WHO AFRO weekly situation report 9

Data as of 2026-07-12
Published
July 12, 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
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Democratic Republic of the Congo | Uganda | France
Weekly External Situation Report 09, Data as of 12 July 2026

Key Figures at a Glance (Democratic Republic of the Congo)

5 Provinces 4 Provinces 331 88.3% 12 370
42 Health Zones 33 Health Zones Cases Bed Contacts
Affected Active Transmission Recovered Occupancy to follow

Summary
New New
Total Cases Total Deaths CFR (%)
Confirmed Confirmed Confirmed Confirmed Probable Probable
Country Cases (Last 7 Deaths (Last 7 Cases (total) Deaths (total) Cases Deaths
(Confirmed & (Confirmed & Confirmed &
Probable) Probable) Probable
days) days)

Democratic
Republic of
the Congo
339 198 1 963 719 - - 1 963 719 36.6%

Uganda 0 0 20 2 1 1 21 3 14.3%

France 0 0 1 0 0 0 1 0 0.0%
Note: Only confirmed and probable cases are reported.

Event description
The Bundibugyo virus disease outbreak in the Democratic Republic of the Congo intensified during the past week,
with epidemiological indicators suggesting sustained and increasing transmission. The outbreak was characterized
by a rising incidence of reported cases, increasing mortality and continued geographic expansion into additional
provinces and health zones, indicating ongoing propagation across affected areas. Outside the Democratic Republic
of the Congo, the epidemiological situation remained unchanged, with no new cases reported in Uganda or France
and no evidence of secondary transmission. Nevertheless, continued geographic expansion and increasing
transmission intensity within the Democratic Republic of the Congo elevate the likelihood of cross-border spread
and reinforce the need for sustained regional surveillance, preparedness and response measures.

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Democratic Republic of the Congo
Since the last update of 5 July 2026 (Situation Report #8), the epidemiological situation in the Democratic Republic
of the Congo has further deteriorated with sustained transmission and continued geographic expansion. An
additional 339 confirmed cases and 198 confirmed deaths have been reported, representing increases of 20.9% and
38.0% in cumulative confirmed cases and deaths, respectively. The crude case fatality ratio (CFR) among confirmed
cases increased from 32.1% to 36.6%, likely reflecting delayed case detection, late presentation for care, and the
persistently high proportion of deaths occurring in the community, rather than increased disease severity.
Geographic spread also continued during the reporting period, with the outbreak expanding from three to five
affected provinces following the confirmation of cases in Haut-Uélé and Tshopo provinces. The number of affected
health zones increased from 36 to 42, with Wamba (Haut-Uélé Province), Ariwara and Boga (Ituri Province), and
Lubunga, Makiso-Kisangani, and Mangobo (Tshopo Province) reporting their first confirmed cases.

Daily reported confirmed cases have continued to increase over the course of the outbreak, although substantial
day-to-day variability is observed. A log-linear model fitted to the daily incidence data estimates an average daily
growth rate of 2.3% (95% CI 2.0% - 2.5%), indicating that the outbreak continues to expand and transmission remains
above the threshold required for sustained epidemic expansion.

Figure 1. Epidemic curve showing daily confirmed case incidence and estimated epidemic growth, Democratic
Republic of the Congo, 11 May–12 July 2026

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Figure 2. Weekly trends of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo
by epidemiological week of report, epidemiological weeks 18 – 28, 2026

Note: The shaded grey area for the most recent epidemiological week represents incomplete data due to reporting delays.

Despite this continued geographic expansion, recent transmission remains concentrated in a subset of affected
areas. Of the 42 affected health zones, 33 have reported at least one confirmed case within the past 21 days. During
this period, 869 confirmed cases and 441 confirmed deaths were reported. Ituri Province continues to bear the
overwhelming burden of the outbreak, accounting for 775 cases (89.2%) and 382 deaths (86.6%), while the remaining
four affected provinces together reported 94 cases (10.8%) and 59 deaths (13.4%). In contrast, nine previously
affected health zones have now surpassed 21 consecutive days without reporting a confirmed case, suggesting an
absence of recent transmission while enhanced surveillance remains in place. These include Miti-Murhesa (53 days)
in South Kivu Province; Aru (38 days), Aungba (23 days), and Gety (52 days) in Ituri Province; and Goma (48 days),
Kalunguta (49 days), Mabalako (29 days), Oicha (26 days), and Vuhovi (31 days) in North Kivu Province.

