WHO AFRO weekly situation report 11

Data as of 2026-07-26
Published
July 26, 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 11, Data as of 26 July 2026

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

5 Provinces 4 Provinces 583 76.8% 15 498
48 Health Zones 42 Health Zones Cases Bed Contacts
Affected Active Transmission Recovered Occupancy to follow

723 123 37 941 18
Active Health Worker Health Worker Bed Testing
Cases in Isolation Cases Deaths Capacity Laboratories

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

Democratic
Republic of
the Congo
567 296 3 262 1 437 - - 3 262 1 437 44.1%

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 (BVD) outbreak in the Democratic Republic of the Congo continued to intensify during
the reporting period, with sustained transmission, increasing mortality, and ongoing geographic expansion within
the country. The cumulative number of reported cases has exceeded the two previously documented Bundibugyo
virus disease outbreaks, making this the largest outbreak caused by the Bundibugyo virus to date. Although no new
cases have been reported outside the Democratic Republic of the Congo, persistent transmission in areas connected
by major national and cross-border mobility corridors continues to sustain a high risk of regional spread. These
epidemiological trends underscore the need for strengthened surveillance, cross-border collaboration, and
preparedness to rapidly detect and contain any international spread.

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Democratic Republic of the Congo
Since the last update of 19 July 2026 (Situation Report #10), the epidemiological situation in the Democratic Republic
of the Congo has continued to deteriorate, with sustained transmission and further geographic expansion. An
additional 839 confirmed cases and 470 confirmed deaths were reported, representing increases of 34.6% and
48.6%, respectively, in cumulative confirmed cases and deaths since the previous reporting period. Of these
additional reports, 272 confirmed cases and 174 confirmed deaths were identified through retrospective data
reconciliation (batch reporting) and therefore do not necessarily represent new infections or deaths that occurred
during the current reporting period. The crude case fatality ratio (CFR) among confirmed cases increased from 39.9%
to 44.1%, reflecting persistent delays in case detection, referral, and access to treatment, together with the
continued predominance of community deaths. During the reporting period, Rungu Health Zone in Haut-Uélé
Province became newly affected, increasing the cumulative number of affected health zones from 47 to 48. No
additional provinces were affected during the reporting period.

Figure 1. Weekly trend of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo
by epidemiological week of notificationreport, epidemiological weeks 18 – 30, 2026

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

Despite continued geographic expansion, intense transmission remained largely concentrated. During the last 21
days, an additional 1,791 confirmed cases and 1,014 confirmed deaths were reported nationally. Ituri Province
continued to account for the overwhelming majority of recent transmission, contributing 1,592 cases (88.9%) and
871 deaths (85.9%), while North Kivu, Haut-Uélé, and Tshopo together accounted for 199 cases (11.1%) and 143
deaths (14.1%). No additional cases or deaths were reported from South Kivu during the period. Of the 48 affected
health zones, 42 reported confirmed cases during the preceding 21 days, whereas six health zones (Gety, Goma,
Kambala, Mabalako, Miti-Murhesa, and Vuhovi) reported no new cases for more than three weeks, suggesting that
transmission may have been interrupted in these areas, provided surveillance remains sufficiently sensitive to detect
ongoing transmission.
The largest increases in confirmed cases over the previous 21 days were recorded in Bunia (301 cases), Nizi (273),
Rwampara (211), Mongbwalu (208), Katwa (84), Lita (77), Mangala (61), Nia-Nia (57), Butembo (32), and Bambu (29).
Together, these ten health zones accounted for 85.8% of all additional confirmed cases reported nationally during
the period. Bunia, Nizi, Mongbwalu and Rwampara remained the principal transmission corridor, accounting for
nearly two-thirds of all newly reported cases. Continued increases in Lita, Nia-Nia, and Mahagi, together with the

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emergence of transmission in Rungu Health Zone, indicate ongoing westward and northward expansion within Ituri
and Haut-Uélé Provinces.
Mortality was similarly concentrated. The largest increases in confirmed deaths over the same period were reported
in Rwampara (166 deaths), Nizi (147), Mongbwalu (90), Bunia (86), Lita (50), Katwa (47), Mangala (44), Nia-Nia (35),
Butembo (29), and Tchomia (22). Collectively, these ten health zones accounted for approximately 83.5% of all
additional confirmed deaths reported nationally during the previous 21 days, demonstrating that mortality remained
concentrated within the same transmission corridor driving the epidemic.

