{"databaseConfigured":true,"generatedAt":"2026-07-11T07:09:18.972Z","totalEvents":62,"latestPublishedAt":"2026-07-03T15:13:57.000Z","riskCounts":{"elevated-watch":25,"high-attention":29,"watch":8},"source":{"name":"WHO Disease Outbreak News","publisher":"World Health Organization","url":"https://www.who.int/emergencies/disease-outbreak-news","updateCadence":"Daily Vercel Cron ingestion at 03:00 UTC"},"events":[{"id":"2026-DON612","title":"Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo & Uganda","disease":"Ebola disease caused by Bundibugyo virus","locations":["Democratic Republic of the Congo & Uganda"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON612","summary":"The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continues to evolve rapidly, with sustained transmission and increasing numbers of reported cases. As of 1 July, a cumulative of 1460 confirmed cases, including 452 deaths, have been reported from the Democratic Republic of the Congo. As of 2 July, Uganda has reported 20 confirmed cases including two deaths, as well as one probable case who has died. In addition, on 24 June 2026, French authorities notified WHO of a laboratory-confirmed case of Ebola disease caused by Bundibugyo virus in a medical doctor returning from the Democratic Republic of the Congo. In Uganda, the outbreak remains epidemiologically linked to transmission originating in the Democratic Republic of the Congo, with evidence of both imported infections and secondary transmission among contacts and healthcare workers. Uganda has not reported any new cases since 21 June 2026. National authorities in the two affected countries, in collaboration with WHO and partners, are implementing an extensive set of response measures. A regional preparedness and prioritization framework continues to guide readiness activities across the African Region.","overview":"Since the last Disease Outbreak News was published on 19 June 2026, the number of confirmed cases and deaths have increased rapidly in the Democratic Republic of the Congo. In total, 1481 confirmed cases; 1460 from the Democratic Republic of the Congo, 20 from Uganda and one from France (linked to DRC); and 454 deaths including two from Uganda, have been reported. At least 229 patients have recovered from the disease; 213 patients from the Democratic Republic of the Congo and 16 patients from Uganda. Figure 1. Distribution of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo as of 1 July and Uganda as of 2 July Democratic Republic of the Congo Since 19 June when the last Disease Outbreak News was published, an additional 564 confirmed cases, including 220 confirmed deaths, have been reported from the Democratic Republic of the Congo. The increase is in part due to the scale up of surveillance activities, testing and diagnostic capacities. As of 1 July 2026, a total of 1460 confirmed cases including 452 deaths (crude case fatality ratio [CFR] 30.9%) have been reported from the Democratic Republic of Congo. So far, 213 patients have recovered. Cases have been reported from 36 health zones (HZ) from Ituri (24/36 HZ), North Kivu (11/35 HZ) and South Kivu provinces (1/34 HZ).[1] To date, 102 confirmed cases including 25 deaths have been reported among health and care workers. Of the 36 affected health zones, the outbreak remains active in 21 health zones from where cases have been reported in the past 21 days. The remaining health zones have not reported any new cases during this period. In the past 21 days, 838 confirmed cases, including 314 confirmed deaths, have been reported. Ituri Province remains the most affected, accounting for 91.3% (1333/1460) of all confirmed cases and 84% (380/452) of all reported deaths nationwide. Within the province, the highest number of confirmed cases have been reported from Bunia (416 cases), Rwampara (308 cases), Mongbwalu (270 cases), Nyankunde (95 cases), and Nizi (65 cases) health zones. As of 1 July, the outbreak has spread to three additional health zones in the province. Following epidemiological investigations, three confirmed cases with travel history from Nia Nia health zone in Ituri province have been reported on 30 June in Wamba health zone in Haut Uele Province and Kisangani in Tshopo province. These cases have been reported under Nia Nia health zone. Response activities, including contact tracing and follow-up, are ongoing in both provinces. Of the total confirmed cases, 17 are yet to be assigned to a specific health zone. As of 1 July, 10 821 contacts have been identified and are under follow-up across Ituri (8376), and North Kivu (2445). Of these, 8954 contacts have been followed up, corresponding to follow-up rates of 83.2% in Ituri, and 81% in North Kivu. Previously listed contacts from South Kivu province have completed 21 days of follow up. In addition, 107 contacts of the case reported in France have been listed and are under follow up in Kinshasa. The outbreak is unfolding in a complex humanitarian and conflict-affected environment, characterized by highly mobile and often displaced populations, often lacking access to basic services, including food, clean water, shelter, healthcare and protection which poses an increased risk of transmission to the populations living in overcrowded internally displaced camps. These dynamics, combined with increasing security-related incidents affecting health facilities, have posed additional operational challenges in affected provinces, such as constrained access for response teams, disrupted surveillance and response activities, and heightened risk of undetected transmission. These conditions underscore the need for response efforts to be led by local leaders and anchored in communities. Figure 2: Number of confirmed cases (n = 1460), in the Democratic Republic of the Congo, by date of reporting, as of 1 July 2026 Figure 3: Number of deaths among confirmed cases (n = 452), in the Democratic Republic of the Congo, by date of reporting, as of 1 July 2026. NB: Newly reported confirmed cases/deaths may be part of the backlog of samples and therefore not necessarily newly acquired infections. Uganda The last confirmed case was reported to be identified on 21 June 2026. As of 2 July 2026, a cumulative of 20 confirmed cases including two deaths in imported cases (reported on 15 May and 5 June), and one probable case who has died, have been reported. Of the confirmed cases, 15 are imported cases, while five are secondary cases among contacts and health workers with links to imported cases from the Democratic Republic of the Congo. The cases have been reported in two districts, Kampala and Wakiso, both part of the Kampala Metropolitan Area. To date, there has been no documented community transmission in Uganda. Exposure risks are associated with healthcare settings and cross-border movements. Following case reclassification, the number of affected healthcare workers was revised from five to four. In total, 16 recoveries have been reported to date. Of the 831 contacts listed as of 28 June, 821 contacts have completed their 21-day follow-up period as of 2 July. Figure 4: Number of confirmed cases (n = 20), in Uganda by date of reporting, as of 2 July 2026 France: On 24 June 2026, French authorities notified WHO of a laboratory-confirmed case of Ebola disease caused by Bundibugyo virus in a middle-aged male medical doctor returning from the Democratic Republic of the Congo. The patient had been deployed for five weeks in Ituri Province, where he was involved in the care of patients with BVD. Upon arrival at Charles de Gaulle Airport on 23 June 2026, the patient self-reported symptoms to airport health authorities, prompting immediate isolation and referral to a designated high-containment healthcare facility. At the time of reporting, the patient was clinically stable and had no fever, with no reported vomiting, diarrhoea, or haemorrhagic manifestations during travel. PCR testing detected Bundibugyo virus. Comprehensive contact tracing has been initiated in the Democratic Republic of the Congo and in France.","assessment":"On 6 June 2026, WHO reassessed the risk of the outbreak of BVD to incorporate newly available information and align with the WHO Temporary Recommendations . The risk for countries sharing land borders with countries with documented Bundibugyo virus (BVDV) detection, currently 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 assessed as very high due to ongoing transmission and the continued expansion of the outbreak into new health zones, increasing the potential for further national and regional spread. The risk in Uganda is assessed as high due to confirmed cross-border spread through imported cases and ongoing epidemiological links along the eastern Democratic Republic of the Congo&ndash;western Uganda corridor, historically affected by Ebola outbreaks, including Bundibugyo and Sudan virus disease outbreaks. The risk for countries with land borders adjoining countries with documented BDBV detection is assessed as high due to sustained population mobility linked to cross-border trade and mining activities, variation in capacities and experience of BVD response, and variable levels of readiness. The risk for the rest of the Africa region and at the global level is assessed as low. For further information, please see the WHO Rapid Risk Assessment &ndash; Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo, Uganda and countries with land borders adjoining countries with documented BDBV detection v3 .","advice":"WHO advises against any restriction of travel to, or trade with, the Democratic Republic of the Congo or Uganda based on the currently available information. WHO continues to closely monitor and, where necessary, verify travel and trade measures in relation to this event. For further information on the considerations for implementing border health and international travel-related temporary recommendations, please see the relevant technical note issued on 26 May 2026 . The Temporary Recommendations issued to State Parties on 22 May 2026 underscore the importance of coordinated outbreak control, enhanced cross‑border collaboration, and sustained surveillance and preparedness to prevent further regional spread and ensure an effective public health response. WHO has convened several technical advisory groups, including the Strategic Advisory Group of Experts on Immunization (SAGE) to assess candidate vaccines and therapeutics for BVD. Key recommendations made are available in the news release published on 28 May 2026. Regular Information products on the outbreak of BVD in the Democratic Republic of the Congo and Uganda Daily update: Epidemiological update on BVD outbreak in Democratic Republic of the Congo and Uganda Published Weekly: Weekly External Situation Report on Ebola Bundibugyo Virus Disease Outbreak, Democratic Republic of the Congo | Uganda Published Fortnightly: Disease Outbreak News | All Hazards Public Health Events, Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo","publishedAt":"2026-07-03T15:13:57.000Z","lastModified":"2026-07-03T15:32:15.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON612","response":"Health authorities in the Democratic Republic of the Congo and Uganda, in collaboration with WHO and partners, are implementing extensive public health measures including implementing the continental response plan, engaging donors and mobilizing additional resources to address critical funding gaps and sustain response operations across affected and at-risk areas. For further information about public health response actions by the respective Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa Ebola Bundibugyo Virus Disease Outbreak Democratic Republic of the Congo | Uganda Weekly External Situation Report | WHO | Regional Office for Africa","epidemiology":"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 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. 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 the deceased. 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. CFRs 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. Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. Outbreak control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.","formattedDate":"2026-07-03T15:31:57Z","matchedSignals":["severity signal","WHO high-risk wording","response escalation"]}},{"id":"2026-DON611","title":"Hantavirus outbreak linked to cruise ship travel, Multi-locations","disease":"Hantavirus outbreak linked to cruise ship travel","locations":["Multi-locations"],"riskLevel":"elevated-watch","signalClass":"Cross-border or severe outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON611","summary":"This is the fifth Disease Outbreak News posting on the Andes hantavirus (ANDV) outbreak linked to the cruise ship M/V Hondius. The outbreak identification followed the notification to the World Health Organization (WHO) on 2 May 2026 of severe acute respiratory illness cases onboard. Since the previous Disease Outbreak News was published on 28 May 2026, one of the probable cases from Tristan da Cunha, an Overseas Territory of the United Kingdom of Great Britain and Northern Ireland (hereafter referred to as the United Kingdom), was laboratory confirmed. As of 2 July, a total of 13 cases, including three deaths, have been notified (case fatality ratio 23%). Twelve cases have been laboratory-confirmed for ANDV infection, and one is a probable case. All confirmed cases are among individuals who travelled onboard the M/V Hondius. Among the ten cases admitted to hospitals, eight have recovered and have been discharged, while two are still undergoing medical treatment. All identified contacts have completed the 42 day follow-up period by local health authorities in line with WHO guidance. The completion of the contact follow up without detection of additional secondary cases demonstrates effective interruption of transmission and confirms outbreak containment. This outbreak no longer poses a public health risk and no further related transmission is expected.","overview":"On 2 May 2026, in accordance with the International Health Regulations (2005) (IHR), WHO received a notification from the National IHR Focal Point (NFP) of the United Kingdom of a cluster of severe acute respiratory illness aboard the Netherlands-flagged cruise ship M/V Hondius, with further details rapidly notified authorities in the Netherlands and South Africa. As of 2 July, a total of 13 cases (12 confirmed and one probable case), including three deaths (two confirmed and one probable), have been reported globally linked to the cruise ship. The case fatality ratio for this outbreak to date is 23%. Since the last Disease Outbreak News was published on 28 May 2026, ANDV infection was laboratory confirmed in a probable case in Tristan da Cunha who developed signs and symptoms after disembarkation from the cruise ship. The early detection and isolation of the case prevented further transmission of the virus, but the limited diagnostic capacities on the island delayed the confirmation of the case until a sample was shipped and tested in the United Kingdom. The patient has recovered and has been discharged. Among the confirmed cases admitted to hospital, eight have recovered and been discharged, while two, one in South Africa and one in France, continue to be hospitalized. All 13 cases are among people who travelled on board the M/V Hondius. Figure 1. Epidemiological curve of Andes hantavirus cases (n = 13) reported to WHO as of 2 July 2026. Nine of the reported cases were males, and four were females. The median age was 65-years-old (IQR 56-70), similar to the median age of the passengers onboard the ship (Figure 2). The ages of the three deceased cases were 69, 70 and 79-years-old. Figure 2. Age and sex distribution of Andes hantavirus cases (n = 13) reported to WHO as of 2 July 2026. Currently available information suggests that infection of initial cases was likely acquired on land prior to embarkation, although the exact source and route of exposure remain undetermined, with subsequent human-to-human transmission occurring aboard the vessel. Investigations remain underway to establish the circumstances and source of the outbreak, including genomic sequencing of ANDV samples from surveillance cases in Chile and Argentina, and will be published as soon as these are available. This outbreak was managed through a coordinated international response, which included comprehensive epidemiological investigations, case isolation and clinical management, medical evacuations, laboratory testing, repatriation of passengers and crew from the ship and international contact tracing, as well as quarantine and monitoring measures. Contact identification and follow-up of contacts of hantavirus cases linked to the cruise ship has been conducted in 33 countries and overseas territories. This included passengers and crew onboard the ship, contacts of the case on Tristan da Cunha, contacts from two different international flights, healthcare workers and airport crew who assisted cases before the detection of the outbreak. As of 2 July 2026, 317 high-risk contacts have completed quarantine and monitoring by local health authorities in the countries and territories where they were repatriated, evacuated or identified. Some 336 low-risk contacts completed self-monitoring in line with the updated guidance on management of contacts of Andes virus (ANDV) cases from the MV Hondius cruise ship published on 17 May 2026.","assessment":"The ANDV outbreak associated with the MV Hondius cruise ship no longer poses a public health risk and no further related transmission is expected. ANDV remains endemic in South America, and it is associated with hantavirus pulmonary syndrome with substantial case fatality, its transmissibility remains limited, typically requiring close and prolonged exposure, and tends to result in temporally and spatially restricted clusters. While the confined maritime environment of this event likely facilitated transmission during the voyage, epidemiological and genomic evidence supports a point source outbreak, originating either from contact with an infected animal or infected person, followed by limited chains of human-to-human secondary transmission, without evidence of sustained transmission. The completion of the 42-day follow-up period for all identified contacts without further detection of additional secondary cases demonstrates effective interruption of transmission and confirms outbreak containment. Additionally, IPC measures continue to be applied for the management of the two cases still hospitalized.","advice":"WHO advises all countries to sustain strong engagement and collaboration to document and learn from this outbreak response, including both successes and operational challenges, and to apply the lessons identified to strengthen preparedness, surveillance including international tracing and follow up of contacts, clinical care, IPC, risk communication, and response capacities for future public health emergencies. WHO further encourages the continuation of epidemiological, clinical, laboratory, and ecological studies to better understand the outbreak, its transmission dynamics, risk factors, and determinants of disease severity. In areas where hantavirus is endemic, WHO recommends strengthening measures to prevent and control transmission through enhanced surveillance, public awareness, environmental management, reduction of exposure to rodent reservoirs and contaminated environments, and early detection, implementation of IPC measures and management of cases. WHO also encourages continued investment in research and development to advance the availability of effective diagnostics, therapeutics, and vaccines, and to improve preparedness and response capabilities for future hantavirus outbreaks.","publishedAt":"2026-07-02T18:00:00.000Z","lastModified":"2026-07-09T15:10:49.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON611","response":"Authorities from States Parties managing cases and/or contacts, WHO, and partners such as the European Centre for Disease Prevention and Control have coordinated response measures, including: Ongoing engagement between WHO and the NFPs of countries managing cases and/or contacts ensured timely information sharing and coordination of response actions. International contact tracing and follow-up of contacts was conducted by local health authorities in line with national arrangements. WHO requested regular information sharing and periodic updates from States Parties through IHR channels regarding the follow-up of contacts and their health status. Ongoing epidemiological investigations to define epidemiological links between cases and exposure factors on the ship, as well as to try to understand the potential source of exposure. A prospective natural history study designed to improve understanding of Andes virus (ANDV) transmission dynamics, incubation periods, immune responses, viral kinetics, and the determinants of severe disease through harmonised longitudinal follow-up of exposed individuals. The study uses a standardised prospective protocol implemented across 21 participating countries. [4] WHO developed and published specific technical guidance documents to support response to the event, including: Technical guidance on the management of hantavirus onboard ships was shared with States Parties through IHR channels Technical note for the disembarkation and onward management of passengers and crew in the context of an ANDV-associated cluster; Management of contacts of Andes Virus (ANDV) cases from the MV Hondius cruise ship Laboratory testing of Andes virus (Orthohantavirus andesense) infection : Interim guidance The NFPs of countries managing cases and/or contacts have been exchanging passenger- and crew-related information. WHO provided risk communication coordination and support, ensured timely evidence-based information sharing, activated the coordination mechanisms across the three organizational levels, and supported national authorities in implementing public health measures, including in accordance with IHR provisions. WHO convened regular Member State briefings, expert discussions covering key technical, laboratory, clinical care and infection prevention and control (IPC) topics, and global webinars via the EPI-WIN knowledge platform to facilitate experience sharing and coordinate support. WHO supported the development of research protocols with national and international partners and planned a hantavirus consultation on medical countermeasures. WHO coordinated the distribution of the laboratory testing and reference materials made available by Chile and Argentina, as well as diagnostic protocols and information on available test kits and their performance.","epidemiology":"Hantavirus disease is a zoonotic viral disease caused by hantaviruses of the genus Orthohantavirus , family Hantaviridae , order Elliovirales, class Bunyaviricetes . More than 20 viral species have been identified within this genus. Human hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of certain species of (specific) infected rodents, or by touching contaminated surfaces. Exposure typically occurs during activities such as cleaning buildings with rodent infestations, though it may also occur during routine activities in heavily infested areas. Human cases are most commonly reported in rural settings, such as forests, fields, and farms, where rodents are present and opportunities for exposure are greater. Limited human-to-human transmission has currently only been reported for hantavirus pulmonary syndrome (HPS) associated with ANDV virus infection. ANDV is endemic in South America, with confirmed circulation and human infections reported primarily in Argentina and Chile, and additional cases and related strains identified in Uruguay, southern Brazil, and Paraguay. Andes virus transmission between humans Based on the available information and the existing observations of the current outbreak, limited human-to-human transmission of ANDV is known to occur. However, no large-scale human-to-human outbreaks have been observed historically. [1] ANDV circulates in specific species of rodents in the Americas, and there have been many sporadic cases reported in Argentina and Chile that have not led to onward transmission. [2] Clusters of human cases have been reported in multiple past outbreaks and have been typically associated with close and prolonged interactions, often in shared indoor environments such as households. The largest reported outbreak of ANDV was reported in Argentina in 2018-2019, 2 where high viral titres in combination with attendance at large social gatherings or extensive contacts among people were associated with higher transmission. While the available evidence suggests that there are multiple modes of transmission that occur with ANDV, the probability of onward transmission between humans remains low. Initial epidemiological investigation and the genomics analysis [3] of the identified cases show that in this outbreak of ANDV infection, human-to-human transmission has occurred on the ship. While detailed information on the interaction between cases or with a contaminated environment aboard the ship is currently not available, these exact modes of transmission might be elucidated by upcoming results from an in-depth epidemiological investigation, as well as publication of the environmental sampling performed after the disembarkation. Response activities operated under the assumption that ANDV transmission: may have included contact with an infected individual or contaminated surfaces; and/or through-the-air transmission (via direct deposition of infectious respiratory particles onto exposed facial mucosal surfaces&mdash;mouth, nose, or eyes); and/or airborne transmission (via inhalation of infectious respiratory particles). Given the attack rate among the ship passengers, as well as the absence of secondary cases among contacts off the ship, the virus did not exhibit transmission dynamics consistent with highly transmissible airborne pathogens (such as measles).","formattedDate":"2026-07-02T18:27:48Z","matchedSignals":["transmission concern","severity signal","response escalation"]}},{"id":"2026-DON609","title":"Nipah virus disease - India","disease":"Nipah virus disease","locations":["India"],"riskLevel":"elevated-watch","signalClass":"Cross-border or severe outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON609","summary":"On 11 June 2026, the Kerala State Health Department confirmed one laboratory confirmed case of Nipah virus (NiV) infection in Kozhikode district, Kerala State, India. The case is an adult male who developed symptoms on 30 May 2026 and was hospitalized on 10 June 2026. He presented with neurological manifestations and at the time of reporting is on ventilatory support in an intensive care unit (ICU). As of 18 June 2026, a total of 104 contacts had been identified and were under monitoring, including health and care workers, with no reported secondary cases to date. NiV is a zoonotic disease transmitted to humans through infected animals, or through consumption of fruits or fruit products, such as raw date palm juice contaminated with the saliva, urine, or excreta of infected bats, as well as close contact with infected individuals. The current event involves a single confirmed case, with no secondary transmission identified to date. Public health measures are in place, including isolation, contact tracing, and enhanced surveillance. However, as the source of infection has not yet been identified and given the known presence of animal reservoirs, additional cases cannot be excluded.","overview":"On 11 June 2026, WHO was informed of a laboratory-confirmed case of Nipah virus infection reported in Kozhikode district, Kerala State. Initial positive results were obtained through PCR testing at local laboratories and were subsequently confirmed by RT‑PCR at the National Institute of Virology, Pune. The case is an adult male resident of Kozhikode district. He developed symptoms on 30 May 2026 and was admitted to hospital on 10 June 2026. The clinical presentation was primarily neurological, without reported respiratory symptoms prior to intubation. The patient is on ventilatory support in the ICU. Following confirmation of the case, extensive contact tracing was initiated. As of 18 June 2026, a total of 104 contacts had been identified, including four very high-risk, 14 high-risk, and 86 low-risk contacts. Among these, 45 are health and care workers. All contacts are under active monitoring with regular follow-up, and no secondary cases have been reported to date. This event follows a pattern of recurrent Nipah virus outbreaks in Kerala, including in Kozhikode district, since the first outbreak was reported in 2018. Additional outbreaks occurred in 2019, 2021, 2023, 2025, and 2026 according to the NCDC Communicable Disease Alert.","assessment":"Nipah virus (NiV) ( Henipavirus nipahense ) is a rare zoonotic pathogen with a high case fatality rate (40&ndash;75%) and no licensed vaccine or specific antiviral treatment. Its natural reservoirs are fruit bats (Pteropus spp.), which are widely distributed across India, South and Southeast Asia, and parts of Oceania. Transmission to humans can occur through direct contact with infected animals, including bats and domestic animals, via contaminated food products such as raw date palm sap, or through close and prolonged contact with infected individuals, particularly in healthcare settings. Since its first identification in 1998, NiV outbreaks have been reported in Bangladesh, India, Malaysia, the Philippines, and Singapore. In India, outbreaks have been recurrent but relatively limited in scale, with the highest numbers reported in 2001 (66 cases) and 2018 (18 cases). Over the past five years, approximately a dozen confirmed cases have been reported, all in Kerala State. Kerala has experienced NiV events since 2018 and has established surveillance systems, laboratory capacity, and rapid response mechanisms, including Rapid Response Teams at central and state levels. Ecological conditions, including those in districts such as Kozhikode, support fruit bat populations, facilitating repeated spillover events. Seasonal patterns are observed and locally, April to September is recognized as a Nipah high‑alert period. The current event involves a single confirmed case with no evidence of secondary transmission as of 23 June 2026. The case has been isolated, and public health measures, including contact tracing, enhanced surveillance, and strengthened infection prevention and control in healthcare settings, have been rapidly implemented. The event appears to be geographically limited, with no evidence of international spread reported. However, as the source of infection has not yet been identified and given the presence of known animal reservoirs and ongoing seasonal risk, additional cases, including sporadic zoonotic spillover, cannot be excluded. This event represents the second notification of NiV infection in India in 2026, following the earlier two epidemiologically linked cases reported in West Bengal state in January 2026. There is an ongoing moderate sub-national risk, driven by recurrent zoonotic spillover, limited clinical specificity during the early stages of disease, and the absence of licensed vaccines or specific therapeutics, with potential for transmission among close contacts and in healthcare settings. At the regional and global levels, the risk remains low, given the absence of cross-border or international spread and the geographically contained nature of the outbreak.","advice":"In the absence of a licensed vaccine or specific therapeutic treatment for Nipah virus disease, reducing or preventing infection in people relies on raising awareness of the risk factors. This includes providing guidance on and reinforcing risk communication messages about the measures that people can take to reduce exposure to the Nipah virus. Patient management should focus on delivering timely supportive care, supported by an effective laboratory system and adequate infection prevention and control measures in health facilities. Intensive supportive care is recommended for treatment of severe respiratory and neurologic complications. Public health educational messages should focus on: Reducing the risk of bat-to-human transmission Efforts to prevent transmission should first focus on decreasing bat access to date palm sap and other fresh food products. Freshly collected date palm juice should be boiled, and fruits should be thoroughly washed and peeled before consumption. Fruits with signs of bat bites should be discarded. Areas where bats are known to roost should be avoided. Reducing the risk of human-to-human transmission. Close unprotected physical contact with NiV-infected people should be avoided. Regular hand washing should be carried out after caring for or visiting sick people along other preventive measures. People experiencing Nipah-like symptoms should be referred to a health facility, as early supportive care is key in the absence of treatment. Contact tracing and monitoring are also key to mitigate human-to-human transmission. Controlling infection in health care settings Health and care workers caring for patients with suspected or confirmed infection, or handling specimens from them, should always implement standard precautions for infection prevention and control at all times, for all patients. When caring for patients with suspected or confirmed NiV, WHO advises the use of contact and droplet precautions including a well-fitting medical mask, eye protection, a fluid-resistant gown, and examination gloves. Airborne precautions should be implemented during aerosol-generating procedures, including placing the patient in an airborne-infection isolation room and the use of a fit-tested filtering facepiece respirator instead of a medical mask. Suspected or confirmed cases of NiV should be placed in a single-patient room. Samples taken from people and animals with suspected NiV infection should be handled by trained staff working in suitably equipped laboratories. Based on the currently available information, WHO does not recommend any travel and/or trade restrictions.","publishedAt":"2026-06-25T18:00:00.000Z","lastModified":"2026-06-25T16:23:05.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON609","response":"National and State authorities have implemented a range of coordinated response measures, including surveillance, case management, contact tracing, risk communication, and One Health investigations. Immediate initiation of response measures upon preliminary positive laboratory results prior to national confirmation. Ongoing monitoring and coordination by State and Central health authorities, including the activation of Rapid Response Teams and coordination meetings at district level. Deployment of central expert teams: a National Centre for Disease Control (NCDC) team and an Indian Council of Medical Research (ICMR) expert team both visited Kozhikode on 13 June 2026 to evaluate the situation and provide technical support for ongoing response activities. Establishment of a State High-Power Committee for Epidemic Control: the Kerala State Health Department has constituted a multi-sectoral expert committee to study recurrent seasonal outbreaks in Kerala and develop evidence-based preventive recommendations. Membership includes government and private-sector clinicians, One Health experts, representatives from Animal Husbandry, Food Safety, Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy (AYUSH), and local government bodies. Identification and monitoring of 104 contacts, with twice-daily follow-up. Establishment of isolation wards and dedicated quarantine facilities at Kozhikode Government Medical College Hospital. Provision and stockpiling of personal protective equipment (PPE) and essential medical supplies. Establishment of a control room for risk communication and public queries. Systematic community surveillance: door-to-door surveys completed across all 320 households (1047 residents) in Ramanattukara Municipality Division 5. No Nipah-compatible symptoms were identified among surveyed residents. Psychosocial support: a district mental health programme is providing psychological support to contacts under quarantine, with 125 contacts reached by 18 June 2026. One Health and environmental investigation: Animal Husbandry Department conducted specimen collection within a 5 km radius of the epicentre, including bat specimens (collected with Forest Department assistance) and faecal samples from bat roosting sites along with samples from other animals. All samples have been dispatched to the National Institute of High Security Animal Diseases (NIHSAD), Bhopal, for Nipah virus testing; results are pending. WHO continues to monitor the evolving situation and support risk assessment and coordination efforts as needed.","epidemiology":"NiV infection is a zoonotic disease transmitted to humans through infected animals (such as bats), or fruit or fruit products contaminated with saliva, urine, and excreta of infected bats. Fruit bats or flying foxes ( Pteropus species) are the natural hosts for the virus. It can also be transmitted directly from person to person through close contact with an infected person. The incubation period ranges from 3 to 14 days. In some rare cases, an incubation period of up to 45 days has been reported. Laboratory diagnosis of a patient with a clinical history of NiV infection can be made during the acute and convalescent phases of the disease by using a combination of tests. The main tests used are RT-PCR from bodily fluids and antibody detection via ELISA. Human infections range from asymptomatic infection to acute respiratory infection (mild, severe), neurological symptoms, and fatal encephalitis (brain swelling). Infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis (brain swelling). Some people can also experience atypical pneumonia and severe respiratory complications, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours. The case fatality ratio (CFR) in outbreaks across Bangladesh, India, Malaysia, and Singapore range from 40% to 75%, depending on local capabilities for early detection and clinical management. Intensive supportive care is recommended to treat severe respiratory and neurologic complications. There are currently no licensed medicines or vaccines specific for NiV infection. Henipavirus nipahense (Nipah virus) is considered a priority pathogen for the accelerated development of medical countermeasures (MCMs) to respond to epidemics and pandemics as part of the WHO R&D Blueprint for Epidemics. Further information about NiV infection can be found here .","formattedDate":"2026-06-25T15:43:28Z","matchedSignals":["transmission concern","severity signal","response escalation","cross-border signal"]}},{"id":"2026-DON610","title":"Yellow fever - Global","disease":"Yellow fever","locations":["Global"],"riskLevel":"elevated-watch","signalClass":"Cross-border or severe outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON610","summary":"Yellow fever is a viral disease found in areas of Africa and the Americas, spread by infected mosquitoes. Following an increase of cases in the Americas in 2025, transmission activity remained into 2026. From 1 January to 26 May 2026, six countries reported a total of 79 human infections along with multiple epizootics, indicating active sylvatic circulation. In Africa, sustained activity continued across parts of the region, affecting 13 high-risk countries (as per classification in the Eliminate Yellow fever Epidemics (EYE) Strategy). From January to May 2026, three countries in Africa reported 16 confirmed human cases, with an additional 32 suspected cases under investigation in five other countries. The recent rapid risk assessment assessed geographical variations in vaccination coverage, evidence of viral circulation, and the presence of competent vectors, concluding that unvaccinated populations in countries or areas with a history of yellow fever transmission remain at greatest risk. Transmission dynamics are further influenced by seasonal ecological factors, particularly rainfall, temperature, and mosquito abundance. Outbreaks reported from October 2025 through May 2026 in countries or areas with a history of yellow fever transmission were generally consistent with seasonal patterns or reflected gaps in immunization coverage. In contrast, cases detected in previously unaffected areas suggest viral introduction and an increased risk of urban transmission. No imported cases were detected outside the two affected WHO regions, but expanding vector suitability, rapid urbanization, climate shifts, and increased mobility continue to create conditions conducive to international spread. WHO emphasizes the importance of active surveillance, timely laboratory testing, cross-border coordination, and information sharing. Vaccination remains the primary means for the prevention and control of yellow fever. WHO continues to support countries in expanding vaccination coverage through routine immunization programmes and preventive vaccination campaigns to enhance population immunity and reduce the risk of outbreaks.","overview":"Globally, in 2025 and early 2026, sylvatic yellow fever (YF) transmission in high-risk areas has been strongly influenced by rainfall, temperature and mosquito ecology. In 2025, the epidemiological situation was defined by sustained transmission in Africa and a notable rise in the Americas, including spread into lower‑risk zones. African Region : Twenty-six countries in the WHO African Region and one in the WHO Eastern Mediterranean Region are considered high-risk for YF as per EYE strategy classification. Of these 27 countries, 26 have introduced the yellow fever vaccine in their routine immunization schedule, however coverage in many countries remains below target with an average coverage of 65% across the region in 2024. Since 2023, eight countries with no recent activity have detected new cases, indicating viral circulation in areas with low vaccination coverage and limited surveillance capacity. In 2025, two outbreaks were recorded (in Angola and in Central African Republic) along with several events that required emergency vaccination. From January to May 2026, 16 confirmed cases were reported in three countries (Burkina Faso, Central African Republic and Cameroon), with additional suspected cases under investigation reported in five countries (Angola, C&ocirc;te d&rsquo;Ivoire, Gabon, Ghana, and Nigeria). Most infections are linked to ongoing sylvatic transmission spilling over into rural, under‑immunized communities. Recurrent events are straining health systems and increasing the risk of cross‑border spread. Region of the Americas: All 13 countries at high-risk for YF as per EYE strategy classification include the vaccine in their routine immunization, but coverage varies widely. After limited activity in 2024, transmission expanded sharply in 2025, including into areas that had not reported cases for decades. The region recorded 241 cases and 100 deaths between late 2024 and early 2025, an eightfold increase from the previous year. From January to May 2026, six countries (Bolivia, Brazil, Colombia, Ecuador, Peru, and Venezuela) reported 79 confirmed cases, with Colombia most affected due to sylvatic exposure and travel by unvaccinated visitors. Ecological suitability for mosquito vectors, uneven vaccination coverage, increased human mobility, and the expansion of urban areas into forested environments continue to facilitate viral transmission. Other Regions: In regions outside Africa and the Americas, the risk of YF is primarily associated with imported cases, as no established local transmission cycles are present. Many countries require proof of vaccination for travellers from at‑risk areas. No imported cases were detected in 2025&ndash;2026, but ongoing transmission elsewhere, expanding vector habitats, rapid urbanization, and high international mobility mean the risk of introduction persists. The impact of any imported case would depend on rapid detection and the ability to respond effectively in areas where competent mosquito vectors are present.","assessment":"Yellow fever remains a significant public health threat in regions with historical transmission, particularly in parts of Africa and South America. Although the virus is maintained primarily through mosquito&ndash;primate transmission cycles, periodic spillover into human populations continues to occur, especially in forested and rural environments. While competent vectors are widely present and ecological and peri‑urban habitats are expanding, the potential for spread into new areas, including urban centres, remains substantial, particularly where population immunity is low. Outbreak risk is further amplified by population movement, fragile health systems, and gaps in routine vaccination. Although most affected countries have established surveillance systems, insecurity, limited healthcare access, and delayed clinical presentation frequently hinder outbreak investigations and timely treatment. While early symptoms resemble other endemic diseases and laboratory capacity is often constrained, delays in diagnosis contribute to under‑reporting, especially in remote areas. As a result, the true burden of yellow fever is likely underestimated. Unvaccinated individuals living in rural or forest‑edge communities remain the most exposed, while urban and peri‑urban populations in newly affected areas may also be at risk when competent vectors are present and immunity gaps persist. Travellers who are not vaccinated and who move into high‑transmission regions similarly face increased risk. Yellow fever introduction into regions where Aedes aegypti is established remains possible through viremic travellers arriving from high‑transmission settings. Although no urban transmission has been documented in 2025-2026 in high‑risk countries, limited vector‑ surveillance and control capacity could facilitate spread if the virus were introduced in an insufficiently immunized population. While a sylvatic cycle has not been established in regions without prior yellow fever circulation, ecological suitability, cross‑border movement, the presence of non‑human primates, and gaps in immunity and surveillance continue to create vulnerability in several African countries classified as moderate risk. In countries lacking competent vectors, imported cases may occur, although onward transmission is unlikely; in these settings, the primary challenge is timely clinical recognition. Vaccination remains the strongest determinant of risk. While vaccinated populations are well protected, unvaccinated individuals in at‑risk areas face the highest likelihood of infection and severe disease. Even in areas without documented circulation, limited surveillance means that undetected transmission cannot be entirely excluded. As of 17 June 2026, WHO assesses the risk of YF transmission to be low at the global level and moderate in regions with historical transmission, specifically the WHO African Region and the WHO Region of the Americas. Further details on the WHO risk assessment are available here.","advice":"Although immunization remains one of the most effective public health interventions for preventing this disease, most cases of yellow fever in humans reported during 2025 and 2026 had no history of yellow fever vaccination. Adequate preparedness and response to yellow fever outbreaks requires the integration of several components in addition to vaccination; epizootic surveillance and entomological surveillance, vector control, and risk communication should be considered. WHO encourages Member States to continue their surveillance and vaccination efforts in areas with history of yellow fever transmission (African Region & Region of the Americas). It is essential that countries achieve high vaccination coverage (A>80% in populations in risk areas, in a homogeneous manner, and that health authorities ensure that they have a strategic reserve inventory that allows them to maintain routine vaccination and, at the same time, respond effectively to possible outbreaks. The global stockpile of yellow fever vaccines, coordinated by the International Coordinating Group (ICG ), is available to all countries to facilitate rapid outbreak response and preventive vaccination efforts. Surveillance Member states in the African Region and the Region of the Americas that have areas at risk for yellow fever are encouraged to maintain strong epidemiological surveillance to detect the virus early and protect communities. Health authorities should issue timely alerts outlining how to identify a suspected case and ensure immediate reporting, even prior to laboratory confirmation. Active case finding, particularly for individuals presenting with fever and jaundice, should be conducted not only in affected areas but also in neighboring locations and places visited by the patient before symptom onset. In addition, retrospective review of recent death records can help identify cases that may have been missed. WHO emphasizes active surveillance, cross-border coordination, and timely information sharing. It is advised to strengthen surveillance through systematic investigation and laboratory testing of all suspected cases. Investigations should include assessment of the probable site of infection, documentation of exposure to wildlife or other potential vectors, verification of vaccination status, contact tracing with identification of potential secondary cases, and characterization of the transmission context. Epizootic surveillance For Member states in the Region of the Americas that have high-risk areas for yellow fever, epizootic surveillance of non human primates is a critical early warning component of yellow fever monitoring. Because these species develop and succumb to infection before humans, confirmed illness or mortality among primates provides one of the earliest indicators of viral circulation in the sylvatic cycle. Detecting these events promptly enables health authorities to initiate rapid response measures, including enhanced human surveillance, field investigations, vector control, and targeted preventive vaccination in populations at risk. When implemented systematically and coordinated across human, animal, and environmental health sectors, this One Health approach strengthens outbreak preparedness and reduces the likelihood of human transmission. Laboratory diagnosis The diagnosis of yellow fever is mainly carried out using virological methods (detection of the virus or genetic material in serum or tissue), serological tests to detect antibodies. Virological diagnosis of yellow fever relies primarily on RT‑PCR, which can detect viral RNA during the first 5&ndash;10 days of illness and provides definitive confirmation when positive. Post‑mortem diagnosis is best achieved through liver histopathology with immunohistochemistry, supported by molecular testing of tissue samples. Serology becomes useful after day 5, but results must be interpreted cautiously due to cross‑reactivity with other flaviviruses and the influence of recent vaccination. PRNT offers greater specificity but can still show cross‑reactions in areas with multiple circulating flaviviruses. Overall, confirmation requires integrating laboratory results with epidemiological context and ruling out other flavivirus infections. Post-vaccination immune response Vaccination induces a relatively low viremia that decreases after 4 to 7 days. Simultaneously, an IgM-type response develops that cannot be differentiated from the IgM response induced by natural infection. Approximately 10 days after vaccination, the person is considered protected against natural infection. Thus, the vaccine IgM response can be detected around day five onwards, with a peak generally occurring two weeks after vaccination. Subsequently, the levels of these antibodies tend to decrease. However, IgM antibodies can persist for years after vaccination. Neutralizing antibodies induced by vaccination can be detected for several decades. This makes the interpretation of serological results in vaccinated individuals particularly complex, requiring careful evaluation. Clinical management Yellow fever is a severe viral hemorrhagic disease with sudden onset and a high fatality rate in its severe forms. The illness progresses through infection, remission, and a toxemic phase marked by jaundice, hemorrhage, and acute liver failure. In the absence of specific antiviral treatment, clinical management relies on early detection, close monitoring, and supportive care. Timely recognition of severe complications, especially liver failure, is essential to improving patient outcomes. Vaccination as a Primary Prevention Tool: Vaccination is the most effective measure for preventing and controlling yellow fever. The yellow fever vaccine is safe, affordable, and provides lifelong protection with a single dose. The WHO's Eliminate Yellow Fever Epidemics (EYE) strategy recommends protecting populations aged 9 months to 60 years in all high-risk countries through routine immunization complemented by preventive mass vaccination campaigns. Achieving and sustaining high immunization coverage among children is essential to maintain strong population immunity. Vaccination of travellers to endemic areas is essential to prevent infection and reduce the risk of international spread. Preventive and outbreak response campaigns should be guided by updated risk assessments, ensuring sufficient vaccine supply and high coverage in at-risk groups. Vaccination decisions must consider precautions such as young age, pregnancy, older adults, and certain immune conditions, while strictly avoiding use in individuals with contraindications. Maintaining robust vaccination strategies is essential to prevent transmission and mitigate outbreak impact. Vector Control and Risk Communication: Effective vector control in urban settings, along with general mosquito bite avoidance strategies, is recommended to prevent disease transmission. Effective risk communication is essential for yellow fever, enabling timely public awareness, promoting preventive behaviors and vaccine acceptance, and should target both travellers and resident populations in high-risk countries. International Travel and Trade: All international travellers aged 9 months and older who are travelling to areas at risk of yellow fever transmission, as defined by WHO, including areas with evidence of persistent or periodic yellow fever virus circulation, are advised to be vaccinated. The vaccine is safe, highly effective, and provides lifelong protection. However, recommendations for infants under 9 months of age, pregnant or breastfeeding women and severely immunocompromised people require careful consideration, with vaccination advised in high-risk settings after weighing potential benefits against risks. Under the International Health Regulations (2005) (IHR), it is a country&rsquo;s prerogative to require proof of yellow fever vaccination from incoming and/or outgoing travellers. For international travel purposes, the administration of yellow fever vaccine shall be documented in the International Certificate of Vaccination or Prophylaxis (ICVP); and the documented administration of one single dose of WHO-approved yellow fever vaccine, conferring lifelong immunity, shall be accepted as valid. Given the evolving nature of yellow fever transmission, WHO advises Member States to remain updated with the latest information and guidelines available on the WHO International Travel and Health website. Local health authorities are encouraged to collaborate closely with WHO and other relevant stakeholders to implement effective yellow fever prevention and control measures, ensuring the safety and well-being of populations at risk. WHO does not recommend any restriction on travel to or trade with the countries named in this report, based on the information available on the current event. Continuous efforts to educate travellers on preventive measures, including vaccination, are encouraged.","publishedAt":"2026-06-24T18:00:00.000Z","lastModified":"2026-06-24T16:28:45.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON610","response":"WHO is strengthening capacities for YF preparedness and response at national, regional, and global levels, including: continuous global surveillance of yellow fever and disease activity, and support for surveillance and outbreak response efforts; assisting countries in developing and implementing prevention and control strategies; strengthening diagnostic capacity and laboratory networks; promoting increased vaccine coverage; enhancing risk communication. To respond effectively to yellow fever outbreaks, public health measures have been implemented in the African Region and the Region of the Americas. The countries have implemented coordination actions to respond to the identified yellow fever cases and outbreaks, focusing on strengthening preventive measures, improving surveillance and implementing vaccination actions. In non-endemic WHO regions, public health actions focus on preparedness to prevent importation and onward transmission of yellow fever. Efforts prioritize traveller vaccination, early detection, and readiness, particularly in areas where competent vectors are present. Coordination The two Regions have implemented coordination actions to respond to the identified yellow fever cases and outbreaks. WHO African Region Regional coordination mechanisms were strengthened through regular engagement with Member States, EYE partners, and technical networks to support preparedness and response activities. Technical support was provided for outbreak verification, risk assessment, and case classification, including regional reviews of PRNT-positive cases from Burkina Faso, Cameroon, C&ocirc;te d&rsquo;Ivoire, Ghana, Nigeria, Uganda, and the Republic of the Congo. Weekly updates on yellow fever events were shared through regional and global coordination platforms, including the Yellow Fever Partners Technical Forum, to facilitate information sharing and operational decision-making. WHO Region of the Americas Ongoing risk assessments were conducted to guide the regional response to the yellow fever outbreak. The response was managed operationally under a structure equivalent to a Level 2 emergency, with coordination mechanisms activated at PAHO Headquarters and in the affected countries. A multidisciplinary Incident Command System (ICS) was established, composed of specialists from various technical units and departments. A strategic regional action plan was developed, linked to the mobilization of financial and technical resources to support preparedness and response activities. The Regional Emergency Response Team was activated and coordinated the deployment of specialists to the affected countries to strengthen national capacities in surveillance, laboratory testing, immunization, clinical management, vector control, and risk communication. Regular coordination and follow-up mechanisms were established with Member States to monitor the epidemiological evolution of the outbreak, share technical information, and facilitate the implementation of harmonized response actions throughout the Region. Surveillance The following activities were implemented in the Regions with reported cases: African Region Surveillance activities were strengthened through support for case detection, investigation, verification, and classification of suspected yellow fever cases. Weekly regional monitoring and analysis of yellow fever events were conducted to support risk assessment and guide response activities, including the production and dissemination of the AFRO Yellow Fever Weekly Update. Technical support was provided for epidemiological investigations and the classification of laboratory-confirmed and PRNT-positive cases in affected countries. Region of the Americas Issuance of regional epidemiological alerts and continuous monitoring of the epidemiological situation in the Americas. Technical support to countries to strengthen epizootic disease surveillance in nonhuman primates as an early warning system. Development of regional guidelines for monitoring epizootics (in progress). Development and updating of regional guidelines for the epidemiological surveillance of yellow fever, including case definitions, outbreak definitions, and outbreak closure criteria (in progress). Organization of the Regional Meeting of Experts on Yellow Fever (Bogot&aacute;, 2026) to review and update regional technical guidelines and promote consensus among experts in the Region. Regional analysis of ecological corridors and areas of transmission expansion. Development of public health action matrices based on epidemiological context (enzootic/non-enzootic) (in progress) Laboratory At the Regional level, the following actions have been carried out: African Region WHO supported laboratory confirmation and case classification of yellow fever cases. Technical support was provided through the regional yellow fever laboratory network to support confirmatory testing, interpretation of laboratory findings, and quality-assured diagnosis. Regional reviews of laboratory results, including PRNT-positive findings from Burkina Faso, Cameroon, C&ocirc;te d&rsquo;Ivoire, Ghana, Nigeria, Uganda, and the Republic of the Congo, were conducted to support case classification and public health decision-making. Region of the Americas All enzootic countries currently have molecular diagnostic capacity to detect the virus in both serum and tissue samples (essential for confirming fatal cases). In addition, support has been provided to expand detection in non-human primates, enhancing epizootic surveillance as an early warning system. Efforts are also underway to implement virus detection in mosquito populations, further broadening surveillance strategies. At the same time, collaboration with selected countries is advancing the decentralization of testing, ensuring access to diagnostic capacity in remote and border areas where timely detection is critical. Case Management Specific actions are taken at the regional level: Region of the Americas Development and dissemination of the Regional Clinical Management Guidelines for Critical Patients with Suspected or Confirmed Yellow Fever (published in 2025). Delivery of regional in-person training and technical assistance to strengthen early detection, severity assessment, patient referral, and management of severe cases. Support to countries in the review and update of clinical protocols and in the preparedness of health services to respond to increased healthcare demand. Development of a virtual course on the clinical management of yellow fever. Training of countries on minimally invasive autopsy techniques for deaths associated with yellow fever. Convening of expert consultations to define and strengthen patient care pathways and clinical management approaches. Immunization African Region Vaccination activities were supported through preventive and reactive vaccination campaigns, strengthening routine immunization, and provision of technical assistance for campaign planning and implementation. In 2025, preventive mass vaccination campaigns reached approximately 15.2 million people in Katanga Province, Democratic Republic of the Congo, 1.6 million people nationwide in Guinea-Bissau, 9.6 million people in Maradi, Agadez, and Tahoua regions of Niger and 4.2 million people in 13 districts of Uganda. By May 2026, an additional 2.4 million people had been vaccinated through a preventive campaign in Dosso District, Niger. Reactive vaccination campaigns were conducted from January 2025 to May 2026 in response to outbreaks or situations with epidemic potential in Burkina Faso, Cameroon and C&ocirc;te d&rsquo;Ivoire. In 2025, these campaigns reached more than one million people in affected districts. By May 2026, additional reactive campaigns reached approximately 491 000 people in C&ocirc;te d&rsquo;Ivoire, 162 000 in Mali, and more than 400 000 people in Cameroon. Technical support was provided to Member States through the International Coordinating Group (ICG) mechanism, including support for vaccine requests, deployment, monitoring, and evaluation. This included support for outbreak response vaccination activities in Central African Republic and vaccine deployment planning in Angola, Liberia, and Mali. Routine immunization strengthening efforts were also implemented, including periodic intensification of routine immunization activities. Gabon also reached 8 156 children in two rounds of Periodic Intensification of Routine Immunization. Overall, preventive and reactive vaccination campaigns supported by WHO and partners reached more than 35 million people across high-risk and affected countries between 2025 and May 2026. Region of the Americas Technical support to countries has focused on the following lines of action: updating the regional yellow fever vaccination guideline, which incorporates the programmatic context for the use of fractional doses, the single‑dose schedule, recommendations for coadministration with measles, mumps, and rubella (MMR) first dose vaccine (MMR1), vaccination considerations for precaution groups, guidance for urban outbreak response, and parameters for safety stock management. The guideline was reviewed and validated by regional experts during the 2026 Yellow Fever Expert Meeting in Bogot&aacute;, ensuring consensus and alignment with the most recent evidence. Technical meetings with countries have been conducted to strengthen Surveillance of Events Supposedly Attributable to Vaccination or Immunization (ESAVI) surveillance in the context of outbreak response and vaccination of precaution groups. A susceptible population estimation tool has been developed and made available to all countries in the Region to support planning for preventive and reactive vaccination campaigns. Immunization teams have also provided support for vaccination planning in preparedness contexts as well as during outbreak response operations, including microplanning for outbreak response campaigns. Entomological Surveillance and Vector Control At the regional level, vector surveillance and control capacities that were developed as part of the arbovirus response: African Region WHO promoted the incorporation of entomological investigations into yellow fever outbreak investigations to better characterize transmission risks and guide public health interventions. Technical guidance supported Member States in considering vector surveillance and vector control measures as part of integrated yellow fever prevention and response strategies. Region of the Americas Development, and publication of regional technical guidelines for entomological surveillance and vector control for yellow fever (2025) . Strengthening national capacities in entomovirology for yellow fever, including detection and characterization of viruses in vectors, with emphasis on personnel training and laboratory capacity building. Strengthening capacities for surveillance of sylvatic and urban vectors of yellow fever, including training in standardized collection methods, taxonomic identification, and safe transport of biological samples, as well as risk assessment for urban transmission and technical support for implementing vector control measures in high-risk areas. Risk Communication and Community Engagement Risk communication and community engagement have been enhanced. Region of the Americas Development and dissemination of regional risk communication materials for communities, health workers, and travelers. Technical support to countries in designing risk communication and community engagement strategies to promote vaccination, report animal disease outbreaks, and strengthen public confidence during outbreaks and vaccination campaigns. Development of messages and guidance for managing rumors, misinformation, and concerns related to vaccine safety. Development of the regional guide &ldquo;Risk Communication and Community Engagement for Yellow Fever Outbreaks in the Americas: Operational Guide for National, Subnational, and Community Teams&rdquo; (in progress)","epidemiology":"Yellow fever is an acute viral disease transmitted by day biting infected mosquitoes, primarily Aedes , Haemagogus and Sabethes species, occurring in tropical regions of Africa and the Americas. A total of 27 countries in Africa and 13 in Central and South America are considered at high risk for yellow fever transmission, with the majority of the global burden reported from Africa. The disease remains a major public health concern due to its epidemic potential and risk of international spread, particularly to areas with competent vectors and low population immunity. Globally, yellow fever is estimated to cause between 67 000 and 173 000 severe cases annually, resulting in approximately 31 000 to 82 000 deaths. Transmission occurs through mosquito bites in three epidemiological cycles: sylvatic (jungle), intermediate, and urban, with the latter posing the greatest risk for large outbreaks in densely populated settings. The incubation period is typically 3&ndash;6 days. Most infections are asymptomatic or present with a mild febrile illness characterized by fever, headache, myalgia, nausea, and vomiting, which generally resolve within a few days. However, approximately 15% of cases progress to a severe form of disease, marked by recurrence of high fever, jaundice, haemorrhage, and multi-organ failure. Among those who develop severe disease, case fatality can reach around 50% within 7&ndash;10 days. Outbreaks can be difficult to detect and quantify, as the clinical presentation overlaps with other endemic diseases such as malaria, dengue and viral hepatitis, and surveillance systems may underreport cases. During epidemics, the actual number of infections is estimated to be 10 to 250 times higher than reported figures. Rapid laboratory confirmation and timely response are therefore critical for outbreak control. Vaccination remains the most effective preventive measure, providing lifelong immunity after a single dose, and is central to outbreak prevention and control strategies, alongside vector surveillance and control measures. The recommendations by the WHO Secretariat for vaccination against YF for international travellers are available here .","formattedDate":"2026-06-24T15:23:22Z","matchedSignals":["severity signal","response escalation","cross-border signal"]}},{"id":"2026-DON608","title":"Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo & Uganda","disease":"Ebola disease caused by Bundibugyo virus","locations":["Democratic Republic of the Congo & Uganda"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON608","summary":"The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continues to evolve rapidly, with sustained transmission and increasing numbers of reported cases. As of 17 June, a cumulative of 896 confirmed cases, including 232 deaths, have been reported from the Democratic Republic of the Congo. As of 18 June, Uganda has reported 19 confirmed cases including two deaths, as well as one probable case who has died. In Uganda, the outbreak remains epidemiologically linked to transmission originating in the Democratic Republic of the Congo, with evidence of both imported infections and secondary transmission among contacts and healthcare workers. Uganda has not reported any new cases since 5 June 2026. National authorities in the two affected countries, in collaboration with WHO and partners, are implementing an extensive set of response measures. A regional preparedness and prioritization framework continues to guide readiness activities across the African Region.","overview":"Since the last Disease Outbreak News was published on 13 June 2026, the number of confirmed cases and deaths have increased rapidly in the Democratic Republic of the Congo. In total, 915 confirmed cases; 896 from the Democratic Republic of the Congo and 19 from Uganda; and 234 deaths including two from Uganda, have been reported. At least 88 patients have recovered from the disease; 78 patients from the Democratic Republic of the Congo and 10 patients from Uganda. Figure 1. Distribution of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo, as of 17 June; and Uganda, as of 18 June Democratic Republic of the Congo Since 13 June when the last Disease Outbreak News was published, an additional 220 confirmed cases, including 96 confirmed deaths, have been reported from the Democratic Republic of the Congo. The increase is in part due to the scale up of testing and diagnostic capacities, enabling testing of the backlog of previously collected samples. As of 17 June 2026, a total of 896 confirmed cases including 232 deaths (case fatality ratio [CFR] 26%) have been reported from the Democratic Republic of Congo. The reported CFR is likely an underestimation, as many deaths that occurred before the outbreak declaration remain under investigation. So far, 78 patients have recovered. Cases have been reported from 33 health zones (HZ) from Ituri (21/36 HZ), North Kivu (11/35 HZ) and South Kivu provinces (1/34 HZ)[1]. The outbreak remains concentrated in Ituri Province, which accounts for 91.1% (817) of the confirmed cases with a CFR of 22.7% (186/817). The highest number of confirmed cases in Ituri Province are reported from Bunia (247 cases), Rwampara (195 cases), Mongbwalu (189 cases), and Nyankunde (68 cases) health zones. So far, the epicentre of the outbreak remains Ituri, with new confirmed cases reported from an additional four health zones as of 17 June. However, the identification of cases in some of these newly reporting health zones may reflect previously undetected transmission rather than recent introduction of the virus. Epidemiological investigations indicate that transmission had likely been occurring in some of these areas for several weeks before the first cases were confirmed and reported. Of the total confirmed cases, 17 are awaiting distribution by health zone. As of 17 June, 6367 contacts have been identified and are under follow-up across Ituri (4659), North Kivu (1628), and South Kivu (80) provinces. Of these, 4525 contacts have been followed up, corresponding to follow-up rates of 70.8% in Ituri, 70.5% in North Kivu, and 100% in South Kivu. The outbreak is unfolding in a complex humanitarian and conflict-affected environment, characterized by highly mobile and often displaced populations, often lacking access to basic services, including food, clean water, shelter, healthcare and protection which poses an increased risk to the populations living in overcrowded internally displaced camps. These dynamics, combined with increasing security-related incidents affecting health facilities, have posed additional operational challenges in affected provinces, such as constrained access for response teams, disrupted surveillance and response activities, and heightened risk of undetected transmission. These conditions underscore the need for response efforts to be led by local leaders and anchored in communities. Figure 2: Number of confirmed cases (n = 896), in the Democratic Republic of the Congo, by date of reporting as of 17 June 2026 Figure 3: Number of deaths among confirmed cases (n = 232), in the Democratic Republic of the Congo, by date of reporting as of 17 June 2026 NB: Newly reported confirmed cases/deaths may be part of the backlog of samples and therefore not necessarily newly acquired infections. Uganda The last confirmed case was reportedly identified on 5 June 2026. As of 18 June 2026, a cumulative of 19 confirmed cases including two deaths in imported cases (reported on 15 May and 5 June), and one probable case who has died, have been reported. Of the confirmed cases, 14 cases are imported and five are secondary transmission among contacts and health workers following cases imported from the Democratic Republic of the Congo. The cases have been reported from two districts, Kampala and Wakiso, both part of the Kampala Metropolitan Area. To date, there has been no documented community transmission in Uganda. Exposure risks are associated with healthcare settings and cross-border movements. Following case reclassification, the number of affected healthcare workers was revised from five to four. In total 10 recoveries have been reported to date. Of the 826 contacts listed as of 18 June, a total of 122 contacts are under active follow up and 694 contacts have completed their 21-day follow-up period. Figure 4: Number of confirmed cases (n = 19), in Uganda by date of reporting as of 18 June 2026","assessment":"On 6 June 2026, WHO reassessed the risk of the outbreak of BVD to incorporate newly available information and align with the WHO Temporary Recommendations . The risk for countries sharing land borders with countries with documented Bundibugyo virus (BVDV) detection, currently 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 assessed as very high due to ongoing transmission and the continued expansion of the outbreak into new health zones, increasing the potential for further national and regional spread. The risk in Uganda is still assessed as high due to confirmed cross-border spread through imported cases and ongoing epidemiological links along the eastern Democratic Republic of the Congo&ndash;western Uganda corridor, historically affected by Ebola outbreaks, including Bundibugyo and Sudan virus disease outbreaks. The risk for countries with land borders adjoining countries with documented BDBV detection is assessed as high due to sustained population mobility linked to cross-border trade and mining activities, variation in capacities and experience of BVD response, and variable levels of readiness. The risk for the rest of the Africa region and at the global level is assessed as low. For further information, please see the WHO Rapid Risk Assessment &ndash; Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo, Uganda and countries with land borders adjoining countries with documented BDBV detection v3 .","advice":"WHO advises against any restriction of travel to, or trade with, the Democratic Republic of the Congo or Uganda based on the currently available information. WHO continues to closely monitor and, where necessary, verify travel and trade measures in relation to this event. For further information on the considerations for implementing border health and international travel-related temporary recommendations, please see the relevant technical note issued on 26 May 2026 . The Temporary Recommendations issued to State Parties on 22 May 2026 underscore the importance of coordinated outbreak control, enhanced cross‑border collaboration, and sustained surveillance and preparedness to prevent further regional spread and ensure an effective public health response. WHO has convened several technical advisory groups, including the Strategic Advisory Group of Experts on Immunization (SAGE) to assess candidate vaccines and therapeutics for BVD. Key recommendations made are available in the news release published on 28 May 2026. Regular Information products on the outbreak of BVD in the Democratic Republic of the Congo and Uganda Daily update: Epidemiological update on BVD outbreak in Democratic Republic of the Congo and Uganda Published every Tuesday: Weekly External Situation Report on Ebola Bundibugyo Virus Disease Outbreak, Democratic Republic of the Congo | Uganda Published every Thursday: Disease Outbreak News | All Hazards Public Health Events, Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo","publishedAt":"2026-06-19T12:10:23.000Z","lastModified":"2026-06-19T12:51:16.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON608","response":"Health authorities in the Democratic Republic of the Congo and Uganda, in collaboration with WHO and partners, are implementing extensive public health measures including implementing the continental response plan, engaging donors and mobilizing additional resources to address critical funding gaps and sustain response operations across affected and at-risk areas. For further information about public health response actions by the respective Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa Ebola Bundibugyo Virus Disease Outbreak Democratic Republic of the Congo | Uganda Weekly External Situation Report 5, Data as of 14 June 2026 | WHO | Regional Office for Africa","epidemiology":"Bundibugyo virus disease (BVD) 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. 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 the deceased. 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. CFRs 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. Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. Outbreak control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.","formattedDate":"2026-06-19T12:51:03Z","matchedSignals":["severity signal","WHO high-risk wording"]}},{"id":"2026-DON607","title":"Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo & Uganda","disease":"Ebola disease caused by Bundibugyo virus","locations":["Democratic Republic of the Congo & Uganda"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON607","summary":"The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continues to evolve rapidly, with increasing case numbers and geographic spread. As of 10 June, a cumulative of 676 confirmed cases, including 136 deaths, have been reported from the Democratic Republic of the Congo. As of 11 June, Uganda has reported 19 confirmed cases including two deaths, as well as one probable case who has died. In Uganda, the outbreak remains epidemiologically linked to transmission originating in the Democratic Republic of the Congo, with evidence of both imported infections and secondary transmission among contacts and healthcare workers. Uganda has not reported any new cases in the past six days. National authorities in the two affected countries, in collaboration with WHO and partners, are implementing a comprehensive package of response measures. A regional preparedness and prioritization framework continues to guide readiness activities across the African Region.","overview":"Since the last Disease Outbreak News was published on 8 June 2026, the number of confirmed cases and deaths have increased rapidly in the Democratic Republic of the Congo. In total, 695 confirmed cases; 676 from the Democratic Republic of the Congo and 19 from Uganda; and 138 deaths including two from Uganda, have been reported from both countries, while at least 37 people have recovered from the disease. Figure 1. Distribution of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo, as of 10 June; and Uganda, as of 11 June Democratic Republic of the Congo Since 8 June, an additional 161 confirmed cases, including 45 confirmed deaths, have been reported from the Democratic Republic of the Congo. The increase is in part due to the scale up of testing and diagnostic capacities, enabling testing of the backlog of previously collected samples. As of 10 June 2026, a total of 676 confirmed cases including 136 deaths (CFR 20.1%) have been reported from the Democratic Republic of Congo. The reported CFR is likely an underestimation, as many deaths that occurred before the outbreak declaration remain under investigation. So far, 32 patients have recovered. Cases have been reported from 29 health zones (HZ) from Ituri (19/36 HZ), North Kivu (9/35 HZ) and South Kivu provinces (1/34 HZ) [1]. Sixteen confirmed cases have been reported among health and care workers to date. The outbreak remains concentrated in Ituri Province, which accounts for 93% (629) of the confirmed cases with a CFR of 17.3% (109/629). The highest number of confirmed cases in Ituri Province are reported from Bunia (185 cases), Rwampara (137 cases), Mongbwalu (132 cases), and Nyankunde (33 cases) health zones. While the epicentre remains Ituri, there has been significant geographic expansion of health zones with confirmed cases since 8 June, with confirmed cases in additional four health zone as of 10 June. Of the total confirmed cases, 94 are awaiting distribution by HZ. As of 10 June, 5768 contacts have been identified and are under follow-up across Ituri (4703), North Kivu (841), and South Kivu (224) provinces. Of these, 4141 contacts have been followed up, corresponding to follow-up rates of 71.4% in Ituri, 71% in North Kivu, and 83.5% in South Kivu. The outbreak is unfolding in a complex humanitarian and conflict-affected environment, characterized by highly mobile and often displaced populations. These dynamics, combined with increasing security-related incidents affecting health facilities, have posed additional operational challenges in affected provinces, such as constrained access for response teams, disrupted surveillance and response activities, and heightened risk of undetected transmission. These conditions underscore the need for response efforts to be led by local leaders and anchored in communities. Figure 2: Number of confirmed cases (n = 676) in the Democratic Republic of the Congo, by date of reporting as of 10 June 2026 NB: Newly reported confirmed cases/deaths may be part of the back log of samples and therefore not necessarily newly acquired infections. Uganda Since the last update dated 8 June, no additional confirmed cases or death have been reported from Uganda. As of 10 June 2026, a cumulative of 19 confirmed cases including two deaths in imported cases, and one probable case who has died, have been reported. Of the confirmed cases, 14 cases are imported and five are secondary transmission among contacts and health workers following cases imported from the Democratic Republic of the Congo. The cases have been reported from two districts, Kampala and Wakiso, both part of the Kampala Metropolitan Area. To date, there has been no documented community transmission in Uganda. Exposure risks are associated with healthcare settings and cross-border movements. Five recoveries have been reported to date. Of the 820 contacts listed as of 11 June, a total of 409 contacts are under active follow up and 394 contacts have completed their 21-day follow-up period. Figure 3: Number of confirmed cases (n = 19) in Uganda by date of reporting as of 11 June 2026","assessment":"On 6 June 2026, WHO reassessed the risk of the outbreak of BVD to incorporate newly available information and align with the WHO Temporary Recommendations. The risk for countries sharing land borders with countries with documented Bundibugyo virus (BVDV) detection, currently 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 assessed as very high due to ongoing transmission and the continued expansion of the outbreak into new health zones, increasing the potential for further national and regional spread. The risk in Uganda is still assessed as high due to confirmed cross-border spread through imported cases and ongoing epidemiological links along the eastern Democratic Republic of the Congo&ndash;western Uganda corridor, historically affected by Ebola outbreaks, including Bundibugyo and Sudan virus disease outbreaks. The risk for countries with land borders adjoining countries with documented BDBV detection, is assessed as high due to sustained population mobility linked to cross-border trade and mining activities, variation in capacities and experience of BVD response, and variable levels of readiness. The risk for the rest of the Africa region and at the global level is assessed as low. For further information, please see the WHO Rapid Risk Assessment &ndash; Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo, Uganda and countries with land borders adjoining countries with documented BDBV detection v3 .","advice":"WHO advises against any restriction of travel to, or trade with, the Democratic Republic of the Congo or Uganda based on the currently available information. WHO continues to closely monitor and, where necessary, verify travel and trade measures in relation to this event. For further information on the considerations for implementing border health and international travel-related temporary recommendations, please see the relevant technical note issued on 26 May 2026 . The temporary recommendations issued to State Parties on 22 May 2026 underscore the importance of coordinated outbreak control, enhanced cross‑border collaboration, and sustained surveillance and preparedness to prevent further regional spread and ensure an effective public health response. WHO has convened several technical advisory groups, including the Strategic Advisory Group of Experts on Immunization (SAGE) to assess candidate vaccines and therapeutics for BVD. Key recommendations made are available in the news release published on 28 May 2026. Regular Information products on the outbreak of BVD in the Democratic Republic of the Congo and Uganda Daily update: Epidemiological update on BVD outbreak in Democratic Republic of the Congo and Uganda Published every Tuesday: Weekly External Situation Report on Ebola Bundibugyo Virus Disease Outbreak, Democratic Republic of the Congo | Uganda Published every Thursday: Disease Outbreak News | All Hazards Public Health Events, Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo","publishedAt":"2026-06-13T08:06:15.000Z","lastModified":"2026-06-13T08:15:28.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON607","response":"Health authorities in the Democratic Republic of the Congo and Uganda, in collaboration with WHO and partners, are implementing comprehensive public health measures including implementing the continental response plan, engaging donors and mobilizing additional resources to address critical funding gaps and sustain response operations across affected and at-risk areas. In the Democratic Republic of the Congo, a subnational risk-stratification analysis has been conducted to further inform the operational response priorities. According to the latest analysis dated 8 June, 159 health zones are categorized as affected or at risk. This underscores the massive geographic scale of response needed to control this outbreak For further information about public health response actions by the respective Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa Ebola Bundibugyo Virus Disease Outbreak Democratic Republic of the Congo | Uganda Weekly External Situation Report 04, Data as of 7 June 2026 | WHO | Regional Office for Africa Following the recommendations of WHO advisory groups on candidate therapeutics to be considered for a clinical trial, WHO, Africa CDC and other partners are supporting the Democratic Republic of the Congo and Uganda in implementing the clinical trial. This include using MBP134 and REGN3479 for treatment, and using obeldesivir for post-exposure prophylaxis, ensuring the highest ethical standards under the leadership of the national health authorities and in close consultation with affected communities. The protocol for the trial has been submitted and is under review by ethics committees and regulatory authorities of the countries. More coordination, and research and development funding, are needed to ensure timely access to candidate therapeutics.","epidemiology":"Bundibugyo virus disease (BVD) 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. 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 the deceased. 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. Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. Control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.","formattedDate":"2026-06-13T08:15:15Z","matchedSignals":["severity signal","WHO high-risk wording"]}},{"id":"2026-DON606","title":"Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo & Uganda","disease":"Ebola disease caused by Bundibugyo virus","locations":["Democratic Republic of the Congo & Uganda"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON606","summary":"The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo continues to evolve rapidly, with increasing case numbers, geographic spread, and cross-border transmission to Uganda. As of 6 June, a total of 515 confirmed cases, with 91 deaths among these confirmed cases, have been reported from the Democratic Republic of the Congo; Uganda has reported 19 confirmed cases including two deaths, as well as one probable case who has died. In Uganda, the outbreak remains epidemiologically linked to transmission originating in the Democratic Republic of the Congo, with evidence of both imported infections and secondary transmission among contacts and healthcare workers. National authorities, in collaboration with WHO and partners, are undertaking a wide-ranging package of response measures. On 5 June, the Africa Centres for Disease Control and Prevention (Africa CDC) and WHO, together with partners, launched a joint Ebola continental preparedness and response plan, with an ask of US$ 518 million to support African countries to prepare for, rapidly detect and respond to the outbreak.","overview":"Since the last Disease Outbreak News was published on 29 May 2026, the number of confirmed cases and deaths have increased rapidly in the Democratic Republic of the Congo and Uganda. In total, 534 confirmed cases including 93 deaths (case fatality rate [CFR] 17.4%) have been reported from both countries, while at least 17 people have recovered from the disease. Figure 1. Distribution of confirmed cases of Bundibugyo virus disease in the Democratic Republic of the Congo and Uganda, as of 6 June 2026 Democratic Republic of the Congo Since 29 May, an additional 390 confirmed cases including 74 confirmed deaths have been reported from the Democratic Republic of the Congo. The increase is in part due to the scale up of testing and diagnostic capacities, enabling testing of the backlog of previously collected samples. As of 6 June 2026, a total of 515 confirmed cases including 91 deaths (CFR 17.7%) have been reported from the Democratic Republic of Congo. The reported CFR is likely an underestimation as many deaths that occurred before the outbreak declaration remain under investigation. So far, 12 patients have recovered. Cases have been reported from 25 health zones (HZ) from Ituri (17/36 HZ), North Kivu (7/35 HZ) and South Kivu Provinces (1/34 HZ)[1]. Sixteen confirmed cases have been reported among health and care workers to date. The outbreak remains concentrated in Ituri Province, which accounts for 94% (487) of confirmed cases. The CFR in Ituri is 15% (74/487); significantly lower than the CFR in North Kivu which is 64% (16/25). The highest confirmed case numbers in Ituri Province are reported from Bunia (142 cases), Rwampara (98 cases), Mongbwalu (92 cases), and Nyankunde (24 cases) HZ. As of 6 June, 5040 contacts had been identified and were under follow-up across Ituri (4118), North Kivu (699), and South Kivu (223) provinces. Of these, 2535 contacts were followed up in the last 24 hours, corresponding to follow-up rates of 43.2% in Ituri, 82.5% in North Kivu, and 80.3% in South Kivu. Increasing security-related incidents affecting health facilities have posed additional operational challenges in affected provinces. These conditions are constraining access for the response, disrupting surveillance and response activities, and increasing the risk of undetected transmission. Such incidents underline the challenges of the context and the importance of working closely with local leaders and communities. Figure 2: Number of confirmed cases (n = 515), including deaths, in the Democratic Republic of the Congo, by date of reporting and as of 6 June 2026 NB: Newly reported confirmed cases/deaths may be part of the back log of samples and therefore not necessarily newly acquired infections. Uganda Since the last update dated 29 May, an additional 10 confirmed cases and one death have been reported from Uganda. As of 6 June 2026, a total of 19 confirmed cases including two deaths in imported cases, and one probable case who has died, have been reported. Five recoveries have been reported. Of the total cases, 14 cases are imported and five are Ugandans. The cases were reported from two districts Kampala and Wakiso. To date, all cases in Uganda can be linked to travelers from the Democratic Republic of the Congo, or secondary infections linked to them; there has been no documented community transmission in Uganda. Exposure risks are associated with healthcare settings and cross-border movements. About 70% of the cases are Congolese nationals who came to Uganda to seek medical care. This includes a Congolese national who travelled from the Democratic Republic of the Congo, via Uganda, to the United Arab Emirates and then back to Uganda. WHO is working with public health authorities in the United Arab Emirates and Uganda to gather additional information to assess the risk of exposure and facilitate contact tracing through the National International Health Regulations (IHR) Focal Point mechanism. Based on the information available to date, there is no evidence that the case exhibited clearly recognized symptoms consistent with BVD during travel to or from the United Arab Emirates. Following notification of the case, UAE authorities rapidly implemented risk assessment, contact tracing activities, follow-up of identified contacts, public health investigations, enhanced preparedness measures at points of entry, and coordination with relevant national and international partners. Epidemiological investigations to date have not identified any secondary cases, local transmission, or evidence of onward spread in the UAE. The findings support the conclusion that the risk of the transmission associated with this event in the United Arab Emirates is low. As of 2 June, a total of 668 contacts linked to the cases have been identified and are under follow-up. These include close residential contacts and hospital contacts where the cases were hospitalized. Figure 3: Number of confirmed cases (n = 19), including deaths, in Uganda by date of reporting and as of 6 June 2026","assessment":"On 6 June 2026, WHO 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 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 assessed as very high due to ongoing transmission and the continued expansion of the outbreak into new health zones, increasing the potential for further national and regional spread. The risk in Uganda is still assessed as high due to confirmed cross-border spread through imported cases and ongoing epidemiological links along the eastern Democratic Republic of the Congo&ndash;western Uganda corridor, historically affected by Ebola outbreaks, including Bundibugyo and Sudan virus disease outbreaks. The risk for countries with land borders adjoining countries with documented BDBV detection, is assessed as high due to sustained population mobility linked to cross-border trade and mining activities, variation in capacities and experience of BVD response and variable levels of readiness. The risk for the rest of the Africa region and at the global level is assessed as low.","advice":"WHO advises against any restriction of travel to, or trade with, the Democratic Republic of the Congo or Uganda based on the currently available information. WHO continues to closely monitor and, where necessary, verify travel and trade measures in relation to this event. For further information on the considerations for implementing border health and international travel-related temporary recommendations, please see the relevant technical note issued on 26 May 2026 The temporary recommendations issued to State Parties on 22 May 2026 underscore the importance of coordinated outbreak control, enhanced cross‑border collaboration, and sustained surveillance and preparedness to prevent further regional spread and ensure an effective public health response. WHO has convened several technical advisory groups, including the Strategic Advisory group of Experts (SAGE) to assess candidate vaccines and therapeutics for BVD. Key recommendations made are available in the news release published on 28 May 2026. Regular Information products on the outbreak of BVD in Democratic Republic of the Congo Daily update: Epidemiological update on BVD outbreak in Democratic Republic of the Congo and Uganda Published every Tuesday: Weekly External Situation Report on Ebola Bundibugyo Virus Disease Outbreak, Democratic Republic of the Congo | Uganda Published every Thursday: Disease Outbreak News | All Hazards Public Health Events, Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo","publishedAt":"2026-06-08T12:35:09.000Z","lastModified":"2026-06-09T13:35:35.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON606","response":"Health authorities in the Democratic Republic of the Congo and Uganda, in collaboration with WHO and partners, are implementing comprehensive public health measures including implementing the continental response plan, engaging donors and mobilizing additional resources to address critical funding gaps and sustain response operations across affected and at-risk areas. Key response activities also include interagency coordination and 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. For further information about public health response actions by the respective Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa: Ebola Bundibugyo Virus Disease Outbreak Democratic Republic of the Congo | Uganda Weekly External Situation Report 03, Data as of 31 May 2026 | WHO | Regional Office for Africa","epidemiology":"Bundibugyo virus disease (BVD) 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. 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 the deceased. 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. Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. Control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.","formattedDate":"2026-06-08T13:12:23Z","matchedSignals":["severity signal","WHO high-risk wording","response escalation"]}},{"id":"2026-DON605","title":"Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo & Uganda","disease":"Ebola disease caused by Bundibugyo virus","locations":["Democratic Republic of the Congo & Uganda"],"riskLevel":"watch","signalClass":"WHO outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON605","summary":"The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo and Uganda continues to evolve rapidly, with increasing case numbers, geographic spread, and ongoing cross-border transmission. As of 27 May, a total of 906 suspected cases and 223 deaths among suspected cases have been reported in the Democratic Republic of the Congo. As of 29 May, a total of 134 confirmed cases, including nine in Uganda, with 18 deaths among the confirmed cases, have been reported across both countries. This is an additional 49 confirmed cases, eight confirmed deaths, 160 suspected cases and 47 suspected deaths since the last update on 21 May. In addition, there is one confirmed case, an individual from the United States of America, who had treated patients in the Democratic Republic of the Congo and is currently receiving care in Germany. In the Democratic Republic of the Congo, transmission is concentrated in Ituri, as well as North Kivu and South Kivu provinces, with challenges in contact tracing and follow-up, insecurity, inadequate isolation, care, and referral systems for patients complicating response efforts. National authorities, in collaboration with WHO and partners, are implementing response measures including deployment of rapid response teams, delivery of medical supplies, strengthened surveillance, laboratory confirmation, infection prevention and control, the set-up of safe and optimized treatment centers, and community engagement.","overview":"Since the last Disease Outbreak News was published on 21 May 2026, the number of suspected and confirmed cases has increased rapidly in the Democratic Republic of the Congo. In total, 906 suspected cases, including 223 deaths among suspected cases have been reported from Democratic Republic of the Congo; and 134 confirmed cases (nine in Uganda), including 18 deaths (one in Uganda) (CFR 14%) have been reported from the two countries as of 29 May. Additionally, a medical doctor from the United States of America who was exposed as part of their work caring for patients in the Democratic Republic of the Congo tested positive on 17 May and was transported to Germany for treatment and care. Figure 1. Distribution of suspected and confirmed cases of Bundibugyo virus disease in Democratic Republic of the Congo and Uganda, as of 29 May 2026 Democratic Republic of the Congo Since the last update dated 21 May, an additional 42 confirmed cases including eight deaths and 160 suspected cases including 47 deaths have been reported from the Democratic Republic of the Congo. As of 27 May 2026, a total of 125 confirmed cases including 17 deaths (CFR 14%); and 906 suspected cases including 223 deaths have been reported from 13 health zones (HZ) in Ituri (7/36 HZ), North Kivu (5/35 HZ) and South Kivu Provinces (1/34 HZ) [1] . Sixteen confirmed cases have been reported among health and care workers to date. Epidemiological and laboratory investigations are ongoing to reclassify all suspected cases and deaths reported in the Democratic Republic of the Congo. The outbreak remains concentrated in Ituri Province, which accounts for 88% (110) of confirmed cases. The highest confirmed case numbers in Ituri Province are reported from Bunia (37 cases), Rwampara (33 cases), Mongbwalu (20 cases), and Nyankunde (10 cases) HZ. Of the 17 deaths among confirmed cases in the Democratic Republic of the Congo, 10 were male (nine were over 15 years old and one under 15) and seven were female (five over 15 years old and two under 15). A total of 774 samples have been collected as of 27 May. Of these, 648 samples (84%) have been analyzed, with 125 testing positive, representing a test positivity rate (TPR) of 19.2%. This is likely an underestimation of the actual positivity rate as over 100 samples are still awaiting testing and have been sent to Kinshasa for further analysis. As of 27 May, 2635 contacts have been listed in Ituri and North Kivu provinces. Security incidents against health facilities, and community resistance, have recently emerged as major operational challenges in Ituri Province, with three recent incidents reported in Mongbwalu and Rwampara HZ. These create additional risks for undetected transmission, disrupt outbreak response efforts, and reinforce the need to strengthen community protection and engagement activities Figure 2: Number of confirmed cases (n=125) and deaths (n=17) by date of reporting in the Democratic Republic of the Congo as of 27 May 2026 Source: Ministry of Health, Democratic Republic of the Congo NB: Newly reported confirmed cases/deaths may be part of the back log of samples waiting to be tested and therefore not necessarily newly acquired infections. Uganda Since the last update dated 21 May, an additional seven confirmed cases have been reported from Uganda. As of 29 May 2026, a total of nine confirmed cases including one death have been reported in Kampala (n=8) and Wakiso (n=1), Uganda. Recent cases include a Ugandan driver who transported the first reported case, a Congolese health worker with linkage to the index case, a Congolese woman who travelled to Uganda for medical care, and two Ugandan health workers linked to earlier confirmed case. As of 26 May, a total of 436 contacts linked to the cases have been identified and are under follow-up. These include close household contacts and hospital contacts where the cases were hospitalized. Exposure risks are associated with healthcare settings and cross-border movements. Figure 3: Number of confirmed cases (n=9) and deaths (n=1) by date of reporting in Uganda as of 29 May 2026 Source: Ministry of Health, Uganda","assessment":"On 22 May 2026, WHO assessed the risk of the outbreak of BVD to be very high at the national level in the Democratic Republic of the Congo, high at the regional level, and low at the global level. The risk assessment will be continuously reassessed in the coming days based on available and shared information. For further information, please see the WHO Rapid Risk Assessment-Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo and Uganda v2 .","advice":"On 19 May 2026, the Director-General of WHO convened the first meeting of the IHR Emergency Committee, which issued the temporary recommendations on 22 May 2026 to States Parties. These recommendations underscore the importance of coordinated outbreak control, enhanced cross‑border collaboration, and sustained surveillance and preparedness to prevent further regional spread and ensure an effective public health response WHO advises against any restriction of travel to, or trade with, the Democratic Republic of the Congo or Uganda based on the currently available information. WHO continues to closely monitor and, where necessary, verify travel and trade measures in relation to this event. For further information on the considerations for implementing border health and international travel-related temporary recommendations, please see the relevant technical note issued on 26 May 2026 Regular Information products on the outbreak of BVD in Democratic Republic of the Congo Daily update: Epidemiological update on BVD outbreak in Democratic Republic of the Congo and Uganda Published every Tuesday: Weekly External Situation Report on Ebola Bundibugyo Virus Disease Outbreak, Democratic Republic of the Congo | Uganda Published every Thursday: Disease Outbreak News | All Hazards Public Health Events, Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo Press Statements - Ministry of Health - Uganda","publishedAt":"2026-05-29T15:58:00.000Z","lastModified":"2026-06-03T11:41:47.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON605","response":"Health authorities in the Democratic Republic of the Congo and Uganda, in collaboration with WHO and partners, are implementing comprehensive public health measures. WHO Director-General, Dr Tedros Adhanom Ghebreyesus, traveled to the Democratic Republic of the Congo on 28 May to support the ongoing response. For further information about public health response actions by the respective Ministry of Health, WHO, and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa: Weekly External Situation Report 02, Data as of 24 May 2026 - DRC and Uganda","epidemiology":"Bundibugyo virus disease (BVD) 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. 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 the deceased. The incubation period for BVD ranges from 2 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, have ranged from approximately 30% to 50%. Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. Control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.","formattedDate":"2026-05-29T15:43:01Z","matchedSignals":["severity signal","response escalation"]}},{"id":"2026-DON604","title":"Hantavirus outbreak linked to cruise ship travel, Multi-locations","disease":"Hantavirus outbreak linked to cruise ship travel","locations":["Multi-locations"],"riskLevel":"elevated-watch","signalClass":"Cross-border or severe outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON604","summary":"This is the fourth Disease Outbreak News report on the Andes hantavirus outbreak linked to cruise ship travel, following the notification to the World Health Organization (WHO) on 2 May 2026 of severe respiratory illness cases aboard M/V Hondius, a cruise ship. Since the last DON was published on 13 May, three additional confirmed cases were reported, from Canada, the Netherlands, and Spain. The previously reported inconclusive case from the United States of America was subsequently determined to be negative following further laboratory testing and has been removed from the total case count. All cases to date have been passengers or crew members on the ship. As of 27 May, a total of 13 cases, including three deaths, have been reported (case fatality ratio 23%). Eleven cases have been laboratory-confirmed for Andes virus (ANDV) infection, and two are probable cases. Given the long incubation period of up to six weeks, it is not unexpected that cases continue to be reported until the end of the six weeks since last exposure. Through the International Health Regulations (2005) (IHR) channels, National IHR Focal Points (NFPs) have all been informed and are supporting international contact tracing and monitoring efforts. WHO has assessed the risk posed by this event to the global population as low and will continue to monitor the epidemiological situation and update the risk assessment as needed.","overview":"On 2 May 2026, WHO received notification from the IHR NFP of the United Kingdom of Great Britain and Northern Ireland (hereafter referred to as the United Kingdom) regarding a cluster of severe acute respiratory illness, including two deaths and one critically ill passenger, aboard the Netherlands-flagged cruise ship M/V Hondius. As of 27 May, a total of 13 cases (eleven confirmed and two probable cases), including three deaths (two confirmed and one probable), have been reported. Since the last Disease Outbreak News was published on 13 May, three additional confirmed cases have been reported among passengers or crew members, one each from Canada, the Netherlands, and Spain. The case in Canada developed symptoms during contact follow-up, whereas the cases in the Netherlands and Spain were identified through routine weekly testing of high-risk contacts during follow-up. The previously reported inconclusive case from the United States of America was subsequently determined to be negative following further laboratory testing and has been removed from the total count on 15 May. All confirmed cases are among people who travelled onboard the M/V Hondius. Figure 1. Epidemiological curve of Andes hantavirus cases (n = 13) reported to WHO as of 27 May 2026, 17:00. Based on currently available information, the working hypothesis is that the first case acquired the infection prior to boarding the cruise, through exposure on land. Investigations are ongoing to elucidate the potential circumstances of exposure and the source of the outbreak, in collaboration with authorities in Argentina and Chile, however, the time between the individual&rsquo;s visit to Chile and the onset of symptoms exceeds the maximum incubation period. Therefore, based on the information currently available, exposure in Chile can be ruled out. Current evidence suggests subsequent human-to-human transmission onboard the ship. This is also supported by a preliminary analysis of the sequences, which show a near-identical sequence from different cases. [1] This outbreak is being managed through a coordinated international response. This includes comprehensive epidemiological investigations, case isolation and clinical management, medical evacuations, laboratory testing, and international contact tracing, as well as quarantine and monitoring measures. Recommendations are subject to change as new epidemiological and laboratory evidence becomes available, including findings from genetic sequencing. Follow-up and contact tracing for all contacts of hantavirus cases linked to the cruise ship is ongoing. This includes passengers who disembarked in Saint Helena, United Kingdom, on 24 April; Ascension, United Kingdom, on 27 April; Praia, Cabo Verde, on 6 May; and Tenerife, Spain, on 10 and 11 May, the remaining 25 crew members and the two healthcare workers from the Netherlands who disembarked in the Netherlands on 18 May and 23 May. Passengers who travelled on flights who may have had exposure to subsequently confirmed cases have been identified and contacted. High-risk contacts are being quarantined and monitored by local health authorities either in their respective countries or in the ship&rsquo;s flag country, the Netherlands, or third countries (Table 1). As of 22 May 2026, more than 600 contacts, including 53% high-risk and 47% low-risk contacts, have been identified across 32 countries, territories and areas, and are either under close monitoring or self-monitoring in line with the updated guidance on management of contacts of Andes virus (ANDV) cases from the MV Hondius cruise ship published on 17 May. Table 1. Contacts being traced for the Andes hantavirus outbreak on a cruise ship reported to WHO as of 25 May 2026, 17:00.","assessment":"WHO continues to assess the risk for passengers and crew who were onboard the cruise ship as moderate, as individuals exposed prior to the implementation of control measures may still develop illness during the incubation period and should therefore be closely monitored. The risk at the global level is assessed as low for the following reasons: Andes virus has demonstrated limited human-to-human transmission in previous outbreaks, typically occurring among close contacts and within household settings, generally requiring prolonged close exposure. Transmission can be contained through early detection, isolation of cases, clinical management, and contact management. However, the ship environment presented an increased risk due to close living quarters, shared indoor spaces, prolonged exposure, and frequent interpersonal interactions, all of which likely facilitated transmission. Human Pulmonary Syndrome caused by hantaviruses in the Americas, including Andes virus, can have a high case fatality ratio, reaching 40-50%, particularly among elderly individuals and those with co-morbidities. The average age of passengers on board the ship was 65 years old. Investigations on the travel history and potential exposures of the first case in the Southern Cone subregion of the Americas are ongoing and suggest possible exposure to rodents during recreational activities. Viral sequencing analyses are also ongoing and are comparing the ANDV strain associated with this outbreak with strains circulating in Argentina and Chile, where the disease is enzootic. The preliminary sequencing analysis for the cases indicates a high degree of genetic similarity amongst sequenced cases &mdash;showing no more than one single nucleotide polymorphisms difference per individual &ndash; which strongly indicates that the outbreak likely arose from a single zoonotic spillover event, or from a very small number of closely related spillover events. [ 1] Additional cases may occur among individuals exposed before implementation of containment measures. However, the current response, including quarantine for those who have left the ship and rapid isolation of any new suspect cases and the monitoring of contacts, is expected to limit the risk of further spread. As there is no specific antiviral treatment for HPS, suspected cases require prompt transfer to an adequately equipped emergency department or intensive care unit, where available, for close monitoring and supportive management to improve chances of recovery. Consequently, for remote areas, rapid transfer to a well-resourced healthcare facility is required, which may be challenging under the current conditions. For the general public, including people not exposed on board the ship or through close contact with a confirmed case, the overall probability of infection remains low. Current evidence indicates that human-to-human transmission occurs through close and prolonged contact, and can be effectively limited through early detection, isolation of cases, and contact tracing.","advice":"WHO advises States Parties involved in this event to continue coordinated public health management efforts related to the management of cases and contacts associated with the affected ship and flights, as well as in countries where cases and/or contacts have been identified. WHO has advised and continues to advise a precautionary approach for management of the outbreak related to the ship, with focus on total containment to minimize the onward risk of transmission to other persons. This strategic decision is guided by: To date, most of the evidence of human-to-human transmission shows it has required prolonged close exposure, although it is possible that some highly infectious individuals could infect others through a lower degree of exposure. Mode(s) of transmission and which mode is dominant if multiple routes of transmission exist are still uncertain. Infection is a result of not only exposure, but the setting and duration where exposure has taken place, how infectious the infected person is, and whether personal protective equipment is used. Although the probability of infection is uncertain, if infection occurs, it can be severe. Currently, there is no specific treatment available and severe disease requires advanced critical care. There is a relatively low burden of additional infection prevention and control measures. At this time, WHO does not recommend any changes to routine activities for the general public. People who were on board the affected ship, or who have had close contact with a confirmed case, should follow national health advice. Guidance may be updated as further evidence becomes available. Recommendations remain dynamic and will be updated as additional epidemiological and laboratory evidence, including genetic sequencing data, becomes available. Coordination WHO advises States Parties involved in this event to continue public health coordination related to the management of cases and contacts in countries where they are present or expected to return, as well as of affected conveyances, as applicable and in close coordination with travel and transport authorities, conveyance operators, and other relevant stakeholders at points of entry. Coordination should ensure the implementation of risk-based, evidence-informed public health measures. Surveillance Ongoing epidemiological investigations include detection, investigation, and reporting of suspected cases, as well as contact tracing and monitoring. As a precautionary measure, high-risk contacts should undergo active monitoring and home or facility quarantine for 42 days following their last exposure. Current evidence does not support routine laboratory testing or quarantine of low-risk contacts; instead, they should undertake passive self-monitoring and seek medical evaluation if symptoms develop. Contact tracing and listing should utilize all available information sources, including interviews and relevant conveyance-related documentation (passenger manifests, passenger locator forms, and other relevant activity logs), to ensure completeness. Early recognition and prompt isolation of suspected cases remain critical to reduce further transmission. Laboratory Laboratory testing of suspected cases should be conducted as part of the outbreak response. Laboratory investigations may include molecular detection, serology, and sequencing to support case confirmation and better understand the outbreak. Recommendations on laboratory approaches will continue to evolve as new evidence becomes available. Case management Early identification, prompt isolation, and clinical evaluation of suspected cases are essential. When HPS is suspected, patients should be promptly referred for close monitoring and supportive care, including admission to emergency or intensive care settings when needed. Clinical management is primarily supportive and may include antipyretics, careful fluid management, hemodynamic monitoring, respiratory support, and escalation to advanced interventions for severe cases. Mechanical ventilation, vasopressors, extracorporeal membrane oxygenation [4] (ECMO), or dialysis may be required for severe disease. Antibiotics are not routinely indicated for confirmed hantavirus infection, but may be used empirically if bacterial infection cannot be ruled out or is suspected. Currently, there is no approved specific antiviral treatment for HPS. Infection Prevention and Control Suspected or confirmed cases should be isolated in a single, well-ventilated room. Standard precautions* should be applied at all times for all patients, including hand hygiene, environmental cleaning, and appropriate waste management, outlined in the interim guidance published on 8 May Transmission-based precautions should be implemented in addition to standard precautions. Health and care workers should use appropriate personal protective equipment, including respirators, eye protection, gowns, and gloves. Suspected or confirmed cases should be isolated in a single, well-ventilated room. Transmission-based precautions should be implemented in addition to standard precautions. Hand hygiene should be performed before and after the use of PPE. Waste from suspected or confirmed cases should be managed as infectious waste. Airborne precautions should be applied during aerosol-generating procedures. The duration of standard and transmission-based precautions should be determined on a case-by-case basis. Risk Communication and Community Engagement (RCCE) Communication strategies should prioritize transparent, timely, and culturally appropriate information to affected individuals and the general public. Risk Communication and Community Engagement (RCCE) efforts should provide clear, consistent, and actionable information, including explanations of the public health measures being implemented. Messaging should address public concerns regarding transmissibility, severity, and international travel, and clarify recommended actions for different population groups. Public health awareness should focus on early detection, timely healthcare seeking, and reducing exposure risks, including occupational and environmental exposures. RCCE activities should be integrated throughout all phases of the response and align with broader public health measures. Environmental management strategies, including rodent control, should be included as part of prevention efforts. Based on the current information available on this event, WHO advises against the application of any travel or trade restrictions beyond the restriction of movement of identified high-risk contacts. *Standard precautions refer to a set of practices that are applied to the care of patients, regardless of the state of infection (suspicion or confirmation), in any place where health services are provided. These practices aim to protect both healthcare professionals and patients and include hand hygiene, use of personal protective equipment, respiratory hygiene and cough etiquette, safe handling of sharps materials, safe injection practices, use of sterile instruments and equipment and cleaning of hospital environments and the environment. Adapted from &ldquo;Standard precautions for the prevention and control of infections: aide-memoire&rdquo;- WHO, 2022. Available at https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.1","publishedAt":"2026-05-28T18:00:00.000Z","lastModified":"2026-06-04T14:23:06.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON604","response":"Authorities from States Parties managing cases and/or contacts, WHO, and partners have initiated coordinated response measures, including: Ongoing engagement between WHO and the IHR NFPs of countries managing cases and/or contacts to ensure timely information sharing and coordination of response actions. International contact tracing and follow up of contacts is ongoing. WHO is requesting regular information sharing and periodic updates from States Parties through IHR channels regarding contact monitoring and the health status of high-risk contacts. Epidemiological investigations continue to better define epidemiological links between cases and exposure factors on the ship, as well as to try to understand the potential source of exposure. WHO has developed and published specific technical guidance documents to support response to the event, including: Technical guidance on the management of hantavirus onboard ships was shared with States Parties through IHR channels Technical note for the disembarkation and onward management of passengers and crew in the context of an Andes-virus-associated cluster; Management of contacts of Andes Virus (ANDV) cases from the MV Hondius cruise ship IHR NFPs of affected countries have been in contact about passenger and crew information through established IHR channels for those who were on the ship, as well as on planes where a known case was on board. Nearly 1000 communications have occurred through these established channels. Risk communication coordination and support are being provided to ensure sharing of regular, timely and evidence-based information. WHO has activated three-level coordination and is supporting national authorities in implementing risk-based, evidence-informed public health measures in accordance with the provisions of the IHR and related WHO technical guidance documents. WHO regularly convenes expert calls across laboratory, clinical management, epidemiology, infection prevention and control (IPC), and border health and points of entry domains to facilitate timely experience sharing and coordinated expert support. WHO has supported the streamlining and development of research protocols on the natural clinical history in collaboration with national partner institutions and planned a hantavirus scientific consultation on medical countermeasures.","epidemiology":"Hantavirus disease is a zoonotic viral disease caused by hantaviruses of the genus Orthohantavirus , family Hantaviridae , order Bunyavirales . More than 20 viral species have been identified within this genus. Human hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of certain species of (specific) infected rodents, or by touching contaminated surfaces. Exposure typically occurs during activities such as cleaning buildings with rodent infestations, though it may also occur during routine activities in heavily infested areas. Human cases are most commonly reported in rural settings, such as forests, fields, and farms, where rodents are present, and opportunities for exposure are greater. Human-to-human transmission has currently only been reported for hantavirus pulmonary syndrome (HPS) associated with Andes virus infection. Andes virus (ANDV) is endemic in South America, with confirmed circulation and human cases reported primarily in Argentina and Chile, and additional cases and related strains identified in Uruguay, southern Brazil, and Paraguay. Andes virus transmission between humans Based on the available information and the existing observations of the current outbreak, limited human-to-human transmission of ANDV is known to occur. However, no large-scale human-to-human outbreaks have been observed historically, [2] suggesting a low probability of transmission per contact. ANDV circulates in specific species of rodents in the Americas, and there have been many sporadic cases reported in Argentina and Chile that have not led to onward transmission. [3] Clusters of human cases have been reported in multiple past outbreaks and have been typically associated with close and prolonged interactions, often in shared indoor environments such as households. The largest reported outbreak of ANDV was reported in Argentina in 2018-2019, [ 2] where high viral titres in combination with attendance at large social gatherings or extensive contacts among people were associated with higher transmission. While the available evidence suggests that there are multiple modes of transmission that occur with ANDV, the probability of onward transmission between humans remains low. In this recent outbreak of ANDV infection reported on a cruise ship, human-to-human transmission has also occurred. Considering the ongoing epidemiological studies and environmental sampling after the disembarkation of all passengers from MV Hondius, the exact mode(s) through which human-to-human transmission occurred and their relative contributions are yet to be fully understood. Therefore, at present, WHO is operating under the assumption that ANDV transmission: may include contact with an infected individual or contaminated surfaces, and/or through-the-air transmission (via direct deposition of infectious respiratory particles onto exposed facial mucosal surfaces--mouth, nose or eyes) and/or airborne transmission (via inhalation of infectious respiratory particles). The virus does not exhibit transmission dynamics consistent with highly transmissible airborne pathogens (such as measles). This information is up to date as of 27 May 2026. It will be updated as new evidence becomes available and the understanding of transmission evolves. Using data from the previously documented human-to-human outbreaks in Argentina [2] and the 13 cases so far recorded from the cruise ship outbreak, WHO estimates that the mean incubation period is 22 days, corresponding to a probability of safe release from quarantine of 96% at 42 days, reducing to 91% at 35 days. This reaffirms WHO&rsquo;s recommendation of 42 days of quarantine for high-risk contacts and self-monitoring for low-risk contacts. Using case incidence data from the ANDV outbreak associated with the cruise ship, the effective reproduction number (Rt) for this outbreak as of 22 May is estimated to be 0.7, where anything less than 1.0 indicates that the spread of disease is declining.","formattedDate":"2026-05-28T14:43:00Z","matchedSignals":["transmission concern","severity signal","response escalation"]}},{"id":"2026-DON603","title":"Ebola disease caused by Bundibugyo virus – Democratic Republic of the Congo","disease":"Ebola disease caused by Bundibugyo virus","locations":["Democratic Republic of the Congo"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON603","summary":"On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare, Democratic Republic of the Congo (DRC), and the Ministry of Health of Uganda declared an outbreak of Ebola Disease following the confirmation of Bundibugyo virus disease (BVD) in both countries. On 17 May 2026, the World Health Organization (WHO) Director-General determined that the Ebola disease caused by Bundibugyo virus in DRC and Uganda constitutes a public health emergency of international concern (PHEIC), as defined in the provisions of IHR. On 19 May 2026, the Director-General of WHO convened the first meeting of the IHR Emergency Committee, and temporary recommendations were issued to State Parties. As of 21 May, 746 suspected cases and 176 deaths among suspected cases were reported in DRC. So far 85 confirmed cases, including two in Uganda, and ten deaths, with one in Uganda, among confirmed cases were reported across both countries. In DRC, transmission is concentrated in Ituri, North Kivu and South Kivu provinces, with challenges in contact follow-up, insecure conditions, and inadequate isolation and referral systems complicating response efforts. Uganda has reported two imported cases with no confirmed local transmission. An American national who was working in DRC has also been confirmed positive and transferred to Germany for care. National authorities, in collaboration with WHO and partners, are implementing response measures including deployment of rapid response teams, delivery of medical supplies, strengthened surveillance, laboratory confirmation, infection prevention and control assessments, the set-up of safe and optimized treatment centers, and community engagement.","overview":"On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare of Democratic Republic of the Congo (DRC) officially declared the 17 th Ebola disease outbreak following the laboratory confirmation of Bundibugyo virus disease (BVD) in eight samples. Concurrently, on 15 May 2026, the Ministry of Health of Uganda confirmed an outbreak of BVD following the identification of an imported case from DRC. On 17 May 2026, the WHO Director-General, after having consulted the States Parties where the event is known to be currently occurring, determined that the Ebola disease caused by Bundibugyo virus in DRC and Uganda constitutes a public health emergency of international concern (PHEIC), as defined in the provisions of International Health Regulation (IHR) Since the last Disease Outbreak News was published on 16 May 2026, the number of suspected and confirmed cases has increased rapidly in DRC, with geographical expansion into North Kivu and South Kivu. In total, 746 suspected cases, including 176 deaths among suspected cases have been reported from DRC as of 21 May 2026; and 85 confirmed cases (two in Uganda), including ten deaths (one in Uganda) (CFR 12%) have been reported from both countries. Figure 1. Distribution of suspected and confirmed cases of Bundibugyo virus disease in Democratic Republic of Congo and Uganda, as of 21 May 2026 Democratic Republic of the Congo As of 21 May 2026, a total of 83 confirmed cases including nine deaths (CFR 11%); and 746 suspected cases including 176 deaths have been reported from 15 health zones (HZ) in Ituri, North Kivu and South Kivu Provinces, DRC. Four health worker deaths have been reported to date. Epidemiological and laboratory investigations are ongoing to reclassify all suspected cases and deaths reported in DRC. The most affected HZ are Mongbwalu, Rwampara and Bunia, which all account for 96% of suspected cases and 79% of confirmed cases. As of 21 May, 1603 contacts have been listed in Ituri province and one contact became a suspected case. However, follow-up remains weak due to insecurity and movement restrictions. The follow-up rate as of 21 May is 21%. On 21 May, 84 new alerts were reported, and 77 alerts were investigated, all of which were validated. An American national, who was working in DRC as a surgeon, has also been identified as a confirmed case. Exposure is thought to have occurred during a medical procedure on 11 May. Onset of symptoms was reported on 16 May and laboratory confirmation was received on 20 May. The case is currently at a High-Level isolation unit in Berlin, Germany undergoing treatment. Figure 2 Risk mapping of Health Zones in DRC as of 21 May 2026 Response efforts continue to face a number of challenges, including: absence of standardized isolation and treatment facilities and weak screening and referral pathways; inconsistent implementation of safe and dignified burial measures further underscores the significant risk of healthcare-associated transmission; cross-border transmission risks remain elevated due to insecurity, humanitarian crises, high population mobility, urban/semi-urban transmission hotspots, and porous borders, requiring intensified surveillance and information sharing; deeply challenging situation for affected communities, with growing concerns over access to free and supportive healthcare services, the ability to ensure respectful and dignified burials, and the spread of misinformation and rumour; ongoing conflict in Ituri province restricting the movement of surveillance teams, the deployment of Rapid Response Teams, and the transporting of laboratory samples. It is currently thought that the event originated in the Mongbwalu HZ, DRC, a high-traffic mining area, with cases subsequently migrating to Rwampara and Bunia to seek medical care. Ituri province borders South Sudan and Uganda with Bunia HZ being less than 40km from Uganda. A full epidemiological investigation and trace back exercise is ongoing. Ituri&rsquo;s role as a commercial and migratory hub and proximity to Uganda and South Sudan increases the risk of regional exportation and cross-border transmission. Uganda As of 20 May 2026, a total of two confirmed cases including one death have been reported in Kampala, Uganda. Both cases were imported from the DRC. The first case was admitted to a private hospital on 11 May and died on 14 May. The transfer of the body to DRC was completed the same day. The second case was confirmed on 16 May in Kampala, in an individual returning from DRC with no apparent links to the first case. The case is currently admitted in Uganda at the Mulago Isolation Treatment Unit. At the time of reporting, no local transmission has been identified in Uganda. As of 18 May, a total of 127 contacts, linked to both confirmed imported cases, have been identified and under follow-up. These include close household contacts and hospital contacts where the cases were hospitalized. Exposure risks are associated with healthcare settings and cross-border movements. Eighteen alerts were reported on 18 May and investigated. Four active cross-border exposure clusters identified in Ntoroko District are under investigation.","assessment":"On 17 May 2026, WHO Director-General, after having consulted the States Parties where the event is known to be currently occurring, determined that the Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern (PHEIC), as per the provisions of the IHR. This is the 17 th Ebola disease outbreak in the DRC since 1976. The last Ebola disease outbreak in the country was an outbreak and Ebola virus disease which was declared on 4 September 2025 with total of 64 cases (53 confirmed, 11 probable), including 45 deaths (CFR 70.3%), reported from six health areas in Bulape Health Zone, Kasai Province. The end of outbreak was declared on 1 December 2025. The last BVD outbreak was reported on 17 August 2012 by the DRC Ministry of Health in Province Orientale. A total of 59 cases, 38 confirmed and 21 probable cases, including 34 deaths were reported. The outbreak was declared over on 26 November 2012 by the MOH. In Uganda, the last outbreak reported was an outbreak of Sudan ebolavirus in 2025. The last BVD outbreak was recorded in the country in 2007. This outbreak is occurring in a complex epidemiological and humanitarian context. A critical four-week detection gap between the onset of symptoms of the presumed index case (25 April 2026) and the laboratory confirmation of the outbreak (14 May 2025) suggests a low clinical index of suspicion among healthcare providers. This is compounded by the presence of co-circulating arboviruses and influenza-like illnesses, masking the initial index of suspicion for Ebola disease and exacerbating community transmission. Furthermore, the infection and death of four healthcare workers within a four-day span at Mongbwalu General Referral Hospital underscores critical breaches in IPC protocols. A large number of community deaths has been reported potentially associated with unsafe burial practices. Ongoing conflict in Ituri province restricts the movement of surveillance teams, limits the deployment of Rapid Response Teams, and hinders the secure transport of laboratory samples. Contact tracing is challenging due to difficult access and highly mobile populations, increasing the risk of high-risk contacts being lost to follow up or never identified Ituri&rsquo;s role as a commercial and migratory hub increases the risk of regional exportation. The proximity to Uganda and South Sudan increases the risk of cross-border transmission if PoE screening and cross border coordination and information sharing are not immediately reinforced. On 15 May 2026, the Ministry of Health of Uganda reported an imported case of BVD. Humanitarian needs in the area are dire. Ituri has 273 403 displaced people, with a total of 1.9 million people in need according to the Humanitarian Response Plan 2026 for DRC. From January to March 2026, 32 600 newly displaced and 30 200 returnees were recorded. The province recorded 5800 protection incidents and 11 incidents against humanitarian actors. Unlike Ebola virus disease, there is no licensed vaccine or specific therapeutics against BDBV. Research and development activities are activated to coordinate efforts to advance potential candidate medical countermeasures. Response and outbreak control relies entirely on a range of interventions and public health measures that will need to be thoroughly implemented, including supportive care, early