The highest levels of recent transmission were recorded in Bunia (207 cases), Rwampara (159), Mongbwalu (92), and
Nizi (80) in Ituri Province, reaffirming the Bunia–Rwampara–Mongbwalu transmission corridor while highlighting Nizi
as an increasingly important hotspot. Transmission also intensified in Mangala (36 cases) and Nia-Nia (33), the latter
serving as the epidemiological source of the newly affected provinces of Haut-Uélé and Tshopo. In North Kivu
Province, Katwa (39 cases) remained the principal hotspot, followed by Butembo (16) and Beni (10). Collectively,
these health zones accounted for 77.3% of all confirmed cases reported during the past 21 days.

A similar pattern was observed for mortality. Bunia reported the highest number of confirmed deaths (108), followed
by Mongbwalu (71), Rwampara (52), Nizi (30), Katwa (28), Mangala (23), Nyankunde (14), Lita (13), Nia-Nia (11), Beni
(8), and Butembo (7). Together, these health zones accounted for 365 (82.8%) of the 441 confirmed deaths reported
during the same period.

The confirmation of cases in Haut-Uélé and Tshopo provinces marks a significant geographic expansion of the
outbreak beyond its original focus in Ituri and North Kivu. Although relatively few cases have been reported in these
newly affected provinces, the detection of cases in three health zones in Tshopo, including Makiso-Kisangani in the
provincial capital, raises concern because of its large urban population and its role as a major transport hub

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connecting northeastern DRC with other parts of the country. Epidemiological investigations indicate that the cases
in Tshopo and Haut-Uélé are linked to transmission originating in Nia-Nia Health Zone in Ituri, suggesting geographic
extension of an existing transmission chain rather than the emergence of independent outbreak foci. The recent
confirmation of the first case in Ariwara Health Zone represents a further northward expansion of the outbreak
towards the borders with South Sudan and Uganda, increasing the potential for cross-border spread through
frequent population movement and trade.

The expanding geographic footprint of the outbreak has also continued to pose risks beyond affected communities.
During the reporting period, a United States humanitarian worker infected with Bundibugyo virus disease while
working in the Democratic Republic of the Congo was medically evacuated to a specialized high-level isolation unit
at Frankfurt University Hospital, Germany. The patient, a logistics staff member with a humanitarian organization
supporting the Ebola response in Bunia, Ituri Province, was reported to be in stable condition following early
diagnosis and treatment. The case highlights the continued occupational risk faced by frontline humanitarian
personnel responding to the outbreak.

Figure 3. Map showing active health zones reporting confirmed cases of Bundibugyo virus disease in the
Democratic Republic of the Congo and Uganda in the last 21 days, 22 June – 12 July 2026

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Since the beginning of the outbreak, the Democratic Republic of the Congo has reported 1963 confirmed cases,
including 719 confirmed deaths (CFR 36.6%). Ituri Province remains the epicentre of the outbreak, accounting for
90.3% (1,772) of all confirmed cases and 84.6% (608) of all reported deaths nationwide. The most affected health
zones continue to be Bunia (503 cases, 156 deaths), Rwampara (384 cases, 89 deaths), Mongbwalu (329 cases, 171
deaths), Nizi (110 cases, 36 deaths), Nyankunde (97 cases, 23 deaths), Mangala (50 cases, 29 deaths), and Lita (45
cases, 19 deaths), all located in Ituri Province, together with Katwa (71 cases, 47 deaths), Butembo (44 cases, 20
deaths), and Beni (30 cases, 20 deaths) in North Kivu Province. Collectively, these health zones account for
approximately 84.7% of all confirmed cases and 84.8% of all confirmed deaths reported nationally.

Figure 4. Geographical distribution of cumulative confirmed cases of Bundibugyo virus disease in the Democratic
Republic of the Congo and Uganda, data as of 12 July 2026

Investigation of 430 confirmed deaths as of 05 July 2026 showed that 397 (92.3%) occurred in the community or
before admission to a treatment facility, highlighting persistent delays in case detection, referral, isolation, and
access to clinical care. Only 33 deaths (7.7%) occurred after patients had been admitted to treatment centres or
healthcare facilities. During the current reporting period, 205 additional confirmed deaths were reported, including
139 (67.8%) community deaths and 66 (32.2%) deaths among patients admitted to treatment facilities, indicating
that delayed presentation for care continues to contribute substantially to mortality.

