WHO AFRO weekly situation report 6

Data as of 2026-06-21
Published
June 21, 2026
Published by WHO, republished here as text
This is the text layer of a PDF published by the WHO Regional Office for Africa, extracted without change and laid out as the PDF lays it out. The record of authority is the PDF in IRIS.

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BUNDIBUGYO VIRUS DISEASE OUTBREAK
Democratic Republic of the Congo | Uganda
Weekly External Situation Report 06, Data as of 21 June 2026

Summary
Total Cases Total Deaths CFR (%)
Confirmed Confirmed Probable Probable
Country (Confirmed (Confirmed Confirmed
Cases Deaths Cases Deaths
& Probable) & Probable) & Probable
Democratic
Republic of the
Congo
1 048 267 - - 1 048 267 25.5%
Uganda 20 2 1 1 21 3 14.3%
Note: Only confirmed and probable cases are reported.

Event description
Since the last update of 14 June 2026 (Situation Report #5), the Bundibugyo virus disease (BVD) outbreak in the
Democratic Republic of the Congo has continued to evolve, with cumulative incidence surpassing the milestone of
1000 laboratory-confirmed cases and the number of affected health zones continuing to increase. Sustained
community transmission continues to be observed across multiple hotspot and newly affected health zones. In
Uganda, one new confirmed case was reported after nearly two weeks without a case.

Democratic Republic of the Congo
Since 14 June 2026, a total of 240 new laboratory-confirmed cases, including 75 new confirmed deaths, have been
reported, representing a 29.7% increase in cumulative confirmed cases and a 39.1% increase in cumulative confirmed
deaths. As of 21 June 2026, a cumulative total of 1048 laboratory-confirmed cases, including 267 confirmed deaths
[case fatality ratio (CFR) 25.5%], has been reported across the three affected provinces of Ituri, North Kivu, and South
Kivu.

Figure 1. Weekly trends of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo
by epidemiological week of report, epidemiological weeks 14 – 25, 2026

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The number of affected health zones has increased from 31 to 34, representing 22 of 36 health zones in Ituri Province,
11 of 34 in North Kivu Province, and one of 34 in South Kivu Province. Newly affected health zones reported since
the previous update include Drodro and Fataki in Ituri Province and Musienene in North Kivu Province. South Kivu
remains comparatively stable, with no new confirmed cases reported since 26 May 2026.

Ituri Province remains the epicentre of the outbreak, accounting for 954 confirmed cases (91.0%) and 216 confirmed
deaths (80.9%) reported nationally. The highest cumulative case counts have been reported from Bunia (285 cases),
Mongbwalu (229 cases), Rwampara (215 cases), and Nyankunde (86 cases) health zones, which together account for
77.8% of all confirmed cases reported in Ituri Province. Additional transmission has also been reported from Nizi (26
cases), Lita (21 cases), and Bambu (14 cases) while sporadic cases continue to emerge from several other health
zones across the province.

North Kivu Province has reported 91 confirmed cases and 50 confirmed deaths to date, corresponding to the highest
provincial CFR (54.9%) among affected provinces. Transmission remains concentrated in Katwa (31 cases), Butembo
(29 cases), and Beni (18 cases) health zones, which are densely populated urban and commercial centres with
substantial population mobility and regional connectivity.

Figure 2. Geographical distribution of confirmed cases of Bundibugyo virus disease in the Democratic Republic of
the Congo and Uganda, as of 21 June 2026

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Of the 34 affected health zones in the Democratic Republic of the Congo, four have not reported any new confirmed
cases for more than 21 days. These include Gety in Ituri Province (31 days), Goma (27 days) and Kalunguta (28 days)
in North Kivu Province, and Miti Murhesa in South Kivu Province (32 days). Despite this, transmission remains highly
concentrated in a limited number of hotspot health zones. Within the past 21 days, the highest numbers of confirmed
cases were reported from Bunia (198 cases), Mongbwalu (196 cases), Rwampara (136 cases), and Nyankunde (46
cases) in Ituri Province, and Butembo (28 cases) and Katwa (26 cases) in North Kivu Province. Together, these six
health zones accounted for 84.7% (630) of all confirmed cases reported nationally during the same period . While
the absence of recent reported cases in some health zones may suggest controlled transmission, continued
surveillance and monitoring remain essential given ongoing operational challenges, including insecurity, population
movement and the potential for delayed case detection and reporting.