Overall, confirmed deaths continued to occur predominantly outside designated treatment centres, indicating
persistent delays in case detection, referral and access to appropriate care. During the last seven reporting days (20
– 26 July 2026), 296 confirmed deaths were reported, of which 186 (62.8%) were classified as community deaths and
110 (37.2%) occurred in designated treatment or care centres. It is important to note that, operationally, community
deaths include all deaths occurring outside designated treatment facilities, even though approximately 30% of these
community deaths occur in non-designated health facilities rather than in the community. The continued
predominance of deaths outside designated treatment centres suggests that many patients are still being detected
late in the course of illness or after death, underscoring the need to strengthen community-based surveillance,
improve early recognition and referral from peripheral health facilities, and expand timely access to specialized
treatment.
Figure 2. Reported Bundibugyo virus disease deaths in the Democratic Republic of the Congo by place of
occurrence, 24 June – 26 July 2026

Of 896 confirmed deaths analysed, children aged under 5 years accounted for 17.4% (n = 156), while persons aged 5
years and older accounted for 82.6% (n = 740), reflecting the predominance of mortality among older children and
adults. However, the highest case fatality ratios were observed among the youngest age groups, reaching 65.9%
among infants aged under one year and 57.8% among children aged 1 – 4 years. CFR remained elevated among
children aged 5 – 9 years (42.2%) and adults aged 60 years and older (41.8%), whereas it ranged from 24.9% to 29.1%
among persons aged 10 – 59 years. The higher mortality observed among young children and older adults is likely
multifactorial and may reflect greater biological vulnerability, less robust immune responses, and a higher prevalence
of underlying conditions or malnutrition among young children in the affected areas. Overall, mortality was higher

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among males (CFR 35.1%) than among females (29.6%). This difference may reflect delayed healthcare seeking,
occupational or behavioural factors associated with later presentation to care, differences in exposure intensity, or
underlying health conditions.
Figure 3. Bundibugyo virus disease case fatality ratio by age group and sex, Democratic Republic of the Congo,
data as of 25 July 2026 (n=896 deaths)

As of 26 July 2026, a total of 15,498 contacts were under follow-up in the Democratic Republic of the Congo, of whom
12,122 (78.2%) were successfully seen within the previous 24 hours. Ituri Province accounted for the majority of
contacts under follow-up, although only 75.6% were successfully monitored, while Haut-Uélé achieved 60.0%, North
Kivu 85.2%, and Tshopo 90.9%. Contact follow-up activities had been completed in South Kivu, reflecting the absence
of recent transmission requiring monitoring. Overall follow-up performance remained substantially below the
operational target of 95%, leaving 3,376 contacts not seen during the reporting period and increasing the risk of
undetected infections and continued community transmission.

Figure 4. Trend in Contacts Under Follow-up and Daily Contact Follow-up Performance, Democratic Republic of
the Congo, 22 June - 26 July 2026

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Since the beginning of the outbreak, the Democratic Republic of the Congo has reported 3,262 confirmed cases,
including 1,437 confirmed deaths, corresponding to a crude CFR of 44.1%. The outbreak now affects 48 health zones
across five provinces. Ituri Province remains the epicentre, accounting for 2,901 confirmed cases (88.9%) and 1,207
confirmed deaths (84.0%) reported nationally. The most affected health zones continue to be Bunia (773 cases, 220
deaths), Rwampara (568 cases, 241 deaths), Mongbwalu (506 cases, 244 deaths), Nizi (357 cases, 171 deaths), Lita
(117 cases, 66 deaths), and Nyankunde (114 cases, 31 deaths) in Ituri Province, together with Katwa (140 cases, 88
deaths) and Butembo (73 cases, 49 deaths) in North Kivu Province. Collectively, these health zones continue to
account for the overwhelming majority of confirmed cases and 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 26 July 2026

Uganda and France
No new cases have been reported in Uganda and France since the previous update. In Uganda, the last confirmed
patient was discharged on 16 July 2026, and the country is on Day 10 of the 42-day countdown to declare the end of
the outbreak. All identified contacts have completed the required 21-day follow-up, and no contacts remain under
active monitoring. In France, no secondary transmission has been detected following the imported case reported on
24 June 2026, and all five flight contacts successfully completed the 21-day follow-up period. Despite the absence of
new cases, Uganda remains at high risk of reintroduction because of the ongoing outbreak in the neighbouring
Democratic Republic of the Congo.