As of 12 July 2026, a total of 12,370 contacts were under follow-up, of whom 10,156 (81.5%) were successfully seen
within the previous 24 hours. Ituri Province accounted for the majority of contacts under follow-up, with 9,866

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contacts, including 7,830 (79.4%) successfully seen during the reporting period. In North Kivu, 2,152 of 2,377 contacts
(90.5%) were successfully followed up, while all contacts in South Kivu had completed the required 21-day
monitoring period. Contact follow-up data for the newly affected provinces of Haut-Uélé and Tshopo were not
reported. The overall follow-up rate remains below the operational target for effective contact tracing. The marked
disparity between provinces is of particular concern. While North Kivu achieved a follow-up rate exceeding 90%,
Ituri, the epicentre of the outbreak and home to more than 80% of contacts under follow-up, reached only 79.4%.
This leaves a substantial number of contacts in the highest transmission setting unreached each day, increasing the
risk of undetected infections and sustained community transmission.

Figure 5. Proportion of identified contacts of confirmed cases of Bundibugyo virus disease reached daily in the last
21 days in the Democratic Republic of the Congo, 21 June – 12 July 2026

Uganda
No new confirmed case has been reported in Uganda since the previous update. The most recent confirmed case,
reported on 21 June 2026, was identified in a truck driver travelling along the Democratic Republic of the Congo–
Uganda international route. Since then, no additional imported or locally acquired cases have been detected and
there is no evidence of ongoing transmission.

As of 12 July 2026, the outbreak remained limited to 21 cases (20 confirmed and one probable), including three
deaths (two confirmed and one probable). Seventeen patients have recovered and been discharged from care,
leaving one confirmed patient currently admitted to a treatment facility. Since the onset of the outbreak, 836
contacts were identified. All contacts have successfully completed the required 21-day follow-up period with 6
secondary cases detected, indicating that known transmission chains have been effectively contained.

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With no new confirmed cases reported since 21 June 2026 and only one patient remaining under clinical care, Uganda
is approaching the final phase of its outbreak response. In accordance with established outbreak response criteria
the 42-day period required for declaration of the end of the outbreak will begin following the recovery and discharge
of the final confirmed case, provided that no additional confirmed cases are detected during this period.
Nevertheless, Uganda remains at high risk of re-introduction due to the ongoing outbreak in the neighbouring
Democratic Republic of the Congo. The continued population movement across the shared border sustains the
potential for cross-border information sharing, rapid case detection and response readiness until transmission has
been interrupted in both countries.

Figure 6. Weekly trends of confirmed cases of Bundibugyo virus disease in Uganda by epidemiological week of
report, epidemiological weeks 18 – 28, 2026

France
No additional Bundibugyo virus disease (BVD) cases have been reported in France since the previous update. No
secondary transmission has been identified among the five flight contacts who were placed under precautionary
quarantine following exposure to the imported case reported on 24 June 2026.Their formal release from follow-up
had not been officially announced at the time of reporting.

Risk Assessment

The overall public health risk in the Democratic Republic of the Congo remains very high, driven by sustained
transmission, increasing mortality, and continued geographic expansion from three to five affected provinces.
Although transmission remains concentrated in Ituri Province, the emergence of new affected health zones in Haut-
Uélé and Tshopo highlights the continued potential for spread to previously unaffected areas.

The increasing crude CFR and the high proportion of community deaths continue to indicate delays in case detection,
isolation, and access to clinical care. Contact tracing remains below the operational target, particularly in Ituri
Province, where follow-up performance is substantially lower than in North Kivu despite accounting for the majority
of ongoing transmission.

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Uganda remains at high risk of re-introduction because of the ongoing outbreak in the neighbouring Democratic
Republic of the Congo despite reporting no new cases during the reporting period. The absence of secondary
transmission following the imported case in France demonstrates the effectiveness of rapid public health measures
but also underscores the continued risk of international spread through travel.

