The World Health Organization has determined that Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern, while not meeting the criteria for a pandemic emergency under the International Health Regulations. The declaration sets out recommendations for affected countries, neighbouring countries and all other States Parties, with emphasis on international coordination, travel and trade, traveller information, evacuation and repatriation and preparedness outside the affected region. Confirmed cases in Ituri Province and Kampala sit alongside suspected cases, suspected deaths, community death clusters and uncertainty about the full scale of spread. The emergency also raises concern over healthcare-associated transmission, infection prevention and control gaps, high mobility and the lack of approved Bundibugyo virus-specific therapeutics or vaccines.
Outbreak Scale and International Spread
As of 16 May 2026, Ituri Province in the Democratic Republic of Congo had eight laboratory-confirmed cases, 246 suspected cases and 80 suspected deaths across at least three health zones, including Bunia, Rwampara and Mongbwalu. Uganda had two laboratory-confirmed cases in Kampala, including one death, among individuals travelling from the Democratic Republic of Congo. The two Kampala cases had no apparent link to each other and were identified within 24 hours, on 15 and 16 May. Both confirmed cases in Kampala required intensive care.
A further case involving an individual returning from Ituri to Kinshasa tested negative for Bundibugyo virus on confirmatory testing by INRB and does not count as a confirmed case. Unusual clusters of community deaths with symptoms compatible with Bundibugyo virus disease have occurred across several health zones in Ituri. Suspected cases have also occurred across Ituri and North Kivu.
At least four deaths among healthcare workers in a clinical context suggestive of viral haemorrhagic fever raise concern about healthcare-associated transmission, gaps in infection prevention and control and possible amplification within health facilities. Major uncertainty remains around the true number of infections, the geographic extent of spread and the epidemiological links between known and suspected cases. Confirmation of cases in Kampala, rising syndromic reporting and death clusters across Ituri indicate potential for further local and regional spread.
Response Measures in Affected Areas
Affected countries are advised to activate national disaster or emergency management mechanisms and establish emergency operation centres under senior government authority. These structures should coordinate response activities across partners and sectors and monitor comprehensive control measures. Core measures include enhanced surveillance with contact tracing, infection prevention and control, risk communication and community engagement, laboratory diagnostic testing and case management.
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Community engagement has a central role in case identification, contact tracing and risk education. Local, religious and traditional leaders and healers should support broad participation, while awareness activities should address cultural norms and beliefs that limit full community involvement. In Eastern DRC, the response also needs integration with wider activities addressing population needs in the context of a protracted humanitarian crisis.
Surveillance and laboratory capacity need strengthening across affected provinces and neighbouring provinces. Dedicated surveillance and response cells, enhanced community surveillance focused on community deaths and decentralised laboratory capacity for Bundibugyo virus testing are part of the response. Health facilities need systematic mapping, triage, targeted infection prevention measures, sustained monitoring and supervision. Healthcare workers need training in infection prevention and control, including proper use of personal protective equipment, as well as appropriate equipment, timely salaries and hazard pay where relevant. Suspected cases require safe transfer to specialised clinical units for isolation and patient-centred management.
Readiness, Travel and Public Information
Neighbouring countries sharing land borders with the Democratic Republic of the Congo face high risk because of population mobility, trade and travel linkages and continuing epidemiological uncertainty. Countries adjoining documented transmission should enhance preparedness through active surveillance in health facilities, active zero reporting, community surveillance for unexplained death clusters, access to qualified diagnostic laboratories and rapid response teams for cases and contacts.
Confirmed cases should be isolated and treated in a Bundibugyo virus disease treatment centre, with no national or international travel until two virus-specific diagnostic tests conducted at least 48 hours apart are negative. Contacts should receive daily monitoring, with restricted national travel and no international travel until 21 days after exposure. Probable and suspected cases should be isolated immediately, with travel restricted according to classification. International travel should not occur for cases or contacts unless it forms part of appropriate medical evacuation.
Other States Parties should avoid border closures and restrictions on travel and trade. National authorities should work with airlines, transport operators and tourism industries so international traffic measures do not exceed current advice. Travellers to affected and at-risk areas need information on risks, measures to reduce exposure and advice for managing potential exposure. States Parties should prepare to facilitate evacuation and repatriation of exposed nationals, including health workers. Entry screening outside the affected region is not needed for passengers returning from areas at risk.
The emergency places the immediate priority on coordinated surveillance, laboratory capacity, infection prevention, community engagement and safe clinical care in affected and neighbouring areas. Wider preparedness centres on clear traveller information, cooperation with transport and tourism sectors, and arrangements for evacuation and repatriation of exposed nationals. Border closures and travel or trade restrictions are not advised, while entry screening outside the affected region is not needed. The response now depends on rapid detection, safe isolation, sustained supplies and coordination across authorities, health services, communities and borders.
Source: World Health Organization
Image Credit: iStock