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Risk Assessment

The overall public health risk in the Democratic Republic of the Congo remains very high, driven by sustained
transmission, increasing mortality, continued geographic expansion across five affected provinces, and persistent
transmission in the Bunia–Rwampara–Mongbwalu–Nizi corridor, the current epicentre of the outbreak. Continued
spread into Haut-Uélé and newly affected health zones indicates that transmission is extending beyond its original
focus.

The risk of further spread remains high because transmission is occurring along major internal and cross-border
mobility corridors. Within the Democratic Republic of the Congo, the Butembo–Beni–Goma, Bunia–Komanda–
Mambasa–Nia-Nia–Kisangani, and Bunia–Mongbwalu–Wamba–Isiro corridors connect the outbreak epicentre with
major population centres. Internationally, the Ariwara–Aru–Mahagi corridor links the affected area with Uganda's
West Nile region and onward to Eastern Equatoria State in South Sudan, while the Bunia–Nizi–Mahagi, Bunia–
Tchomia (Lake Albert) and Beni–Kasindi corridors provide additional routes for cross-border spread. Frequent
movement of traders, miners, displaced populations, humanitarian workers and other travellers along these routes
continues to increase the risk of national and international spread.

Although Uganda has reported no new cases during the reporting period and all contacts from the previous imported
case have completed follow-up, both Uganda and South Sudan remain at high risk of importation because of
sustained transmission along these major mobility corridors. Continued cross-border surveillance, information
sharing and preparedness remain essential to rapidly detect and contain any imported cases.

Figure 5. Bundibugyo virus disease transmission risk along major mobility corridor in the Democratic Republic of
the Congo, data as of 26 July 2026

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Table 1. Confirmed cases and deaths of Bundibugyo virus disease in the Democratic Republic of the Congo
and Uganda by geographic area, as of 26 July 2026
Province / Health zone / Cum. Cum. Cases (last Deaths (last Days since
Country CFR % Date last case
Region district cases deaths 21 d) 21 d) last case

Boma Mangbetu 7 4 57.1 7 4 2026-07-24 2

Isiro 12 7 58.3 12 7 2026-07-24 2
Democratic Republic
Haut-Uélé Pawa 8 6 75.0 8 6 2026-07-26 0
of the Congo
Rungu 1 0 0.0 1 0 2026-07-24 2

Wamba 11 4 36.4 11 4 2026-07-24 2

Subtotal — Haut-Uélé 39 21 53.8

Adja 11 1 9.1 11 1 2026-07-26 0

Ariwara 7 1 14.3 7 1 2026-07-20 6

Aru 5 5 100.0 2 4 2026-07-22 4

Aungba 5 4 80.0 0 2 2026-07-26 0

Bambu 57 11 19.3 29 2 2026-07-26 0

Boga 1 1 100.0 0 0 2026-07-11 15

Bunia 773 220 28.5 301 86 2026-07-26 0

Damas 16 8 50.0 11 8 2026-07-24 2

Drodro 10 5 50.0 7 2 2026-07-26 0

Fataki 18 10 55.6 15 9 2026-07-24 2

Gety 1 0 0.0 0 0 2026-05-21 66

Kambala 2 2 100.0 0 0 2026-06-30 26

Kilo 14 5 35.7 5 4 2026-07-24 2

Komanda 29 14 48.3 6 6 2026-07-24 2
Democratic Republic
Ituri Lita 117 66 56.4 77 50 2026-07-26 0
of the Congo
Logo 11 5 45.5 4 5 2026-07-24 2