Table 1. Confirmed cases and deaths of Bundibugyo virus disease in the Democratic Republic of the Congo and
Uganda by geographic area, as of 12 July 2026
Country Province / Health zone / Cum. Cum. CFR % Cases (last Deaths (last Date last case Days since
Region district cases deaths 21 d) 21 d) last case
Democratic Haut-Uélé Wamba 7 7 100.0 7 7 2026-07-12 0
Republic of the
Congo
Subtotal - Haut-Uélé 7 7 100.0 7 7 2026-07-12 0
Ituri Aru 3 1 33.3 0 0 2026-06-04 38

Ariwara 1 1 100.0 1 1 2026-07-11 1

Aungba 6 2 33.3 0 0 2026-06-19 23
Bambu 31 10 32.3 17 8 2026-07-05 0
Boga 1 1 100.0 1 1 2026-07-11 1
Bunia 503 156 31.0 207 108 2026-07-12 0
Damas 5 0 0.0 1 0 2026-06-27 15
Drodro 4 3 75.0 3 2 2026-06-27 15
Fataki 4 1 25.0 3 1 2026-07-05 7
Gety 1 0 0.0 0 0 2026-05-21 52
Kambala 2 2 100.0 1 1 2026-06-30 12
Kilo 9 1 11.1 2 0 2026-06-24 18
Komanda 25 8 32.0 15 5 2026-07-04 8
Lita 45 19 42.2 21 13 2026-07-02 10
Logo 7 0 0.0 2 0 2026-06-25 17
Lolwa 1 1 100.0 1 1 2026-06-30 12
Mandima 8 3 37.5 8 3 2026-07-02 10
Mambasa 5 4 80.0 3 3 2026-07-09 3
Mangala 50 29 58.0 36 23 2026-07-05 7
Mongbwalu 329 171 52.0 92 71 2026-07-12 0
Nia-Nia 35 13 37.1 33 11 2026-07-12 0
Nizi 110 36 32.7 80 30 2026-07-12 0
Nyankunde 97 23 23.7 11 14 2026-07-12 5
Rimba 4 0 0.0 1 0 2026-07-12 0
Rwampara 384 89 23.2 159 52 2026-07-12 0
Tchomia 19 4 21.1 11 4 2026-07-02 10
Unallocated health 17 0 0.0 - -- - -
zones
Subtotal — Ituri 1 772 608 34.3 775 382 2026-07-12 0
North Kivu Beni 30 20 66.7 10 8 2026-07-12 0
Butembo 44 20 45.5 16 7 2026-07-12 0
Goma 1 0 0.0 0 0 2026-05-25 48
Kalunguta 2 1 50.0 0 0 2026-05-24 49
Katwa 71 47 66.2 39 28 2026-07-12 0
Kyondo 7 3 42.9 4 2 2026-07-11 1
Mabalako 1 0 0.0 0 0 2026-06-13 29
Masereka 3 0 0.0 2 0 2026-07-05 7

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

Musienene 10 2 20.0 8 1 2026-07-05 7
Oicha 3 2 66.7 0 0 2026-06-16 26
Vuhovi 1 1 100.0 0 0 2026-06-11 31

Subtotal — North Kivu 177 100 56.5 83 50 2026-07-12 0
South
Kivu Miti Murhesa 3 1 33.3 0 0 2026-05-20 53

Subtotal — Tshopo 3 1 33.3 0 0 2026-05-22 53

Tshopo
Lubunga 1 0 0.0 1 0 2026-07-11 1

Makiso-Kisangani 2 2 100.0 2 2 2026-07-11 1

Mangobo 1 0 0.0 1 0 2026-07-11 1

Subtotal — Tshopo 4 2 50.0 4 2 2026-07-11 1
Uganda Kampala Kampala 21 3 14.3 0 0 2026-06-21 21

Subtotal — Uganda 21 3 14.3 0 0 2026-06-21 21
Cells shaded green indicate health zones with no newly reported confirmed case for 21 or more days. Values are reproduced as published in the source situation report.
** During the reporting period, 77 previously unallocated confirmed cases and 10 deaths were retrospectively reallocated to health zones in Ituri Province.

Public health response
Coordination
• The Continental BVD Incident Management Support Team (IMST) continued to coordinate response
operations in the Democratic Republic of the Congo and Uganda while supporting preparedness activities
in 11 additional high-risk countries under the One Plan, One System, One Report framework.

• In the Democratic Republic of the Congo, high-level government leadership and coordination were
reinforced during the reporting period. The Minister of Public Health convened coordination meetings with
national and provincial authorities, WHO, and technical and financial partners to review the evolving
epidemiological situation and response priorities, including the expansion of the outbreak into Tshopo and
Haut-Uélé provinces.