Among the 501 confirmed cases with complete age and sex information available for analysis, 400 cases (79.8%)
occurred among adults aged 20 – 49 years, with the highest numbers reported among females aged 20 – 29 years
(101 confirmed cases) and males aged 30 – 39 years (70 cases), indicating sustained transmission among
economically active population groups. The overall CFR was higher among males (30.7%) compared to females
(20.8%). The highest age-specific CFRs were observed among children aged 0 – 9 years, reaching 75% overall,
including 80% among females and 68.8% among males. Elevated CFRs were also observed among adults aged ≥70
years (35.7%), suggesting disproportionately severe outcomes among the youngest and oldest age groups.

Figure 3. Demographic distribution of confirmed cases of Bundibugyo virus disease by age group and sex in the
Democratic Republic of the Congo (n=501)

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Figure 4. Case fatality ratio of Bundibugyo virus disease by age group and sex in the Democratic Republic of the
Congo (n=501)

As of 21 June 2026, a total of 8424 contacts were under follow-up across the three affected provinces, of whom 5962
(70.8%) had reportedly been seen within the previous 24 hours. Contact follow-up coverage remains suboptimal,
particularly in North Kivu Province (64.3%) and Ituri Province (72.7%), posing ongoing challenges to the timely
identification of secondary case and rapid interruption of transmission chains.

During the reporting period, insecurity, community resistance, and operational constraints continued to impact
outbreak response activities in several affected areas, particularly in Ituri and North Kivu provinces. Reports indicated
ongoing hostility toward response measures, including resistance to safe and dignified burial operations, as well as
continued challenges for response teams operating in insecure and hard-to-reach communities.

Uganda
One new confirmed case has been reported in Uganda since the previous external situation report, following nearly
two weeks without any case. As of 20 June 2026, Uganda has reported a cumulative total of 21 cases (20 confirmed
and one probable), including three deaths (two confirmed and one probable), across Kampala and Wakiso districts
within the Kampala Metropolitan Area. The outbreak remains epidemiologically linked to cross-border transmission
from the Democratic Republic of the Congo.

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Figure 5. Weekly trends of confirmed cases of Bundibugyo virus disease in Uganda by epidemiological week of
report, epidemiological weeks 18 – 25, 2026

Males accounted for 13 of the 20 confirmed cases (65%) and females for seven cases (35%). Cases have been
reported across several adult age groups, with the highest numbers observed among persons aged 30 – 39 years and
50 – 59 years, each accounting for six cases (30%), followed by 20 – 29 years (four cases, 20%). Relatively few cases
were reported among children and adolescents, with one case each reported among females aged 0 – 9 years and
10 – 19 years. Overall, the age and sex distribution indicates that transmission in Uganda has predominantly affected
working-age adults, particularly males, likely reflecting patterns of occupational exposure, mobility, caregiving
responsibilities, and cross-border movement associated with the outbreak.
Since the start of the outbreak, a total of 826 contacts have been identified. As of 20 June 2026, 56 contacts remain
under active follow-up.

Table 1. Confirmed cases and deaths of Bundibugyo virus disease in the Democratic Republic of the Congo and
Uganda by geographic area, as of 21 June 2026
Country Province / Health zone / Cum. Cum. CFR % Cases (last Deaths (last Date last case Days since last
Region district cases deaths 21 d) 21 d) case
Democratic Ituri Aru 3 1 33.3 1 0 2026-06-04 17
Republic of
the Congo Aungba 6 2 33.3 3 2 2026-06-18 3
Bambu 14 2 14.3 10 0 2026-06-20 1
Bunia 285 45 15.8 198 17 2026-06-21 0
Damas 4 0 0.0 3 0 2026-06-13 8
Drodro 1 1 100.0 1 1 2026-06-12 9
Fataki 1 0 0.0 1 0 2026-06-16 5
Gety 1 0 0.0 0 0 2026-05-21 31
Kambala 1 1 100.0 1 1 2026-06-10 11
Kilo 7 1 14.3 3 1 2026-06-17 4
Komanda 10 3 30.0 8 1 2026-06-17 4
Lita 21 6 28.6 12 2 2026-06-21 0
Logo 2 0 0.0 2 0 2026-06-04 17
Mambasa 2 1 50.0 2 0 2026-06-01 20
Mangala 11 5 45.5 11 5 2026-06-21 0
Mongbwalu 229 96 41.9 196 87 2026-06-21 0