Lolwa 6 2 33.3 5 1 2026-07-24 2

Mahagi 10 4 40.0 10 4 2026-07-26 0

Mambasa 17 10 58.8 13 7 2026-07-24 2

Mandima 16 8 50.0 11 6 2026-07-24 2

Mangala 82 58 70.7 43 38 2026-07-24 2

Mongbwalu 506 244 48.2 208 90 2026-07-26 0

Nia-Nia 90 47 52.2 57 35 2026-07-24 2

Nizi 357 171 47.9 273 147 2026-07-26 0

Nyankunde 114 31 27.2 18 11 2026-07-24 2

Rimba 7 0 0.0 3 0 2026-07-24 2

Rwampara 568 241 42.4 211 166 2026-07-26 0

Tchomia 37 17 45.9 22 15 2026-07-24 2

Unallocated health zones 17 0 0.0 0 0 — —

Subtotal — Ituri 2,901 1,207 41.6

Beni 45 32 71.1 16 13 2026-07-24 2

Democratic Republic Butembo 73 49 67.1 32 29 2026-07-26 0
North Kivu
of the Congo Goma 1 0 0.0 0 0 2026-05-25 62

Kalunguta 5 3 75.0 1 0 2026-07-26 0

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

Katwa 140 88 62.9 84 47 2026-07-26 0

Kyondo 13 9 69.2 9 7 2026-07-24 2

Mabalako 1 0 0.0 0 0 2026-06-13 43

Masereka 4 0 0.0 1 0 2026-07-22 4

Musienene 31 17 54.8 23 15 2026-07-26 0

Oicha 4 3 75.0 1 1 2026-07-19 7

Vuhovi 1 1 100.0 0 0 2026-06-11 45

Subtotal — North Kivu 314 204 65.0

Democratic Republic
South Kivu Miti-Murhesa 3 1 33.3 0 0 2026-05-20 67
of the Congo

Subtotal — South Kivu 3 1 33.3

Lubunga 1 0 0.0 1 0 2026-07-11 15
Democratic Republic
Tshopo Makiso-Kisangani 3 3 100.0 3 3 2026-07-11 15
of the Congo
Mangobo 1 1 100.0 1 1 2026-07-11 15

Subtotal — Tshopo 5 4 80.0

Uganda Kampala Kampala 21 3 14.3 0 0 2026-06-21 35

Subtotal — Uganda 21 3 14.3

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.

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. WHO, Africa
Centres for Disease Control and Prevention, and partners continued to provide coordinated technical,
operational, and resource mobilization support under the Incident Management System to sustain the
regional response.

• National and subnational coordination structures in the Democratic Republic of the Congo continued to
oversee the multisectoral response across the five affected provinces. National response leadership was
strengthened with the deployment of a new National Incident Manager, while the harmonization of
epidemiological data between the national and provincial levels continued to enhance situational
awareness and support coordinated decision-making.

• Cross-border coordination between the Democratic Republic of the Congo and Uganda intensified through
high-level bilateral engagement and sustained political commitment to strengthen cross-border
collaboration and response coordination, alongside joint technical assessments and preparedness
activities.

• 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

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(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; the Standby Partnership (SBP);
and other partners through technical assistance, expert deployments, surge capacity, laboratory
strengthening, logistics, and field operations.

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 from approximately US$9.37 million to US$10.62 million. Of
this amount, the value of delivered supplies increased from US$2.59 million (28%) to US$3.59 million (34%),
while the value of supplies in transit decreased from US$3.54 million (38%) to US$2.86 million (27%). The
value of commodities awaiting procurement or shipment increased to US$4.17 million (39%), reflecting
continued procurement to support the expanding response operations.

• Delivery of emergency supplies increased substantially, with the cumulative value of delivered commodities
rising by nearly US$1.0 million during the reporting period. Delivered cargo increased from approximately
232 metric tons to 265.5 metric tons and from 1,333 cubic metres to 1,583.2 cubic metres, further
strengthening operational support for response activities in the Ituri and Kivu hubs.