• Response operations were rapidly expanded to the newly affected provinces, where multisectoral response
pillars were established and strengthened to support early detection, surveillance, case management, and
rapid containment of emerging transmission. Field coordination and operational oversight were reinforced
through joint assessment missions by the national Incident Management Team and WHO, alongside
continued harmonization of epidemiological data across Ituri, Tshopo, and Haut-Uélé to support
coordinated decision-making.

• The National Incident Management Systems in the Democratic Republic of the Congo and Uganda
continued to receive operational support from WHO; the Africa Centres for Disease Control and Prevention
(Africa CDC); the United Nations Children’s Fund (UNICEF); the International Organization for Migration
(IOM); Médecins Sans Frontières (MSF); the Alliance for International Medical Action (ALIMA); International
Medical Corps (IMC); Samaritan’s Purse; the European Union (EU); the Global Outbreak Alert and Response
Network (GOARN); Emergency Medical Teams (EMTs); the Health Cluster; and other partners through
technical assistance, expert deployments, surge capacity, and field operations.

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Operations Support and Logistics (OSL)
• Procurement and deployment of critical response supplies continued to expand during the reporting
period. The total emergency supply pipeline increased to approximately US$9.37 million, compared with
about US$9.19 million previously. Of this amount, US$2.59 million (28%) had been delivered, US$3.54
million (38%) was in transit, and US$3.24 million (35%) remained under procurement.

• The value of delivered supplies increased substantially from approximately US$1.92 million to US$2.59
million, while delivered cargo rose to about 232 metric tons and 1,333 cubic metres, strengthening support
to response operations in the Ituri and North Kivu hubs.

• Essential commodities continued to reach affected areas, including personal protective equipment,
laboratory diagnostics and PCR supplies, medical equipment, medicines, hospital beds, tents, infrared
thermometers, patient liners, gloves, gowns, and coveralls. Laboratory and IPC commodities represented
the largest share of delivered supplies.

• Supply chain activity remained high during recent epidemiological weeks, supporting case management,
laboratory testing, surveillance, infection prevention and control, and field operations. However,
substantial quantities of gloves, coveralls, and other critical items remained in transit or under
procurement, requiring continued close monitoring of stock availability.

• Procurement and shipment coordination continued through WHO’s international supply network and
logistics hubs in Kinshasa, Nairobi (Kenya), Dubai (United Arab Emirates), and Dakar (Senegal). Most orders
continued to originate directly from suppliers, while regional hubs supported consolidation, onward
transport, shipment tracking, and distribution to affected areas.

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.

• A high volume of alerts continued to be reported, although the timeliness and coverage of rapid alert
verification and investigation varied considerably across affected provinces. On 12 July 2026, 1156 alerts
were reported from four affected provinces in the Democratic Republic of the Congo, of which 1049 (90.5%)
were investigated within 24 hours. Most alerts originated from North Kivu (694), followed by Ituri (425),
Haut-Uélé (32), and South Kivu (5). Investigation coverage was above 95% in North Kivu, South Kivu, and
Haut-Uélé, while Ituri reported a lower investigation rate of 81.9%. Of the total alerts, 268 suspected cases,
including 112 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 12 July 2026, all 71 PoE/PoC sites were operational across Ituri and
North Kivu provinces. During the reporting period, 144,094 travellers passed through PoE/PoC screening
sites, of whom 95.4% were screened for BVD symptoms.

• In Uganda, alert management, surveillance for non-trauma deaths, and community-based surveillance
continued nationwide. As of 12 July 2026, all contacts have completed 21 days of follow-up.

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• 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
• Laboratory decentralization continued to expand, reaching 60% completion, with plans to establish 15 – 20
operational laboratories to strengthen decentralized testing and reduce turnaround times. As of 12 July
2026, 14 diagnostic laboratories and testing units were operational across Ituri and North Kivu provinces, in
addition to the Institut National de Recherche Biomédicale (INRB) in Kinshasa and INRB-Goma laboratories.

• In North Kivu, the laboratory backlog was fully cleared during the reporting period, with all pending samples
processed.

• Laboratory testing capacity has been further strengthened through the deployment of 54 laboratory experts
(approximately five per facility), as well as the distribution of 2496 polymerase chain reaction (PCR) test kits
and 14,000 RadiOne tests.