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Country Province / Health zone / Cum. Cum. CFR % Cases (last Deaths (last Date last case Days since last
Region district cases deaths 21 d) 21 d) case

Nia-Nia 2 2 100.0 2 2 2026-06-21 0
Nizi 26 5 19.2 18 0 2026-06-18 3
Nyankunde 86 9 10.5 46 6 2026-06-21 0
Rimba 3 0 0.0 3 0 2026-06-02 19
Rwampara 215 36 16.7 136 16 2026-06-21 0
Tchomia 7 0 0.0 7 0 2026-06-21 0

Subtotal — Ituri 954 216 22.6 664 141 2026-06-21 0
North Beni 18 12 66.7 18 12 2026-06-21 0
Kivu
Butembo 28 13 46.4 28 13 2026-06-21 0
Goma 1 0 0.0 0 0 2026-05-25 27
Kalunguta 2 1 50.0 0 0 2026-05-24 28
Katwa 31 19 61.3 26 15 2026-06-21 0
Kyondo 3 1 33.3 2 0 2026-06-21 0
Mabalako 1 0 0.0 1 0 2026-06-13 8
Masereka 1 0 0.0 1 0 2026-06-10 11
Musienene 2 1 50.0 2 1 2026-06-21 0
Oicha 2 1 50.0 1 1 2026-06-16 5
Vuhovi 1 1 100.0 1 1 2026-06-10 11

Subtotal — North Kivu 91 50 54.9 80 43 2026-06-21 0
South
Kivu Miti Murhesa 3 1 33.3 0 0 2026-05-20 32

Subtotal — South Kivu 3 1 33.3 0 0 2026-05-20 32
Uganda Kampala Kampala 20 3 10 11 1 2026-06-19 2
Wakiso 1 0 0 0 0 2026-05-25 27

Subtotal — Uganda 21 3 10 11 1 2026-06-19 2

Cells shaded green indicate health zones with no newly reported confirmed case for more than 21 days. Values are reproduced as published in the source situation report.

Public health response
Coordination
• The continental Incident Management Support Team (IMST), co-led by WHO and Africa Centres for Disease
Prevention and Control (Africa CDC), remains activated to coordinate strategic and operational support to
affected and at-risk countries under a unified “One Response” approach.

• In the Democratic Republic of the Congo, coordination of the response continues under the leadership of
the Minister of Health through the Public Health Emergency Operations Centre (COUSP RDC) and the Ebola
Incident Management System, with a progressively decentralized zonal coordination approach being
implemented to strengthen operational oversight in hotspot health zones. In Uganda, national and district
task forces remain activated to coordinate preparedness and response activities.

• High-level political engagement intensified during the reporting period, including deployment of three
national ministers to Ituri Province and joint review sessions involving the provincial leadership, technical
and financial partners, and operational response teams. Cross-border coordination between the

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Democratic Republic of the Congo and Uganda also continued to be strengthened.

• National Incident Management Systems in both countries continue to receive coordination support from
WHO, Africa CDC, UNICEF, the International Organization for Migration (IOM), Médecins Sans Frontières
(MSF), International Medical Corps (IMC), Samaritan’s Purse, the European Union, and other operational
partners. Through the WHO-coordinated Global Outbreak Alert and Response Network (GOARN), expert
deployments continue to support response and preparedness activities in affected and at-risk countries.

• As of 21 June 2026, there is a substantial funding shortfall, a gap of USD 81.2 million (71%) against an appeal
of USD 115 million for the BVD response. The funding gap continues to constrain full implementation of
response activities, particularly decentralized operations and surge capacity in hotspot and insecure areas..

Operations Support and Logistics (OSL)
• WHO continues to support response operations through the deployment of multidisciplinary field
personnel across the Democratic Republic of the Congo and Uganda to support preparedness and response
activities.

• Operations support and logistics activities continued to scale up across affected areas in the Democratic
Republic of the Congo. As of 21 June 2026, the procurement and shipment pipeline for the response in the
Democratic Republic of the Congo was valued at approximately USD 5.25 million, an increase from
approximately USD 4.3 million reported during the previous reporting period. Of this amount, supplies
worth approximately USD 1.37 million (26%) had been delivered.