detection, adequate IPC, rigorous contact tracing, safe burials, and community engagement. WHO assessed the risk of the outbreak of BVD to be very high at the national level in DRC, high at the regional level, and low at the global level.","advice":"On 19 May 2026, the Director-General of WHO convened the first meeting of the IHR Emergency Committee who issued the following temporary recommendations on 22 May 2026 to State Parties: For countries with documented detection of Bundibugyo virus (the Democratic Republic of the Congo and Uganda) Coordination and high-level engagement Declare the Bundibugyo virus disease (BVD) epidemic a health emergency, at national or sub-national level, in accordance with domestic laws, and as appropriate. Activate national disaster or health emergency management mechanisms and activate or establish an emergency operation centre, under the authority of the Head of State or relevant government authority, to coordinate response activities across Government sectors, administrative levels, and partners to ensure efficient and effective implementation and monitoring of comprehensive BVD control measures. These measures must include enhanced surveillance, including case identification; contact tracing; infection prevention and control (IPC), risk communication and community engagement; laboratory diagnostic testing, case management, and safe and dignified burials. Coordination and response mechanisms should be established at national level, as well as at subnational level in areas where BDBV has been detected and at-risk areas. Establish and maintain up to date a register of signals consistent with BVD (&ldquo;alerts&rdquo;), including status of their investigation. Establish and maintain up to date a line list of suspected cases &ndash; including identified through syndromic surveillance, probable cases, and confirmed BVD cases. Establish and maintain up to date the list of contacts of all confirmed and probable BVD cases; monitor each contact for 21 days after the date of last known exposure; Both the evolution of the epidemic and resources available may require the risk-based prioritization of contacts requiring identification and monitoring. Negotiate, as applicable, and establish security corridors, including cross-border, to allow responders to safely reach affected communities, as well as to allow communities to seek appropriate health care. Notify WHO, through the relevant WHO IHR Contact Point in the WHO Regional Office, the detection of suspected, probable and confirmed BVD cases daily, as per WHO case definitions available here. Risk communication and community engagement Implement large-scale trust building and community engagement interventions - using all trusted available communication channels, and working closely with local religious and traditional leaders, and traditional healers -, so that communities are fully aware of the risk and benefits of control measures, and pro-actively contribute and support the early detection and early isolation of cases; the identification and monitoring of contacts; and safe and dignified burial practices Strengthen community awareness, engagement and participation, to establish and strengthen trust, including by identifying and addressing cultural norms and beliefs that may serve as barriers to their full participation in the response; and by integrating interventions and community feedback, within the wider response, to address the needs of the population, particularly in contexts of the protracted humanitarian crisis in the Eastern provinces of the Democratic Republic of the Congo. Train community leaders on the rationale underpinning public health measures, including the isolation of cases, monitoring of contacts, and safe burials in a dignified, non-stigmatizing, and non-punitive manner. Activate local networks, including community health workers, Red Cross volunteers, and other trusted community actors to promote protective behaviours; facilitate early detection and referral of suspected BVD cases; support contact tracing activities; and collect and relay community feedback to enhance the acceptance of public health measures. Enable adherence to movement restrictions, associated with the application of control measures, by providing food, water, communication, financial and psychosocial support. Surveillance and laboratory Strengthen surveillance and laboratory capacity, decentralized across first sub-national administrative levels (e.g., provinces) with documented BDBV detection, as well as in their neighbouring first sub-national administrative levels, through: Dedicated surveillance and response teams within each health zone and and in neighbouring health zones determined to be at high-risk for the introduction of BVD; Active case finding and enhanced community surveillance for clusters of unexplained illness or deaths; The investigation of &ldquo;alerts&rdquo; within 24 hours from detection; The scale-up and strengthen RT-PCR laboratory capacities for timely testing for BDBV, including the establishment of protocols for safe sample collection, sample referral pathways, biosafety training for laboratory workers; The decentralization of the laboratory capacities should be considered to allow for quick turn-around time and support patient care, as well as any clinical trials that may take place. Field laboratories should be set-up in accordance with biosecurity and biosafety standards. A near point of care assay might be considered provided that its performance is validated against current RT-PCR standards. NB: The GeneXpert platform cannot detect Bundibugyo virus (BDBV). Identify and monitor, for 21 days after the date of last known exposure, the health of contacts of suspected probable, and confirmed BVD cases. The health status of contacts being monitored should be assessed and recorded daily. Any contact developing symptoms compatible with BVD should be assessed, isolated, tested and cared for. Establish a mechanism to monitor the evolution of indicators related to the performance of contact tracing activities. Infection prevention and control in health facilities and in the context of care Strengthen measures to prevent nosocomial infections, including systematic mapping of health facilities, the establishment and dissemination of protocols for triage, targeted IPC interventions and sustained monitoring and supervision. Provide continuous IPC training to health care workers, including the proper use of personal protective equipment (PPE). Provide health facilities with sufficient supplies of appropriate PPE equipment to ensure the safety and protection of their staff, resources for timely payment of their salaries and, as appropriate, hazard pay. Establish channels for health workers to report and be assessed following exposures, and have access to psychosocial support and, when possible post-exposure prophylaxis under compassionate use or clinical trial. All health worker occupational exposure must be investigated to allow for immediate corrective actions. Consider building community IPC capacity by training community leaders, and emphasizing that hand hygiene not only contributes to bringing the BVD epidemic under control, but also reduces the risk of transmission of other communicable diseases present in the same areas. Hand hygiene shall be facilitated at critical spots, such as schools, churches, bars, markets, local gatherings sites, points of entry, etc. Patient referral pathway and access to safe and optimized intensive care Establish dedicated BVD isolation and treatment centers or units for suspected, probable, and confirmed cases, located within, or close to, areas with documented BDBV detection, with sufficient staff who are specifically trained and equipped to implement optimized intensive supportive care. Establish protocols for transferring suspected BVD patients safely to dedicated health care facilities for their isolation, assessment and treatment in a humane and patient-centred approach. This includes trained ambulance teams, mechanisms to notify the receiving health care facility, the application of appropriate IPC precautions during transfer, and decontamination protocols for vehicles and equipment. Establish protocols for the handling and disposal of medical waste, in accordance with biosafety principles. Establish survivor follow-up programmes, including clinical care, counselling, semen testing and sexual health advice and condoms where appropriate, along with psychosocial support and stigma-reduction programmes. Maintain the package of essential health services, including providing IPC equipment for them to operate safely. This includes, at minimum, malaria diagnosis and treatment, and maternal and child health services. Safe and dignified burials Establish protocols ensuring funerals and burials are conducted by well-trained personnel, with provision made for the presence of the family and cultural practices, and in accordance with relevant national laws and regulations. Operations, supplies and logistics Establish logistics support to maintain a robust supply pipeline for PPE, diagnostics, therapeutics, and other medical commodities, IPC materials, including for safe burial. Border health, international travel and mass-gathering events Enhance, through arrangements between countries sharing borders, surveillance at ground crossings and border areas. Implement measures, in accordance with national laws and regulations, to prevent suspected, probable, and confirmed BVD cases, as well as their contacts from undertaking international travel, unless the travel is part of an appropriate medical evacuation. Prevent the cross-border movement of the human remains of deceased suspected, probable or confirmed BVD cases, unless authorized through bilateral arrangements. Implement exit screening at all points of entry - airports, ports and ground crossings -, consisting of, at a minimum, a questionnaire encompassing history of potential exposure to BVD, a temperature measurement and, in case of fever, an in depth assessment of the risk of BVD, by personnel trained and equipped with PPE. Any traveller determined to present with an illness consistent with BVD should not be allowed to travel unless the travel is part of an appropriate medical evacuation. Report to WHO, through the relevant WHO IHR Contact Point in the WHO Regional Office, the implementation of any international traffic related measure adopted. Consider postponing mass gatherings until BVD transmission is interrupted. Research and development of medical countermeasures Engage, when feasible, with research partners and international institutions to: Define a robust laboratory strategy, urgently implement head-to-head comparison studies of PCR diagnostics to validate or invalidate the PCR platform (Radione &reg;) currently used in the field. Implement ethically approved, scientifically robust clinical trials to advance the development and use of candidate therapeutics for treatment and post-exposure prophylaxis and for vaccines. Establish, with a view to support research, expedited and efficient national regulatory and ethics reviews, community engagement, pharmacovigilance (where applicable), data sharing and equitable access arrangements. For countries with land borders adjoining countries with documented Bundibugyo virus disease Establish a national coordination mechanism articulated with subnational levels. Enhance rapidly the status of readiness to respond to BVD cases, including establishing active surveillance across health facilities, with zero reporting; enhancing community-based surveillance for clusters of unexplained deaths; establishing access to laboratories qualified to test for BVD; raising the awareness of health workers regarding BVD; training health workers on IPC precautions; establishing rapid response teams for the investigation and management of BVD patients and their contacts; establishing a mechanism for the identification and monitoring of contacts. Establish the capacity at national reference laboratory(ies) to timely and safely perform testing for BDBV along with relevant differential testing. Considerations may be given to shipment to an international reference laboratory for inter-laboratory comparison as part of external quality assurance implementation. Conduct international contact tracing operations as necessary, including obtaining information from airlines and other conveyances operations; identifying contacts associated with conveyances on an international voyage, and communicate with States Parties known as final destination of those contacts. Intensify risk communication and community engagement activities, in communities residing in border areas and at points of entry, including airports and ports with direct connection with States Parties with documented BDBV detection, and provide the general public with accurate and up to date information regarding the BVD epidemic and measures to reduce the risk of exposure. Exercise arrangements in place to respond to BVD through simulation exercises relating to management of BVD &rdquo;alerts&rdquo;, including cross-border; sample referral; activation of rapid response teams and mechanisms. Establish, with a view to support research, expedited and efficient national regulatory and ethics reviews, community engagement, pharmacovigilance (where applicable), data sharing and equitable access arrangements. Border health and international travel Provide travelers with accurate and up to date information regarding the BVD epidemic and measures to reduce the risk of exposure, including discouraging travel to areas with documented BDBV detection. Enhance, through arrangements between countries sharing borders, surveillance at ground crossings. This includes establishing coordination mechanisms for the detection and assessment of travelers with unexplained febrile illness; and the timely sharing of information regarding contacts who have, or may have, crossed the border, thus enabling continuity of follow-up. Pre-position PPE, other IPC materials, sample collection kits, case investigation forms, and safe burial supplies in border areas adjacent to those with documented BDBV detection. Activate health contingency plans at airport and ports, involving conveyance operators, to detect, assess, and manage travellers from States Parties with documented BDBV detection, presenting with symptoms compatible with BVD, and the identification of their contacts, according to established protocols. This entails the availability of trained personnel, referral mechanisms, application of IPC measures. Coordinate with conveyance operators to facilitate timely communication, prior to arrival and to relevant authorities, of any suspected BVD cases on board conveyances, and to identify contacts associated with conveyances on an international voyage. The identification of such contacts entails, where applicable, the communication of personal details to the States Parties known as final destination of those contacts. At the time these temporary recommendations are issued, neither the suspension of flights or waterways routes with States Parties with documented BDBV detection, nor denial of entry to travellers and conveyances arriving from those States Parties, are recommended. Report to WHO, through the relevant WHO IHR Contact Point, the implementation of any international traffic related measure adopted. Treat as a health emergency, including through a formal declaration according to domestic laws, the detection of a suspected or confirmed BVD case, of a contact thereof, or of a cluster of unexplained deaths. This include investigating any of those events within 24 hours and, by instituting case isolation and management; establishing a definitive diagnosis; and undertaking the identification and monitoring of contacts. Notify to WHO immediately, through the relevant WHO IHR Contact Point in the WHO Regional Offices, any suspected, probable or confirmed BVD case, as per WHO case definitions available here. In the presence of a BVD case, temporary recommendations for State Parties States Parties with documented BDBV detection apply. For all other countries Make arrangements to detect, assess, report and manage travelers with unexplained febrile illness arriving from areas with documented BDBV detection. These include, but are not limited to, disseminating the definition of BVD cases to public and private health care facilities, including travel clinics, and general practitioners; identifying laboratories to conduct testing for BDBV; identifying isolation facilities allowing for safe assessment and clinical care. Provide non-governmental organizations and other entities deploying personnel internationally to respond to the BVD epidemic with information on risk, measures to minimize the risk of exposure, and advice for managing a potential exposure. Prepare to facilitate the evacuation and repatriation of nationals (e.g., health workers) who have been exposed to BVD cases. Provide the general public with accurate and up to date information regarding the BVD epidemic and measures to reduce the risk of exposure, including discouraging travel to areas with documented BDBV detection. Border health and international travel Provide accurate and up to date information regarding the BVD epidemic to travel clinics, other health facilities and professionals, and discourage travel to areas with documented BDBV detection. Provide incoming travelers, at points of entry, with information about measures to take should they develop symptoms compatible with BVD within 21 days after arrival. Coordinate with the transport sector, including conveyance and points of entry operators, for the timely management of suspected BVD cases, including communication prior to arrival if the individual is on board; as well as for the identification of their contacts on board conveyance. The identification of such contacts entails, where applicable, the communication of personal details to the States Parties known as final destination of those contacts. At the time these temporary recommendations are issued, neither the suspension of flights from States Parties with documented BDBV detection, nor denial of entry to travellers and conveyances arriving from those States Parties, are recommended. Report to WHO, through the relevant WHO IHR Contact Point, the implementation of any international traffic related measure adopted. Notify to WHO immediately, through the relevant WHO IHR Contact Point in the WHO Regional Offices, any suspected, probable or confirmed BVD case, as per WHO case definitions available here. In the presence of a BVD case, temporary recommendations for States Parties with documented BDBV detection apply. Regular Information products on the outbreak of BVD in DRC Daily update: Epidemiological update on BVD outbreak in DRC and Uganda Published every Tuesday: Weekly External Situation Report on Ebola Bundibugyo Virus Disease Outbreak, Democratic Republic of the Congo | Uganda Published every Thursday: Disease Outbreak News | All Hazards Public Health Events, Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo","publishedAt":"2026-05-21T22:00:47.000Z","lastModified":"2026-05-26T16:42:14.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON603","response":"Health authorities in DRC , in collaboration with WHO and partners are implementing public health measures, including but not limited to the following: Coordination The Incident Management System has been activated to coordinate response to the outbreak, with technical support from WHO and health partners Subnational coordination structures are being activated at the provincial and health zones level to coordinate operational activities. Daily provincial coordination meetings involving all response pillars and operational partners are ongoing. Rapid response teams from MoH and WHO have been deployed to Bunia, Mongbwalu, and Rwampara HZ. Surveillance Surveillance for suspected and probable cases is ongoing (including at relevant Points of Entry and borders). Alert management and case investigations are being scaled up. Investigation teams have been deployed to Bunia and Rwampara, with alerts under investigation in Ituri, North Kivu, South Kivu, and Tshopo provinces. Contact tracing has been initiated with 541 contacts identified, although major operational challenges persist due to insecurity. Data managers have been trained on the DHIS2 tracker, and a surveillance and digital health coordination meeting is being implemented to improve harmonization across digital platforms. The International Organization for Migration (IOM) is supporting points-of-entry (PoEs) surveillance; however, informal crossings and weak alert management at PoEs remain significant gaps. Case Management WHO and partners are supporting the ongoing establishment and operationalization of isolation and treatment facilities in affected areas WHO and partners are working to maintain access to essential health and other services. Laboratory Laboratory surge capacity is being scaled-up. The Institut National de la Recherche Biom&eacute;dicale (INRB) teams are deploying to Bunia to establish and scale-up testing. A decentralization strategy is being developed to add additional field laboratories to Mongbwalu and Mahagi (Ituri &ndash; Uganda border). Goma laboratory is activated and provide testing capacities for North Kivu. PCR kits have been sourced, while WHO Regional Emergency Hub in Dakar is deploying reagents, Piccolo machines, and cold-chain modules to strengthen field laboratory operations. Genomic and epidemiological analyses are underway, and sequences have been uploaded through a joint publication (by DRC and Uganda) on virological.org. Risk Communication and Community Engagement (RCCE) Community mobilization has started in Mongbwalu, while social listening activities and deployment of UNICEF digital platforms (U-Report and I-Hear-You) are underway to improve community feedback and information sharing. WHO is supporting engagement interventions with community and religious leaders WHO shared a multi-country infodemic management report providing an initial analysis of community perceptions, including key questions, concerns, rumours, misinformation, and disinformation, to guide targeted risk communication and community engagement interventions. WHO and partners have developed a shared RCCE message repository to harmonize risk communication content Infection Prevention and Control (IPC) Coordination mechanism for IPC response is being established under the leadership of the Division of Provincial Health and the Public Health Emergency Operations Centre. Local human resources are being scaled-up to enable required key intervention. More than 150 health workers have been trained on basic IPC and Ebola-specific measures, with an ongoing cascade training plan targeting an additional 500 health workers. Operational teams are being established and briefed for decontamination, safe and dignified burials and health facility assessments. IPC supplies including PPE are being donated to priority health facilities. Operational support and Logistics Over 17 tons of emergency supplies were shipped to DRC, including personal protective equipment (PPE), Viral Haemorrhagic Fever supplies, tents, body bags, infection prevention and control materials, stretchers, medicines and other case management supplies. Deployment of EpiShuttle patient isolation transport systems, vehicles, telecommunications equipment, laboratory consumables, portable point-of-care diagnostic machines, reagents, cold-chain modules, and Ebola polymerase chain reaction (PCR) testing kits to strengthen clinical transport, laboratory diagnostics, and field response operations are ongoing. Coordination is underway to mobilize one helicopter, three ambulances, and two armored vehicles to support cargo and personnel movement. Human resource deployment structures are being finalized and United Nations Humanitarian Air Service (UNHAS) is supporting staff movement to Bunia. Global Logistics Cluster partners briefed on situation and work is under way for planning WFP/Logistics Cluster support for common partner services. Efforts are ongoing with partners to provide subsidized air cargo into the region, and into Bunia A four-week forecast of critical PPE requirements across case management, infection, prevention and control, and burial operations has been finalized to support sustained response activities. A high priority items list has been finalized to facilitate collective monitoring. Item-needs calculator being finalized for sharing. Border Health, Travel and Mass Gatherings WHO travel and border health guidance has been disseminated across countries and transport sectors, emphasizing that suspected, probable and confirmed cases and their contacts should avoid travel unless medically evacuated, and advising against travel or trade restrictions and border closures. Affected and neighbouring countries are strengthening their preparedness to detect, investigate, refer, isolate and care for any suspected cases, including activation of health emergency plans, enhanced screening at airports, seaports, land crossings and major internal transit routes. Health authorities in Uganda , in collaboration with WHO and partners, are implementing public health measures, including but not limited to the following: Coordination The Incident Management System has been activated to coordinate response to the outbreak, with technical support from WHO and health partners The National Public Health Emergency Operations Centre and regional Emergency Operations Centres (EOCs) were activated in Fort Portal, Arua, Yumbe, Kampala Capital City Authority, Kabale, and Hoima, with the national response plan and rapid risk assessment finalized. Surveillance and Laboratory Field teams are utilizing Go.Data for contact tracing, benefiting from experience in implementing the tool during previous mpox, cholera and Sudan virus disease outbreaks. Screening is being strengthened at official and informal border crossings, major transit routes, and pilgrimage corridors. Case Management Isolation facilities in high-risk districts have been activated and the Uganda National Emergency Medical Team deployed to support clinical management. Laboratory Sequencing and sample transport systems are being strengthened A mobile laboratory is being deployed to Kasese near the DRC border, with a virtual diagnostics coordination meeting supporting cross-country laboratory operations. Risk Communication and Community Engagement (RCCE) Risk communication systems have been activated with community messaging and public awareness campaigns ongoing through District Health Officer networks, with health workers receiving guidance on standard precautions and public health messaging. Infection Prevention and Control (IPC) Advising health workers to remain vigilant and adhere strictly to infection prevention measures.","epidemiology":"Bundibugyo virus disease (BVD) 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 occurs through close contact with the blood or secretions of infected wildlife, such as bats or non-human primates, and 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. 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 the deceased. The incubation period for BVD ranges from 2 to 21 days, and individuals are usually not infectious until symptom onset. Early symptoms are non-specific, including fever, fatigue, muscle pain, headache, and sore throat, which complicates clinical diagnosis and can delay detection. These 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 DRC in 2007 and 2012, have ranged from approximately 30% to 50%. Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. Control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.","formattedDate":"2026-05-22T21:06:24Z","matchedSignals":["PHEIC language","transmission concern","severity signal","response escalation"]}},{"id":"2026-DON602","title":"Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo & Uganda","disease":"Ebola disease caused by Bundibugyo virus","locations":["Democratic Republic of the Congo & Uganda"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON602","summary":"On 5 May 2026, the World Health Organization (WHO) was alerted of a high-mortality outbreak of unknown illness in Mongbwalu Health Zone, Ituri Province, Democratic Republic of the Congo (DRC), including deaths among health workers. On 14 May 2026, the Institut national de recherche biomédicale (INRB) Kinshasa analyzed 13 blood samples from Rwampara Health Zone, Ituri Province. Laboratory analysis confirmed Bundibugyo virus disease (BVD) in eight of these samples on 15 May, a species of Ebola. The case fatality rates in the past two BVD outbreaks have ranged from 30% to 50%. Unlike Ebola virus disease, there is no licensed vaccine or specific therapeutics against Bundibugyo virus, though early supportive care is lifesaving. On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare, DRC, officially declared the 17th Ebola Disease outbreak in DRC. Concurrently, the Uganda Ministry of Health confirmed an outbreak of BVD following the identification of one imported case from DRC, a Congolese man who died in the capital city of Kampala. On 17 May 2026, WHO Director-General, after having consulted the States Parties where the event is known to be currently occurring, determined that the Ebola disease caused by Bundibugyo virus in DRC and Uganda constitutes a public health emergency of international concern (PHEIC), as defined in the provisions of IHR. Response measures include deployment of rapid response teams, delivery of medical supplies, strengthened surveillance, laboratory confirmation, infection prevention and control assessments, the set-up of safe treatment centers, and community engagement. WHO is supporting the coordination of the response, case management, and cross-border preparedness. WHO advice has been issued to countries.","overview":"On 5 May 2026, WHO received an alert regarding an unknown illness with high mortality reported in Mongbwalu Health Zone, Ituri Province, including four health workers who died within four days. Following an in-depth investigation by the rapid response team in Mongbwalu and Rwampara health zones (HZ) on 13 May, the outbreak was subsequently confirmed as Bundibugyo virus disease (BVD) due to Bundibugyo virus (BDBV) ( Orthoebolavirus bundibugyoense, species) on 15 May. On 15 May 2026, the Ministry of Public Health, Hygiene and Social Welfare officially declared the 17 th Ebola Disease outbreak in the DRC, occurring in Rwampara, Mongwalu and Bunia HZ. The first currently known suspected case, a health worker, reported onset of symptoms including fever, hemorrhaging, vomiting and intense malaise on 24 April 2026. The case died at a medical centre in Bunia. As of 15 May, a total of 246 suspected cases and 80 deaths (four deaths among confirmed cases) have been reported from three HZ: Rwampara (six health areas affected), Mongbwalu (three health areas affected), and Bunia . Twenty four suspected cases are currently in isolation facilities across the three HZ. In addition, unusual clusters of community deaths with symptoms compatible with Bundibugyo virus disease (BVD) are being investigated across other HZ in Ituri and North Kivu. A further case reported on 16 May, an individual returning from Ituri to Kinshasa, has tested NEGATIVE for Bundibugyo virus on confirmatory testing by the Institut National de la Recherche Biom&eacute;dicale (INRB) of DRC, and is therefore not considered a confirmed case. Most of the suspected cases are between 20 and 39 years old, with females accounting for over 60%, suggesting significant risks associated with household and caregiver transmission. Initial testing of 20 samples collected in Rwampara HZ and analysed at the Provincial Public Health Laboratory in Bunia using standard Ebola Xpert were negative for Ebola virus. Samples were sent to INRB for further analysis, of which eight samples analysed were confirmed as Orthoebolavirus by polymerase chain reaction (PCR) on 15 May. Genomic sequencing confirmed the virus species as Bundibugyo virus (BDBV). As of 15 May, 65 contacts have been listed, with 15 identified as high-risk. However, follow-up remains weak due to insecurity and movement restrictions. Several listed contacts became symptomatic and died before they could be isolated. On 15 May 2026, the Ministry of Health of Uganda confirmed an outbreak of BVD following the identification of an imported case from the DRC. The case is an elderly man who was admitted to a private hospital on 11 May with severe symptoms and died on 14 May. The post-mortem transfer of the body to DRC was completed the same day. A clinical sample collected when the case was admitted on 11 May was tested at the Central Emergency Surveillance and Response Support Laboratory, Wandegeya, and was confirmed as Bundibugyo virus on 15 May 2026. A second imported case was confirmed on 16 May in Kampala, in an individual returning from DRC with no apparent links to the first case. At the time of reporting, no local transmission has been identified in Uganda. On 17 May 2026, the Director-General of WHO, after having consulted the States Parties where the event is known to be currently occurring as defined in the provisions of the International Health Regulations (2005) (IHR), determined that the Ebola disease caused by Bundibugyo virus in DRC and Uganda constitutes a PHEIC. It is currently thought that the event originated in the Mongbwalu HZ, DRC, a high-traffic mining area, with cases subsequently migrating to Rwampara and Bunia to seek medical care. Ituri province borders South Sudan and Uganda (and Bunia HZ is less than 500km from Uganda). A full epidemiological investigation and trace back exercise is ongoing. Ituri&rsquo;s role as a commercial and migratory hub and proximity to Uganda and South Sudan increases the risk of regional exportation and cross-border transmission. Figure 1. Health Zones affected by Bundibugyo virus disease in Democratic Republic of Congo, as of 16 May 2026","assessment":"On 17 May 2026, WHO Director-General, after having consulted the States Parties where the event is known to be currently occurring, determined that the Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern (PHEIC), as per the provisions of the IHR. Temporary recommendations for State Parties will be issued. In the meantime, WHO issued advice to countries, as stated below. This is the 17th Ebola disease outbreak in the DRC since 1976. The last Ebola disease outbreak in the country was declared on 4 September 2025 with total of 64 cases (53 confirmed, 11 probable), including 45 deaths (CFR 70.3%), reported from six health areas in Bulape Health Zone, Kasai Province. The end of outbreak was declared on 1 December 2025. The last BVD outbreak was reported on 17 August 2012 by the DRC Ministry of Health in Province Orientale. A total of 59 cases, 38 confirmed and 21 probable cases, including 34 deaths were reported. The outbreak was declared over on 26 November 2012 by the MOH. This outbreak is occurring in a complex epidemiological and humanitarian context. A critical four-week detection gap between the onset of symptoms of the presumed index case (25 April 2026) and the laboratory confirmation of the outbreak (14 May 2025) suggests a low clinical index of suspicion among healthcare providers. This is compounded by the presence of co-circulating arboviruses and influenza-like illnesses, masking the initial index of suspicion for Ebola disease and exacerbating community transmission. Furthermore, the infection and death of four healthcare workers within a four-day span at Mongbwalu General Referral Hospital underscores critical breaches in IPC protocols. A large number of community deaths has been reported potentially associated with unsafe burial practices. Ongoing conflict in Ituri province restricts the movement of surveillance teams, limits the deployment of Rapid Response Teams, and hinders the secure transport of laboratory samples. Contact tracing is challenging due to difficult access and highly mobile populations, increasing the risk of high-risk contacts being lost to follow up or never identified. Ituri&rsquo;s role as a commercial and migratory hub increases the risk of regional exportation. The proximity to Uganda and South Sudan increases the risk of cross-border transmission if PoE screening and cross border coordination and information sharing are not immediately reinforced. On 15 May 2026, the Ministry of Health of Uganda reported an imported case of BVD. Humanitarian needs in the area are dire. Ituri has 273 403 displaced people, with a total of 1.9 million people in need according to the Humanitarian Response Plan 2026 for DRC. From January to March 2026, 32 600 newly displaced and 30 200 returnees were recorded. The province recorded 5800 protection incidents and 11 incidents against humanitarian actors. Unlike Ebola virus disease, there is no licensed vaccine or specific therapeutics against BDBV. Research and development activities are activated to coordinate efforts to advance potential candidate medical countermeasures. Response and outbreak control relies entirely on a range of interventions and public health measures that will need to be thoroughly implemented, including supportive care, early detection, adequate IPC, rigorous contact tracing, safe burials, and community engagement.","advice":"For countries where the event is occurring (the Democratic Republic of the Congo and Uganda) Coordination and high-level engagement Activate their national disaster/emergency management mechanisms and establish an emergency operation centre, under the authority of the Head of State and relevant government authority, to coordinate response activities across partners and sectors to ensure efficient and effective implementation and monitoring of comprehensive Bundibugyo virus disease control measures. These measures must include enhanced surveillance including contact tracing, infection prevention and control (IPC), risk communication and community engagement, laboratory diagnostic testing, and case management. Coordination and response mechanisms should be established at national level, as well as at subnational level in affected areas and at-risk areas. Should national capacities be overwhelmed, collaboration with partners should be enhanced to strengthen operations and ensure the ability to implement control measures in all affected and neighbouring areas. Risk communication and community engagement Ensure that there is a large-scale and sustained effort to fully engage the community &ndash; through local, religious and traditional leaders and healers &ndash; so communities play a central role in case identification, contact tracing and risk education; the population should be made fully aware of the benefits of early treatment. Strengthen community awareness, engagement, and participation in particular to identify and address cultural norms and beliefs that serve as barriers to their full participation in the response, and integrate the response within the wider response required to address the needs of the population, particularly in contexts of the protracted humanitarian crisis in Eastern DRC. Surveillance and laboratory Strengthening surveillance and laboratory capacity across affected provinces and neighbouring provinces, through the establishment of (1) dedicated surveillance and response cells within affected health zones and across key at-risk neighbouring health zones; (2) enhanced community surveillance, particularly focused on community deaths; and (3) decentralized laboratory capacity for testing of Bundibugyo virus. Infection prevention and control in health facilities and in the context of care Strengthen measures to prevent nosocomial infections, including systematic mapping of health facilities, triage, targeted IPC interventions and sustained monitoring and sustained supervision. Ensure healthcare workers receive adequate training on IPC, including the proper use of PPE, and that health facilities have appropriate equipment to ensure the safety and protection of their staff, their timely payment of salaries and, as appropriate, hazard pay. Patients&rsquo; referral pathway and access to safe and optimized intensive care. Ensure that suspected cases can be safely transferred to specialized clinical units for their isolation and management in a human and patient-centred approach. Establish specialized treatment centers or units, located close to outbreak epicenter(s), with staff trained and equipped to implement optimized intensive supportive care. Research and development of medical countermeasures Implement clinical trials to advance the development and use of candidate therapeutics and vaccine, supported by partners. Border health, travels and mass-gathering events Undertake cross-border screening and screening at main internal roads to ensure that no suspected case is missed and enhance the quality of screening through improved sharing of information with surveillance teams. There should be no international travel of Bundibugyo virus disease contacts or cases, unless the travel is part of an appropriate medical evacuation. To minimize the risk of international spread of Bundibugyo virus disease: Confirmed cases should immediately be isolated and treated in a Bundibugyo virus disease Treatment Centre with no national or international travel until two Bundibugyo virus-specific diagnostic tests conducted at least 48 hours apart are negative; Contacts (which do not include properly protected health workers and laboratory staff who have had no unprotected exposure) should be monitored daily, with restricted national travel and no international travel until 21 days after exposure; Probable and suspect cases should immediately be isolated and their travel should be restricted in accordance with their classification as either a confirmed case or contact. Implement exit screening of all persons at international airports, seaports and major land crossings, for unexplained febrile illness consistent with potential Bundibugyo virus disease. The exit screening should consist of, at a minimum, a questionnaire, a temperature measurement and, if there is a fever, an assessment of the risk that the fever is caused by Bundibugyo virus disease. Any person with an illness consistent with Bundibugyo virus disease should not be allowed to travel unless the travel is part of an appropriate medical evacuation. Consider postponing mass gatherings until BVD transmission is interrupted. Safe and dignified burials Ensure funerals and burials are conducted by well-trained personnel, with provision made for the presence of the family and cultural practices, and in accordance with national health regulations, to reduce the risk of Bundibugyo virus infection. The cross-border movement of the human remains of deceased suspect, probable or confirmed Bundibugyo virus disease cases should be prohibited unless authorized in accordance with recognized international biosafety provisions. Operations, supplies and logistics Strong supply pipeline needs to be established to ensure that sufficient medical and laboratory commodities and other critical items, especially personal protective equipment (PPE), are available to those who appropriately need them. WHO advises against any restrictions on travel and/or trade to DRC or Uganda based on available information for the current outbreak. For countries with land borders adjoining countries with documented Bundibugyo virus disease Unaffected States Parties with land borders adjoining States Parties with documented Bundibugyo virus disease transmission should urgently enhance their preparedness and readiness capacity, including active surveillance across health facilities with active zero reporting, enhancement of community surveillance for clusters of unexplained deaths; establish access to a qualified diagnostic laboratory; ensure that health workers are aware of and trained in appropriate IPC procedures; and establish rapid response teams with the capacity to investigate and manage BVD cases and their contacts. Dedicated coordination mechanisms should be in place at national and subnational level in all Unaffected States Parties with land borders adjoining States Parties with documented cases of Bundibugyo virus disease. States should be prepared to detect, investigate, and manage Bundibugyo virus disease cases; this should include assured access to a qualified diagnostic laboratory for Bundibugyo virus disease, isolation and case management capacity and activation of rapid response teams. Any State Parties newly detecting a suspected or confirmed Bundibugyo virus disease case or contact, or clusters of unexplained deaths should treat this as a health emergency, take immediate steps in the first 24 hours to investigate and stop a potential outbreak by instituting case isolation, case management, establishing a definitive diagnosis, and undertaking contact tracing and monitoring as required. If Bundibugyo virus disease is confirmed to be occurring in the State Party, the full recommendations for State Parties with Bundibugyo virus disease transmission should be implemented, on either a national or subnational level, depending on the epidemiologic and risk context. State Parties should immediately report the confirmation of Bundibugyo virus disease to WHO. Risk communications and community engagement, especially at points of entry, should be increased. At-risk countries should put in place approvals for investigational therapeutics as an immediate priority for preparedness. For all other countries No country should close its borders or place any restrictions on travel and trade. Such measures are usually implemented out of fear and have no basis in science. They push the movement of people and goods to informal border crossings that are not monitored, thus increasing the chances of the spread of disease. Most critically, these restrictions can also compromise local economies and negatively affect response operations from a security and logistics perspective. National authorities should work with airlines and other transport and tourism industries to ensure that they do not exceed WHO&rsquo;s advice on international traffic. States Parties should provide travelers to Bundibugyo virus disease affected and at-risk areas with relevant information on risks, measures to minimize those risks, and advice for managing a potential exposure. The general public should be provided with accurate and relevant information on the Bundibugyo virus disease outbreak and measures to reduce the risk of exposure. State Parties should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to Bundibugyo virus disease. Entry screening at airports or other ports of entry outside the affected region are not considered needed for passengers returning from areas at risk.","publishedAt":"2026-05-16T22:00:00.000Z","lastModified":"2026-05-26T16:32:37.