• Laboratory testing throughput remained high, particularly in Ituri, where positivity rates ranged from 37.9%
to 63.3%, indicating sustained intense transmission, while North Kivu maintained lower positivity rates
between 3% and 4.2%, alongside the clearance of residual testing backlog.

• Despite ongoing scale-up efforts, laboratory operations continued to face challenges related to delayed
result reporting, weak data integration and information management systems, limited logistics capacity, and
shortages of complementary diagnostic tests for clinical care.

Case Management
• Case management capacity continued to expand across the Democratic Republic of the Congo, with
approximately 750 isolation and treatment beds available nationally across more 25 Ebola treatment centres
(ETCs) and care facilities. Additional treatment capacity is being established Nizi, Kisangani Sota, NiaNia, and
other hotspot areas, including plans to establish 100 additional beds in Bunia within five days.

• As of 12 July 2026, 736 patients were in isolation nationally, including 549 in Ituri, 170 in North Kivu, and 17
in South Kivu, with treatment facilities operating at or near full capacity in high transmission areas. Official
occupancy remained critically high at 88.3% nationally.

• Recovery outcomes continued to improve, with cumulative recoveries increasing from 273 on 05 July to 331
by 12 July 2026. Daily supportive care activities included the provision of hot meals across treatment facilities
and the rollout of free healthcare services in four priority health zones in Ituri Province.

• The WHO-sponsored PARTNERS clinical trial was officially launched in the Democratic Republic of the Congo
on 02 July 2026, becoming the first clinical trial specifically evaluating therapeutics for BVD. The trial is
assessing the monoclonal antibody MBP134 and remdesivir, individually and in combination, within
participating treatment centres under the coordination of the INRB, WHO, Africa CDC, ALIMA, Médecins Sans
Frontières (MSF), the Institute of Tropical Medicine Belgium, and the University of Oxford.

• Case management operations continued to receive support from multiple national and international

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partners, including WHO, the Ministry of Health, ALIMA, MSF, Samaritans Purse, IMC, MEDAIR and Malteser
Africa CDC, and academic and research institutions supporting clinical care, treatment centre operations,
and research activities.
• An integrated outreach centre was established in Bunia to facilitate central dispatch of ambulances services
for cases to transit/treatment centers and for SDB teams, tracking performance of this system is required.

• Alongside scale-up efforts in bed capacity, WHO has delivered five additional picollo machines for clinical
laboratory testing and five high flow oxygen support devices as well, with aims to augment capacity to care
for the critically ill patients. The growing number of CTEs will require additional scale up of these critical
medical supplies.

Infection Prevention and Control (IPC) and Water, Sanitation and Hygiene (WASH)
• IPC activities continued to scale up across affected provinces, including briefings for health workers and
community relays, assessments in 140 health facilities in North Kivu, and the training of 34 providers from
17 priority health facilities.

• Safe and dignified burial operations and decontamination activities remained ongoing in Ituri, alongside the
decontamination of households, health facilities, and transport vehicles linked to confirmed cases.

• IPC performance remained critically weak in several hotspot areas. IPC/WASH assessments in North Kivu
showed an average facility score below 50%, with only two facilities achieving scores above 80%, indicating
major gaps in infection prevention standards and healthcare facility readiness.

• Healthcare worker infections continued to increase, with 112 infections and 35 deaths reported among
health workers, corresponding to a CFR of 31.3%. This highlights persistent occupational exposure risks and
inadequate IPC implementation in health facilities.

Risk Communication and Community Engagement (RCCE)
• RCCE activities continued across affected provinces to strengthen community awareness, promote early alert
reporting, support contact tracing, and facilitate safe and dignified burial operations, particularly in hotspot
areas of Ituri and North Kivu.

• Additional RCCE personnel are being identified and deployed to expand response activities in the newly
affected provinces of Haut-Uele and Tshopo. Anthropological expertise is also being strengthened to better
understand community perceptions and ensure response activities are aligned with local needs, expectations
and realities.

• Community feedback mechanisms continued to identify concerns related to transmission risks, access to
services, vaccination and response activities. These insights are regularly analyzed and shared with
operational pillars to inform response actions and messaging.