• Critical commodities delivered or in transit included gloves, coveralls, gowns, polymerase chain reaction
(PCR) diagnostic tests, infrared thermometers, tents, hospital beds, and RADIONE diagnostic materials to
support frontline response operations, decentralized diagnostics, and treatment capacity expansion.
Delivered commodities accounted for 155.9 metric tons and 901.4 cubic metres of cargo dispatched to
logistics hubs in Ituri and North Kivu provinces.

• Logistics coordination mechanisms continued to support shipment tracking, supply distribution, partner
coordination, and monitoring of operational gaps in both the Democratic Republic of the Congo and
Uganda. The majority of procurement originated directly from suppliers (61%), while additional supplies
were sourced through WHO logistics hubs in the Democratic Republic of the Congo, Nairobi (Kenya), and
Dubai (United Arab Emirates).

Surveillance
• Surveillance activities continued across affected and at-risk areas, including active case finding, alert
management, case investigation, contact tracing, mortality surveillance, community-based surveillance, and
cross-border surveillance.

• In the Democratic Republic of the Congo, as of 21 June 2026, a total of 8424 contacts were under follow-up,
including 6244 in Ituri Province, 2122 in North Kivu Province, and 58 in South Kivu Province. Overall contact
follow-up remained suboptimal, with only 70.8% of contacts seen within the previous 24 hours. Follow-up
rates remained low in North Kivu (64.3%) and Ituri (72.7%) provinces, while South Kivu maintained 100.0%
follow-up.

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• As of 21 June 2026, 831 alerts had been reported across the three affected provinces in the Democratic
Republic of the Congo, all of which were investigated. A total of 202 suspected cases, including 60 community
deaths were validated.

• Points of entry (PoE) and points of control (PoC) surveillance activities continued to be strengthened in the
Democratic Republic of the Congo. As of 20 June 2026, 60 of the 72 planned PoE/PoC sites were operational
nationally, including 44 of 55 in Ituri Province and 12 of 13 in North Kivu Province. During the reporting
period, 133 554 travellers passed through PoE/PoC screening sites, of whom 96.0% were screened for BVD
symptoms.

• In Uganda, active case finding, case investigation, contact tracing, alert management, surveillance for non-
trauma deaths, and community-based surveillance continued nationwide, particularly in Kampala and
Wakiso districts. As of 21 June 2026, nine contacts remained under active follow-up.

• In Uganda, inbound and outbound screening continued at points of entry, including Entebbe International
Airport and high-risk border crossings. Mandatory digital Passenger Locator Forms remained in use for all
inbound travellers, while holding facilities continued to be maintained for high-risk travellers. Temporary
travel restrictions between Uganda and the Democratic Republic of the Congo also remained in place.

Laboratory
• Diagnostic testing continues across the affected countries through national and subnational laboratory
networks.

• In the Democratic Republic of the Congo, laboratory testing has been decentralized to Aru, Nyakunde, Beni,
Mongbwalu, Lwiro, and Bukavu health zones, in addition to existing testing capacity in Bunia, Kinshasa, and
Goma. Reagents were delivered and backlogged samples tested. The National Institute for Biomedical
Research (INRB) continues to implement a decentralized laboratory strategy aimed at expanding diagnostic
capacity to additional locations and reducing testing turnaround times.

• INRB has deployed additional polymerase chain reaction (PCR) equipment, sequencing equipment, supplies
and personnel to Bunia as well as RadiOne plateforms (KH Medical, Republic of Korea) to Bunia, Mongbwalu,
Nyakunde and Aru. With support from the Regional Mobile Laboratory in Goma, testing was initiated in Beni
and mobile laboratories were set up in Lwiro (moving to Kayina) and Bukavu health zones.

• WHO and partners continue replenishing laboratory reagents, test kits, and consumables to sustain
diagnostic operations. A total of 8016 RadiOne (KH Medical, Republic of Korea) and 960 Altona screening
PCR (Altona Diagnostics GmbH, Germany) tests were delivered to the Democratic Republic of the Congo
through WHO support, while additional testing supplies have been pledged by Africa CDC (4800 tests).