• Essential response commodities continued to reach affected areas, including 42,974 coveralls, 1.83 million
examination gloves, 156,600 Level 3 gowns, 261 hospital beds, 20,016 rapid polymerase chain reaction (PCR)
tests, infrared thermometers, patient liners, medicines, and laboratory equipment. Personal protective
equipment (PPE) and infection prevention and control (IPC) supplies remained the largest procurement
category (US$5.99 million), followed by medical equipment, laboratory supplies, logistics equipment, and
medicines.

• Supply chain operations remained robust, supporting case management, laboratory diagnostics,
surveillance, infection prevention and control, and field operations. Although the proportion of commodities
in transit declined, 39% of the procurement pipeline (US$4.17 million) remained pending shipment, requiring
continued monitoring to ensure the timely availability of critical response supplies as the outbreak expanded.

• 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
procurement (81%; US$8.12 million) continued to originate directly from international suppliers, while
regional logistics 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 rapid alert investigation remained suboptimal in
some affected provinces. On 26 July 2026, 1,303 alerts were reported from the affected provinces in the

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Democratic Republic of the Congo, of which 1,078 (82.7%) were investigated within 24 hours. Most alerts
originated from North Kivu (650) and Ituri (593), followed by Haut-Uélé (60). Investigation performance
remained highest in North Kivu (91.7%), while Ituri investigated 81.3% of reported alerts within 24 hours. No
alerts were investigated in Haut-Uélé during the reporting period (0.0%), highlighting a critical surveillance
gap requiring immediate attention. A total of 326 suspected cases, including 216 live alerts and 110
community deaths, were validated.

• Points of entry (PoE) and points of control (PoC) surveillance continued to be strengthened in the Democratic
Republic of the Congo. As of 26 July 2026, 76 of 76 (100%) planned PoE/PoC sites were operational, including
60 in Ituri, 16 in North Kivu, and all activated sites in Tshopo (60%). During the reporting period, 152,039
travellers passed through PoE/PoC screening sites, of whom 96.8% were screened for Bundibugyo virus
disease (BVD) symptoms. Five alerts were generated through PoE/PoC surveillance, all of which were
validated live alerts. One (20.0%) was referred to a treatment centre, and one confirmed positive case was
identified among referred suspected cases during the reporting period.

• Contact tracing activities continued but remained below the operational target. As of 26 July 2026, 15,498
contacts were under follow-up, of whom 12,122 (78.2%) were successfully seen, remaining well below the
operational target of 95%. Follow-up performance was highest in Tshopo (90.9%), followed by North Kivu
(85.2%), Ituri (75.6%), and Haut-Uélé (60.0%), while contact follow-up had been completed in South Kivu.

• In Uganda, alert management, surveillance for non-trauma deaths, community-based surveillance, and
point-of-entry screening continued nationwide. All previously identified contacts had completed the 21-day
follow-up period, while enhanced surveillance and digital Passenger Locator Form requirements remained
in place to support early detection of imported cases.

Laboratory
• Laboratory decentralization continued to expand with the goal to reduce turnaround times. As of 29 July
2026, 19 diagnostic laboratories and testing units were operational across Ituri, South Kivu, Tshopo, Haut-
Uélé 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.

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Case Management
Case management capacity continued across the Democratic Republic of the Congo, with operational
treatment centres and care facilities providing 941 isolation and treatment beds. As of 26 July 2026, 723
patients were in isolation, corresponding to an overall bed occupancy rate of 76.8%. Bed occupancy
remained particularly high in North Kivu (136.2%), indicating continued pressure on treatment capacity,
while Ituri reported an occupancy rate of 66.4%. Of the 723 patients in isolation, 325 were confirmed cases
and 398 were suspected cases.
• Clinical outcomes continued to improve, with cumulative recoveries increasing to 568 by 26 July 2026,
reflecting the continued provision of supportive clinical care despite increasing case numbers.

Operational Research
• Clinical research and access to investigational therapeutics continued through the WHO-supported
PARTNERS clinical trial, which began on 2 July 2026 in the Democratic Republic of the Congo and is evaluating
MBP134 and remdesivir for the treatment of BVD. This is complemented by the partner-supported EBO-PEP
trial, which commenced on 14 July 2026 and is assessing obeldesivir as post-exposure prophylaxis for high-
risk contacts.

