Ebola disease caused by Bundibugyo virus - Democratic Republic of the Congo

Since the previous Disease Outbreak News was published on 25 September 2026, an additional 775 confirmed cases, including 379 confirmed deaths, have been reported in the Democratic Republic of the Congo.  

In the most recent 24-hour period, as of 6 October, 62 new confirmed cases were reported, with Ituri accounting for 33 cases and North Kivu for 30. No new cases were reported in Bas-Uélé, South Kivu or Sud-Ubangi during that period. Across the preceding seven days, the average number of new cases rose to 72 per day. 

As of 6 October, cumulative confirmed cases have reached 8728, including 4205 deaths and 2269 recoveries. The overall crude CFR is 48.2%.  

Confirmed cases have now been identified in 64 health zones across seven provinces. Forty-eight of the 64 affected zones reported at least one new case during the preceding 21 days, while 16 reported no recent cases. Ituri remains the most extensively affected province, with 28 of 36 health zones reporting cases during this outbreak, followed by North Kivu (17/34), Haut-Uélé (7/13), Tshopo (7/23), Bas-Uélé (3/11), South Kivu (1/34) and Sud-Ubangi (1/16). Alimbongo in North Kivu is the most recently affected health zone and reported four confirmed cases, including two deaths. 

Figure 1. Distribution of cumulative confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo, as of 6 October 2026

Ituri remains the epicentre, with 6480 cumulative confirmed cases and 2989 deaths. North Kivu follows with 1755 confirmed cases and 1013 deaths, and continues to record the highest provincial CFR, at 57.7%. Haut-Uélé has reported 364 cases and 153 deaths, while Tshopo has recorded 51 cases and 17 deaths. The less-affected provinces continue to report substantially fewer cases, but transmission persists in several of them. The most affected health zones were Beni and Katwa in North Kivu, and Rwampara, Bunia and Mandima in Ituri. The continued occurrence of cases across multiple provinces shows that the outbreak remains geographically active even as intensity varies between health zones. 

Contact follow-up remains a major operational pressure and has fluctuated below the response target in recent weeks. Coverage was 87.6% on 16 September, briefly above the target of 85%, but fell to 74.7% by 25 September. Although coverage subsequently improved to 82.0% on 27 September, it remained below target and stood at 80.4% in the latest reporting period, with 23 741 of 29 535 contacts reached as of 4 October. The current level therefore reflects a persistent gap in the ability to monitor exposed people consistently throughout the 21-day follow-up period.  

Figure 2: Number of confirmed Bundibugyo virus disease cases in the Democratic Republic of the Congo, by date of notification, as of 6 October 2026 

On 6 October 2026, the Ministry of Health of Kenya reported the first laboratory-confirmed imported case of BVD in Kenya.  

According to an official statement from the Ministry of Health, the individual is an adult who lived in the Democratic Republic of the Congo. The patient became ill approximately one month ago and was treated in several hospitals while in the Democratic Republic of the Congo. The patient travelled from the Democratic Republic of the Congo to Kampala, Uganda, by road before arriving in Nairobi, Kenya by air on 3 October. It is currently unclear if and when he was symptomatic during these travels, but upon arriving ill in Kenya, the patient was transported by a relative directly to Nairobi Hospital and isolated in the facility. A sample collected from the patient on 5 October was positive for BDBV at both the National Virology Reference Laboratory and the Kenya Medical Research Institute Laboratory on the same day. The patient was given supportive treatment but subsequently died.  

A safe and dignified burial has been conducted. Public health response actions were immediately initiated. Contact tracing is ongoing, including for the international flight.  

Given the timelines of the illness, and the one month time from initial symptoms to death, it is presumed he was not initially sick with BVD, which does not usually have such a long progression from infection to symptoms and death, but became infected with BVD in a health facility or community while seeking care for another ailment.  

The Netherlands  

On 1 October 2026, the Netherlands reported the medical evacuation of a healthcare worker who tested positive by PCR for BDBV in the Democratic Republic of the Congo where the patient was working on the Ebola disease outbreak response. Following confirmation of the diagnosis, the patient was safely repatriated to the Netherlands under strict medical and infection-prevention procedures, in close coordination with the relevant health authorities in the Democratic Republic of the Congo and the Netherlands. As with previous medically evacuated cases, this case will not be reported as a local case of BVD in the Netherlands. 

Bundibugyo virus disease (BVD) is a severe Ebola disease caused by the Bundibugyo virus, one of the Orthoebolavirus species. It is a zoonotic disease, with fruit bats suspected to be the natural reservoir. 

Human infection is thought to initially occur through close contact with the blood or secretions of infected wildlife, such as bats or non-human primates, and it subsequently spreads from person-to-person through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals or contaminated surfaces and materials. Transmission is particularly amplified in health-care settings when infection prevention and control (IPC) measures are inadequate, and during unsafe burial practices involving direct contact with deceased individuals. 

The incubation period for BVD ranges from two to 21 days, and infected individuals are not infectious until symptom onset. Early symptoms such as fever, fatigue, muscle pain, headache, and sore throat are non-specific, which complicates clinical diagnosis and can delay detection. These symptoms then progress to gastrointestinal symptoms, organ dysfunction, and, in some cases, haemorrhagic manifestations. 

The CFR from the previous two BVD outbreaks, reported in Uganda and in the Democratic Republic of the Congo in 2007 and 2012, were 30% and 50%, respectively. 

Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation. Outbreak control relies on rapid case identification and investigation, isolation and care, contact tracing, safe burials and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD. 

Since first detected in May 2026, this BVD outbreak has rapidly evolved into a large and geographically expanding epidemic in the Democratic Republic of the Congo, with sustained transmission, high mortality and an increasing risk of further international spread. The current outbreak is the second documented Bundibugyo virus disease outbreak in the country, after the 2012 outbreak, and the largest Ebola disease outbreak ever recorded in the Democratic Republic of the Congo irrespective of virus species. The population at greatest risk of exposure is concentrated in communities living in and moving through the health areas with active transmission.  

Health authorities in the Democratic Republic of the Congo, in collaboration with WHO and partners, are continuing to implement and coordinate extensive public health measures, including disease surveillance, laboratory testing, infection prevention and control, clinical care, community engagement, research, logistics and support for response interventions and essential health services, engaging donors and mobilizing additional resources to address critical funding gaps and sustain response operations across affected and at-risk areas. A substantial scale-up is ongoing across all response pillars to get ahead of the outbreak. 

Based on the currently available information, WHO advises against any restriction of travel to, or trade with, affected countries. WHO continues to closely monitor and, where necessary, verify travel and trade measures in relation to this event. 

The updated Temporary Recommendations issued to States Parties on 24 August 2026 underscore the importance of coordinated outbreak control, strengthened cross‑border collaboration, and sustained surveillance and preparedness to prevent further regional spread and ensure an effective public health response. Rapid recognition of cases, testing and optimized supportive care can reduce mortality, and improve community perceptions and acceptance of health care within the response.