• In Uganda, Bundibugyo virus testing is being conducted through four operational laboratories, including
mobile laboratories in Bwera (Kasese District) and Arua City, with additional support from the Central Public
Health Laboratories (CERSL) in Wandegeya and the Uganda Virus Research Institute (UVRI) in Entebbe..
Case Management
• In the Democratic Republic of the Congo, case management activities continued across affected provinces,
with treatment and isolation centres in Ituri, North Kivu, and South Kivu managing both confirmed and

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suspected cases. As of 21 June 2026, a total of 371 patients were in isolation or hospitalization, including 196
confirmed cases and 175 suspected cases, with a national bed occupancy rate of 82.8%. Occupancy remained
highest in Ituri Province (89.3%), reflecting sustained pressure on treatment capacity.

• During the reporting period, 67 new admissions were recorded across treatment and isolation facilities, while
75 patients were discharged, including 21 deaths, 40 non-cases, and eight recoveries. Six patient
abscondments were also reported in Ituri Province, highlighting persistent challenges related to patient
retention, psychosocial support, and community trust in treatment centres.

• Twelve patients were declared recovered on 21 June 2026 after obtaining two negative control tests,
including nine in Ituri and three in North Kivu, bringing the cumulative number of recoveries to 112
nationally. Nutritional support activities also continued in treatment centres.

• Clinical severity remained particularly concerning in North Kivu, where the CFR reached 57.1%, significantly
above the national average, suggesting continued delays in care-seeking, referral and access to timely
treatment.

• Mental health and psychosocial support services continued to support confirmed and suspected patients,
caregivers, separated children, and affected households, although coverage remained uneven, particularly
in Ituri and North Kivu provinces.

• In Uganda, treatment capacity included 84 beds, including 10 critical care beds, at the Mulago isolation
facility in Kampala; 56 beds, including four critical care beds, at the Entebbe isolation facility; and an
additional 32 beds at the Mulago Field Isolation Facility. A total of 14 cases had recovered while four were
still in admission.

Infection Prevention and Control (IPC) and Water, Sanitation and Hygiene (WASH)
• In the Democratic Republic of the Congo, IPC performance remained critically weak despite ongoing scale-
up efforts. As of 21 June 2026, 236 health facilities had been assessed across 28 health zones, including 70
facilities reporting cases. Overall IPC performance averaged only 44%, with 66% of facilities classified as
insufficient (<50%), highlighting major preparedness and infection prevention gaps.

• The most critical IPC weaknesses identified included safe and dignified burial preparedness (22%), isolation
capacity (23%), and post-exposure management (27%). Better-performing components included injection
safety (79%), healthcare waste management (75%), sterilization (69%), patient placement (66%), and water
supply systems (64%).

• WHO and partners continued to support the Ministry of Health of the Democratic Republic of the Congo to
strengthen IPC implementation through rapid training and deployment of frontline healthcare workers,
supportive supervisors, decontamination teams, and Safe and Dignified Burial (SDB) teams, particularly in
newly affected and high-risk health zones. International surge staff and additional national IPC focal points
from previous outbreaks were also deployed to hotspot areas.

• In Uganda, IPC preparedness and capacity-building activities continued nationwide. A three-day IPC Training
of Trainers in Bundibugyo District prepared 55 trainers to cascade IPC knowledge to healthcare facilities.
During the reporting period, 23 baseline IPC assessments were completed and 34 healthcare workers

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received on-site mentorship. Cumulatively, 1,147 IPC assessments had been conducted, 3,832 healthcare
workers oriented, and 547 healthcare workers trained, with an overall IPC performance score of 66.6%.
However, 311 facilities remained below the minimum IPC threshold and required targeted support.

Risk Communication and Community Engagement (RCCE)
• In the Democratic Republic of the Congo, RCCE activities continue to expand in high-risk zones, prioritizing
hotspot areas aligned with epidemiological trends.

• Community feedback indicates persistent concerns regarding delays in safe and dignified burial procedures,
transport of suspected cases and quality of care at BVD treatment centres.

• Engagement with local leaders and community networks has contributed to improved access and have
helped address community concerns about resource distribution and rumours linked to self-medication,
though trust gaps remain.