• Additionally, Phase I evaluation of candidate Bundibugyo virus vaccines is underway in the United Kingdom,
with additional studies expected to begin in Africa. WHO continues to support research preparedness
through the development of standardized epidemiologic protocols, a regional research tracking system, and
community engagement materials to improve understanding of clinical research.

Infection Prevention and Control (IPC) and Water, Sanitation and Hygiene (WASH)
• In the Democratic Republic of the Congo, as of 26 July 2026, 947 health care facilities (HCFs) had been
assessed for IPC readiness across the four affected provinces (Ituri, North Kivu, South Kivu, and Tshopo),
covering 51 health zones. The average overall IPC score was 38.0% (median: 37.1%), indicating that IPC
capacity across the response area remained critically low compared with the 80% threshold considered
satisfactory for Ebola preparedness.

• Of the 947 HCFs assessed, 705 (74%) were classified as "Insufficient", 221 (23%) as "Partial", and only 21 (2%)
met the "Satisfactory" threshold (≥80%). Additionally, 248 facilities (26%) had reported at least one
suspected or confirmed case, underscoring the urgency of addressing these IPC gaps.

• Across the 17 standardized IPC components assessed, the weakest areas were personal protective
equipment (PPE) (11%), training (13%), isolation area set-up (17%), post-exposure management (23%), and
cleaning and disinfection (25%), all of which were rated "Insufficient." Even the strongest-performing
components – injection safety (75%), patient placement (72%), waste treatment (65%), sterilization (58%),
and water supply (52%) – remained within the "Partial" category, indicating that no IPC component had yet
reached the standard required for adequate Ebola response readiness at the national level.

• Healthcare worker infections continued to increase, with 123 infections and 37 deaths reported among
healthcare workers, corresponding to a CFR of 29.8%. This underscores persistent occupational exposure
risks and inadequate implementation of IPC measures in health facilities. Gaps also remain in the availability
of appropriate personal protective equipment (PPE) for different categories of healthcare workers.

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• In response to these findings, WHO and partners continued to scale up IPC/WASH interventions across
affected areas. More than 1,000 frontline health workers, supervisors, hygienists, and members of safe and
dignified burial (SDB) teams received IPC training. In addition, more than 450 IPC rings were activated,
resulting in the decontamination of over 1,000 households and health facilities, the distribution of more than
130 IPC kits to health facilities, and over 450 assessments of exposed health workers. Furthermore, more
than 115 screening and triage points were established, with over 500 supportive supervision and mentorship
visits conducted. IPC/WASH assessments were also completed at all eight Ebola treatment centres (ETCs).

• Safe and dignified burial (SDB) operations and decontamination activities continued across affected health
zones, including the decontamination of households, health facilities, and transport vehicles linked to
confirmed cases.

Risk Communication and Community Engagement (RCCE)
• RCCE activities continued across affected provinces to strengthen community awareness, promote early alert
reporting, support contact tracing, and SDB operations, particularly in hotspot areas of Ituri and North Kivu.
Additional RCCE personnel and anthropological expertise were deployed to newly affected provinces to
strengthen community engagement.

• Community feedback and rapid community assessments continued to inform the response by identifying
concerns related to transmission risks, access to services, vaccination, and response activities. Findings are
being translated into community-led interventions and expanded across affected areas of the Democratic
Republic of the Congo, with plans to extend implementation to Uganda and South Sudan.

• Capacity-building efforts continued through the development of an RCCE Humanizing the Response training
package and the training of trainers for response partners. A targeted RCCE strategy was also developed for
IDP camps, incorporating findings from rapid community assessments to strengthen community
engagement.

• Key RCCE challenges persisted, including delay in intervention services (like SDB), insecurity in hotspot areas,
limited community trust and acceptance in mining and conflict-affected communities, misinformation, and
highly mobility of populations. Community engagement efforts therefore remained focused on building trust
in response services and improving access among high-risk populations.

