Bundibugyo Ebola in DRC and Uganda

What we know

• ● Strain. Lab-confirmed Bundibugyo ebolavirus (BDBV). This is the third recognised BDBV outbreak; prior ones were Uganda 2007–2008 (149 cases, 37 deaths) and DRC 2012 Orientale Province (57 cases, 29 deaths).
• ● Geography. On 30 June, Reuters reported that DRC health authorities were tracing possible 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 morgue sample tested positive; contact tracing is now under way across the province. In Haut-Uele, two Niania contacts who had been placed in isolation fled to the province, one testing positive and the other awaiting confirmation, before both were returned to Niania; DRC's National Institute of Biomedical Research had earlier confirmed a Haut-Uele case to AFP. Haut-Uele borders South Sudan and the Central African Republic, and Tshopo lies west of Ituri around the Congo River hub of Kisangani; Haut-Uele's involvement means the whole of DRC's northeast, home to about 15 million people, is now affected. Tshopo remains under investigation and outside the confirmed headline. The DRC Interior Ministry banned political rallies, marches and other mass gatherings in Kinshasa and the northeastern provinces of Tshopo, Haut-Uele and Bas-Uele to limit physical contact. ECDC's 1 July update places DRC confirmed cases across 35 health zones in Ituri, North Kivu, and South Kivu: Ituri 1,214 confirmed cases and 335 deaths from 23 of 36 health zones, North Kivu 116 and 63 from 11 health zones, and South Kivu 3 and 1 from one health zone, and it now lists Haut-Uele as a newly affected province identified through cases in Ituri's Nia-Nia health zone. WHO DON608 remains the latest public health-zone count snapshot for the highest-count zones: Bunia 247, Rwampara 195, Mongbwalu 189, and Nyankunde 68. Uganda reports 20 confirmed cases on its 2 July dashboard, unchanged on the headline count: 15 imported cases and 5 local cases, with reported geography still centred on Kampala and Wakiso. ECDC says Uganda's most recent confirmed case was reported on 21 June and no new confirmed cases had been reported since. France reported one imported confirmed case on 24 June in a doctor returning from a DRC transmission zone; ECDC and CDC list it alongside one earlier US citizen medically evacuated to Germany, both imported from affected DRC areas. Uganda and Rwanda have both closed their borders with DRC. Africa CDC has named 10 at-risk neighbouring countries: Angola, Burundi, Central African Republic, Republic of Congo, Ethiopia, Kenya, Rwanda, South Sudan, Tanzania, and Zambia. WHO assesses DRC risk as very high, Uganda risk as high, land-border countries adjoining documented BDBV detection as high, and risk to the rest of Africa and globally as low. CDC says no US cases have been confirmed because of this outbreak and recommends avoiding non-essential travel to Ituri, North Kivu, and South Kivu.
• ● Counts. The headline tally counts confirmed cases only in DRC and Uganda: 1,426 cases and 440 deaths. CDC's case-count CSV now lists DRC at 1,406 confirmed cases and 438 confirmed deaths as of 30 June, up from 1,333 / 399 the day before, with about 210 people recovered per WHO; ECDC, last updated 1 July, still carries the preceding 1,333 confirmed cases and 399 deaths as of 29 June, with 609 people hospitalised in isolation and an 82.7% contact follow-up rate. Uganda holds at 20 confirmed cases and 2 confirmed deaths on its 2 July dashboard, plus one probable case and one probable death; the probable case/death is not folded into the confirmed headline. Uganda's dashboard lists 16 recoveries, 2 current admissions, 2,152 people tested, 831 all-time contacts, 0 active contacts under follow-up, 821 contacts who completed 21-day follow-up, 604 alerts, 594 verified alerts and 5,465 travellers screened at points of entry (2,105 inbound, 1,714 outbound). The imported France case is noted separately and kept outside the DRC-plus-Uganda headline total unless WHO, ECDC or CDC include France in affected-country totals. WHO officials have said the response has scaled up but is still being outpaced: treatment capacity has increased from fewer than 10 beds to more than 500 beds across 19 health centres, and laboratory capacity has expanded to more than 2,000 tests per day across nine laboratories, yet contact tracing, isolation capacity and safe burials still lag what is needed. Tedros has stressed that the response is fighting the outbreak without approved vaccines or therapeutics for Bundibugyo virus. On 2 July, the UN Development Programme estimated the outbreak could cut DRC economic output by more than US$1 billion and push nearly one million more people into poverty, with Africa-wide losses of US$2.37 billion to US$3.6 billion. The apparent case-fatality rate of 30.9% reflects confirmed-case reporting and will keep moving as late deaths and suspected cases are classified.
• ● WHO classification. PHEIC declared 17 May 2026 - the IHR Emergency Committee cited urban spread, healthcare-worker infections, and the lack of approved countermeasures for this strain.
• ● Countermeasures. No approved vaccine or therapeutic targets Bundibugyo virus. All approved products (Ervebo, Zabdeno + Mvabea, Inmazeb, Ebanga) cover Zaire ebolavirus only. On 5 June, WHO and Africa CDC launched a six-month US$518 million continental preparedness and response plan covering June-November 2026, with priorities including surveillance, laboratory testing, IPC, clinical care, community engagement, logistics, research, and essential health services. On 30 June, DRC President Tshisekedi announced a national response plan budgeted at US$319 million, with initial emergency funds already mobilised, and the Interior Ministry banned mass gatherings in Kinshasa, Tshopo, Haut-Uele and Bas-Uele. 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. On 17 June, WHO issued filovirus clinical-management guidelines covering Bundibugyo virus disease, with emphasis on 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. On 2 July, WHO announced that patient enrolment had begun in the PARTNERS trial (Platform Adaptive Randomised Trial for New and Repurposed Filovirus TreatmentS), the first clinical trial of treatments for Bundibugyo virus disease, which enrolled its first patient in Bunia. Sponsored by WHO and coordinated by the Congolese National Institute of Biomedical Research, the Institute of Tropical Medicine in Antwerp and the University of Oxford, it randomises patients of any age with confirmed disease 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 and a target of 700 to 1,000 participants over six months; the United States and Gilead Sciences are donating the doses. The Oxford Vaccine Group announced on 22 May that it is working with the Serum Institute of India to scale doses of its monovalent ChAdOx1 BDBV candidate, with trial doses estimated 2-3 months out; the single-dose rVSV-based BDBV candidate developed by IAVI, which WHO has identified as the most promising vaccine in development, is seven to nine months from human efficacy trials. On 1 June, CEPI committed up to US$62 million to fast-track three BDBV 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, covering preclinical work and Phase 1 trials. A WHO expert consultation on 28 May concluded that Ervebo should not be used outside carefully designed research settings for Bundibugyo, because evidence of cross-protection to other Ebola species remains limited and inconclusive. WHO stressed that every identified candidate be used exclusively within clinical trials. Investigational candidates and supportive care define the response.