A severe outbreak of Bundibugyo virus disease (BVD), a strain of Ebola, is currently unfolding in the Democratic Republic of Congo (DRC) and has extended to neighboring Uganda. Health authorities, supported by the World Health Organization (WHO) and other global partners, are racing against time to contain the rapidly evolving situation, particularly as case numbers surge in the DRC. The latest reports highlight a challenging scenario, especially in the DRC where the outbreak continues to expand into new areas. Meanwhile, Uganda, despite facing imported cases, has demonstrated effective control measures, preventing further community spread in recent weeks. This public health emergency underscores the critical need for coordinated action, robust surveillance, and strong community engagement to safeguard lives and prevent wider regional transmission. ## Understanding Bundibugyo Virus Disease (BVD) Bundibugyo virus disease is a serious and often deadly illness caused by the Bundibugyo virus, one of the species within the *Orthoebolavirus* family. While less commonly known than the Zaire strain, BVD presents a significant health threat, with past outbreaks recording high fatality rates, ranging from 30% to 50%. The virus is naturally found in animals, with fruit bats suspected to be its primary reservoir. Humans typically contract the disease through close contact with the blood or other bodily fluids of infected wildlife, such as bats or non-human primates. Once a person is infected, the virus can then spread from human to human. Human-to-human transmission primarily occurs through direct contact with blood, secretions, organs, or other bodily fluids of infected individuals, or by touching contaminated surfaces and objects. This spread is often dramatically amplified in healthcare settings if proper infection prevention and control (IPC) measures are not strictly followed. Unsafe burial practices, which often involve direct contact with the deceased, also pose a significant risk for transmission. The incubation period for BVD, the time from exposure to symptom onset, can range from two to 21 days. People are not infectious until they start showing symptoms. Early symptoms of BVD are non-specific and can include fever, extreme tiredness, muscle pain, headache, and a sore throat. These symptoms can easily be mistaken for other common illnesses like malaria, making early diagnosis challenging and potentially delaying detection and isolation. As the disease progresses, patients may develop gastrointestinal symptoms such as vomiting and diarrhea, followed by severe organ dysfunction, and in some cases, internal and external bleeding. Due to the non-specific early signs, laboratory confirmation using tests like PCR or antigen/antibody assays is essential to accurately diagnose BVD and differentiate it from other febrile illnesses. ## The Situation in the Democratic Republic of Congo (DRC) The Democratic Republic of Congo is currently grappling with a rapidly intensifying BVD outbreak. As of June 17, 2026, a staggering 896 confirmed cases have been reported, leading to 232 deaths, indicating a case fatality ratio (CFR) of 26%. This figure represents a significant jump since the last update on June 13, with an additional 220 confirmed cases and 96 deaths identified. This increase is partly attributed to an enhanced capacity for testing and diagnosis, allowing for the processing of a backlog of previously collected samples, which means some reported cases may reflect older, undetected infections rather than brand new ones. The outbreak is primarily concentrated in Ituri Province, which accounts for over 91% of the confirmed cases. Cases have also been identified in health zones across North Kivu and South Kivu provinces, indicating a broadening geographic spread. The complex humanitarian crisis and ongoing conflict in these regions pose immense challenges to the response efforts. Highly mobile and displaced populations, often living in overcrowded camps and lacking access to basic services like food, clean water, and healthcare, are particularly vulnerable. Frequent security incidents affecting health facilities further disrupt surveillance and response activities, increasing the risk of undetected transmission. Addressing these challenges requires response efforts that are led by local communities and leaders, fostering trust and cooperation. Health teams are actively engaged in contact tracing, with 6,367 contacts identified across Ituri, North Kivu, and South Kivu provinces. Follow-up rates are commendable, with over 70% of contacts being monitored, and 100% in South Kivu, underscoring dedicated efforts to break chains of transmission. ## Uganda's Response and Status Uganda has also reported cases of Bundibugyo virus disease, with a total of 19 confirmed cases, including two deaths among imported cases, and one probable case who sadly died, as of June 18, 2026. Encouragingly, Uganda has not reported any new confirmed cases since