Preventing and Responding to Sexual Exploitation, Abuse, and Harassment (PRSEAH)
• Visibility and operational materials were distributed to community awareness-raising teams in Bunia to
strengthen field activities. The teams received seven megaphones, 55 T-shirts, 55 vests, one box of batteries,
one package of hand sanitiser gel, 70 posters, and 1,000 information, education and communication (IEC)
flyers.

• An evaluation of PRSEAH pillar activities, including field-based awareness-raising interventions, was
conducted to assess progress, identify key implementation challenges, and inform the planning of upcoming
awareness-raising activities. A total of 40 participants, including 30 women, took part in the evaluation.

• A PRSEAH induction briefing was conducted for 15 WHO staff members, all of whom signed the
Organization's Code of Conduct. In Ituri, North Kivu, South Kivu, and Tshopo Provinces, as well as at the
Rwampara Ebola Treatment Centre, 443 individuals, including 265 women, participated in PRSEAH

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orientation sessions. Participants included psychologists, health care providers, community outreach
workers, hygiene promoters, Red Cross volunteers, and administrative staff.

• A total of 1,556 people, including 770 women and 47 girls, participated in PRSEAH awareness sessions
targeting religious leaders, pregnant women, health care workers, taxi drivers, motorcycle taxi riders, and
other community members.

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, 30 of the 47 Member States (64%) have
updated their readiness assessments. In addition, three high-priority countries (Angola, South Sudan, and
Tanzania) have completed repeat readiness assessments, demonstrating significant improvements in their
average readiness scores.

• Regional deployments to support preparedness in high-risk Member States continued during the reporting
period, with ongoing deployments in Burundi, the Central African Republic, and the Democratic Republic of
the Congo.

Border Health, Travel and Mass Gatherings
• Screening has been reinforced at airports, high-risk border crossings, and internal transit routes in both the
Democratic Republic of the Congo and Uganda. National authorities, the International Organization for
Migration (IOM), and partners continue to support the implementation of WHO border health guidance,
strengthen cross-border coordination, and facilitate the timely detection and referral of suspected cases at
PoEs and PoCs along priority travel corridors.

• Cross-border preparedness and response are being strengthened through enhanced coordination among the
Democratic Republic of the Congo, Uganda, and South Sudan to improve the early detection of cases and
reduce the risk of cross-border spread. Priority actions include strengthening coordinated cross-border
disease surveillance, event-based surveillance, active case finding, joint contact tracing where required, and
real-time information sharing through regular cross-border coordination meetings and harmonized
reporting mechanisms.

• Priority operational actions include rapid assessments and mapping of PoEs, strengthening monitoring along
high-risk cross-border mobility corridors, including informal crossings, and major congregation points, and
ensuring that field teams are adequately staffed and equipped, with sustained availability of trained
personnel, equipment, PPE, screening materials, disinfectants, and referral systems for the safe
management of suspected cases

• Mass gathering risk assessment capacity is being strengthened through training and technical support. 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

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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 BVD outbreak in the Democratic Republic of the Congo continues to intensify despite the ongoing scale-up of
response operations. The sustained increase in transmission and mortality indicates that the outbreak remains
uncontrolled. Although transmission remains concentrated within a number of interconnected health zones, its
continued expansion into adjacent areas suggests that current interventions have not yet been sufficient to reduce
transmission intensity or halt the geographic spread of the outbreak. The persistently high proportion of community
deaths, suboptimal contact follow-up, and critically weak IPC capacity indicate that many transmission chains
continue to be detected too late to prevent onward spread. Although no international spread has been reported
during the current reporting period, sustained transmission along major domestic and cross-border mobility
corridors continues to pose a substantial risk of regional spread. Strengthening early case detection, community
engagement, IPC, and coordinated cross-border preparedness remains critical to interrupt transmission and reduce
the risk of further national and international spread.

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[PAGE 15]

Contributors Editorial Advisory Group, WHO Regional
Office for Africa
• WILLIAMS, George Sie (WHO AFRO)
• 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
Response
• BORIS, Pavlin (WHO HQ)
• HAMBLION, Esther (WHO HQ)
• KASSAMALI, Zyleen (WHO HQ) • Dr Etien Koua — Programme Area
Manager, HIS/EPR/AFRO
• DIAZ, Janet Victoria (WHO HQ)
• 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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