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON602","response":"Health authorities in DRC are implementing public health measures, including but not limited to the following: Coordination Rapid response teams have been deployed to Rwampara and Mongbwalu HZ. Provincial coordination and emergency meetings by le centre d&rsquo;operation des urgences en sante publique (COUSP) have been held. Surveillance and Laboratory Surveillance for suspected and probable cases is ongoing (including at relevant Points of Entry and borders). Operational case definitions have been elaborated in Ituri. Sequencing confirmed Bundibugyo virus in positive RT-PCR samples. Risk Communication and Community Engagement (RCCE) Social mobilization meeting was held with community leaders in the Rural commune of Mongbwalu under the leadership of the Mayor. Infection Prevention and Control (IPC) IPC assessment in key health facilities is ongoing: Bunia Hospital Centre of the Evangelical Medical Centre (CME), Mongbwalu General Referral Hospital and Abelkozo Health Centre. CME Bunia is maintaining isolation protocols. Healthcare workers have been briefed on the specific diagnostic profile of this strain. Logistics Logistical support has been provided for investigations in Mongbwalu and Rwampara Health Zones. Support has been provided for the transportation of samples to INRB Kinshasa. Health authorities in Uganda are implementing public health measures, including but not limited to the following: Activating national and district-level emergency measures, including enhanced surveillance, screening at borders, deployment of rapid response teams, isolation of a high-risk contact, and quarantine of all identified contacts. Strengthening of preparedness activities such as mobile laboratory deployment, infection prevention, and risk communication. Rapid response readiness teams have been deployed at all official and informal points of entry along the western border, major transit routes, and pilgrimage corridors. Advising health workers to remain vigilant and adhere strictly to infection prevention measures. WHO is supporting the national authorities, including through: Deployment of technical expertise and rapid response teams to support response efforts. Deployment of IPC, clinical management and sample collection kits. Identification of isolation facilities for case management in Bunia, Rwampara, and Mongbwalu HZ . Dissemination of WHO case management protocol. In-depth investigations and listing of contacts of suspected/probable cases. Strengthening epidemiological surveillance, IPC and RCCE at all points of entry. Strengthening Point of Entry (PoE) screening and cross border coordination, including mass gatherings. Supporting the Ministry of Health in implementation of the Response Plan and WHO internal Response Plan. Following up with the IHR National Focal Points (IHR NFP) in DRC and Uganda on the official IHR notification while concurrently managing communication across the IHR NFP network to ensure timely coordination. Coordinating the delivery of key supplies. Engaging experts on research and development priorities.","epidemiology":"Bundibugyo virus disease (BVD) 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 occurs through close contact with the blood or secretions of infected wildlife, such as bats or non-human primates, and subsequently spreads from person to person through direct contact with the blood, secretions, organs, or other bodily fluids of infected individuals or contaminated surfaces. 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 the deceased. The incubation period for BVD ranges from 2 to 21 days, and individuals are usually not infectious until symptom onset. Early symptoms are non-specific, including fever, fatigue, muscle pain, headache, and sore throat, which complicates clinical diagnosis and can delay detection. These 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 DRC in 2007 and 2012, have ranged from approximately 30% to 50%. Differentiating BVD from other endemic febrile illnesses such as malaria is challenging without laboratory confirmation using PCR or antigen/antibody-based assays. Control relies on rapid case identification, isolation and care, contact tracing, safe burials, and strong community engagement, as no approved vaccines or specific treatments currently exist for BVD.","formattedDate":"2026-05-17T09:35:15Z","matchedSignals":["PHEIC language","transmission concern","novel or unusual signal","severity signal","response escalation","cross-border signal"]}},{"id":"2026-DON601","title":"Hantavirus cluster linked to cruise ship travel, Multi-country","disease":"Hantavirus cluster linked to cruise ship travel","locations":["Multi-country"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON601","summary":"This is the third Disease Outbreak News report on the hantavirus cluster, following the notification to the World Health Organization (WHO) on 2 May 2026 of severe respiratory illness cases aboard MV Hondius, a cruise ship. Since the last DON was published on 8 May, two additional confirmed cases were reported from France and Spain. In addition, there is one inconclusive result for a case in the United States of America. All were passengers on the ship. As of 13 May, a total of 11 cases, including three deaths, have been reported (case fatality ratio 27%). Eight cases were laboratory-confirmed for Andes virus (ANDV) infection, two are probable, and one case remains inconclusive and undergoing further testing. Through the International Health Regulations (2005) (IHR) channels, National IHR Focal Points (NFPs) have all been informed and are supporting international contact tracing efforts. WHO has assessed the risk posed by this event to the global population as low and will continue to monitor the epidemiological situation and update the risk assessment as needed.","overview":"On 2 May 2026, WHO received notification from the IHR NFP of the United Kingdom of Great Britain and Northern Ireland (hereafter referred to as the United Kingdom) regarding a cluster of severe acute respiratory illness, including two deaths and one critically ill passenger, aboard the Dutch-flagged cruise ship MV Hondius. As of 13 May, a total of 11 cases (eight confirmed, one inconclusive and two probable cases), including three deaths (two confirmed and one probable), have been reported. Since the last Disease Outbreak News was published on 8 May, two additional confirmed cases and one inconclusive case have been reported among passengers. These are one confirmed case from France, who became symptomatic during repatriation, one confirmed case from Spain, tested upon arrival following repatriation but currently well and asymptomatic, and one case considered inconclusive. The latter was repatriated to the United States of America, is currently asymptomatic with inconclusive laboratory results (one positive and one negative result from two different laboratories), and is being retested. The individual was sampled due to high-risk exposure to confirmed cases on board. All laboratory-confirmed cases are confirmed for ANDV infection. All were passengers onboard the MV Hondius. Figure 1. Epidemiological curve of Andes hantavirus cases (n = 11) reported to WHO as of 13 May 2026, 17:00. Based on currently available information, the working hypothesis is that the first case acquired the infection prior to boarding the cruise, through exposure on land. Investigations are ongoing to elucidate the potential circumstances of exposure and the source of the outbreak, in collaboration with authorities in Argentina and Chile. Current evidence suggests subsequent human-to-human transmission onboard the ship. This is also supported by a preliminary analysis of the sequences, which show a close, near-identical sequenced from different cases. [1] The outbreak is being managed through a coordinated international response, including in-depth epidemiological investigations, case isolation and clinical management, medical evacuations, laboratory testing and international contact tracing, quarantining and monitoring. Recommendations may be updated as additional epidemiological and laboratory evidence, including genetic sequencing data, becomes available. Follow-up and contact tracing for all contacts of hantavirus cases linked to the cruise ship is ongoing. This includes passengers who disembarked in Saint Helena, United Kingdom, on 24 April; Praia, Cabo Verde, on 6 May; and Tenerife, Spain, on 10 and 11 May. Passengers who travelled on flights who may have had exposure to subsequently confirmed cases have been identified and contacted. Contacts are being monitored by local health authorities in their respective countries. On 10 May, the ship arrived in the Canary Islands, Spain, where disembarkation began. Passengers and most of the crew were repatriated from the Canary Islands to their respective residence countries or transit points via specially arranged non-commercial flights, with WHO and partners supporting the disembarkation process. The ship left the Canary Islands on 11 May and is sailing to the Netherlands, with 25 crew members remaining on board, along with two Dutch health and care workers to conduct their health monitoring and provide any healthcare that may be necessary.","assessment":"WHO currently assesses the public health risk for those who were onboard the cruise ship as moderate, and at the Global level as low for the following reasons: Andes virus has demonstrated limited human-to-human transmission in previous outbreaks, typically occurring among close contacts and within household settings, generally requiring prolonged close exposure. Transmission can be contained through early detection, isolation of cases, clinical management, and contact management. However, the ship environment presented an increased risk due to close living quarters, shared indoor spaces, prolonged exposure, and frequent interpersonal interactions, all of which likely facilitated transmission. The HCPS with hantaviruses in the Americas, including Andes can have a high case fatality ratio, reaching 40-50%, particularly among elderly individuals and those with co-morbidities. The average age of passengers on board the ship was 65 years old. Investigations on the travel history and potential exposures of the first case in the Southern Cone subregion of the Americas are ongoing and suggest possible exposure to rodents during bird watching activities. Viral sequencing analyses are also ongoing and will compare the ANDV strain associated with this outbreak with strains circulating in Argentina and Chile, where the disease is enzootic. The preliminary sequencing analysis for the cases indicates a high degree of genetic similarity&mdash;showing no more than one single nucleotide polymorphisms (SNP) difference per individual&mdash;strongly indicates that the outbreak likely arose from a single zoonotic spillover event, or from a very small number of closely related spillover events. [1] Additional cases may occur among individuals exposed before implementation of containment measures. However, the current response, including quarantine for those who have left the ship and rapid isolation of any new suspect cases and the monitoring of contacts, is expected to limit the risk of further spread. As there is no specific antiviral treatment for HPS, suspected cases require prompt transfer to an adequately equipped emergency department or intensive care unit, where available, for close monitoring and supportive management to improve chances of recovery. Consequently, for remote areas, rapid transfer to a mainland healthcare facility is required, which may be challenging under the current conditions. For the general public, including people not exposed on board the ship or through close contact with a confirmed case, the overall probability of infection remains low. Current evidence indicates that transmission occurs through close and prolonged contact, and can be effectively limited through early detection, isolation of cases, and contact tracing. More detailed epidemiological, clinical and laboratory investigations are required to inform further iterations of this risk assessment.","advice":"WHO advises that States Parties involved in this event continue public health coordination and management efforts related to the ship and relevant flights, and in countries where cases and/or contacts are present or will be returning to. Based on information available and ongoing epidemiological, clinical and environmental investigations, and applying the precautionary principle, this includes contact tracing and monitoring, detection, investigation, reporting of suspected cases, laboratory testing of suspected cases, case management, infection prevention and control measures, and clear and transparent communication to affected individuals and the general public. Outside the context of the ship, high-risk contacts may include intimate partners, household members and persons with prolonged close indoor exposure, healthcare workers with unprotected exposure, and individuals handling contaminated materials or body fluids without appropriate personal protective equipment, outlined in the interim guidance published on 8 May. Given that infectiousness peaks in the early phase of illness, and that pre-symptomatic transmission cannot be entirely ruled out, as a precautionary principle , WHO recommends active monitoring and home or facility quarantine of high-risk contacts for 42 days following last exposure. Current evidence does not support routine laboratory testing of contacts for outbreak control nor the quarantine of low-risk contacts; low-risk contacts should undertake passive self-monitoring and seek medical evaluation if symptoms occur. Recommendations are dynamic and will be adapted as more evidence emerges. Contact investigations should use available information sources, including interviews, passenger manifests, seating arrangements and activity logs, to improve completeness of contact identification. Early recognition of suspected cases, prompt isolation, and consistent adherence to recommended infection prevention and control measures remain essential to protect healthcare personnel, other passengers and crew members. In healthcare settings: Apply standard precautions* at all times for all patients, including hand hygiene, environmental cleaning, and waste management. Isolate any suspected or confirmed case in a single, well‑ventilated room with doors closed. Implement transmission‑based precautions in addition to standard precautions for suspected or confirmed cases. Ensure health and care workers wear appropriate personal protective equipment (respirators, eye protection, gowns, and gloves). Perform hand hygiene before and after the use of personal protective equipment. Manage waste generated from suspected or confirmed cases as infectious waste. Apply airborne precautions during aerosol‑generating procedures. When HPS is suspected, patients should be promptly transferred to an emergency department or intensive care unit for close monitoring and supportive management. Initial management should include supportive care with antipyretics and analgesics as needed. For confirmed hantavirus, antibiotics are not routinely indicated. However, before a definitive diagnosis is established (and bacterial infection is a diagnostic possibility), or if secondary bacterial infection is suspected, empiric broad-spectrum antibiotics may be appropriate. Clinical management relies primarily on careful fluid administration, hemodynamic monitoring, and respiratory support. Given the rapid progression of HPS, close monitoring and early transfer to ICU are critical for more severe cases. Mechanical ventilation, judicious fluid management, and vasopressors may be required. For severe cardiopulmonary insufficiency, extracorporeal membrane oxygenation may be lifesaving. [5] In severe cases of renal dysfunction, dialysis may be required. Although ribavirin has shown efficacy against hantavirus haemorrhagic fever with renal syndrome, it has not demonstrated effectiveness for HPS and is not licensed for either treatment or prophylaxis of hantavirus pulmonary syndrome. At present, there is no specific antiviral treatment approved for HPS; a number of existing drugs have antiviral activity in laboratory studies but not yet demonstrated in human disease. Public health awareness efforts should focus on improving early detection, ensuring timely treatment, and reducing exposure risks. Preventive measures should address occupational and ecotourism-related exposures, emphasize infection prevention and control measures, and include rodent control strategies. Most routine tourism activities carry little or no risk of exposure to rodents or their excreta. Risk communication and community engagement (RCCE) interventions should prioritize transparent, timely, and culturally appropriate communication to raise awareness of hantavirus transmission risks. RCCE strategies should support coordinated, timely and aligned evidence-based information to ensure concerned people receive clear, consistent and actionable information, including explanations of the public health measures being implemented. RCCE activities should explicitly address public concerns regarding transmissibility, severity, and international travel, and clarify what actions are and are not necessary for different population groups. Operational measures should integrate RCCE activities throughout all phases of the event. The implementation of integrated environmental management strategies aimed at reducing rodent populations is also recommended. At this time, WHO does not recommend any changes to routine activities for the general public. People who were on board the affected ship, or who have had close contact with a confirmed case, should follow the specific monitoring and public health advice outlined above. Guidance may be updated as further evidence becomes available. Based on the current information available on this event, WHO advises against the application of any travel or trade restrictions beyond the restriction of movement of identified high-risk contacts. *Standard precautions refer to a set of practices that are applied to the care of patients, regardless of the state of infection (suspicion or confirmation), in any place where health services are provided. These practices aim to protect both healthcare professionals and patients and include hand hygiene, use of personal protective equipment, respiratory hygiene and cough etiquette, safe handling of sharps materials, safe injection practices, use of sterile instruments and equipment and cleaning of hospital environments and the environment. Adapted from &ldquo;Standard precautions for the prevention and control of infections: aide-memoire&rdquo;- WHO, 2022. Available at https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.1","publishedAt":"2026-05-13T18:00:00.000Z","lastModified":"2026-05-13T19:30:55.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON601","response":"Authorities from States Parties managing cases and/or contacts, WHO, and partners have initiated coordinated response measures, including: Ongoing engagement between WHO and the NFPs of countries managing cases and/or contacts to ensure timely information sharing and coordination of response actions. International contact tracing is ongoing. WHO is requesting regular information sharing and periodic updates from States Parties through IHR channels regarding contact monitoring and the health status of high-risk contacts Crew members still onboard, to take the MV Hondius to the Netherlands, have been advised to practice physical distancing and remain in their cabins where possible, while on the cruise ship. Experts from WHO and the European Centre for Disease Prevention and Control (ECDC) were deployed on board the ship to support epidemiological investigation and provide public health advice before disembarkation in the Canary Islands, Spain. Two Dutch medical doctors boarded the ship in Cabo Verde to conduct health monitoring and provide any health care that may be necessary. One disembarked in Tenerife, while a Dutch nurse boarded, to assist in monitoring and providing any healthcare to the remaining crew members on board. WHO Director-General Dr Tedros Adhanom Ghebreyesus travelled to the Canary Islands on 9 May, along with other experts from WHO, to meet with the national authorities, including ministers, and support the coordination of the operations. He met with the Prime Minister of Spain on 12 May. [4] Epidemiological investigations continue to better define epidemiological links between cases and exposure factors on the ship, as well as to try to understand the potential source of exposure WHO has developed and published specific technical guidance documents to support response to the event, including: Technical guidance on the management of hantavirus on board the ship; Technical note for the disembarkation and onward management of passengers and crew in the context of an Andes-virus-associated cluster; Management of contacts of Andes Virus (ANDV) cases from the MV Hondius cruise ship NFPs of affected countries have been in contact about passenger and crew information through established IHR channels for those on the ship, as well as on planes where a known case was on board. The NFP of Argentina aided in the reconstruction of the travel itinerary of the first two cases in the Southern Cone subregion of the Americas and assess any potential exposure to hantavirus. They also shared the National Hantavirus Epidemiological Circular: Update epidemiological Surveillance and Management Standards on Hantavirus. WHO supported collaboration across relevant laboratories with prior experience to ensure timely testing, with further analyses ongoing, including serology, molecular diagnostics, sequencing, and metagenomics. Risk communication coordination and support are being provided to ensure sharing of regular, timely and evidence-based information. WHO has activated three-level coordination and is supporting national authorities in implementing risk-based, evidence-informed public health measures in accordance with the provisions of the IHR and related WHO technical guidance documents. WHO regularly convenes expert calls across laboratory, clinical management, epidemiology, and Infection prevention and control (IPC) domains to facilitate timely experience sharing and coordinated expert support. WHO supported the streamlining and development of research protocols on the natural clinical history in collaboration with national partner institutions and planned a hantavirus scientific consultation on medical countermeasures.","epidemiology":"Hantavirus cardiopulmonary syndrome (HCPS), also known as hantavirus pulmonary syndrome (HPS), is a zoonotic, viral respiratory disease caused by hantaviruses of the genus Orthohantavirus , family Hantaviridae , order Bunyavirales . More than 20 viral species have been identified within this genus. Hantaviruses are associated with two major distinct clinical syndromes in humans: HPS predominantly reported in the Americas, and hemorrhagic fever with renal syndrome (HFRS), mainly reported in Europe and Asia. However, human-to-human transmission has only been reported for HPS associated with Andes virus infection. Andes virus is endemic in South America, with confirmed circulation and human cases reported primarily in Argentina and Chile, and additional cases and related strains identified in Uruguay, southern Brazil, and Paraguay. Human Hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of infected rodents or by touching contaminated surfaces. Exposure typically occurs during activities such as cleaning buildings with rodent infestations, though it may also occur during routine activities in heavily infested areas. Human cases are most commonly reported in rural settings, such as forests, fields, and farms, where rodents are present, and opportunities for exposure are greater. HPS is characterized by headache, dizziness, chills, fever, myalgia, and gastrointestinal symptoms, such as nausea, vomiting, diarrhoea, and abdominal pain, followed by sudden onset of respiratory distress and hypotension. Symptoms of HPS typically occur from 1-6 weeks after initial exposure to the virus. However, symptoms may appear as early as one week and as late as eight weeks following exposure. Hantavirus infections are relatively uncommon globally. In 2025, in the Region of the Americas, eight countries reported HPS, 229 cases and 59 deaths with a CFR of 25.7%. [2] HPS is not reported in other parts of the world. In the European Region, 1885 hantavirus infections causing HFRS were reported in 2023 (0.4 per 100 000), marking the lowest rate observed between 2019 and 2023. [3] In East Asia, particularly China and the Republic of Korea, HFRS continues to record thousands of cases annually, although incidence has declined in recent decades. The overall CFR for HPS can be as high as 50%. While there are no licensed treatment nor vaccines for hantavirus infections, early supportive care and immediate referral to a facility with a complete ICU can improve survival. Environmental and ecological factors affecting rodent populations can influence disease trends seasonally. Since hantavirus reservoirs are sylvatic rodents, transmission can occur when people come into contact with rodent habitats. Although uncommon, limited human‑to‑human transmission of HPS due to Andes virus has been reported in community settings involving close and prolonged contact. Secondary infections among healthcare workers have been previously documented in healthcare facilities, though remain rare. Secondary transmission appears most likely during the early phase of illness, when the virus is more transmissible. Currently, little evidence is available due to the scarcity of hantavirus outbreak related to human-to-human transmission.","formattedDate":"2026-05-13T19:30:36Z","matchedSignals":["cross-border signal","transmission concern","severity signal","response escalation"]}},{"id":"2026-DON600","title":"Hantavirus cluster linked to cruise ship travel, Multi-country","disease":"Hantavirus cluster linked to cruise ship travel","locations":["Multi-country"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON600","summary":"On 2 May 2026, a cluster of passengers with severe respiratory illness aboard a cruise ship was reported to the World Health Organization (WHO). At that time, according to the ship operator, 147 passengers and crew were onboard, and 34 passengers and crew had previously disembarked. Since the last Disease Outbreak News published on 4 May, three of the suspected cases were confirmed, and one additional confirmed case was reported. As of 8 May, a total of eight cases, including three deaths (case fatality ratio 38%), have been reported. Six cases have been laboratory-confirmed as hantavirus infections, with all identified as Andes virus (ANDV). Through the International Health Regulations (2005) (IHR) channel, National IHR Focal Points (NFPs) have all been informed and are supporting international contact tracing. WHO assesses the risk to the global population posed by this event as low and will continue to monitor the epidemiological situation and update the risk assessment. The risk for passengers and crew on the ship is considered moderate.","overview":"On 2 May 2026, WHO received notification from the National IHR Focal Point of the United Kingdom of Great Britain and Northern Ireland (hereafter referred to as the United Kingdom) regarding a cluster of severe acute respiratory illness, including two deaths and one critically ill passenger, aboard a Dutch-flagged cruise ship. Since the last Disease Outbreak News was published on 4 May, three of the suspected cases were confirmed, and one additional confirmed case was reported. As of 8 May, a total of eight cases (six confirmed and two probable cases), including three deaths (two confirmed and one probable), case fatality ratio 38%, have been reported. All six laboratory-confirmed cases were identified as Andes virus through virus specific polymerase chain reaction (PCR) or sequencing. Two medical evacuation flights, from Cabo Verde, carrying two symptomatic confirmed patients and one previously suspected case landed in the Netherlands on 6 and 7 May. As of 8 May, four patients are currently hospitalised, one in intensive care in Johannesburg, South Africa, two in different hospitals in the Netherlands and the other in Zurich, Switzerland. The previously suspected case was transferred directly to Germany, where she was tested, and both PCR and serology tests were negative for Andes virus, she is therefore no longer considered to be a case. Contact tracing of passengers who disembarked in St Helena is ongoing; passengers have been contacted and advised to self-monitor for symptoms. Additionally, passengers who travelled on the same flight from St Helena to South Africa with one of the cases who was subsequently confirmed, have been contacted. On 6 May, the ship left Cabo Verde, heading to the Canary Islands, Spain where disembarkation is planned. Further investigations into the potential exposure of the first case and the source of the outbreak are ongoing in collaboration with authorities in Argentina and Chile. The outbreak is being managed through a coordinated international response, including in-depth epidemiological investigations, case isolation and clinical management, medical evacuations, laboratory testing and international contact tracing and monitoring. Summary of confirmed and probable cases: Case 1: An adult male who boarded the ship on 1 April, after more than three months of travel in Argentina, Chile, and Uruguay. Developed symptoms on 6 April and died onboard on 11 April. No microbiological tests were performed. He is considered a probable case. Case 2: An adult female, who was a close contact of case 1, who travelled and boarded the ship with him, went ashore at Saint Helena on 24 April with gastrointestinal symptoms. She subsequently deteriorated on a flight to Johannesburg, South Africa, on 25 April. She died on 26 April in a Johannesburg clinic. On 4 May, she was subsequently confirmed by PCR testing with hantavirus infection. Case 3: An adult male who developed symptoms on 24 April. He was disembarked and medically evacuated from Ascension Island on 27 April and is currently hospitalised in an Intensive Care Unit (ICU) in Johannesburg, South Africa. PCR testing confirmed hantavirus infection on 2 May, and Andes virus was confirmed through sequencing. Case 4: An adult female, with onset of symptoms (fever and general malaise) on 28 April, later presenting with pneumonia, died on 2 May. A post-mortem sample was collected and sent to the Netherlands with the evacuated patients, where it was confirmed to be Andes virus. Case 5: An adult male, working as the ship doctor, reported onset of symptoms on 30 April, including fever, fatigue, muscle pain, and mild respiratory symptoms. His samples confirmed PCR positivity for Andes virus on 6 May. The case was medically evacuated to the Netherlands on 6 May and is currently stable in isolation. Case 6: An adult male, working as a ship guide. Onset of symptoms was reported on 27 April with mild respiratory and gastrointestinal symptoms. Laboratory samples confirmed PCR positivity for Andes virus on 6 May. The case was medically evacuated to the Netherlands on 7 May and is currently stable in isolation. Case 7: An adult male, who disembarked in St Helena on 22 April and flew back to Switzerland on 27-28 April, through South Africa and Qatar. He started experiencing symptoms on 1 May after arrival in Switzerland, where he immediately self-isolated and reported to local public health authorities. He is currently hospitalised and in isolation in Switzerland. His samples confirmed PCR positivity for Andes virus on 5 May. [1] Case 8: An adult male, who disembarked in Tristan da Cunha on 14 April. Onset of symptoms was reported on 28 April with diarrhoea and two days later with fever. He is currently stable and in isolation. He is currently a probable case until laboratory confirmation. One case previously reported as suspected has now been reclassified as a non-case after testing negative for Andes virus through PCR and serology. Nevetheless, monitoring continues until the end of their incubation period from last exposure. Table 1. Distribution of reported Andes hantavirus cases by case status and outcome, as of 8 May 2026 Operational outbreak case definitions Suspected case : anyone who shared or visited a conveyance where there has been a confirmed or probable ANDV case AND with acute (or history of) symptoms compatible with ANDV infection, including fever (38&deg;C or above), myalgia, chills, acute gastrointestinal (e.g. nausea, vomiting, diarrhoea, abdominal pain) or acute respiratory (e.g. cough, shortness of breath, chest pain, difficulty breathing) symptoms. Probable case : a person with signs and symptoms of a suspected case that has been evaluated by a health professional AND a known epidemiological link with a confirmed or probable ANDV case AND for which laboratory tests have not been conducted. Confirmed case : a person with laboratory confirmation of ANDV through RT-PCR or serology testing. Non-case*: a suspected or probable case who tests negative for ANDV by RT-PCR or serology. *Non-cases who develop symptoms compatible with the suspected case definition after a negative test and within the maximum incubation period after last exposure to a probable or confirmed case should be retested and reclassified as appropriate. Figure 1. Epidemiological curve of Andes hantavirus cases reported to WHO as of 8 May 2026, 17:00. Based on currently available information, the working hypothesis is that case 1 most probably acquired the infection prior to boarding through environmental exposure during activities he conducted in Argentina. Investigations are ongoing to assess the full itinerary of his activities and possible exposure factors. Current evidence points to subsequent human-to-human transmission onboard (Figure 1), given documented epidemiological links of some of the subsequent cases with case 1 during his illness, and the timing of their symptom onset, which clusters around the most likely incubation periods previously documented for ANDV. However, ongoing epidemiological and sequencing investigations will help better understand the epidemiological links between cases and their most likely exposure.","assessment":"WHO currently assesses the public health risk related to the cruise ship as moderate, and at the Global level as low for the following reasons: The disease can have a high case fatality ratio, reaching 40-50%, particularly among elderly individuals and those with co-morbidities. The average age of passengers on board the ship is 65 years old. Andes virus has demonstrated limited human-to-human transmission in previous outbreaks, typically occurring among close contacts and within household settings, generally requiring prolonged close exposure. Transmission can usually be contained through early detection, isolation of cases, clinical management, and contact tracing. However, the ship environment presents an increased risk due to close living quarters, shared indoor spaces, prolonged exposure, and frequent interpersonal interactions, all of which may facilitate transmission. Investigations on the travel history and potential exposures of the first case in the Southern Cone subregion of the Americas are ongoing and suggest possible exposure to rodents during bird watching activities. Viral sequencing analyses are also ongoing and will compare the ANDV strain associated with this outbreak with strains circulating in Argentina, Chile and Uruguay, where the disease is enzootic. Additional cases may occur among individuals exposed before implementation of containment measures. However, the current response, including rapid isolation of any new suspect cases and the monitoring of contacts, is expected to limit the risk of further spread. As there is no specific antiviral treatment for HPS, suspected cases require prompt transfer to an adequately equipped emergency department or intensive care unit, where available, for close monitoring and supportive management to improve chances of recovery. Consequently, rapid transfer to a mainland healthcare facility is required, which may be challenging under the current conditions. More detailed epidemiological, clinical and laboratory investigations are required to inform further iterations of this risk assessment.","advice":"WHO advises that States Parties involved in this event continue public health coordination and management efforts on board conveyances and in countries where cases and/or contacts are present or will be returning to. This includes contact tracing and monitoring detection, investigation, reporting of suspected cases, laboratory testing of suspected cases, case management, infection prevention and control measures, and clear and transparent communication to affected individuals and the general public. In the context of the current outbreak, people on board the affected ship and flights should practice frequent hand hygiene, monitor any early symptoms, including headache, dizziness, chills, fever, myalgia, and gastrointestinal problems, such as nausea, vomiting, diarrhoea, and abdominal pain, for 42 days after last potential exposure. Should any early symptoms or sudden onset of respiratory distress occur, people should immediately inform health authorities and self-isolate until medical evaluation is conducted. If respiratory symptoms are present, people should practice respiratory etiquette and wear a respirator. A precautionary approach should be applied to contact identification, classification, tracing and follow-up, particularly for persons exposed on board of the ship or during travel. Contacts should be classified according to exposure risk, considering the intensity and duration of exposure, proximity to the case, exposure to enclosed or shared spaces, and use of personal protective equipment. High-risk contacts may include cabin mates, intimate partners, persons with prolonged close indoor exposure, healthcare workers with unprotected exposure, and individuals handling contaminated materials or body fluids without appropriate personal protective equipment. Given the documented transmission of ADNV in past outbreaks stemmed from close, prolonged contact, that infectiousness peaks in the early phase of illness, and that pre-symptomatic transmission cannot be entirely ruled out, as a precautionary principle , WHO recommends for active monitoring and home or facility quarantine of high-risk contacts for 42 days following last exposure. Current evidence does not support routine laboratory testing of contacts for outbreak control (or public health response) or the quarantine of low-risk contacts; low-risk contacts should undertake passive self-monitoring and seek medical evaluation if symptoms occur. Recommendations are dynamic and will be adapted as more evidence emerges. Contact investigations should use available information sources, including interviews, passenger manifests, seating arrangements and activity logs, to improve completeness of contact identification. Early recognition of suspected cases, prompt isolation, and consistent adherence to recommended infection prevention and control measures remain essential to protect healthcare personnel, other passengers and crew members. In healthcare environments, standard precautions* should be applied for all patients, including hand hygiene, environmental cleaning and waste management. In addition to standard precautions, transmission-based precautions should be implemented for management of suspect or confirmed cases. For aerosol-generating procedures, airborne precautions should be used. [5] When HPS is suspected, patients should be promptly transferred to an emergency department or intensive care unit for close monitoring and supportive management. Initial management should include supportive care with antipyretics and analgesics as needed. For confirmed hantavirus, antibiotics are not routinely indicated. However, before a definitive diagnosis is established (and bacterial infection is a diagnostic possibility), or if superadded bacterial infection is suspected, empiric broad-spectrum antibiotics may be appropriate. Clinical management relies primarily on careful fluid administration, hemodynamic monitoring, and respiratory support. Given the rapid progression of HCPS, close monitoring and early transfer to ICU are critical for more severe cases. Mechanical ventilation, meticulous volume control, and vasopressors may be required. For severe cardiopulmonary insufficiency, extracorporeal mechanical oxygenation may be lifesaving. In severe cases of renal dysfunction, dialysis may be required. Although ribavirin has shown efficacy against hantavirus haemorrhagic fever with renal syndrome, it has not demonstrated effectiveness for HCPS and is not licensed for either treatment or prophylaxis of hantavirus pulmonary syndrome. At present, there is no specific antiviral treatment approved for HCPS; a number of existing drugs have antiviral activity in laboratory studies but not yet demonstrated in human disease. Public health awareness efforts should focus on improving early detection, ensuring timely treatment, and reducing exposure risks. Preventive measures should address occupational and ecotourism-related exposures, emphasize infection prevention and control measures, and include rodent control strategies. Most routine tourism activities carry little or no risk of exposure to rodents or their excreta. Risk communication and community engagement (RCCE) interventions should prioritize transparent, timely, and culturally appropriate communications to raise awareness of hantavirus transmission risks&mdash;particularly. RCCE strategies should support coordinated, timely and aligned evidence based information to ensure concerned people receive clear, consistent and actionable information and explanations of the public health measures. Operational measures should integrate RCCE activities through the whole event. The implementation of integrated environmental management strategies aimed at reducing rodent populations is also recommended. *Standard precautions refer to a set of practices that are applied to the care of patients, regardless of the state of infection (suspicion or confirmation), in any place where health services are provided. These practices aim to protect both healthcare professionals and patients and include hand hygiene, use of personal protective equipment, respiratory hygiene and cough etiquette, safe handling of sharps materials, safe injection practices, use of sterile instruments and equipment and cleaning of hospital environments and the environment. Adapted from &ldquo;Standard precautions for the prevention and control of infections: aide-memoire&rdquo;- WHO, 2022. Available at https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.1 WHO advises against the application of any travel or trade restrictions based on the current information available on this event.","publishedAt":"2026-05-08T18:00:00.000Z","lastModified":"2026-05-10T10:26:21.