, Sud-Kivu Province", "lat": -2.5045, "lng": 28.8606, "cases": 3, "deaths": 1, "note": "South Kivu's only affected zone, north of Bukavu: 3 confirmed cases and 1 death, unchanged in the 11 October table, and no longer counted as currently affected. Marker coordinates are approximate to Bukavu.", "noteFr": "Seule zone touchée du Sud-Kivu, au nord de Bukavu : 3 cas confirmés et 1 décès, sans changement au 11 octobre ; elle ne figure plus parmi les zones actuellement affectées. Position approximative (Bukavu)." }, { "name": "Haut-Uele", "country": "DRC", "healthZone": "Haut-Uele Province (Wamba, Isiro area)", "lat": 2.7739, "lng": 27.6186, "cases": 383, "deaths": 162, "note": "Fourth affected DRC province: 383 confirmed cases and 162 deaths as of 11 October across seven of 13 health zones. Wamba holds 128 cases, Isiro 102, Pawa 100. SitRep N°149 reports two confirmed patients escaped from the Pawa treatment centre.", "noteFr": "Quatrième province touchée : 383 cas confirmés et 162 décès au 11 octobre dans sept des 13 zones de santé. Wamba compte 128 cas, Isiro 102, Pawa 100. Le SitRep N°149 signale l'évasion de deux cas confirmés du CTE de Pawa.", "scope": "province" }, { "name": "Kisangani", "country": "DRC", "healthZone": "Tshopo Province (Kisangani area)", "lat": 0.5153, "lng": 25.1911, "cases": 59, "deaths": 22, "note": "Tshopo capital and Congo River hub: 59 confirmed cases and 22 deaths as of 11 October across seven of 23 zones, 32 in Makiso-Kisangani. No new case on 11 October. A Kabondo surveillance worker was badly wounded with a machete in early October.", "noteFr": "Chef-lieu de la Tshopo et port fluvial : 59 cas confirmés et 22 décès au 11 octobre dans sept des 23 zones, dont 32 à Makiso-Kisangani. Aucun nouveau cas le 11 octobre. Un agent de surveillance de Kabondo a été blessé à la machette début octobre.", "scope": "province" }, { "name": "Buta", "country": "DRC", "healthZone": "Buta area, Bas-Uele Province", "lat": 2.808, "lng": 24.7297, "cases": 13, "deaths": 4, "note": "Bas-Uele, sixth affected province: 13 confirmed cases and 4 deaths as of 11 October across four of eleven zones. Dakwa became the 65th affected zone nationally on 8 October. The province still has no standard treatment centre.", "noteFr": "Bas-Uélé, sixième province touchée : 13 cas confirmés et 4 décès au 11 octobre dans quatre des onze zones. Dakwa est devenue le 8 octobre la 65e zone touchée du pays. La province n'a toujours pas de CTE aux normes.", "scope": "province" }, { "name": "Kampala", "country": "Uganda", "lat": 0.3476, "lng": 32.5825, "cases": 20, "deaths": 2, "note": "Uganda declared its outbreak over on 28 July 2026; WHO concurred on 26 August after 42 days without a new confirmed case. Final national count: 20 confirmed cases, 18 recoveries and two confirmed deaths, a case-fatality rate of about 10%, plus one probable case and one probable death that CDC lists and we keep outside the confirmed tally. Fifteen cases were imported from DRC and five were Ugandans infected while caring for patients, four health workers and a driver; reported geography stayed within Kampala and neighbouring Wakiso. The last confirmed case was reported on 21 June and the last admitted patient was discharged from Mulago National Referral Hospital on 16 July. Africa CDC has cited Uganda as evidence the outbreak can be controlled.", "noteFr": "L'Ouganda a déclaré la fin de son épidémie le 28 juillet 2026 ; l'OMS l'a actée le 26 août après 42 jours sans nouveau cas. Bilan final : 20 cas confirmés, 18 guérisons et 2 décès. Quinze cas étaient importés de RDC." }, { "name": "Nairobi", "country": "Kenya", "lat": -1.2921, "lng": 36.8219, "cases": 1, "deaths": 1, "note": "Imported case, outside the headline: a Kenyan citizen living in DRC travelled by road to Kampala, flew to Nairobi on 3 October, tested positive on 5 October and died. 122 contacts listed; 108 in quarantine without symptoms as of 11 October.", "noteFr": "Cas importé, hors total : un Kényan vivant en RDC, venu par la route jusqu'à Kampala puis en avion à Nairobi le 3 octobre, testé positif le 5 octobre, est décédé. 122 contacts listés, dont 108 en quarantaine sans symptômes au 11 octobre.", "imported": true } ] } }