• In affected areas more than 1.7 million people have been directly reached through community outreach
activities. Over 180 community and religious leaders along with 54 local chiefs have been engaged through
community dialogue sessions to support outbreak awareness and response efforts. Media engagement has
continued via 178 radio stations across Ituri Province and Goma in North Kivu Province, complemented by
collaboration with social media influencers to strengthen public awareness and counter misinformation.
Additionally, sensitization sessions on barrier measures and patient admission procedures were conducted
for healthcare workers and caregivers at health facilities in Bunia.

• In Uganda, RCCE activities focused on institutional and community sensitization, engagement with religious
leaders, schools, hotels, and border communities, and strengthening school-based surveillance. Fifty
bloggers and digital influencers were also oriented to amplify accurate messaging and counter
misinformation through social media platforms.

• Community feedback, community assessments and perception studies continue in affected areas to better
understand perceptions, behaviours, and practices influencing outbreak transmission and response
acceptance.

Preventing and Responding to Sexual Exploitation, Abuse, and Harassment (PRSEAH)
• PRSEAH coordination activities continued in collaboration with government authorities, the inter-agency
PRSEAH network, international non-governmental organizations, United Nations agencies, and operational
partners to strengthen prevention and response measures within the Ebola outbreak response.

• Joint PRSEAH briefings were conducted for 2007 humanitarian actors engaged in the BVD response, including
820 women (41%), to strengthen awareness of sexual exploitation, abuse, and harassment risks, reporting
mechanisms, and accountability standards among frontline responders.

• Joint community awareness and risk communication activities were conducted in Mongbwalu and Bunia
health zones in Ituri Province, Goma in North Kivu Province, and Miti Murhesa in South Kivu Province to raise
awareness on the prevention of sexual exploitation and abuse and promote use of the toll-free reporting
hotline. A total of 1616 girls and women were reached, representing 42% of all individuals sensitized during

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the reporting period.

• Data collection for the assessment of sexual exploitation and abuse risk factors has been completed, and
analysis is ongoing to identify priority mitigation measures and strengthen prevention strategies in affected
communities.

• The PRSEAH preparedness plan and associated human resource requirements have been finalized for 12
high-risk countries to strengthen operational readiness and enhance prevention and response capacity for
sexual exploitation abuse and harassment risks in priority settings.

Operational Readiness
• A regional preparedness and prioritization framework continues to guide readiness activities across the
African Region, with countries categorized according to risk and preparedness needs. Priority 1A countries
include the Democratic Republic of the Congo and Uganda; Priority 1B countries include South Sudan,
Burundi, and Rwanda; Priority 2 countries include Angola, Central African Republic, Republic of the Congo,
Ethiopia, Kenya, Tanzania, and Zambia; while all other countries remain classified as Priority 3.

• Recent assessments showed an average readiness score of 58% among Priority 1 and 2 countries, with 90%
of readiness assessments completed and submitted. To date, 26 of 47 Member States, in addition to
Zanzibar, have updated their readiness assessments, while nine of the ten Priority 1 and 2 countries have
completed and shared contingency plans (80%). Regional deployments to support high risk member states
have is ongoing in South Sudan, Kenya, and the Democratic Republic of the Congo.

• Priority preparedness activities continue to focus on activation of emergency operations centres,
strengthening of points of entry and border health measures, revision and testing of contingency plans,
dissemination of case definitions, training of healthcare workers, deployment of supplies to high-risk areas,
and deployment of regional support teams to provide technical assistance. International Health Regulations
(IHR) National Focal Point profiles have also been updated to support timely notification and reporting of
alerts.

Border Health, Travel and Mass Gatherings
• PoE and traveller screening operations have been reinforced at airports, high-risk crossings and internal
transit routes in both the Democratic Republic of the Congo and Uganda, with national authorities, IOM and
partners supporting PoE surveillance and implementation of WHO travel and border health guidance, as well
as measures at points of control on high priority travel corridors.

• 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.

• Priority operational actions include rapid assessments and mapping of PoEs, as well as cross-border
population mobility mapping to identify key movement patterns, high-risk cross-border routes, including
informal crossings, and major congregation points. Additional priorities include ensuring that field teams
have adequate staffing, equipment, training, PPE, screening materials, disinfectants, and referral systems.