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON600","response":"Authorities from States Parties involved in the management of the event to date &ndash; Argentina, Cabo Verde, Chile, Germany, the Netherlands, South Africa, Spain, Switzerland, and the United Kingdom &ndash; WHO, and partners have initiated coordinated response measures including: Ongoing engagement between WHO and the National IHR Focal Points of Argentina, Cabo Verde, Chile, Germany, the Netherlands, South Africa, Spain, Switzerland and the United Kingdom, to ensure timely information sharing and coordination of response actions. International contact tracing involving partners is ongoing. Passengers onboard have been advised to practice physical distancing and remain in their cabins where possible, while on the cruise ship. One expert from WHO and one from the European Centre for Disease Prevention and Control (ECDC) are on board the ship for the provision of public health advice to passengers during the journey. Epidemiological investigations are underway to determine the source of exposure. WHO shared information about the event, technical guidance on the management of hantavirus on board the ship, a technical note for the disembarkation and onward management of passengers and crew, information on the management of contacts of Andes virus cases, its rapid risk assessment of the associated public health risk, case investigation forms and details on primers and probes for Andes virus detection with National IHR Focal Points globally through its secure Event Information Site for IHR NFPs to support States Parties in responding to the event. The National IHR Focal Points of countries with cases have shared passenger and crew lists with the National IHR Focal Points of the respective countries, according to each person&rsquo;s nationality. IHR NFP international contact tracing efforts are ongoing for conveyances. The National IHR Focal Point of Argentina requested information, which has been provided, on the first two cases to reconstruct their travel itinerary in the Southern Cone subregion of the Americas and assess any potential exposure to hantavirus. They also shared the National Hantavirus Epidemiological Circular: Update epidemiological Surveillance and Management Standards on Hantavirus. In line with the Working Arrangement between the WHO Emergency Medical Team (EMT) Secretariat and the EU Emergency Response Coordination Centre (ERCC), the EMT Secretariat has launched formal discussions to support the clinical management and medical evacuation of symptomatic passengers. EU Health Task Force (EUHTF) has also been activated for support. Logistic support has been provided, including sample collection items. WHO supported the shipment of samples to the Institut Pasteur de Dakar, Senegal. Laboratory testing and confirmation of hantavirus infection have been conducted at the National Institute for Communicable Diseases (NICD) of South Africa. Identification of Andes virus was performed through genomic sequencing at NICD and virus-specific PCR at Geneva University Hospitals, Switzerland. WHO supported collaboration across laboratories to ensure further timely testing, involving laboratories in Senegal, the United Kingdom, the Netherlands and Argentina. Further testing is currently on-going including serology, sequencing and metagenomics. WHO has developed guidance documents in support of countries affected by the event, including covering management of the event on the ship, investigation of cases, disembarkation and management of returning passengers and crew members. Risk communication coordination and support are being provided to ensure sharing of regular, timely and evidence-based information. WHO has activated three-level coordination and is supporting national authorities in implementing risk-based, evidence-informed public health measures in accordance with the provisions of the IHR and related WHO technical guidance documents.","epidemiology":"Hantavirus cardiopulmonary syndrome (HCPS), also known as hantavirus pulmonary syndrome (HPS), is a zoonotic, viral respiratory disease caused by hantaviruses of the genus Orthohantavirus , family Hantaviridae , order Bunyavirales . More than 20 viral species have been identified within this genus. In the Americas, Sin Nombre virus is the predominant cause of HPS in North America, while Orthohantavirus andesense is responsible for most cases in South America. Hantaviruses found in Europe and Asia are known to cause haemorrhagic fever with renal syndrome (HFRS), which primarily affects the kidneys and blood vessels. Human-to-human transmission has not been documented in this part of the world. Human Hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of infected rodents or by touching contaminated surfaces. Exposure typically occurs during activities such as cleaning buildings with rodent infestations, though it may also occur during routine activities in heavily infested areas. Human cases are most commonly reported in rural settings, such as forests, fields, and farms, where rodents are present, and opportunities for exposure are greater. HPS is characterized by headache, dizziness, chills, fever, myalgia, and gastrointestinal symptoms, such as nausea, vomiting, diarrhoea, and abdominal pain, followed by sudden onset of respiratory distress and hypotension. Symptoms of HPS typically occur from 1-6 weeks after initial exposure to the virus. However, symptoms may appear as early as one week and as late as eight weeks following exposure. Hantavirus infections are relatively uncommon globally. In 2025, in the Region of the Americas, eight countries reported 229 cases and 59 deaths with a CFR of 25.7%. [2] In the European Region, 1885 hantavirus infections were reported in 2023 (0.4 per 100 000), marking the lowest rate observed between 2019 and 2023. [3] In East Asia, particularly China and the Republic of Korea, hantavirus haemorrhagic fever with renal syndrome (HFRS) continues to account for many thousands of cases annually, although incidence has declined in recent decades. Hantavirus infections are associated with a case fatality rate of <1&ndash;15% in Asia and Europe and up to 50% in the Americas. While there are no licensed treatment nor vaccines for hantavirus infections, early supportive care and immediate referral to a facility with a complete ICU can improve survival. Environmental and ecological factors affecting rodent populations can influence disease trends seasonally. Since hantavirus reservoirs are sylvatic rodents, transmission can occur when people come into contact with rodent habitats. Although uncommon, limited human‑to‑human transmission of HPS due to Andes virus has been reported in community settings involving close and prolonged contact. Secondary infections among healthcare workers have been previously documented in healthcare facilities, though remain rare. Secondary transmission appears most likely during the early phase of illness, when the virus is more transmissible. [4] Currently, little evidence is available due to the scarcity of hantavirus outbreak related to human-to-human transmission.","formattedDate":"2026-05-08T21:31:10Z","matchedSignals":["cross-border signal","transmission concern","severity signal","response escalation"]}},{"id":"2026-DON599","title":"Hantavirus cluster linked to cruise ship travel, Multi-country","disease":"Hantavirus cluster linked to cruise ship travel","locations":["Multi-country"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON599","summary":"On 2 May 2026, a cluster of passengers with severe respiratory illness aboard a cruise ship was reported to the World Health Organization. The ship is carrying 147 passengers and crew. As of 4 May 2026, seven cases (two laboratory confirmed cases of hantavirus and five suspected cases) have been identified, including three deaths, one critically ill patient and three individuals reporting mild symptoms. Illness onset occurred between 6 and 28 April 2026 and was characterized by fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock. Further investigations are ongoing. The outbreak is being managed through coordinated international response, and includes in-depth investigations, case isolation and care, medical evacuation and laboratory investigations. Human hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of infected rodents. It is a rare but severe disease that can be deadly. Although uncommon, limited human to human transmission has been reported in previous outbreaks of Andes virus (a specific species of hantavirus). WHO currently assesses the risk to the global population from this event as low and will continue to monitor the epidemiological situation and update the risk assessment.","overview":"On 2 May 2026, WHO received notification from the National International Health Regulations (2005) (IHR) Focal Point of the United Kingdom of Great Britain and Northern Ireland (hereafter referred to as the United Kingdom) regarding a cluster of severe acute respiratory illness, including two deaths and one critically ill passenger, aboard a Dutch-flagged cruise ship. On 2 May 2026, laboratory testing conducted in South Africa confirmed hantavirus infection in one patient who is critically ill and in intensive care. On 3 May, one additional death was reported. A further three suspected cases remain on board. As of 4 May, a total of seven (two confirmed and five suspected) cases, including three deaths, have been reported. The vessel departed Ushuaia, Argentina, on 1 April 2026 and followed an itinerary across the South Atlantic, with multiple stops in remote and ecologically diverse regions, including mainland Antarctica, South Georgia, Nightingale Island, Tristan da Cunha, Saint Helena, and Ascension Island. The extent of passenger contact with local wildlife during the voyage, or prior to boarding in Ushuaia remains undetermined. The vessel carries a total of 147 individuals, including 88 passengers and 59 crew members. Onboard passengers and crew represent 23 nationalities. As of 4 May 2026, the vessel is moored off the coast of Cabo Verde. Summary of cases: Case 1: An adult male developed symptoms of fever, headache, and mild diarrhoea on 6 April 2026 while on board the ship. By 11 April, the case developed respiratory distress and died on board on the same day. No microbiological tests were performed. The body of the passenger was removed from the vessel to Saint Helena (a British Overseas Territory) on 24 April. Case 2: An adult female, who was a close contact of case 1, went ashore at Saint Helena on 24 April 2026 with gastrointestinal symptoms. She subsequently deteriorated during a flight to Johannesburg, South Africa, on 25 April. She later died upon arrival at the emergency department on 26 April. On 4 May, the case was subsequently confirmed by PCR with hantavirus infection. Contact tracing for passengers on the flight has been initiated. Cases 1 and 2, had travelled in South America, including Argentina, before they boarded the cruise ship on 1 April 2026. Case 3: An adult male presented to the ship's doctor on 24 April 2026 with febrile illness, shortness of breath and signs of pneumonia. On 26 April, his condition worsened. He was medically evacuated from Ascension to South Africa on 27 April, where he is currently hospitalised in an Intensive Care Unit (ICU). Laboratory testing on an extensive respiratory pathogen panel was negative; however, polymerase chain reaction (PCR) testing confirmed hantavirus infection on 2 May 2026. Serology, sequencing and metagenomics are ongoing. Case 4: An adult female, with presentation of pneumonia, died on 2 May 2026. The onset of symptoms was on 28 April, with fever and a general feeling of being unwell. Three suspected cases have reported high fever and/or gastrointestinal symptoms and remain on board. Medical teams in Cabo Verde are evaluating the patients and collecting additional specimens for testing.","assessment":"Hantavirus cardiopulmonary syndrome (HCPS), also known as hantavirus pulmonary syndrome (HPS), is a zoonotic, viral respiratory disease caused by hantaviruses of the genus Orthohantavirus , family Hantaviridae , order Bunyavirales . More than 20 viral species have been identified within this genus. In the Americas, Sin Nombre virus is the predominant cause of HPS in North America, while Orthohantavirus andesense is responsible for most cases in South America. Human Hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of infected rodents or by touching contaminated surfaces. Exposure typically occurs during activities such as cleaning buildings with rodent infestations, though it may also occur during routine activities in heavily infested areas. Human cases are most commonly reported in rural settings, such as forests, fields, and farms, where rodents are present, and opportunities for exposure are greater. HPS is characterized by headache, dizziness, chills, fever, myalgia, and gastrointestinal problems, such as nausea, vomiting, diarrhoea, and abdominal pain, followed by sudden onset of respiratory distress and hypotension. Symptoms of HPS typically occur from 2-4 weeks after initial exposure to the virus. However, symptoms may appear as early as one week and as late as eight weeks following exposure. Hantavirus infections are relatively uncommon globally. In 2025 (as of epidemiological week 47), in the Region of the Americas, eight countries reported 229 cases and 59 deaths with a CFR of 25.7%. [1] In the European Region, 1885 hantavirus infection reported in 2023 (0.4 per 100,000), marking the lowest rate observed between 2019 and 2023. [2] In East Asia, particularly China and the Republic of Korea, Hantavirus haemorrhagic fever with renal syndrome (HFRS) continues to account for many thousands of cases annually, although incidence has declined in recent decades. Hantavirus infections are associated with a case fatality rate of <1&ndash;15% in Asia and Europe and up to 50% in the Americas. While there are no specific treatment nor vaccines for hantavirus infections, early supportive care and immediate referral to a facility with a complete ICU can improve survival. Environmental and ecological factors affecting rodent populations can influence disease trends seasonally. Since hantavirus reservoirs are sylvatic rodents, transmission can occur when people come into contact with rodent habitats. Although uncommon, limited human‑to‑human transmission of HPS due to Andes virus has been reported in community settings involving close and prolonged contact. Secondary infections among healthcare workers have been previously documented in healthcare facilities, though remain rare. WHO currently assesses the risk to the global population from this event as low and will continue to monitor the epidemiological situation and update the risk assessment as more information becomes available.","advice":"WHO advises that States Parties involved in this event continue efforts in detection, investigation, reporting, case management, infection control, and public health management on board, including ship sanitation measures, in close coordination with the conveyance operator, to prevent and control infections caused by hantaviruses. In the context of the current outbreak, passengers and crew members should practice frequent hand hygiene, remain vigilant of Hantavirus symptoms and undertake active symptom monitoring for 45 days. Crew must ensure adequate environmental cleaning (avoiding dry sweeping) and ventilation in the ship. Passengers and crew members experiencing symptoms should inform medical professionals on board and self-isolate. If respiratory symptoms are present to practice respiratory etiquette and wear a medical mask. Vigilance among travellers, crew, including those involved in implementing ship sanitation measures, or other personnel returning from areas where hantavirus is known to be present, as well as on conveyances engaged in eco-tourism on a journey from and through those areas, is essential. Early recognition of suspected cases, prompt isolation, and consistent adherence to recommended infection prevention and control measures remain essential to protect healthcare personnel. Diagnosis of HPS is with serologic testing for IgM or rising titres of IgG antibodies using enzyme-linked immunoassay (ELISA) or with reverse transcriptase polymerase chain reaction (RT&ndash;PCR) to detect viral RNA. In healthcare environments, standard precautions* should be applied for all patients, including hand hygiene, environmental cleaning and safe handling of blood and body fluids. In addition to standard precautions, transmission-based precautions should be implemented for management of suspect or confirmed cases. Standard precautions combined with transmission-based precautions during close contact are considered sufficient. For aerosol-generating procedures, airborne precautions should be used. [3] When HPS is suspected, patients should be promptly transferred to an emergency department or intensive care unit for close monitoring and supportive management. Initial management should include supportive care with antipyretics and analgesics as needed. For confirmed hantavirus, antibiotics are not routinely indicated. However, before a definitive diagnosis is established (and bacterial infection is a diagnostic possibility), or if superadded bacterial infection is suspected, empiric broad-spectrum antibiotics may be appropriate. Clinical management relies primarily on careful fluid administration, hemodynamic monitoring, and respiratory support. Given the rapid progression of HCPS, close monitoring and early transfer to ICU are critical for more severe cases. Mechanical ventilation, meticulous volume control, and vasopressors may be required. For severe cardiopulmonary insufficiency, extracorporeal mechanical oxygenation may be lifesaving. In severe cases of renal dysfunction, dialysis may be required. Although ribavirin has shown efficacy against hantavirus haemorrhagic fever with renal syndrome, it has not demonstrated effectiveness for HCPS and is not licensed for either treatment or prophylaxis of hantavirus pulmonary syndrome. At present, there is no specific antiviral treatment approved for HCPS. Public health awareness efforts should focus on improving early detection, ensuring timely treatment, and reducing exposure risks. Preventive measures should address occupational and ecotourism-related exposures, emphasize standard and transmission-based infection prevention and control practices, and include rodent control strategies. Most routine tourism activities carry little or no risk of exposure to rodents or their excreta. The potential for human-to-human transmission should be considered in areas where Andes and potentially other South American hantaviruses are endemic. Individuals engaging in outdoor activities where endemic transmission is known, such as visiting rural areas, camping or hiking, should take precautions to minimise potential exposure to infectious materials. Risk communication and community engagement interventions should prioritize transparent, timely, and culturally appropriate communication to raise awareness of hantavirus transmission risks&mdash;particularly exposure to rodent excreta in endemic areas&mdash;and promote practical preventive behaviours such as safe food storage, avoiding contact with rodents, wet-cleaning methods (no dry sweeping), and proper ventilation. Community engagement strategies should involve local leaders and workers in high-risk occupations to co-develop and disseminate tailored messages, address misinformation, and reinforce early care seeking. Surveillance for HPS should be integrated into a comprehensive national surveillance system and include clinical, laboratory, and environmental components. The implementation of integrated environmental management strategies aimed at reducing rodent populations is also recommended. *Standard precautions refer to a set of practices that are applied to the care of patients, regardless of the state of infection (suspicion or confirmation), in any place where health services are provided. These practices aim to protect both healthcare professionals and patients and include hand hygiene, use of personal protective equipment, respiratory hygiene and cough etiquette, safe handling of sharps materials, safe injection practices, use of sterile instruments and equipment and cleaning of hospital environments and the environment. Adapted from &ldquo;Standard precautions for the prevention and control of infections: aide-memoire&rdquo;- WHO, 2022. Available at https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.1 WHO advises against the application of any travel or trade restrictions based on the current information available on this event.","publishedAt":"2026-05-04T18:00:00.000Z","lastModified":"2026-05-05T18:30:34.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON599","response":"Authorities from States Parties involved in the management of the event to date &ndash; Cabo Verde, the Netherlands, Spain, South Africa and the United Kingdom - have initiated coordinated response measures including: Ongoing engagement between WHO and the National IHR Focal Points of Cabo Verde, the Netherlands, South Africa, Spain and the United Kingdom, to ensure timely information sharing and coordination of response actions. WHO shared information about the events with National IHR Focal Points globally. Passengers onboard have been advised to practice maximal physical distancing and remain in their cabins where possible. Epidemiological investigations are underway to determine the source of exposure. The National IHR Focal Point of Argentina shared the passenger and crew lists with the National IHR Focal Points of the respective countries, according to each person&rsquo;s nationality. In line with the Working Arrangement between the WHO Emergency Medical Team (EMT) Secretariat and the EU Emergency Response Coordination Centre (ERCC ) , the EMT Secretariat has launched formal discussions to support the clinical management and medical evacuation of symptomatic passengers. Logistic support has been provided, including sample collection items. Laboratory testing and confirmation of hantavirus infection have been conducted at the National Institute for Communicable Diseases (NICD) of South Africa. Serology, sequencing and metagenomics are ongoing. Additional laboratory samples from symptomatic passengers are being sent, with WHO support, to the Institut Pasteur de Dakar, Senegal, for testing. WHO has activated three-level coordination and is supporting national authorities in implementing risk-based, evidence-informed public health measures in accordance with the provisions of the IHR and related WHO technical guidance documents.","epidemiology":"","formattedDate":"2026-05-04T21:48:22Z","matchedSignals":["cross-border signal","transmission concern","severity signal","response escalation"]}},{"id":"2026-DON598","title":"Measles - Bangladesh","disease":"Measles","locations":["Bangladesh"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON598","summary":"On 4 April 2026, the National International Health Regulations (IHR) Focal Point for Bangladesh notified WHO of a nationwide increase in measles cases, geographically affecting 58 out of 64 districts across all eight divisions in Bangladesh. A total of 19 161 suspected measles cases and 2897 laboratory-confirmed measles cases have been reported between 15 March and 14 April 2026, including 166 measles related deaths (CFR 0.9%). The majority (79%) of the reported cases are children aged under 5 years. A targeted measles-rubella (MR) vaccination campaign started on 5 April, and various outbreak response measures are ongoing including strengthening nationwide surveillance and epidemiological analysis to enhance case detection and reporting. Based on currently available information, WHO assesses the risk at the national level as high due to ongoing transmission across multiple divisions, the large number of susceptible children, documented immunity gaps, and the occurrence of suspected measles-related deaths.","overview":"On 4 April 2026, the National IHR Focal Point of Bangladesh notified WHO of a significant increase in measles cases, driven by sustained domestic transmission. Since January 2026, Bangladesh has experienced a marked increase in measles cases. Geographically, cases have been reported across all eight divisions, in 58 out of 64 districts (91% of districts), indicating widespread transmission nationally. Since 15 March 2026 and as of 14 April, a total of 19 161 suspected measles cases and 2973 laboratory-confirmed measles cases have been reported. Moreover, 166 suspected measles-related deaths (CFR 0.9%) and 30 confirmed measles-related deaths (CFR= 1.1%) have been recorded. A total of 12 318 hospital admissions and 9772 hospital discharges have also been reported. The highest cumulative burden of suspected measles cases since 15 March 2026 has been reported in Dhaka (8263 cases), Rajshahi (3747 cases), Chattogram (2514 cases), and Khulna (1568 cases). In Dhaka, cases are concentrated in densely populated informal settlements, including Demra, Jatrabari, Kamrangirchar, Korail, Mirpur, and Tejgaon industrial and slum clusters. (HEOC, DGHS, 15 April 2026). Children aged under 5 years account for the majority of reported cases (79%), including children aged under 2 years (66%) and infants aged under 9 months (33%). A total of 166 suspected deaths have been reported (CFR 1%), mainly among unvaccinated children aged under 2 years.","assessment":"Measles is a highly contagious viral disease that affects susceptible individuals of all ages and remains one of the leading causes of death among young children globally. Measles can cause serious illness in at-risk groups, including children under 5 years of age, those who are malnourished especially those with vitamin A deficiency and people with weakened immune systems. Measles complications include hearing loss, diarrhoea, pneumonia and blindness. Severe complications of measles include encephalitis, brain damage, and death. The current outbreak in Bangladesh is occurring in the context of suboptimal population immunity. A substantial proportion of cases occurred among children who were either unvaccinated or had received only one dose of measles-containing vaccine. In addition, some children were infected before reaching the age of eligibility for vaccination at 9 months. Most cases (91%) occurred among children aged 1 to 14 years, indicating substantial immunity gaps in this age group. Before this outbreak, Bangladesh had made substantial progress towards measles elimination. Reported coverage with the first dose of measles-containing vaccine increased considerably between 2000 (89% - WUENIC) and 2016 (118% - WUENIC), while coverage with the second dose also improved between its nationwide introduction in 2012 (22% - WUENIC) and 2024 (121% - WUENIC). During the same period, confirmed measles incidence declined sharply. However, recent declines in MR1 and MR2 coverage due to nationwide stockout of MR vaccine between 2024-2025, combined with routine immunization gaps and the absence of regular nationwide supplementary measles-rubella campaigns since 2020, have increased the number of susceptible children and contributed to the current outbreak. The risk at the national level is assessed as high due to ongoing transmission across multiple divisions, the large number of susceptible children, documented immunity gaps, and the occurrence of suspected measles-related deaths. The concentration of cases among unvaccinated and under-vaccinated children including infants too young to be vaccinated, raises concern for continued uninterrupted transmission and severe disease outcomes. Overall, the outbreak suggests a reversal from Bangladesh&rsquo;s previous progress towards measles elimination and highlights increasing vulnerability to sustained transmission. Continued spread is likely unless urgent measures are implemented to strengthen surveillance, rapidly detect and respond to cases, and close immunity gaps through high-quality vaccination activities. There are considerable risks of cross-border spread, facilitated by cross-border population movement, with major urban centres such as Dhaka, Chattogram, Sylhet, and Cox&rsquo;s Bazar being important international travel and transit hubs increasing the likelihood of national and international spread, particularly among unvaccinated or inadequately vaccinated travelers. Measles is endemic across the South-East Asia region. The risk is assessed as high at regional level. Bangladesh shares extensive land borders with India and Myanmar, and population mobility across these borders may facilitate continued transmission. In Myanmar there is a considerable number of unvaccinated/zero dose children. With ongoing conflict and humanitarian crisis, surveillance and response capacities are limited. India, despite achieving high vaccination coverage, has reported a rise in case count over the past six months. Cities with high incidence such as Jashore and Chapainawabganj (an identified hotspot) share busy land crossings with India, thereby increasing the risk of introduction across the border. Despite Bangladesh&rsquo;s progress towards measles elimination the current outbreak highlights the vulnerability of the population and underscores the fragility of immunization gains. The risk at the global level is assessed as moderate due to high levels of population mobility, combined with ongoing widespread measles transmission and immunity gaps.","advice":"WHO recommends maintaining sustained homogeneous coverage of at least 95% with the first and second doses of the MCV vaccine in all municipalities and strengthening integrated epidemiological surveillance of measles and rubella to achieve timely detection of all suspected cases in public, private, and social security healthcare facilities. WHO recommends strengthening epidemiological surveillance in high-traffic border areas to rapidly detect and respond to highly suspected measles cases. Providing a rapid response to imported measles cases to avoid the re-establishment of endemic transmission through the activation of rapid response teams trained for this purpose and by implementing national rapid response protocols when there are imported cases. Once a rapid response team has been activated, continued coordination between the national, sub-national, and local levels must be ensured, with permanent and fluid communication channels between all levels. During outbreaks, it is recommended to establish adequate hospital case management to avoid nosocomial transmission, with appropriate referral of patients to isolation rooms (for any level of care) and avoiding contact with other patients in waiting rooms and/or other hospital rooms. WHO recommends vaccination of at-risk populations (without proof of vaccination or immunity against measles and rubella), such as healthcare workers, persons working in tourism and transportation (hotels, airports, border crossings, mass transportation, and others), and international travelers. Implementing a plan to immunize migrant populations in high-traffic border areas, prioritizing those considered at-risk, including both migrants and residents, in these municipalities increases vaccination coverage to increase population immunity. In all settings, consideration should be given to providing susceptible contacts with post-exposure prophylaxis (PEP), including a dose of MCV or normal human immunoglobulin (NHIG) (if available) for those at risk and in whom the vaccine is contraindicated. In well-resourced settings, MCV should be provided to susceptible contacts within 3 days. For contacts for whom vaccination is contraindicated or is not possible within 3 days post-exposure, consideration can be given to providing NHIG up to 6 days post-exposure. Infants, pregnant women, and the immunocompromised should be prioritized. WHO recommends maintaining a stock of the MR and/or measles, mumps, rubella (MMR) vaccine, and syringes/supplies for control actions of imported cases. Facilitating access to vaccination services according to the national scheme to those from other countries or people from the same country who perform temporary activities in countries with ongoing outbreaks; displaced populations; indigenous populations, or other vulnerable populations. WHO does not recommend any restriction on travel and trade based on the information available on the current outbreak.","publishedAt":"2026-04-23T12:58:07.000Z","lastModified":"2026-04-23T13:14:43.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON598","response":"A nationwide measles-rubella (MR) vaccination campaign was approved by the National Immunization Technical Advisory Group (NITAG) on 30 March 2026, targeting children aged 6&ndash;59 months (with expanded coverage for 6&ndash;8 months), and started on 5 April in 30 upazilas (sub-districts) of 18 priority districts. A nationwide campaign commenced on 20 April. Vitamin A campaign was held throughout the country on 15 March 2025. During this outbreak response, Vitamin A supplementation is provided to all suspected and confirmed measles cases as an essential component of standard treatment and case management. District Rapid Response Teams (RRTs) have been activated, and vaccine procurement fast-tracked by the Ministry of Health. Other outbreak response actions include strengthening routine immunization to prevent further spread of the outbreak, enhancing hospital preparedness, ensuring availability of vitamin A, strengthening isolation capacity, and reinforcing infection prevention and control measures. Strengthening nationwide surveillance and epidemiological analysis, is also ongoing including measures to improve case detection and reporting. Trainings are being conducted at health facilities to improve case detection and reporting, and weekly situation reports produced to support evidence-based decision-making. National and divisional guidelines have been issued to guide response activities, including vaccination, clinical management, infection prevention and control, patient care pathways, and procurement.","epidemiology":"Measles is a highly contagious acute viral disease which affects individuals of all ages and remains one of the leading causes of death among young children globally. The mode of transmission is airborne or via droplets from the nose, mouth, or throat of infected persons. Initial symptoms, which usually appear 10-14 days (range 7-23 days) after infection, include high fever, usually accompanied by a runny nose, bloodshot eyes, cough and tiny white spots inside the mouth. The rash usually appears 10-14 days after exposure and spreads from the head to the trunk to the lower extremities. A person is infectious from four days before up to four days after the appearance of the rash. There is no specific antiviral treatment for measles, and most people recover within 2-3 weeks. Measles is usually a mild or moderately severe disease. However, measles can lead to complications such as pneumonia, diarrhoea, secondary ear infection, inflammation of the brain (encephalitis), blindness, and death. Postinfectious encephalitis can occur in about one in every 1000 reported cases. About two or three deaths may occur for every 1000 reported cases. Vaccination with measles containing vaccine is safe and effective, providing protection against measles and its complications for all eligible populations. WHO recommends two doses of Measles Containing Vaccine (MCV) to be provided through the routine immunization schedule. Strong routine immunization systems are therefore critical foundations for achieving and sustaining high levels of population immunity to vaccine preventable diseases such as measles. WHO further recommends the conduct of Supplementary Immunization Activities (SIAs) or mass immunization campaigns as an effective strategy for delivering vaccination to children who may have been missed by routine services. In protecting vulnerable populations against measles, mass vaccination campaigns can rapidly improve population immunity by reducing the number of susceptible individuals in the population.","formattedDate":"2026-04-23T13:14:13Z","matchedSignals":["transmission concern","severity signal","WHO high-risk wording","response escalation","cross-border signal"]}},{"id":"2026-DON597","title":"Avian Influenza A(H9N2) - Italy","disease":"Avian Influenza A(H9N2)","locations":["Italy"],"riskLevel":"elevated-watch","signalClass":"Cross-border or severe outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON597","summary":"On 21 March 2026, the National International Health Regulations (IHR) Focal Point for Italy notified the World Health Organization (WHO) of the identification of a human case of avian influenza A(H9) in an adult male returning from Senegal. Next generation sequencing confirmed Influenza A(H9N2). According to epidemiological investigations, the patient had no known history of exposure to poultry or any person with similar symptoms prior to the onset of symptoms. Authorities in Italy have implemented a series of measures aimed at monitoring, preventing and controlling the situation. According to the IHR (2005), a human infection caused by a novel influenza A virus subtype is an event that has the potential for high public health impact and must be notified to the WHO. This is the first imported human case of avian Influenza A(H9N2) reported in the European Region. Based on currently available information, WHO assesses the current risk to the general population posed by A(H9N2) viruses as low but continues to monitor these viruses and the situation globally.","overview":"On 21 March 2026, the National IHR Focal Point for Italy notified WHO of the identification of a human case of avian influenza A(H9) in an adult male. The patient had been in Senegal for more than six months and traveled to Italy in mid-March. Upon arrival, he visited the emergency department with a fever and a persistent cough. On 16 March, a bronchoalveolar lavage specimen was collected, which showed a positive Mycobacterium tuberculosis result, as well as detection of un-subtypeable influenza A virus. The patient was placed in a negative-pressure isolation room with airborne precautions. He was treated with antitubercular medication and antiviral oseltamivir. By 9 April, his condition was stable and improving. On 20 March, a regional reference laboratory identified the A(H9) subtype, and on 21 March, next-generation sequencing confirmed influenza A(H9N2). Initial genetic findings suggest the infection was likely acquired from an avian source linked to Senegal. Additional samples have been sent to Italy&rsquo;s National Influenza Center, where further characterization confirmed virus subtype Influenza A(H9N2), with close genetic similarity to strains previously identified in poultry in Senegal. No direct exposure to animals, wildlife or rural environments was identified. There was also no reported contact with symptomatic or confirmed human cases. Further epidemiological investigations on the source of exposure are ongoing. Contacts identified in Senegal were asymptomatic. All identified and traced contacts in Italy have tested negative for influenza and completed the period of active monitoring for the onset of symptoms and the quarantine required by national guidelines. They also received oseltamivir as a preventive measure.","assessment":"Most reported human cases of A(H9N2) virus infection have been linked to exposure to infected poultry or contaminated environments, with the majority of cases experiencing mild clinical illness. Sporadic human cases following exposure to infected birds or contaminated environments can be expected since the virus remains enzootic in poultry populations. Avian influenza A(H9N2) viruses have been detected in poultry and environmental samples collected at live bird markets in Senegal and authorities in the country reported a human case of infection with an A(H9N2) virus in 2020. Current epidemiological and virological evidence indicates that none of the characterized influenza A(H9N2) viruses thus far have acquired the ability for sustained transmission among humans. Thus, the likelihood of sustained human-to-human spread is low at this time. Infected individuals traveling internationally from affected areas may be identified in another country during or after arrival. However, if this were to occur, further community-level spread is considered unlikely. The risk assessment would be revisited if and when further epidemiological and virological information becomes available.","advice":"This case does not change the current WHO recommendations on public health measures and surveillance of influenza. The public should avoid contact with high-risk environments such as live animal markets/farms or surfaces that might be contaminated by poultry feces. Respiratory protection is highly recommended for those handling live or dead (including slaughtering) poultry in occupational or backyard-farming settings. Good hand hygiene, i.e. frequent washing of hands or the use of alcohol-based hand sanitizer is recommended. WHO does not recommend any specific additional measures for travelers. Under Article 6 of the IHR, all human infections caused by a new subtype of influenza virus are notifiable. The case definition for notification of human influenza infection caused by a new subtype under the IHR is provided here . State Parties to the IHR are required to immediately notify WHO of any laboratory-confirmed case of a human infection caused by such an influenza A virus. WHO advises against the application of any travel or trade restrictions based on the current information available on this event.","publishedAt":"2026-04-10T13:51:44.000Z","lastModified":"2026-04-10T14:03:22.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON597","response":"Contact tracing procedures have been initiated, and relevant authorities in Italy, as well as internationally (National IHR Focal Point for Senegal, WHO, and European Centre for Disease Prevention and Control (ECDC)) have been informed through IHR channels. Once avian influenza was suspected, the response moved quickly from hospital-level management to regional laboratory confirmation and national coordination. Additionally, the regional surveillance system was notified, integrated within the One Health avian influenza reporting framework.","epidemiology":"Animal influenza viruses normally circulate in animals but can also infect people. Infections in humans have primarily been acquired through direct contact with infected animals or through indirect contact with contaminated environments. Depending on the original host, influenza A viruses can be classified as avian influenza, swine influenza, or other types of animal influenza viruses. Avian influenza virus infections in humans may cause diseases ranging from mild upper respiratory tract infection to more severe diseases and can be fatal. Conjunctivitis, gastrointestinal symptoms, encephalitis and encephalopathy have also been reported. Laboratory tests are required to diagnose human infection with influenza. WHO periodically updates technical guidance protocols for the detection of zoonotic influenza using molecular methods. Human infections with influenza A(H9) viruses have been reported from countries in Africa and Asia, where these viruses are also detected in poultry. The majority of cases of human avian influenza A(H9N2) infection have been reported from China. This is the first imported human case of avian Influenza A(H9N2) virus infection reported in the European Region.","formattedDate":"2026-04-10T14:03:01Z","matchedSignals":["transmission concern","novel or unusual signal","response escalation"]}},{"id":"2026-DON596","title":"International food safety event: Infant formula and products containing arachidonic acid oil contaminated with cereulide toxin - Multi-country","disease":"International food safety event: Infant formula and products containing arachidonic acid oil contaminated with cereulide toxin","locations":["Multi-country"],"riskLevel":"elevated-watch","signalClass":"Cross-border or severe outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON596","summary":"Multi-country recalls of infant formula and other products have been initiated after cereulide toxin, was detected in batches of multiple internationally distributed brands. Investigations have identified arachidonic acid (ARA) oil, used as an ingredient in the implicated products, as the source of contamination. However, the full root cause analysis and complete traceability of all affected batches remains under investigation. Contaminated formulae, nutritional products, and oil mixes have been distributed to 99 countries and territories across six WHO Regions, with the first product recalls initiated on 10 December 2025. Between 1 January and 25 February 2026, 144 suspected and confirmed cases were reported across ten countries in three WHO Regions, with investigations ongoing. Based on the available information, WHO assesses the overall public health risk as moderate due to the vulnerability of the affected population (infants), the ongoing uncertainty regarding the full extent of distribution and exposure, and remaining gaps in case detection and root cause information.","overview":"Since 10 December 2025, and as of 25 February 2026, 99 countries and territories have been identified as having received batches of infant formula products subject to recall due to contamination with cereulide toxin. During this period, 144 suspected and confirmed cases were reported across 10 countries. The epidemiological investigations and product‑traceback activities remain ongoing in many countries. The case definitions in use by the International Food Safety Authorities Network (INFOSAN) are currently: Suspect case: A person presenting symptoms of cereulide intoxication with a history of consumption of the recalled product, without laboratory confirmation in a clinical sample. Confirmed case: A person presenting symptoms of cereulide intoxication with a history of consumption of recalled product, with laboratory confirmation in a clinical sample. Health authorities are actively searching for cases and conducting laboratory testing of human specimens and infant formula products. However, case definitions used may differ from those established by INFOSAN, such as those established by the European Centre for Disease Prevention and Control, creating challenges with comparability of reported case numbers. Since this is not a routinely tested contaminant or condition, diagnostic challenges and limited surveillance capacity are hindering Member States&rsquo; ability to identify confirmed cases. One country has laboratory confirmed cases linked to the contaminated products (Belgium). The limited case numbers appearing in multiple, geographically separated areas is consistent with sporadic exposures to contaminated products that were widely distributed. ​Precautionary recalls have been issued across all countries and territories where products were distributed. These measures aim to prevent further exposures, although the speed and completeness of product recall and withdrawal vary by location according to various factors including inspection and enforcement capacities.","assessment":"WHO assesses the overall public health risk associated with this event to be Moderate. This assessment is based on the information currently available and reflects the wide international distribution of contaminated products, ongoing uncertainties regarding the full extent of contaminated product distribution, case detection, and root cause of contamination, and the vulnerability of infants and young children to dehydration and electrolyte imbalance from with vomiting illness associated with cereulide toxin ingestion. Several considerations contribute to this assessment: Cereulide is a thermostable emetic toxin that can cause acute vomiting and rapid dehydration particularly in very young infants which can have severe consequences if untreated; mild or self-limiting cases are likely to go unreported, especially in settings with limited healthcare access or diagnostic capacities. The extent of the contaminated ARA oil distribution remains uncertain, as complete traceability from the original implicated manufacturer has not been provided to WHO. Secondary distribution through commercial supply chains has further complicated efforts to identify all affected products. Additional investigation is required to determine the source and extent of the cereulide contamination. The international spread of contaminated products has already disrupted trade and supply chains across at least 99 countries and territories, with the possibility of further recalls if additional affected batches or product categories are identified. These recalls, while essential for public health protection, have created a risk of localized shortage of infant formula, particularly in settings where reliance on specific products is high, despite manufacturers&rsquo; efforts to increase production of unaffected products. A residual risk of exposure persists while investigations and traceability efforts continue, as competent authorities manage evolving distribution information and update risk communication measures. Mild clinical presentations can resemble common childhood illnesses, laboratory capacity for cereulide testing in contaminated products or human samples varies widely, and variations in case definitions across countries complicate consistent reporting and may delay detection. Although limited numbers of suspected and confirmed cases have been reported to date, without continued investment in surveillance for toxin‑related events, strengthened laboratory networks, training of health‑care providers, and clear communication on recalls and safe alternatives, delays in detection and response could lead to preventable morbidity in infants.","advice":"Based on the information available, WHO recommends Member States to maintain epidemiological surveillance, enhance readiness of laboratory capacity for cereulide testing of suspected contaminated products and in clinical samples of suspected cases, and facilitate effective implementation of recalls and withdrawals, as needed. WHO advises Member States to: Identify, trace, and withdraw all affected products from the market. Verify the effectiveness of recalls at retail and distribution levels and ensure that affected products are not available for sale, including online sales. Conduct sampling and laboratory testing of suspect products and human specimens. Strengthen requirements for traceability across the supply chain and food recalls. Enhance inspection and oversight of facilities producing or handling ingredients used in infant nutrition. Share relevant information through established international information-sharing mechanisms, including INFOSAN. Issue targeted alerts to consumers, caregivers, health workers, and retailers, while providing clear guidance on identifying and disposing of affected products. Promote breastfeeding and address barriers to accessing safe alternative nutrition. Encourage early presentation to health facilities for infants with sudden vomiting. Reinforce guidance on dehydration management and red-flag symptoms, while supporting availability of tools for safe clinical management of affected infants. WHO recommends that no restrictions be applied for travel to, or trade with, the countries named in this report, based on the information available on the event reported here.","publishedAt":"2026-03-13T19:00:00.000Z","lastModified":"2026-03-13T16:05:23.