• Findings from the first round of rapid community assessments conducted in priority hotspots of Ituri Province
have been endorsed by the research pillar and are being translated into community-led actions through RCCE
interventions. Efforts are now underway to scale the assessments across affected areas of DRC and extend
implementation to Uganda and South Sudan to strengthen cross-border community intelligence and

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engagement.

• Community engagement efforts are increasingly focused on building trust in and improving access to
response services, while addressing concerns raised by both communities and frontline health workers.
Targeted engagement of high-risk and mobile populations, remains a priority, including mining communities
internally displaced populations, and cross-border groups affected by insecurity, displacement and frequent
movement between eastern Democratic Republic of the Congo and neighbouring countries.

• Key RCCE challenges persisted, including insecurity in some hotspot areas, community resistance in mining
and insecure areas, misinformation risks, and difficulties maintaining timely follow-up of contacts across
highly mobile populations and porous border areas.

Preventing and Responding to Sexual Exploitation, Abuse, and Harassment (PRSEAH)
• During the reporting period, a total of 352 participants, including 142 women (five persons with disabilities),
received PRSEAH orientation in Ituri, North Kivu, South Kivu, and Tshopo. The sessions targeted nurses, local
NGO representatives, journalists, and members of the Tshopo Emergency Medical Team, and concluded with
the signing of the Code of Conduct.

• Additionally, PRSEAH community awareness activities targeting community outreach workers, healthcare
workers, internally displaced persons, pregnant women, religious groups, students, teachers, parents, and
motorcycle taxi riders reached 4677 people, including 1419 women (three persons with disabilities) and 1001
girls, participated.

• A regional PRSEAH coordination meeting was convened involving staff from WHO Headquarters, WHO
Regional Office for Africa, Africa CDC, and the National PRSEAH Coordination of the Democratic Republic of
the Congo to strengthen inter-agency collaboration, share best practices, and align strategic priorities for the
outbreak response.

• During the reporting period, newly deployed Ministry of Health experts received orientation on PRSEAH
principles and responsibilities to support their effective integration into the outbreak response, while
community media disseminated PRSEAH messages to promote prevention and strengthen safe reporting
mechanisms.

Public health preparedness
Operational Readiness
• 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, 28 of the 47 Member States have updated their
readiness assessments (60%).

• Regional deployments to support preparedness in high-risk Member States continued during the reporting
period. In Kenya, designated isolation units and other preparedness facilities were assessed, while standard
operating procedures (SOPs) and operational guidelines were finalized to strengthen readiness for a
potential importation event.

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Border Health, Travel and Mass Gatherings
• Screening has 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 border health guidance, as well as measures at points of control on high priority travel
corridors.
• 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 and paid
staff , equipment, training, PPE, screening materials, disinfectants, and referral systems.

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

• 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.

• 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 outbreak appears to be entering a new phase characterized by progressive geographic expansion beyond its
original epicentre in Ituri. While the highest burden of disease remains concentrated in Bunia, Rwampara,
Mongbwalu and surrounding health zones, the emergence of cases in Tshopo, Haut-Uélé and Ariwara demonstrates
how population movement is extending transmission into new areas, including densely populated urban centres and
strategic border locations. These developments increase the complexity of the response and elevate the risk of
further national and cross-border spread.

At the same time, the response is being increasingly challenged by operational constraints. Community resistance,
attacks on healthcare workers, patients leaving treatment centres before completion of care, and recent strike action
by frontline responders have affected surveillance, contact tracing, case management, and other critical response
activities. These challenges have contributed to continued community transmission and the introduction of cases
into previously unaffected areas, including Tshopo and Haut-Uélé provinces.

Interrupting transmission in the established hotspots of Ituri and North Kivu remains the immediate priority, while
rapidly containing newly detected transmission in Haut-Uélé and Tshopo is essential to prevent the establishment of
sustained local transmission. Achieving these objectives will require an integrated community-based strategy that
involves enhanced community engagement, intensified active case finding, timely isolation and treatment,
comprehensive contact tracing, uninterrupted response operations, and enhanced cross-border surveillance and
coordination.

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[PAGE 15]

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

© WHO Regional Office for Africa
This is not an official publication of the World Health Organization.

Correspondence on this publication may be directed to:
Health Emergency Intelligence, Surveillance and Laboratory Programme
WHO Emergency Preparedness and Response
WHO Regional Office for Africa
Email: afrooutbreak@who.int
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