The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo and Uganda is a rapidly evolving crisis that demands urgent attention and action. As of June 6, 2026, the situation is dire, with a total of 534 confirmed cases and 93 deaths reported from both countries, while at least 17 people have recovered. This outbreak is particularly concerning due to its severity, rapid spread, and potential for cross-border transmission.
The outbreak is concentrated in the Ituri Province of the Democratic Republic of the Congo, which accounts for 94% of confirmed cases. The case fatality rate (CFR) in Ituri is 15%, significantly lower than the 64% CFR in North Kivu. However, the outbreak is expanding into new health zones, increasing the potential for further national and regional spread.
In Uganda, the outbreak remains epidemiologically linked to transmission originating in the Democratic Republic of the Congo. As of June 6, 2026, Uganda has reported 19 confirmed cases, including two deaths, and one probable case who has died. All cases in Uganda can be linked to travelers from the Democratic Republic of the Congo, with no documented community transmission.
The Bundibugyo virus disease is a severe and often fatal form of 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 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 or items.
The incubation period for BVD ranges from two to 21 days, and 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. Case fatality rates in the past two BVD outbreaks, reported in Uganda and in the Democratic Republic of the Congo in 2007 and 2012, were 30% and 50% respectively.
The public health response to this outbreak is multifaceted, involving health authorities in the Democratic Republic of the Congo and Uganda, in collaboration with WHO and partners. Key response activities include interagency coordination, deployment of field teams, delivery of medical supplies, strengthening surveillance, increasing laboratory capacity, infection prevention and control, the set-up of safe and optimized treatment centers, risk communication and community engagement, and research on potential medical countermeasures.
The WHO has reassessed the risk of the outbreak of BVD to incorporate newly available information and the WHO Temporary Recommendations. The risk for countries sharing land borders with countries with documented Bundibugyo virus (BVDV) detection, as of this report, the Democratic Republic of the Congo and Uganda, has been separated out from the risk for other countries in the African Region. The risk in the Democratic Republic of the Congo remains very high due to ongoing transmission and the continued expansion of the outbreak into new health zones.
In conclusion, the Bundibugyo virus disease outbreak in the Democratic Republic of the Congo and Uganda is a serious public health crisis that requires immediate and coordinated action. The WHO and national authorities are working together to implement comprehensive public health measures to control the outbreak and prevent further regional spread. However, the situation remains dire, and the need for continued vigilance and support cannot be overstated.