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON596","response":"WHO Response: Since 7 January 2026, when distribution of the products was confirmed to extend beyond the European Union, WHO, through the INFOSAN Secretariat, has been contacting INFOSAN Emergency Contact Points in the countries and territories identified as affected to notify them of recalled products exported to their markets and to support information exchange and coordinated response. Communication within the European Union has been managed through the European Rapid Alert System for Food and Feed (RASFF), with close coordination between INFOSAN and RASFF. Response measures in affected countries and territories: Recalls and communication campaigns have been carried out in many countries and territories where contaminated products were distributed, preventing further exposures despite variable implementation of recall and withdrawal measures. Active case-finding and laboratory confirmation efforts are ongoing in affected countries and territories, with most countries and territories reporting no linked illnesses to date.","epidemiology":"Cereulide is a heat-stable toxin produced by certain strains of Bacillus cereus , a Gram-positive, spore-forming bacterium ubiquitous in soil, dust, and food production environments. The primary hazard in this event is suspected to have occurred during the production of ARA oils used in infant formula, although a root cause analysis has not yet been provided to WHO. Cereulide is not contagious; illness occurs only when a person ingests the toxin, such as through consumption of contaminated products. The toxin withstands cooking temperatures (stable up to 121&deg;C) and common pasteurization, persisting in finished products. Symptoms manifest rapidly, typically within 0.5&ndash;6 hours post-ingestion, and usually present as acute gastrointestinal symptoms (nausea, vomiting, abdominal pain) with risk of rapid dehydration and electrolyte imbalance which can be particularly severe in infants due to their physiological vulnerability and limited reserves. The toxin has a very low symptomatic dose threshold and remains fully active despite gastric conditions, contributing to its clinical potency. For babies who rely entirely on formula, repeated feedings can increase the amount of toxin consumed, and using contaminated formula for rehydration can worsen illness. The absence of specific antidotes or targeted therapies places greater emphasis on supportive clinical care, effective risk communication to caregivers and health workers, and robust coordination between food safety and public health authorities. Where there is limited access to health care and where there may be delays in care seeking, rapid dehydration and electrolyte imbalance in infants may be fatal. As of 25 February 2026, the following countries have notified suspected cases: Austria (9), Brazil (5), China, Hong Kong SAR, (1), Czechia (4), France (11), Italy (1), Singapore (3), Spain (41), and the United Kingdom of Great Britain and Northern Ireland (61). In other countries, including Denmark (32) and the Netherlands (221) the number of suspected cases is based on self-reporting and is therefore not comparable with the INFOSAN case definition. To date, Belgium is the only country with laboratory‑confirmed cases, reporting eight confirmed intoxications linked to the implicated products.","formattedDate":"2026-03-13T16:05:10Z","matchedSignals":["cross-border signal"]}},{"id":"2026-DON595","title":"Mpox: recombinant virus with genomic elements of clades Ib and IIb – Global situation","disease":"Mpox: recombinant virus with genomic elements of clades Ib and IIb","locations":["Global situation"],"riskLevel":"elevated-watch","signalClass":"Cross-border or severe outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON595","summary":"Recombination of monkeypox virus (MPXV) strains has been documented in recent months, with two cases of a recombinant strain comprising clade Ib and IIb MPXV reported. Recombination is a known natural process that can occur when two related viruses infecting the same individual exchange genetic material, producing a new virus. The first case was detected in the United Kingdom of Great Britain and Northern Ireland (hereafter “United Kingdom”), with travel history to a country in South-East Asia, and the second in India, with travel history to a country in the Arabian Peninsula. Detailed analysis of the virus genomes shows that the two individuals fell ill several weeks apart with the same recombinant strain, suggesting that there may be further cases than are currently reported. Both cases had similar clinical presentation to that observed for other clades. Neither patient experienced severe outcomes. Contact tracing for both cases in the reporting countries has been completed; no secondary cases were detected. Based on available information, the overall WHO public health risk assessment for mpox remains unchanged: the risk is assessed as moderate for men who have sex with men with new and/or multiple partners and for sex workers or others with multiple casual sexual partners, and low for the general population without specific risk factors.","overview":"In December 2025, the United Kingdom detected the first reported case of a clade Ib/IIb MPXV recombinant strain.​ 5 ​ After classification of this case and posting in a public database as a novel MPXV recombinant strain, a case of mpox detected in India in September 2025 was retrospectively reclassified as a closely-related recombinant strain based on sequencing data. To date, these are the only known cases of this recombinant virus. Case detected in the United Kingdom of Great Britain and Northern Ireland The case was identified following testing of a vesicular swab from a traveler who had returned from a country in the Asia Pacific region in October 2025. During laboratory confirmation, the virus was initially typed as clade Ib MPXV by qPCR. Subsequent whole genome sequencing revealed that the MPXV strain identified was distinct from other known clade Ib MPXV strains with phylogenetic analysis indicating that the genome had regions similar to both clade Ib and clade IIb MPXV reference sequences, suggesting that it is an inter-clade recombinant. To confirm this unusual finding, sequencing was repeated on the original extract from the primary sample, a fresh extract from the same primary sample, a second swab collected from the patient at the same time, and a cultured isolate derived from the initial swab. This repeat sequencing yielded identical viral genome sequences from the two clinical swabs and the cultured isolate, supporting the initial findings of a new recombinant strain, and showing that it can replicate and presents potential for onward transmission. This strain is a recombinant MPXV, containing genetic elements from both clade Ib and clade IIb MPXV. A small number of contacts were identified and followed up in the United Kingdom; none developed any clinical features of mpox. Health worker contacts had worn full personal protective equipment (PPE) during provision of medical care to the patient. The authorities of the United Kingdom continue to investigate the significance of this recombinant MPXV strain through phenotypic characterization studies. Case detected in India On 13 January 2026, the National IHR Focal Point (NFP) of India notified WHO of a mpox case with an inter‑clade recombinant MPXV which was, upon whole-genome sequencing, found to have genomic elements of clades Ib and IIb MPXV. The recombinant virus was found in samples from a man with mpox who had presented for care in September 2025. The patient had reported recent travel from a country in the Arabian Peninsula, where he resides as an overseas worker. He developed symptoms on 1 September 2025, while still abroad. After his return to India, real‑time PCR confirmed MPXV infection on 11 September 2025. Clade differentiation PCR performed on 15 September 2025 initially identified this virus as clade II MPXV. Initial genomic sequencing analysis suggested features consistent with clade IIb MPXV. However, following the update of the global Nextclade database on 16 December 2025, which included the recombinant clade Ib/IIb MPXV strain reported by the United Kingdom, the virus from the patient in India was reclassified as belonging to the recombinant strain. Recombination analysis demonstrated mosaic patterns containing genomic regions derived from both parent clades. Following the initial diagnosis, the patient was hospitalized, did not experience any medical complications, and fully recovered, testing negative for MPXV on 29 September 2025. The case reported no close contacts in India, and no known secondary cases were identified following this introduction of the recombinant clade Ib/IIb MPXV in India. Full or near‑full genome retrieval (>99%) from both the sample and a sample-derived virus isolate enabled phylogenetic analysis showing >99.9% similarity to the recombinant strain detected in the United Kingdom. A total of 34 recombinant tracts were observed in the sequence reported by India, while 28 recombinant tracts were observed in the sequence reported by the United Kingdom; 16 recombinant tracts were common to both strains. This case in India therefore represents the earliest known detection of this recombinant strain globally, having preceded the event reported in the United Kingdom. Consistent with the case reported in the United Kingdom, clinical presentation was consistent with cases due to clade I or clade II MPXV (non-recombinant MPXV) infection.","assessment":"Mpox outbreaks must be considered in their local context, with meaningful involvement of affected communities, to ensure an in-depth understanding of the epidemiology, modes of transmission, risk factors for severe disease, viral reservoir and evolution, and relevance of strategic approaches and countermeasures for prevention and control. Multiple strains of MPXV are circulating through interconnected sexual networks across many countries and settings. Co-infection with different strains, that could lead to emergence of recombinant virus strains, while rare, can be expected. The case in India was infected with the same recombinant Ib/IIb MPXV strain detected in the United Kingdom. Symptom onset in the case reported in India occurred more than two months earlier than the case in the United Kingdom, and the great degree of similarity between their sequences suggests a common evolutionary history. This information has two important implications: i) the origin of the recombinant strain remains unknown; and ii) transmission of this recombinant virus already involves at least four countries in three WHO regions, and is therefore likely to be more widespread than currently documented. For the cases in the United Kingdom and India, the initial clade differentiation PCR results indicated clade Ib and IIb MPXV, respectively. Thus, clade differentiation PCR assays alone may not reliably identify recombinant MPXV strains, and genomic sequencing is likely to be required for their detection. Due to the small number of cases found to date, conclusions about transmissibility or clinical characterization of mpox due to recombinant strains would be premature, and it remains essential to maintain vigilance regarding this development. In light of the limited information available on this recombinant MPXV strain, the overall WHO public health risk assessment for mpox remains unchanged: the risk is assessed as moderate for men who have sex with men with new and/or multiple partners and for sex workers or others with multiple casual sexual partners, and low for the general population without specific risk factors. All countries should remain alert to the possibility of MPXV genetic recombination. The public health risk posed by any newly detected recombinant strain should be assessed on a case-by-case basis, considering available epidemiological, clinical and genomic information.","advice":"Based on the information available, WHO recommends maintaining epidemiological surveillance, laboratory and genomic sequencing capacity for mpox, case management, infection prevention and control (IPC) measures, vaccination for people at risk, locally relevant risk communication and community engagement, and public health guidance for mpox. All recommendations are made in the context of ongoing transmission of clades Ib and IIb MPXV in key populations at risk in all WHO regions, including undetected or pre- and asymptomatic infections, as well as unreported cases. They additionally apply to settings where clades Ia and IIa MPXV continue to spread through a mix of zoonotic and human-to-human contact. There is likely to be wider circulation of this emerging recombinant strain of MPXV since at least September 2025 than reflected by the two cases documented and linked to four countries in three WHO regions. WHO advises Member States to: maintain mpox surveillance and rapid reporting, including prompt IHR notification of any unusual events and imported cases in line with the WHO Standing Recommendations issued under the IHR (2005) and extended to August 2026; continue to carry out genomic sequencing of all laboratory specimens from confirmed cases in early outbreak settings, and a representative sample of at least 10% of laboratory specimens from confirmed cases in settings experiencing community transmission, as per WHO guidance; carry out targeted sample characterization for specific situations of interest, especially for cases who report recent travel to locations with clade I MPXV circulation or to locations which provide opportunities for sex tourism, prioritizing sequencing for cases in key populations at risk and for imported, unusual, or severe cases, and sharing sequences rapidly in public databases; ensure quality case management and robust IPC practices and strengthen vaccination strategies, including ensuring access to mpox vaccines for key populations at risk; continue to advance integration of HIV/STI and mpox health services to ensure early HIV testing and care for any person with suspected or confirmed mpox and rapid initiation or resumption of antiretroviral therapy in people living with HIV as needed for any person with mpox; strive to eliminate human-to-human transmission of mpox where MPXV circulation remains low and ensure the maintenance of capacity for prompt outbreak response; continue to provide information to travelers who may be at risk. WHO recommends that no restrictions be applied for travel to, or trade with, the countries named in this report, based on the information available on the event reported here.","publishedAt":"2026-02-14T19:00:00.000Z","lastModified":"2026-02-14T17:54:34.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON595","response":"WHO Response: WHO maintains global mpox surveillance and continues to provide response guidance and support for all countries, including access to diagnostics and vaccines through multi-partner coordination including through the Access and Allocation Mechanism for mpox. WHO and partners are establishing the longer-term International Coordinating Group for mpox vaccine provision (ICG) to further accelerate timely outbreak response and ensure sustainable support for the future. Furthermore, WHO continues to evaluate available rapid diagnostic tests for field use. Response measures in the United Kingdom: The United Kingdom Health Security Agency (UKHSA) continues to work closely with the National Health Service England, public health agencies in Scotland, Wales and Northern Ireland, and is monitoring the situation in the United Kingdom and undertaking public health actions in accordance with the Mpox control: UK strategy 2025 to 2026 . Public health information was made available to health care providers and the public. Contact tracing was completed in line with national guidance. Contacts were given appropriate health advice, offered vaccination, and monitored for symptoms. All suspected mpox cases in the UK are tested using Orthopoxvirus-generic, MPXV-generic, and MPXV-specific PCR as primary testing, with clade differentiation assays performed on any positive samples. All samples identified as clade Ib, and selected samples identified as clade IIb cases undergo whole genome sequencing through Illumina-based workflows. Response measures in India: Public health measures, including contact tracing and monitoring, were implemented to prevent onward transmission. No secondary case was detected. All suspected mpox cases in India are tested using Orthopoxvirus‑generic and MPXV‑specific PCR with clade differentiation assays. Positive cases undergo whole genome sequencing through Illumina‑based workflows.","epidemiology":"Mpox is an infectious disease caused by the MPXV, which is part of the genus Orthopoxvirus , that includes the variola virus, the causative agent for smallpox. There are two known clades of MPXV: clade I (previously called the Congo Basin clade), which includes subclades Ia and Ib; and clade II (previously called the West Africa clade), which includes subclades IIa and clade IIb. Subclades Ia and Ib were defined after the emergence of subclade Ib in the South Kivu province of the Democratic Republic of the Congo in 2023, and subclade Ia encompasses all other strains of clade I that are not Ib.​ As reported here, there have also been two cases of the clade Ib/IIb recombinant strain, detected in the UK and in India. Mpox spreads among humans through direct close physical contact with an infected person, including sexual contact. Transmission can also occur through indirect contact (with contaminated materials), through infectious respiratory particles in limited cases, and from mother to child (vertical transmission).​ Historically mpox was primarily characterized by zoonotic transmission, with outbreaks occurring in tropical rainforest regions of East, Central and West Africa, and occasional exportation of cases to other areas. In the context of zoonotic transmission, which continues to occur in historically endemic areas, MPXV is transmitted to humans through direct contact with infected wild animals (e.g., through hunting, trapping, or petting), and possibly through processing and consuming infected wild game or their body parts and fluids. To date, animal-to-human transmission has always been documented in or linked to known endemic regions of Africa. All other outbreaks in Africa or in other parts of the world are to date presumed to be due to human-to-human transmission, until proven otherwise. Symptoms of mpox in humans include swollen lymph nodes, fever, and a skin rash and/or mucosal lesions that may initially resemble those of other illnesses such as chickenpox (caused by the varicella virus), or sexually transmitted infections such as herpes or syphilis if the rash or lesions appear in the genital or anal region. The ongoing global outbreak has shown that mpox can also present with few lesions, and asymptomatic infection can occur.​ The contribution of pre- and asymptomatic infection to transmission remains poorly understood.","formattedDate":"2026-02-14T14:07:30Z","matchedSignals":["cross-border signal","transmission concern","novel or unusual signal","response escalation"]}},{"id":"2026-DON594","title":"Nipah virus infection - Bangladesh","disease":"Nipah virus infection","locations":["Bangladesh"],"riskLevel":"elevated-watch","signalClass":"Cross-border or severe outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON594","summary":"On 3 February 2026, the International Health Regulations National Focal Point (IHR NFP) for Bangladesh notified WHO of one confirmed case of Nipah virus (NiV) infection in Rajshahi Division. The patient developed fever and neurological symptoms on 21 January. Nipah virus infection was laboratory-confirmed on 29 January. The patient reported no travel history but had a history of consuming raw date palm sap. All 35 contact-persons are being monitored and have tested negative for NiV and no further cases have been detected to date. Bangladesh regularly has small NiV outbreaks, with cases reported at different times of the year, though outbreaks tend to occur between December and April corresponding with the harvesting and consumption of date palm sap. The Ministry of Health and Family Welfare in Bangladesh has implemented several public health measures. WHO assesses the overall public health risk posed by NiV to be low at the national, the regional and global level. The risk of international disease spread is considered low.","overview":"On 3 February 2026, the Bangladesh IHR NFP notified WHO of one confirmed case of NiV infection that occurred in Rajshahi Division, northwestern Bangladesh. The case was confirmed by Polymerase Chain Reaction (PCR) and Enzyme-Linked Immunosorbent Assay (ELISA) testing on 29 January 2026. The patient is female, aged between 40-50 years, residing in Naogaon District, Rajshahi Division. She developed symptoms consistent with NiV infection on 21 January, including fever, headache, muscle cramps, loss of appetite (anorexia), weakness, and vomiting, followed by hypersalivation, disorientation, and convulsion. On 27 January, she became unconscious and was referred by a local physician to a tertiary hospital. She was admitted on 28 January, and the Nipah surveillance team collected throat swabs and blood samples. The patient died the same day. The patient reported repeated consumption of raw date palm sap between 5 and 20 January 2026. Following the confirmed diagnosis, an outbreak investigation team, including One Health stakeholders, started investigations on 30 January. A total of 35 contact persons has been identified, including three household contact persons 14 community contact persons and 18 hospital contact persons. Samples were collected from six symptomatic contact persons, including three from household, two from communities and one from hospital. All six samples tested negative for NiV infection by PCR and anti-Nipah IgM antibody detection by ELISA. As of 3 February, no additional cases have been identified. Contact persons are under monitoring. Bangladesh reported its first case of NiV infection in 2001. Since then, human infections have been reported almost every year. In 2025, four laboratory-confirmed fatal cases were reported from Bangladesh.","assessment":"Nipah virus is a zoonotic pathogen with a high death rate and no licensed vaccine or treatment, though early supportive treatment can save lives. Its reservoirs are fruit bats or flying foxes (bats of the Pteropus genus), which are distributed in the coastal regions and on several islands in the Indian ocean, India, south-east Asia and Oceania. The virus can be transmitted to humans from wild and domestic animals. Secondary human-to-human transmissions are also possible. Cases of Nipah virus infection were first reported in 1998 and since then have been reported in Bangladesh, India, Malaysia, Philippines and Singapore. The virus is present in Bangladesh, while NiV cases are reported throughout the year, outbreaks tend to occur between December and April corresponding with the harvesting and consumption of date palm sap. Clusters of cases are mainly reported in the country&rsquo;s central and northwest districts. To date, since 2001 Bangladesh has documented 348 NiV disease cases, including 250 deaths, corresponding to an overall case fatality rate of 72%. Nearly half of these cases (n=162) were primary cases with a confirmed history of consuming raw date palm sap or tari (fermented date palm sap), while 29% resulted from direct person-to-person transmission. Most cases detected in Bangladesh were reported through December to April, suggesting a seasonal pattern. Based on the current available information, WHO assesses the overall public health risk posed by NiV at the national level to be low due to the following reasons: The case fatality rate from NiV infection is high. There are currently no specific drugs or vaccines available for NiV infection, although WHO has identified Nipah as a priority disease for research under WHO Research and Development Blueprint. Intensive supportive care is recommended for the treatment of severe respiratory and neurologic complications. The initial signs and symptoms of NiV infection are non-specific, and the diagnosis is often not suspected at the time of presentation. This can delay timely diagnosis and create challenges in outbreak detection, effective and timely infection control measures, and outbreak response activities. Fruit bats ( Pteropus spp .), as a natural reservoir of the Nipah virus, are present in Bangladesh and repeated spillover of the virus from its reservoir to the human population has been demonstrated. Despite ongoing efforts at risk communication and community engagement to address awareness, there is continued consumption of raw date palm sap by the community. However, the yearly number of NiV cases reported in Bangladesh remains under 10 since 2016, with exception in 2023 when 14 cases were reported. Although human-to-human transmission has been reported in previous outbreaks, it has been less frequent in recent years. In addition, strong public health measures are in place to detect and control outbreaks, including a hospital-based systematic human NiV infection surveillance system which has been established since 2006, the utilization of the National Rapid Response Team (NRRT) at the central level and the Rapid Response Team (RRT) at the district level and the capacity to rapidly test samples. Bangladesh borders India and Myanmar, and WHO assesses the risk at the regional level to be low. While there have not been any instances of cross-border transmission by humans previously, the risk remains, given shared ecological corridor for the virus's natural host Pteropus bats in Bangladesh and India. However, Bangladesh has strong capacities and experience of controlling previous NiV outbreaks. WHO assesses the risk at the global level to be low, as there have been no previous confirmed cases outside Bangladesh, India, Malaysia, Philippines and Singapore.","advice":"In the absence of a licensed vaccine or specific therapeutic treatment for Nipah virus disease, reducing or preventing infection in people relies on raising awareness of the risk factors. This includes providing guidance on and reinforcing risk communication messages about the measures that people can take to reduce exposure to the Nipah virus. Case management should focus on delivering timely supportive care, supported by an effective laboratory system and adequate infection prevention and control measures in health facilities. Intensive supportive care is recommended for treatment of severe respiratory and neurologic complications. Public health educational messages should focus on: Reducing the risk of bat-to-human transmission Efforts to prevent transmission should first focus on decreasing bat access to date palm sap and other fresh food products. Freshly collected date palm juice should be boiled, and fruits should be thoroughly washed and peeled before consumption. Fruits with signs of bat bites should be discarded. Areas where bats are known to roost should be avoided. Reducing the risk of human-to-human transmission Close unprotected physical contact with NiV-infected people should be avoided. Regular hand washing should be carried out after caring for or visiting sick people along other preventive measures. People experiencing Nipah-like symptoms should be referred to a health facility, as early supportive care is key in the absence of treatment. Contact tracing and monitoring are also key to mitigate human-to-human transmission. Controlling infection in health care settings Health and care workers caring for patients with suspected or confirmed infection, or handling specimens from them, should always implement standard precautions for infection prevention and control at all times, for all patients. When caring for patients with suspected or confirmed NiV, WHO advises the use of contact and droplet precautions including a well-fitting medical mask, eye protection, a fluid-resistant gown, and examination gloves. Airborne precautions should be implemented during aerosol-generating procedures, including placing the patient in an airborne-infection isolation room and the use of a fit-tested filtering facepiece respirator instead of a medical mask. Suspected or confirmed cases of NiV should be placed in a single-patient room. For family members and caregivers visiting patients with suspected or confirmed Nipah virus, similar precautions should be applied. Samples taken from people and animals with suspected NiV infection should be handled by trained staff working in suitably equipped laboratories. Based on the currently available information, WHO does not recommend any travel and/or trade restrictions.","publishedAt":"2026-02-06T19:00:00.000Z","lastModified":"2026-02-10T16:05:50.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON594","response":"Several public health measures have been implemented by local authorities, including: On 30 January 2026, the Ministry of Health and Family Welfare (MoHFW), in collaboration with relevant sectors, initiated an outbreak investigation using a coordinated One Health approach. Active contact tracing was implemented to identify and monitor exposed individuals. Preparations were undertaken to conduct an advocacy meeting involving Civil Surgeons, Upazila Health Officers, Hospital Directors, and Superintendents from Nipah-endemic districts. Community awareness programmes are being planned with the involvement of field-level health workers. Audio-visual health education materials on NiV infection are being developed for point-of-entry staff and travellers. The support provided by WHO includes: WHO is monitoring the situation closely, in coordination with the national and sub-national health authorities. WHO facilitated IHR event communication to notify the case.","epidemiology":"NiV infection is a zoonotic disease transmitted to humans through infected animals (such as bats), or food contaminated with saliva, urine, and excreta of infected animals. It can also be transmitted directly from person to person through close contact with an infected person. Fruit bats, also known as flying foxes, ( Pteropus species) are the natural hosts for the virus. The incubation period ranges from 3 to 14 days. In some rare cases, incubation of up to 45 days has been reported. Laboratory diagnosis of a patient with a clinical history of NiV infection can be made during the acute and convalescent phases of the disease by using a combination of tests. The main tests used are RT-PCR from bodily fluids and antibody detection via ELISA. Human infections range from asymptomatic infection to acute respiratory infection (mild, severe), and fatal encephalitis (brain swelling). Infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. Some people can experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours. Further information about NiV infection can be found here . The CFR in previous outbreaks across Bangladesh, India, Malaysia, Philippines and Singapore ranged from 40% to 75%, depending on local capabilities for early detection and clinical management. There are currently no licensed medicines or vaccines specific for NiV infection. Early intensive supportive care is recommended to treat severe respiratory and neurologic complications. Henipavirus nipahense (or Nipah virus) is considered a priority pathogen for the acceleration of medical countermeasures to respond to epidemics and pandemics as part of the WHO R&D Blueprint for Epidemics.","formattedDate":"2026-02-06T21:43:10Z","matchedSignals":["transmission concern","severity signal","response escalation"]}},{"id":"2026-DON593","title":"Nipah virus disease - India","disease":"Nipah virus disease","locations":["India"],"riskLevel":"watch","signalClass":"WHO outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON593","summary":"On 26 January 2026, the National IHR Focal Point for India notified WHO of two laboratory‑confirmed cases of Nipah virus (NiV) infection in West Bengal State. Both are healthcare workers at the same private hospital in Barasat (North 24 Parganas district). NiV infection was confirmed at the National Institute of Virology in Pune on 13 January. One case remains on mechanical ventilation as of 21 January, the other case experienced severe neurological illness but has since improved. Authorities have identified and tested over 190 contacts, who all tested negative for NiV with support from a mobile BSL‑3 laboratory deployed by the National Institute of Virology, Pune. No further cases have been detected to date. This event represents the third NiV infection outbreak reported in West Bengal (previous outbreaks reported in Siliguri in 2001 and Nadia in 2007). Enhanced surveillance and infection prevention and control (IPC) measures are in place while investigations into the source of exposure are ongoing. NiV infection is a serious but rare zoonotic disease transmitted to humans through infected animals (such as bats), or food contaminated with saliva, urine, and excreta of infected animals. It can also be transmitted directly from person to person through close contact with an infected person. There are currently no licensed medicines or vaccines for NiV infection, however early supportive care can improve survival. WHO assesses the risk posed by Nipah to be moderate at the sub-national level, and low at the national, the regional and global levels.","overview":"On 26 January 2026, the India IHR NFP notified WHO of two confirmed NiV infection cases that occurred in West Bengal State. Preliminary laboratory testing suggested NiV infection, and confirmation was received from the National Institute of Virology, Pune on 13 January 2026. The cases were confirmed through Reverse Transcription Polymerase Chain Reaction (RT-PCR) and Enzyme-Linked Immunosorbent Assay (ELISA) testing. The first case is a female nurse and the second case is a male nurse. Both cases were between 20 &ndash; 30 years old, from Barasat, North 24 Parganas district. Both cases developed symptoms typical of severe NiV infection in late December 2025 and were admitted to hospital in early January 2026. As of 21 January 2026, the second case showed clinical improvement, while the first case remained under critical care. Following the two confirmed cases, Indian health authorities identified and tested over 190 contact persons, including health and care workers and community contacts. All samples from contact persons tested negative for NiV. The Indian National Centre for Disease Control, announced on 27 January that no further confirmed cases have been detected in West Bengal from December 2025 to date.","assessment":"Nipah virus ( Henipavirus nipahense ) is a rare zoonotic pathogen with a high CFR (40-75%) and no licensed vaccine or treatment. Its reservoirs are fruit bats or flying foxes (bats in the Pteropus genus), which are distributed in the coastal regions and on several islands in the Indian ocean, India, south-east Asia and Oceania. The virus can be transmitted to humans from wild and domestic animals, however, as the disease can be transmitted by domesticated animals, secondary human-to-human transmissions are also possible. Cases of Nipah virus infection were first reported in 1998 and since then have been reported in Bangladesh, India, Malaysia, Philippines and Singapore. The virus is present in India, with seasonal outbreaks linked to bat activities and cultural practices such as the consumption of raw date palm sap. Seasonal outbreaks occur between December and May, coinciding with the harvesting of date palm sap. This event represents the third Nipah outbreak reported in West Bengal, while multiple Nipah outbreaks were also documented in Kerala since 2018. In West Bengal, previous outbreaks occurred in 2001 (Siliguri) and 2007 (Nadia district). Based on the current available information, WHO assesses the overall public health risk posed by NiV at the sub-national level to be moderate, taking into consideration no availability of specific drugs or vaccines for NiV infection and the difficulty of early diagnosis. Although sensitive and specific laboratory methods exist, the symptoms during the first phase are not specific and could potentially delay a timely diagnosis, outbreak detection and response. In addition, fruit bats ( Pteropus spp .) are the natural reservoir of NiV, and they are present in India and repeated spillover of the virus from its reservoir to the human population has been demonstrated. Human-to-human transmission has been documented in previous outbreaks, mostly reported in health-care settings and among family and caregivers of sick people through close contact with bodily fluids. Implementation of adequate infection prevention and control measures in health care facilities is critical to mitigate health care associated infection. The yearly number of NiV infection cases reported in India has remained relatively low since 2001, except for 2001, when 66 cases were reported and 2018 when 18 cases were reported. Over the past 5 years, a dozen confirmed cases were reported in India, all in Kerala State. Strong public health measures are implemented in India to detect and control outbreaks, including established NiV surveillance, and the availability of Rapid Response Teams (RRT) at both the Central and State levels, along with the capacity to rapidly test samples. For neighbouring countries, WHO assesses the public health risk posed by NiV at the regional level to be low. There have been no reports of cross‑border transmission, and the current outbreak remains geographically limited. Nevertheless, the risk of disease occurrence persists due to the shared ecological corridor of fruit bats and the history of human cases previously reported in the region. India has demonstrated strong capacity and experience in managing past NiV outbreaks. WHO assesses the public health risk posed by NiV at the global level to be low, as there has been no confirmed spread of cases outside India.","advice":"In the absence of a licensed vaccine or specific therapeutic treatment for Nipah virus disease, reducing or preventing infection in people relies on raising awareness of the risk factors. This includes providing guidance on and reinforcing risk communication messages about the measures that people can take to reduce exposure to the Nipah virus. This is also important in the context of mass gatherings, where attendees come from different countries and may be unfamiliar with disease and its mode of transmission, as well as actions they can take to protect themselves. and case management should focus on delivering timely supportive care, supported by an effective laboratory system and adequate infection prevention and control measures in health facilities. Intensive supportive care is recommended for treatment of severe respiratory and neurologic complications. Public health educational messages should focus on: Reducing the risk of bat-to-human transmission Efforts to prevent transmission should first focus on decreasing bat access to date palm sap and other fresh food products. Freshly collected date palm juice should be boiled, and fruits should be thoroughly washed and peeled before consumption. Fruits with signs of bat bites should be discarded. Areas where bats are known to roost should be avoided. Reducing the risk of human-to-human transmission. Close unprotected physical contact with NiV-infected people should be avoided. Regular hand washing should be carried out after caring for or visiting sick people along other preventive measures. People experiencing Nipah-like symptoms should be referred to a health facility, as early supportive care is key in the absence of treatment. Contact tracing and monitoring are also key to mitigate human-to-human transmission. Controlling infection in health care settings Health and care workers caring for patients with suspected or confirmed infection, or handling specimens from them, should always implement standard precautions for infection prevention and control at all times, for all patients. When caring for patients with suspected or confirmed NiV, WHO advises the use of contact and droplet precautions including a well-fitting medical mask, eye protection, a fluid-resistant gown, and examination gloves. Airborne precautions should be implemented during aerosol-generating procedures, including placing the patient in an airborne-infection isolation room and the use of a fit-tested filtering facepiece respirator instead of a medical mask. Suspected or confirmed cases of NiV should be placed in a single-patient room. For family members and caregivers visiting patients with suspected or confirmed Nipah virus, similar precautions should be applied. Samples taken from people and animals with suspected NiV infection should be handled by trained staff working in suitably equipped laboratories. Based on the currently available information, WHO does not recommend any travel and/or trade restrictions.","publishedAt":"2026-01-30T19:00:00.000Z","lastModified":"2026-02-11T08:14:47.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON593","response":"Several public health measures have been implemented by local authorities, including: The Government of India, in close coordination with the Government of West Bengal, initiated prompt and comprehensive public health measures in accordance with established protocols. Investigations were conducted in collaboration with other sectors through a One Health coordinated approach. Contact tracing has been carried out around the identified cases, with continuous follow-up. Surveillance efforts have been strengthened and enhanced to ensure early case detection. Health education and awareness campaigns, including community engagement and advocacy, are ongoing. Clinicians have been sensitized and alerted to NiV. Infection prevention and control has been strengthened at health-care settings. Prompt sample collection, transportation, and testing were conducted at the reference laboratory teams. The support provided by WHO includes: Providing event communication support at national and international levels, including the submission of an official IHR notification. Monitoring of the evolving outbreak situation, especially during the ongoing Nipah season, including support for assessment of epidemiological patterns, risk factors, and geographic spread.","epidemiology":"NiV infection is a zoonotic disease transmitted to humans through infected animals (such as bats), or food contaminated with saliva, urine, and excreta of infected animals. It can also be transmitted directly from person to person through close contact with an infected person. Fruit bats or flying foxes ( Pteropus species) are the natural hosts for the virus. The incubation period ranges from 3 to 14 days. In some rare cases incubation of up to 45 days has been reported. Laboratory diagnosis of a patient with a clinical history of NiV infection can be made during the acute and convalescent phases of the disease by using a combination of tests. The main tests used are RT-PCR from bodily fluids and antibody detection via ELISA. Human infections range from asymptomatic infection to acute respiratory infection (mild, severe), and fatal encephalitis (brain swelling). Infected people initially develop symptoms including fever, headaches, myalgia (muscle pain), vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. Some people can also experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours. Further information about NiV infection can be found here . The case fatality ratio (CFR) in outbreaks across Bangladesh, India, Malaysia, and Singapore range from 40% to 75%, depending on local capabilities for early detection and clinical management. There are currently no licensed medicines or vaccines specific for NiV infection. Intensive supportive care is recommended to treat severe respiratory and neurologic complications. Henipavirus nipahense (Nipah virus) is considered a priority pathogen for the acceleration of medical countermeasures (MCMs) to respond to epidemics and pandemics as part of the WHO R&D Blueprint for Epidemics.","formattedDate":"2026-01-30T16:32:57Z","matchedSignals":["transmission concern","response escalation"]}},{"id":"2026-DON592","title":"Marburg virus disease- Ethiopia","disease":"Marburg virus disease- Ethiopia","locations":[],"riskLevel":"elevated-watch","signalClass":"Cross-border or severe outbreak signal","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON592","summary":"On 26 January 2026, the Ministry of Health of Ethiopia declared the end of the Marburg virus disease (MVD) outbreak. This declaration came after two consecutive incubation periods (a total of 42 days) since the last person confirmed with MVD died and was given a safe and dignified burial, in accordance with WHO recommendations on 14 December 2025. As of 25 January 2026, a cumulative total of 19 cases, including 14 confirmed (including nine deaths) and five probable cases (all deaths), were reported. A total of 857 contacts listed for monitoring all had completed their 21-day follow-up as of 25 January 2026. WHO, through its country office and partners, provided technical, operational and financial support to the government to contain this outbreak.","overview":"On 14 November 2025, after the laboratory confirmation of suspected viral hemorrhagic fever (VHF) cases in Jinka town, South Ethiopia Regional State, Ethiopia, the Ministry of Health of Ethiopia declared an outbreak of Marburg Virus Disease (MVD). Molecular testing conducted by the National Reference Laboratory at the Ethiopian Public Health Institute (EPHI) identified Marburg virus (MARV) in patient samples. This was the first time Ethiopia was reporting a MVD outbreak . The first known case was an adult from Jinka town who developed symptoms on 23 October. The patient presented to the General Hospital the following day with vomiting, loss of appetite, and abdominal cramps. As of 25 January 2026, a cumulative total of 14 confirmed cases, including nine deaths (Case Fatality Rate (CFR) 64.3%) and five probable cases, all of whom had died, were reported by the Ministry of Health from Jinka, Malle and Dasench woredas in South Ethiopia Region and Hawassa in Sidama Region. As of 25 January 2026, a total of 857 contacts were listed who completed 21 days of follow-up, 760 from the South Ethiopia Region and 97 from the Sidama Region. As of 5 January 2026, 3800 samples were tested for the virus. On 26 January 2026, after two consecutive incubation periods (a total of 42 days), without a new confirmed case reported, after the last confirmed case died and was given a safe and dignified burial, on 14 December 2025, the Ministry of Health of Ethiopia declared the end of the MVD outbreak, as per WHO recommendations. Figure 1: Map of districts reporting confirmed and probable Marburg virus disease cases in Ethiopia, as of 25 January 2026","assessment":"This was the first-ever confirmed MVD outbreak reported in Ethiopia. Based on the outbreak investigation and surveillance activities during the response, which included contact tracing, alert management, active case search, and mortality surveillance, no additional cases have been reported during the 42-day countdown period, as per WHO recommendations. However, there remains a risk of re-emergence of MVD following the declaration of the end of the outbreak, with potential spillovers from interactions with the animal reservoir. Risk communication and community engagement activities will continue to provide timely and accurate information, monitor and address community feedback and rumours, while supporting efforts to reduce stigma toward individuals affected by the outbreak.","advice":"WHO encourages maintaining early detection and care capacities in addition to sustaining the ability to quickly respond after the outbreak ends. This is to make sure that if the disease re-emerges, health authorities can detect it immediately, prevent the disease from spreading again, and ultimately save lives. Raising awareness of risk factors for MVD and protective measures that individuals can take is an effective way to reduce human transmission. WHO advises the following risk reduction measures as an effective way to reduce MVD transmission in healthcare facilities and in communities: Reducing the risk of bat-to-human transmission arising from prolonged exposure to mines or caves inhabited by fruit bat colonies. People visiting or working in mines or caves inhabited by fruit bat colonies should wear gloves and other appropriate protective clothing (including masks). Capabilities for early detection of MVD patients should be maintained over time in settings at risk of the disease. Reducing the risk of human-to-human transmission in the community arising from direct or close contact with infected patients, particularly with their body fluids. Close physical contact with MVD patients should be avoided. Patients suspected or confirmed for MVD should be isolated in a designated treatment centre for early care and to avoid transmission at home. Communities affected by MVD, along with health authorities, should ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures. Outbreak containment measures include safe and dignified burial of the deceased, identifying people who may have been in contact with someone infected with MVD and monitoring their health for 21 days and providing care to the confirmed patient. Any sick people with symptoms matching MVD should be referred to a health facility with adequate capacity. Critical infection prevention and control measures should be implemented and/or strengthened in all health care facilities, per WHO&rsquo;s Infection prevention and control guideline for Ebola and Marburg disease . Health workers caring for patients with confirmed or suspected MVD should apply transmission-based precautions in addition to: standard precautions , including appropriate use of PPE and hand hygiene according to the WHO 5 moments to avoid contact with patient&rsquo;s blood and other body fluids and with contaminated surfaces and objects. Waste generated in healthcare facilities must be safely segregated, collected, transported, stored, treated and finally disposed. Follow the national guidelines, rules and regulations for safe waste disposal or follow the WHO&rsquo;s guidelines on safe waste management . Patient-care activities should be undertaken in a clean and hygienic environment that facilitates practices related to the prevention and control of health-care-associated infections (HAIs) as outlined in Essential environmental health standards in health care . Safe water, adequate sanitation and hygiene infrastructure and services should be provided in healthcare facilities. For details on recommendations and improvement, follow the WASH FIT implementation Package WHO encourages countries to implement a comprehensive care programme to support people who have recovered from MVD with any subsequent sequelae and to enable them to access body fluid testing and to mitigate the risk of transmission through infected body fluids by adequate practices. Based on the current risk assessment, WHO advises against any travel and trade restrictions with Ethiopia.","publishedAt":"2026-01-26T19:00:00.000Z","lastModified":"2026-01-26T17:03:04.