• Mass gathering risk assessment capacity is being strengthened through training and the provision of

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recommendations. The postponement of mass gatherings is advised in areas with documented BVD
transmission until transmission is interrupted, while a risk-based approach is recommended for events held
elsewhere in the region and outside affected areas. A Mass Gathering Readiness Checklist for host countries
sharing land borders with affected countries and expecting attendees from areas with documented BVD
transmission is being finalized.

• Event-specific risk assessments should be conducted using the WHO all-hazards mass gathering risk
assessment tool. These assessments should be complemented by implementation of measures before,
during, and after events, as outlined in WHO guidance for mass gatherings attended by individuals from areas
with documented Bundibugyo virus detection, including the establishment of referral pathways and RT-PCR
testing capacity. Capacities for symptom-based screening combined with travel history and exposure
assessment within the previous 21 days should also be in place, alongside promotion of hand hygiene and
BVD risk communication. These measures should be further complemented by event-based surveillance,
coordination with public health authorities for cross-border contact tracing, and post-event surveillance for
at least 21 days following the event.

• Event organisers should distribute participant information to all attendees before and during the event,
covering BVD symptoms, what to do if feeling unwell, and available health services, in line with WHO
guidance for mass gathering events attended by individuals from areas with documented BDBV detection.

Situation interpretation
The BVD outbreak in the Democratic Republic of the Congo remains a complex and evolving public health emergency,
characterized by sustained community transmission, increasing numbers of cases and deaths, and continued
geographic expansion across Ituri and North Kivu provinces. Transmission remains concentrated in major hotspot
health zones, particularly Bunia, Mongbwalu, and Rwampara, while spread into newly affected health zones
highlights continued expansion beyond the initial epicentres. Although surveillance, laboratory, logistics, and
treatment operations continue to scale up, response efforts remain constrained by low contact follow-up rates,
increasing pressure on treatment capacity, shortages of key supplies, insecurity, population mobility, and community
resistance in affected areas. In Uganda, one new confirmed case was reported during the reporting period, after
nearly two weeks without any newly confirmed cases. While the epidemiological situation remains relatively stable,
the continued link to transmission in the Democratic Republic of the Congo underscores the ongoing risk of cross-
border spread and secondary transmission. Sustained operational, financial, and security support will remain critical
to addressing ongoing response challenges, strengthening outbreak control measures, interrupt transmission and
prevent further spread.

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Contributors Editorial Advisory Group, WHO Regional
• WILLIAMS, George Sie (WHO AFRO) Office for Africa
• HOLLIS, Sara (WHO AFRO)
• Dr Marie Roseline Darnycka Belizaire —
• OTSHUDIEMA, John (WHO AFRO)
Regional Emergency Director, EPR/AFRO
• CONTEH, Ishata (WHO AFRO)
& Regional Incident Manager, BVD
• MASINA, John (WHO AFRO) Response
• MAMADU, Ibrahim (WHO AFRO)
• ROQUILLE, Denise (WHO AFRO)
• MUTEBA, Michel (WHO AFRO)
• Dr Otim Patrick Ramadan — Programme
Area Manager, EMR/EPR/AFRO &
• BORIS, Pavlin (WHO HQ)
Deputy Regional Incident Manager, BVD
• HAMBLION, Esther (WHO HQ)
Response
• KASSAMALI, Zyleen (WHO HQ)
• AWOFISAYO-OKUYELU, Adedoyin Abiola (WHO HQ)
• ALLAIN IOOS, Sophie (WHO HQ)
• Dr Etien Koua — Programme Area
Manager, HIS/EPR/AFRO
• HAMOUDA, Mahmoud Aly Zeenelabdin (WHO HQ)
• MOLINARO, Paul (WHO HQ)
• LEGAND, Anaïs (WHO HQ) • Dr Dick Chamla — Programme Area
• WAUQUIER, Nadia (WHO HQ) Manager, HEP/EPR/AFRO
• SODAGAR, Vaishali (WHO HQ)
• WANG, Ninglan (WHO HQ)
• Mr Adama Thiam — Programme Area Manager,
•
OSL/EPR/AFRO
SELENIC MINET, Dubravka (WHO HQ)
• ALEXANDROVA EZERSKA, Lidia (WHO HQ)
• RUBANGAKENE, Moses (WCO Uganda)
• MGAMB, Elizabeth Adhiambo (WCO Uganda)
• FOTSING, Richard (WCO DR Congo)
• AJONG, Brian (WCO DR Congo)

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