June 5, 2026. This suggests that the robust public health measures implemented have been effective in containing the spread within the country. Of the confirmed cases in Uganda, 14 were identified as imported, originating from the DRC, while five cases resulted from secondary transmission among close contacts and healthcare workers. These cases have been reported in the Kampala Metropolitan Area, specifically from Kampala and Wakiso districts. Crucially, there has been no documented community transmission within Uganda, indicating that the virus has not spread widely beyond known chains of infection. The primary exposure risks in Uganda have been linked to healthcare settings and cross-border movements from the DRC. Ugandan health authorities have been diligent in contact tracing, listing 826 contacts. Of these, 122 are currently under active follow-up, and 694 contacts have successfully completed their 21-day monitoring period, demonstrating the effectiveness of the surveillance system in preventing further spread. ## Coordinated Response and Prevention Strategies In response to this critical outbreak, both the Democratic Republic of Congo and Uganda, in close collaboration with the WHO and various international partners, are implementing an extensive array of public health measures. These efforts are guided by a continental response plan, focusing on critical interventions to control the virus. Key strategies include rapid identification of new cases, isolating and providing care for infected individuals, meticulous contact tracing to identify and monitor those exposed, and ensuring safe and dignified burial practices that prevent further transmission. Community engagement is paramount, ensuring that local populations are informed, involved, and empowered to adopt preventive behaviors. Enhancing infection prevention and control (IPC) in all healthcare facilities is a top priority to protect both patients and healthcare workers, who are often at the frontline of these outbreaks. While there are currently no approved vaccines or specific treatments for Bundibugyo virus disease, research and development are ongoing. The WHO's Strategic Advisory Group of Experts on Immunization (SAGE) has convened to assess candidate vaccines and therapeutics, providing vital recommendations for future interventions. Furthermore, sustained efforts are underway to mobilize additional resources and address critical funding gaps to ensure that response operations in affected and at-risk areas can continue uninterrupted. ## Risk Assessment and Global Implications The World Health Organization conducted a thorough risk assessment on June 6, 2026, to evaluate the potential for further spread of BVD. The risk within the Democratic Republic of Congo is currently assessed as very high due to the ongoing and expanding transmission of the outbreak into new health zones. This situation increases the potential for both national and regional spread across its borders. Uganda's risk is also assessed as high. This is attributed to confirmed cross-border spread through imported cases and the persistent epidemiological links along the eastern DRC–western Uganda corridor, an area historically affected by Ebola outbreaks, including those caused by Bundibugyo and Sudan viruses. For countries sharing land borders with the DRC and Uganda, the risk is similarly assessed as high. This elevated risk is due to significant population mobility driven by cross-border trade and mining activities, as well as varying levels of preparedness and experience in responding to BVD outbreaks. For the rest of the African region and globally, the risk is considered low. Despite these risks, the WHO currently advises against any restrictions on international travel to or trade with the Democratic Republic of Congo or Uganda. This recommendation is based on the available scientific information, with the WHO continuously monitoring and verifying any travel or trade measures implemented by countries. The International Health Regulations (IHR) Emergency Committee has also issued temporary recommendations, emphasizing coordinated outbreak control, enhanced cross-border collaboration, and sustained surveillance to prevent further regional spread. ## Looking Ahead: Sustained Vigilance and Community Engagement The fight against Bundibugyo virus disease in the DRC and Uganda demands sustained vigilance and collaborative action. The current outbreak highlights the urgent need for strengthening health systems, improving surveillance capabilities, and investing in preparedness across the African region. Community engagement remains the bedrock of any successful public health response, ensuring that local knowledge and practices are integrated into prevention and control strategies. With continued international support and unwavering commitment from national authorities, there is hope for bringing this challenging outbreak under control and protecting the health of the affected populations.