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2026-DON592","response":"Local and national health authorities in Ethiopia implemented the following public health measures: A National Taskforce established at the Ministry of Health to provide strategic guidance, make decisions and mobilize resources. A costed national three-month response plan developed and launched by the MoH/EPHI The MoH regularly disseminated information on the MVD outbreak to the public and key partners. Public Health Emergency Operational Centres were activated at national and regional levels, with incident management structures established to coordinate the response. The Ministry of Health, in collaboration with EPHI and regional health offices, conducted integrated surveillance and response activities, including at priority points of entry (PoEs) and points of control (PoCs). Community surveillance, contact tracing, house-to-house visits, and medical service delivery were enhanced. Two hospitals designated as treatment centres, with dedicated health workers deployed to manage cases. Laboratory capacities were strengthened both at national level and through the deployment of a mobile laboratory in Jinka for timely confirmation. Field assessments conducted by a rapid response team (RRT). Risk Communication and Community Engagement (RCCE) teams disseminated MVD prevention messages, conducted community dialogues, developed activity plans for targeted community interventions, monitored social media to address misinformation, and assessed trusted communication channels to enhance public awareness and engage local networks and influencers. WHO, through its country office and partners, provided technical, operational and financial support to the government to contain this outbreak. These include: WHO provided policy, technical and operational support across all response pillars, including on PoE surveillance, laboratory, case management, IPC, safe and dignified burial, RCCE, logistics and cross-border coordination. Provided emergency supplies including testing kits, VHF kits, treatment centre modules. Deployed technical experts to provide operational support across all response pillars. Provided technical support for capacity building and supervision on surveillance, integrated case management and IPC activities. Continued providing technical and strategic support for the transition plan, including the integration of the MVD response into essential health services. Supported the Regional Health Bureau (RHB) with community-based active case searching and mortality surveillance across various clusters. Provided technical and programmatic support to the RHB for the development and implementation of the Survivors Program.","epidemiology":"Marburg virus disease (MVD) is a severe disease caused by either of two closely related viruses, Marburg virus and Ravn virus. MVD has a high case fatality rate, ranging from 24% to 88% from previous outbreaks. The CFR can be lowered with early supportive patient care. The virus is initially transmitted to humans from fruit bats ( Rousettus aegyptiacus ) and then spreads among people through direct contact with bodily fluids, contaminated surfaces, or infected materials. Healthcare workers, caregivers, and individuals involved in burial practices are particularly at risk when appropriate infection, prevention and control measures are not in place. MVD symptoms typically begin abruptly after an incubation period of two to 21 days and include high fever, severe headache, malaise, muscle aches, and progressive gastrointestinal symptoms such as diarrhea and vomiting. In severe cases, patients may experience bleeding from multiple sites and die from shock and organ failure within a week of symptom onset. There are no approved treatment or vaccines for MVD, although early supportive care improves survival. Some candidate vaccines and therapeutics are currently under investigation. Nineteen outbreaks of MVD have previously been reported globally. The most recent outbreak was reported from the Republic of Tanzania between January and March 2025. Additional countries that have reported outbreaks of MVD in the African Region include Angola, the Democratic Republic of the Congo, Equatorial Guinea, Ghana, Guinea, Kenya, Rwanda, South Africa, and Uganda.","formattedDate":"2026-01-26T17:02:50Z","matchedSignals":["transmission concern","severity signal","response escalation"]}},{"id":"2025-DON591","title":"Middle East respiratory syndrome coronavirus - Global update","disease":"Middle East respiratory syndrome coronavirus","locations":["Global update"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON591","summary":"Since the beginning of 2025 and as of 21 December 2025, a total of 19 cases of Middle East respiratory syndrome coronavirus (MERS- CoV), including four deaths have been reported to WHO globally. Of the 19 cases, 17 were reported by the Kingdom of Saudi Arabia (KSA), and two were reported from France. Between 4 June and 21 December 2025, the Ministry of Health (MoH) of KSA reported a total of seven cases of MERS-CoV infection, including two deaths. In addition, at the beginning of December 2025, the National IHR Focal Point (IHR NFP) for France also reported two MERS-CoV travel – associated cases; involving individuals with recent travel to countries in the Arabian Peninsula. The notification of these latest cases does not change the overall risk assessment, which remains moderate at both the global and regional levels. These cases show that the virus continues to pose a threat in countries where it is circulating in dromedary camels, with regular spillover into the human population. WHO recommends implementation of targeted infection, prevention and control (IPC) measures to prevent the spread of health care-associated infections of MERS-CoV and onward human transmission.","overview":"Since the first report of MERS-CoV in the KSA and Jordan in 2012, a total 2635 laboratory-confirmed cases of MERS-CoV infection, with 964 associated deaths (Case Fatality Ratio (CFR) of 37%), have been reported to WHO from 27 countries, across all six WHO regions (Figure 1). The majority of cases (84%; n=2224), have been reported from the KSA (Figure 2). Since the beginning of 2025 and as of 21 December, a total of 19 cases have been reported to WHO. Overall, 17 cases were reported in the KSA from five regions named: Riyadh (n=10), Taif (n=3), Najran (n=2), Hail (n=1), and Hafr Al-Batin City (n=1) (Figure 3). In addition, two travel associated cases of MERS-CoV infection have been reported in France, with likely exposure occurring during recent travel in the Arabian Peninsula (Figure 3). This disease outbreak news report focuses on the recent nine cases of MERS-CoV infection reported between 4 June - 21 December 2025: seven cases from the KSA and the two imported cases to France. The details of cases reported earlier in 2025 can be referred to in the previously published disease outbreak news on 13 March 2025 and 12 May 2025 . Between 4 June and 21 December 2025, the MoH of the KSA reported a total of seven cases of MERS CoV infection. The cases were reported from three regions: Najran (2), Riyadh (3), and Taif (2). No epidemiological links were identified between the seven cases. In addition, between 2 and 3 of December 2025, the IHR NFP for France reported two cases of MERS &ndash; CoV with recent travel to the Arabian Peninsula during the month of November. Follow-up has been completed for all contacts and no secondary infections have been identified or reported. From September 2012, France has recorded a total of four laboratory-confirmed cases of MERS-CoV infection, including one death: two cases were reported in 2013, and the latest two cases in December 2025. All cases had been travelers exposed in the Arabian Peninsula and returning back to France. For additional details please see Table 1. Figure 1: Epidemic curve of MERS-CoV infections (2635) and deaths (964) reported globally between 2012-2025 Figure 2: Epidemic curve of MERS-CoV infections (2224) and deaths (868) reported in KSA between 2012-2025 Figure 3. Geographical distribution of MERS-CoV infections between 1 January and 21 December 2025 (n=19). Table 1: MERS-CoV cases reported by KSA and France between 4 June and 21 December 2025","assessment":"As of 21 December 2025, a total of 2635 laboratory-confirmed cases of MERS-CoV infection have been reported globally to WHO, with 964 associated deaths. The majority of these cases have occurred in countries on the Arabian Peninsula, including 2224 cases with 868 related deaths (CFR 39%) reported from the KSA. A notable outbreak outside the Middle East occurred in the Republic of Korea, in May 2015, during which 186 laboratory-confirmed cases (185 in the Republic of Korea and 1 in China) and 38 deaths were reported. However, the index case in that outbreak had a history of travel to the Middle East. Three limited healthcare-related clusters have recently been reported from the KSA, two in 2024 comprised of three and two cases each, and one in 2025 comprised of 7 cases; the previous cluster before that had been observed in May 2020, also in the KSA. Extensive contact tracing was applied in the 2025 cluster, which lead to detection of four asymptomatic and two mild cases, who fully recovered. Despite these recent clusters, zoonotic spillover remains an important mode of human infection, leading to isolated cases and limited onwards transmission between humans. Global total cases reflect laboratory-confirmed cases reported to WHO under IHR (2005) or directly by Ministries of Health from Member States. These figures may underestimate the true number of cases if some were not reported to WHO, as they may be missed by current surveillance systems and not be tested for MERS-CoV &ndash; either due to similar clinical presentation as other circulating respiratory diseases or because infected individuals remained asymptomatic or had only mild disease. The total number of deaths includes those officially reported to WHO through follow-up with affected Member States. The notification of these new cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East and/or other countries where MERS CoV is circulating in dromedaries, and that cases will continue to be exported to other countries by individuals who were exposed to the virus through contact with dromedaries or their products (for example, consumption of raw camel milk, camel urine, or eating meat that has not been properly cooked), or in a healthcare setting. Due to the similarity of symptoms with other respiratory diseases that are widely circulating, like influenza or COVID-19, detection and diagnosis of MERS cases may be delayed, especially in unaffected countries, and provide an opportunity for onward human-to-human transmission to go undetected. WHO continues to monitor the epidemiological situation and conducts risk assessments based on the latest available information. No vaccine or specific treatment is currently available, although several MERS-CoV-specific vaccines and therapeutics are in development. Treatment remains supportive, focusing on managing symptoms based on the severity of the illness.","advice":"Surveillance: Based on the current situation and available information, WHO re-emphasizes the importance of strong surveillance by all Member States for acute respiratory infections, with the inclusion of MERS-CoV into the testing algorithm where warranted, and to carefully review any unusual patterns. Clinical Management The incubation period is typically 2-15 days (median 5 days), although prolonged incubation periods have been reported in the immunocompromised. Although mild disease does occur, clinicians should be aware that symptoms may frequently progress rapidly non-specific signs of upper respiratory tract infection, cough and breathlessness, to respiratory failure and cardiovascular collapse. [3] MERS-CoV infection should be managed supportively with respiratory support titrated to the needs of the patient; there is a wide spectrum of severity, with many patients requiring mechanical ventilation. The largest clinical trial in MERS compared a combination of lopinavir&ndash;ritonavir and interferon &beta;-1b with placebo (95 patients). [4] Active treatment caused lower 90-day mortality in hospitalized patients with laboratory-confirmed MERS (90-day mortality of 48% and 29% respectively). Further analysis suggested a positive effect only in patients treated within 7 days of symptom onset. Although there is increasing use of corticosteroids for some respiratory conditions (specifically in COVID-19 and some other forms of pneumonia), their use in MERS-CoV is of uncertain benefit, and harms relating to their immunomodulatory effects may be significant; more data are needed. The use of convalescent plasma has not been proven, although has been used in a limited number of patients in a non-trial setting. While antibiotics have been used in severe disease to presumptively treat concurrent bacterial infection, there are no controlled data on efficacy. A retrospective analysis of 349 MERS patients examined macrolide antibiotic therapy. No difference in 90-day mortality was found in the 136 patients receiving macrolides compated with those who did not . [5] Infection prevention and control: Human-to-human transmission of MERS-CoV in healthcare settings has been associated with delays in recognizing the early symptoms of MERS-CoV infection, slow triage of suspected cases and delays in implementing timely IPC measures. IPC measures are therefore critical to prevent the spread of MERS-CoV in healthcare facilities and onwards in the community. Healthcare workers should always apply standard precautions consistently with all patients and perform risk assessments at every interaction in healthcare settings to determine the necessary protection measures. For patients with suspected MERS-CoV infection that require hospitalization, place patient in an adequately ventilated single room away from other patient care areas. In addition to standard precautions. Droplet and contact precautions should be implemented when providing care to patients with symptoms of acute respiratory infection who are suspects of any respiratory disease, including probable or confirmed cases of MERS-CoV infection. [6,7] Droplet and contact precautions should be maintained until the patient is no longer symptomatic (for at least 24 hours) and has two upper respiratory (URT) swabs (taken 24hrs apart) test negative in RT-PCR or according to local guidance. Additionally, airborne precautions should be applied when performing aerosol generating procedures or in settings where aerosol generating procedures are conducted. Early identification, case management and prompt isolation of suspected respiratory infected patients and cases, quarantine of contacts, together with appropriate IPC measures in health care settings, including improving ventilation in enclosed spaces and public health awareness can prevent the spread of human-to-human transmission of MERS-CoV. Public health and social measures: MERS-CoV appears to cause more severe disease in people with underlying chronic medical conditions such as diabetes, renal failure, chronic lung disease, and immunosuppression. Therefore, people with these underlying medical conditions should avoid close contact with animals, particularly dromedaries, when visiting farms, markets, or barn areas where the virus may be circulating. General hygiene measures, such as regular hand hygiene before and after touching animals or animal products and avoiding contact with sick animals, should be adhered to. In addition, hygiene practices should be observed including the five keys to safer food should be followed when dealing with food items of camels; people should avoid drinking raw camel milk or camel urine or eating meat that has not been properly cooked. WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend the application of any travel or trade restrictions.","publishedAt":"2025-12-24T05:38:07.000Z","lastModified":"2026-01-06T10:00:01.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2025-DON591","response":"WHO is supporting Member States in strengthening preparedness and response. Activities in the Kingdom of Saudi Arabia include; Strengthened surveillance with immediate notification of all suspected and confirmed cases. Strict implementation of infection prevention and control transmission-based precautions (Contact and Droplet precautions) in healthcare facilities for suspect or confirmed patients, and airborne precautions for patients undergoing aerosol-generating procedures. Identification of health and care worker contacts and perform risk assessment of their exposure, considering the timely identification of symptomatic patients, implementation of IPC measures, and correct utilization of PPE while treating patients, Exposed health and care workers are followed up for 14 days to monitor symptoms. If they develop symptoms, they are to be removed from working with patients until tested and symptoms are fully resolved. Patients exposed to MERS-CoV in the healthcare setting must be tested to determine their ability to continue working with patients without further transmission, which could potentially lead to outbreaks in the healthcare facility. Identification of all potential community contacts and active follow-up to monitor symptoms for 14 days. All community acquired cases are investigated for having direct or indirect contact with camels or their products. Cases linked to camel exposures are notified to the National Center for Prevention and Control of Plants, Pests, and Animal Diseases (Weqaa) to investigate potential camel sources. Camels identified as a presumed source are quarantined and tested for MERS-CoV, and if live virus is detected, the quarantine period will be extended until live virus is no longer detected in camel. Activities in France include; On 4 December 2025, MoH France published information regarding the two imported cases of MERS-CoV in the country ( link ). Genomic sequencing was conducted from the first case and reported as being the same lineage that is circulating in the Arabian Peninsula. Further laboratory analyses are ongoing. Contact tracing was initiated as soon as the first case was detected for the monitoring and surveillance of fellow travellers and co-exposed individuals, high-risk contacts, and hospital contacts. It was completed in week 51 and no additional cases among the travellers have been reported, nor any secondary cases as of 19 December 2025. Asymptomatic co-exposed individuals and at-risk contacts located in France were offered a full testing protocol (nasopharyngeal swab, sputum, rectal swab and serology) on a voluntary basis up to 29 days after their last exposure, even if they did not exhibit any symptoms.","epidemiology":"Middle East respiratory syndrome (MERS) is a respiratory illness caused by a coronavirus (MERS-CoV). The case fatality ratio (CFR) among confirmed cases is around 37%. The CFR is calculated based solely on laboratory-confirmed infections and may overestimate the actual mortality rate since milder cases often go undetected or unreported. Humans can contract MERS-CoV through multiple transmission pathways; the primary route being through direct or indirect contact with dromedary camels, which serve as the virus&rsquo;s natural host and primary zoonotic reservoir. Additionally, human-to-human transmission can occur via infectious respiratory particles primarily in close-contact situations and can also occur through direct or indirect contact; this is especially prominent in health-care settings. Human-to-human transmission of the virus has occurred in health care facilities in several countries, including transmission from patients to health care providers and transmission between patients before MERS-CoV was diagnosed. It is not always possible to identify patients with MERS‐CoV early or without testing because symptoms and other clinical features may be non‐specific. Outside these environments, there has been limited documented human-to-human transmission. MERS can present with no symptoms (asymptomatic), mild symptoms (including mild respiratory issues), or severe illness leading to acute respiratory distress and death. Common symptoms include fever, cough, and breathing difficulties, with pneumonia frequently observed, though not always present. Some patients also experience gastrointestinal symptoms such as diarrhoea. Severe cases may require intensive care, including mechanical ventilation. Those at higher risk of severe outcomes include older adults, individuals with weakened immune systems, and those with chronic conditions like diabetes, kidney disease, cancer, or lung disorders. The number of MERS-CoV infections reported to WHO substantially declined since the beginning of the COVID-19 pandemic. Initially, this was likely the result of epidemiological surveillance for SARS-CoV-2 being prioritized. Similar clinical pictures of both diseases may have resulted in reduced testing and detection of MERS-CoV infections. However, the MoH of the KSA has been working to improve testing capacities for better detection of MERS-CoV since the easing of the COVID-19 pandemic, with MERS-CoV included into sentinel surveillance testing algorithms since the second quarter of 2023, for samples that test negative for both influenza and SARS-CoV-2. In addition, recommended IPC measures (e.g., mask-wearing, hand hygiene, physical distancing, improving ventilation) and public health and social measures in the community to reduce SARS-CoV-2 transmission, (stay-at-home orders, reduced mobility) also likely reduced onward human-to-human transmission of respiratory infections including MERS-CoV. Potential cross-protection conferred from infection with or vaccination against SARS-CoV-2 and any reduction in MERS-CoV infection or disease severity and vice versa has been hypothesized but requires further investigation. [1,2]","formattedDate":"2025-12-24T09:19:23Z","matchedSignals":["cross-border signal","transmission concern","novel or unusual signal","severity signal","response escalation"]}},{"id":"2025-DON586","title":"Seasonal influenza - Global situation","disease":"Seasonal influenza","locations":["Global situation"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON586","summary":"Seasonal influenza (‘the flu’) is an acute respiratory infection caused by influenza viruses that circulate globally and year-round. It can cause illness ranging from mild to severe, sometimes resulting in hospitalization or death. Seasonal influenza activity has increased globally in recent months, with an increased proportion of seasonal influenza A(H3N2) viruses being detected. This rise coincides with the onset of winter in the northern hemisphere and an increase in acute respiratory infections caused by influenza and other respiratory viruses typically observed at this time of year. Although global activity remains within expected seasonal ranges, early increases and higher activity than typical at this time of year have been observed in some regions. Seasonal influenza viruses, including A(H3N2) viruses, continually evolve over time. Since August 2025, there has been a rapid increase of A(H3N2) J.2.4.1 alias K subclade viruses detected from several countries based on available genetic sequence data. These subclade K viruses have several changes from related A(H3N2) viruses. Current epidemiological data do not indicate an increase in disease severity, although this subclade marks a notable evolution in influenza A(H3N2) viruses. Early estimates suggest that the influenza vaccine continues to provide protection against hospital attendance in both children and adults, even though its effectiveness against clinical disease during the current season remains uncertain. Vaccines remain essential, especially for people at high risk of influenza complications and their care givers. Even if there are some genetic differences between the circulating influenza viruses and the strains included in the vaccines, the seasonal influenza vaccine may still provide protection against drifted viruses and the other virus strains included in the vaccine. Vaccination is still expected to protect against severe illness and remains one of the most effective public health measures. WHO continues to monitor global influenza activity and influenza viruses, supports countries in surveillance capacity and updates guidance as needed.","overview":"Globally, influenza activity has increased since October 2025 with influenza A viruses predominant among the viruses detected globally. In many northern hemisphere countries, acute respiratory infection levels increase at this time of year. These increases are typically caused by seasonal epidemics of respiratory pathogens such as influenza, respiratory syncytial virus (RSV) and other common respiratory viruses. The exact timing of the onset, the duration, magnitude and the severity of each epidemic might vary by location, influenced by multiple factors such as type of circulating viruses (including influenza and other respiratory pathogens), relative population immunity and environmental conditions. In the northern hemisphere, some countries have reported early starts to the influenza season. In other countries, influenza activity is starting to increase, but has not yet reached the epidemic threshold. In the southern hemisphere, some countries have had unusually long seasons compared to previous years, with virus activity remaining higher than usual in recent months. Global influenza surveillance and monitoring is conducted through the Global Influenza Surveillance and Response System (GISRS), a WHO-coordinated network of over 160 institutions in 131 Member States. GISRS is tasked with conducting year-round surveillance and monitoring of influenza viruses and serving as the global alert mechanism for the emergence of novel influenza viruses and other respiratory pathogens with pandemic potential. In the northern hemisphere temperate and sub-tropical countries, areas and territories, influenza activity was generally low from June to August 2025. Activity gradually increased in September and continued to increase through November 2025. Influenza A viruses, especially A(H3N2) viruses, predominated during this period (Fig. 1). In the southern hemisphere temperate and sub-tropical countries, areas and territories, influenza activity generally decreased from June 2025 and remained low through August. However, a slight increase has been observed since September. Influenza A(H1N1)pdm09 viruses predominated in June and July; however, A(H3N2) viruses have predominated since September (Fig. 2). In tropical areas, there has been sustained influenza activity from June through November. Influenza A(H1N1)pdm09 viruses predominated through July. Since then, the proportion of influenza A(H3N2) viruses among reported detections has increased and has become predominant since the end of September (Fig. 3). Figure 1. Virus detections by subtype reported to FluNet, from 1 June to 30 November 2025 for the northern hemisphere temperate and sub-tropical countries, areas and territories. Source: GISRS: https://worldhealthorg.shinyapps.io/flunetchart/ Figure 2. Virus detections by subtype reported to FluNet, from 1 June to 30 November 2025, for the southern hemisphere temperate and sub-tropical countries, areas and territories. Source: GISRS: https://worldhealthorg.shinyapps.io/flunetchart/ Figure 3. Virus detections by subtype reported to FluNet, from 1 June to 30 November 2025, for tropical countries, areas and territories. Source: GISRS: https://worldhealthorg.shinyapps.io/flunetchart/ Genetic characteristics of recent seasonal influenza viruses Influenza A(H1N1)pdm09 and influenza B/Victoria lineage viruses continue to circulate in all regions albeit at low levels. Influenza A(H3N2) viruses Based on genetic sequence data available in GISAID , a mixture of A(H3N2) haemagglutinin (HA) clades and subclades are currently circulating globally; however, there has been a recent and rapid rise in a particular subclade of A(H3N2), J.2.4.1 (alias subclade K Nextclade / Nextstrain nomenclature). A(H3N2) subclade K viruses have genetically drifted from related J.2.4 viruses and have several amino acid changes in their HA in comparison. Detections of subclade K viruses are increasing in many parts of the world, with the exception, to date, of South America. Subclade K viruses were particularly evident from August 2025 in Australia and New Zealand and have now been detected in more than 34 countries over the last 6 months. Figure 4. Influenza A(H3N2) percent positivity reported for epidemiological week 48 (24 to 30 November) 2025 Source: GISRS: https://www.who.int/teams/global-influenza-programme/surveillance-and-monitoring/influenza-surveillance-outputs Overview of seasonal influenza by WHO Region African region Influenza detections in the WHO African Region overall increased in October with influenza A(H3N2) predominant. The timing and predominant virus varied by zone. In the western part of the region, influenza detections increased in September and October with A(H3N2) predominant since October. All seasonal subtypes have been detected continuously in the middle and eastern parts of the region. Influenza activity peaked in May 2025 in South Africa with almost exclusively A(H3N2) detections; in recent weeks influenza activity has increased slightly but remained low. Eastern Mediterranean Region While influenza activity in the WHO Eastern Mediterranean Region overall increased in October with A(H3N2) viruses predominant, there were variations by zone. In countries in the northern part of the region, influenza detections increased in October with influenza A(H1N1)pdm09 predominant and lesser proportions of influenza A(H3N2) and B virus detections reported. In the Arabian Peninsula, influenza detections also increased in October but with influenza A(H3N2) viruses predominant. European Region As of 21 November 2025, reported rates of influenza-like illness (ILI) and/or acute respiratory infection (ARI) in primary care were at baseline levels for most countries and areas of the WHO European Region. However, detections were increasing and regionally pooled test percent positivity in primary care sentinel surveillance rose above 10% in weeks 45 and 46 (ending on 15 November), marking the start of the 2025/26 influenza season for the European Region. This was approximately four weeks earlier than the median, but not out of the ordinary, with epidemiological trends similar to those observed in the 2022/23 influenza season. Influenza activity was variable between countries, with those in the west of the Region generally seeing earlier increases of influenza indicators compared to others. Influenza admissions, detections, and percent positivity in hospital surveillance were also increasing from inter-seasonal levels, with a higher proportion aged 65 years or older. A majority of influenza detections from sentinel and non-sentinel primary care and hospital surveillance systems were A(H3N2) viruses. Region of the Americas During the 2025 southern hemisphere season in the Americas, influenza transmission exceeded the seasonal threshold in mid-March, remaining mostly at low to moderate levels. Circulation was driven by influenza A(H1N1)pdm09, reaching a peak positivity of 19%. Activity then declined to low levels until the end of August, when an increase in circulation was observed, associated with influenza A(H3N2) in Brazil and Chile. As of beginning of November, Chile remains at moderate levels of influenza A(H3N2) transmission, without evidence of increased severity or rises in outpatient consultations. As of 4 November 2025, subclade K had not been detected in South America. In the northern hemisphere countries of the Americas, during week 45 of 2025, seasonal influenza circulation remained low, with influenza A(H1N1)pdm09 predominating in the Caribbean and Central America. In North America, influenza activity&mdash;although still low&mdash;was increasing, mainly driven by influenza A virus detections. While most detections in Mexico were influenza A(H1N1)pdm09, a predominance of influenza A(H3N2) has been observed in the United States and Canada, with growing detections of the A(H3N2) subclade K. South-East Asia Region Influenza detections in the South-East Asia Region started increasing from June, peaked in August and since then have generally remained low with some exceptions. During the 2025 till November, the proportion of Influenza A among all influenza viruses tested positive was 66% Influenza A(H3N2) was the predominant sub-type (43%) in transmission followed by A(H1N1)pdm09 (~20%). In Thailand, influenza detections of predominantly A(H3N2) increased in October and November. Influenza A(H3N2) detections also increased since July in Bangladesh and October in Sri Lanka. While the region has seen an increase in Influenza A(H3N2), 22 sequences of subclade K have been reported in GISAID from Nepal (1), India (4) and Thailand (17) as of 30 November. Western Pacific Region Since the beginning of October 2025, influenza seasonal activity has increased in the Western Pacific Region. In some countries, including Japan and the Republic of Korea, the onset of the typical seasonal influenza activity period started earlier than in previous years. As of 9 November 2025, influenza positivity ranged from 8% to 56% in the northern hemisphere countries. In southern hemisphere countries, influenza activity shows mixed trends; positivity has declined in Australia, remains high in New Zealand and is rapidly increasing in Fiji. The elevated influenza activity in New Zealand and Fiji is unusual for this time of the year. The predominant circulating influenza subtype is influenza A(H3N2), marking a shift from A(H1N1)pdm09, which predominated during the 2024-2025 northern hemisphere winter season. The increases in influenza have predominantly been driven by the expansion of A(H3N2) subclade K, which represents 89% of sequences submitted to GISAID from the Western Pacific Region (as of 21 November 2025).","assessment":"Seasonal influenza activity has increased globally in recent months, and influenza A(H3N2) viruses are predominant. This rise coincides with the onset of winter in the northern hemisphere. Epidemics and outbreaks of seasonal influenza and other circulating respiratory viruses can place significant pressure on healthcare systems. Although global activity remains within expected seasonal ranges, early increases and higher activity than typical at this time of year have been observed in some regions. Seasonal influenza could place significant pressure on healthcare systems even in non-temperate countries. Genetically drifted influenza A(H3N2) viruses, known as subclade K viruses, have been detected in many countries. While data on how well the vaccine works against clinical disease this season are still limited, vaccination is still expected to protect against severe illness and remains one of the most effective public health measures.","advice":"Surveillance Due to the constantly evolving nature of influenza viruses, WHO continues to stress the importance of year-round global surveillance to detect and monitor virological, epidemiological and clinical changes associated with emerging or circulating influenza viruses that may affect human health and timely virus sharing for risk assessment. Countries are encouraged to remain vigilant to the threat of influenza viruses and review any unusual epidemiological patterns. WHO advises Member States to maintain surveillance for respiratory pathogens through an integrated approach, considering country context, priorities, resources and capacities. WHO has published guidance on integrated respiratory virus surveillance. WHO has also updated guidance on assessing influenza epidemic and pandemic severity , including the impact on healthcare facilities. Clinical management and prophylaxis Clinical care for seasonal influenza focuses on identifying illness severity, assessing risk of progression, and linking to definitive care. Most cases are mild and self-limiting, but severe disease, marked by respiratory distress, sepsis, acute respiratory distress syndrome or multi-organ failure, requires urgent supportive care and often hospitalization. Clinical management of influenza involves high-quality supportive care&mdash;oxygen therapy, monitoring, hydration and respiratory support&mdash;and is foundational to improving outcomes, especially in severe cases. Diagnostic testing should support rapid decision-making: nucleic acid amplification test (NAAT) is conditionally recommended for confirmation of suspected disease in severely unwell patients, while either NAAT or digital immunoassay may be used for non-severe cases, depending on context and resource availability. Testing should be performed early with the aim of identifying people in need of treatment and linking them to care, including antivirals where indicated. Patients at high risk of progressing to severe disease are likely to benefit from antiviral to reduce their chance of admission to hospital. High-risk groups include adults &ge;65 years, those with immunocompromising conditions, chronic cardiovascular, neurological or respiratory disease; malignancy, pregnancy and diabetes further elevate risk. Individuals &ge;85 years or those with multiple risk factors are considered extremely high risk and might be considered for antiviral prophylaxis if exposed to influenza. Infection prevention and control measures in health-care settings Seasonal influenza is known to cause health care-associated infection outbreaks, in particular in long-term care facilities. WHO advises the use of syndromic screening at all entry points to health-care settings and as part of daily inpatient assessment to ensure that patients with suspected or confirmed infections that are transmissible in health-care settings, including influenza, are identified as soon as possible and that appropriate transmission-based precautions are implemented. WHO advises the use of droplet precautions when caring for patients with suspected or confirmed influenza. This includes appropriate patient placement (isolation) of suspected or confirmed cases, and the use of a medical mask by all health and care workers and visitors when caring for patients with suspected or confirmed influenza. Appropriate risk assessment for additional personal protective equipment (e.g. eye protection, filtering facepiece respirators, gown, gloves) should be performed by health and care workers when caring for patients with influenza. Increased risk of influenza transmission may occur instances where care activities or patient symptoms are likely to generate splashes or sprays of blood, body fluids, secretions and excretions onto mucosa of eyes, nose or mouth; or if in close contact with a patient with respiratory symptoms (e.g. coughing/sneezing) and sprays of secretions may reach the mucosa of eyes, nose or mouth directly, or indirectly via contaminated hands. When performing an aerosol-generating procedure on patients with suspected or confirmed influenza, patient placement in an airborne infection isolation room as well as airborne and contact precautions with eye protection are advised. Vaccination Vaccination is the best way to prevent influenza disease. Safe and effective vaccines have been used for more than 60 years. Influenza viruses are constantly changing, so the composition of the seasonal influenza vaccine is regularly updated to contain viruses that are more related to those circulating. WHO, through the Global Influenza Programme and GISRS, in collaboration with partners, continuously monitors influenza viruses and activity globally and recommends seasonal influenza vaccine compositions in February and September for the following northern and southern hemisphere influenza seasons, respectively. WHO recommends annual vaccination for high-risk groups, including health and care workers. People should ideally get vaccinated just before the influenza season begins for the most effective coverage, although getting vaccinated at any time during the influenza season can still help prevent flu infections. While the effectiveness of the vaccine may vary across seasons and risk groups, it reduces disease severity and lowers the chance of complications and death. Vaccination is especially important for people at high risk of influenza complications and their caregivers. Genetic changes or drift can occur in the circulating influenza viruses before or during the influenza season, including during the time between vaccine strain selection and the influenza season. Even if there are some genetic differences between the circulating influenza viruses and the strains that are included in the vaccines, the seasonal influenza vaccine may still provide protection against drifted viruses. Current vaccines include three influenza viruses: influenza A(H1N1)pdm09, influenza A(H3N2) and influenza B/Victoria lineage viruses. Therefore, circulation of a drifted virus does not always result in seasonal influenza vaccines being less effective in offering protection against influenza associated illness. As of now, it remains unclear how the vaccine will protect against clinical disease during this current season. However, early vaccine effectiveness estimates show the current vaccine is 70 to 75% effective at preventing hospital attendance in children aged 2 to 17 years and 30 to 40% effective in adults. [1] ,[2] Public health and social measures in the community The implementation of appropriate and proportionate public health and social measures (PHSM) is an essential component in the overall response to seasonal influenza epidemics. Measures such as performing hand hygiene, respiratory hygiene and cough etiquette as well as voluntary self-isolation and mask wearing of individuals who are symptomatic or have tested positive for influenza viruses can reduce transmission of influenza viruses. Countries should consider developing a plan to scale up additional PHSM in the event of high or extraordinarily high epidemics. Risk communication and community engagement Member States should consider to update and strengthen their risk communication and community engagement (RCCE) strategy integrating respiratory viruses. Enhanced risk communication and community engagement approach support empowerment of individuals to make informed decisions, countering misinformation, and community-led protection strategies. Clear, regular, evidence-based, culturally acceptable and context adapted RCCE approaches are essential for building and maintaining trust with the concerned and affected populations to ensure adoption of interventions, practices and behaviours. For RCCE efforts to be successful, it is vital that national policies for RCCE incorporate community engagement and feedback mechanisms that acknowledge and address contextual challenges faced by different population groups, particularly those made most vulnerable. The integration of RCCE approaches to promote vaccination against influenza is also recommended. WHO does not recommend any restriction on travel to or trade with the countries named in this report, based on the information available on the current event.","publishedAt":"2025-12-10T19:00:00.000Z","lastModified":"2025-12-10T19:55:04.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2025-DON586","response":"WHO is enhancing national, regional, and global capacities for influenza preparedness and response, including: continuous global monitoring of influenza viruses and disease activity; issuing seasonal influenza vaccine composition recommendations for both hemispheres; providing technical guidance to Member States on vaccine selection and campaign timing; supporting countries in developing prevention and control strategies; enhancing diagnostic capabilities and laboratory networks; monitoring vaccine effectiveness and susceptibility to approved antivirals; supporting disease surveillance and outbreak response activities; promoting increased vaccine coverage among high-risk groups; facilitating research and development of new therapeutics and countermeasures; and enhancing risk communication for the onset of the influenza season.","epidemiology":"Seasonal influenza (the flu) is an acute respiratory infection caused by influenza viruses that circulate globally and year-round. In temperate regions, seasonal influenza typically peaks during the winter months, whereas in tropical areas, influenza viruses can circulate year-round with seasonality and intensity that varies across countries. There are four types of influenza viruses, types A, B, C and D. Influenza A and B viruses circulate and cause seasonal epidemics of disease: Influenza A viruses are further classified into subtypes according to the combinations of the proteins on the surface of the virus. Currently circulating in humans are subtype A(H1N1) and A(H3N2) influenza viruses. Influenza B viruses are not classified into subtypes but can be broken down into lineages. Influenza type B viruses belong to either B/Yamagata or B/Victoria lineage. Influenza spreads easily between people when they cough or sneeze. Influenza disease can cause illness ranging from mild to severe, sometimes resulting in hospitalization or death. While most individuals recover within a week without need for medical care, influenza can lead to serious complication including death, especially among high-risk groups such as young children, the elderly, pregnant women and those with underlying conditions. Health and care workers are at high risk of acquiring influenza virus infection due to increased exposure to the patients, and of further spreading particularly to vulnerable individuals.","formattedDate":"2025-12-10T19:54:36Z","matchedSignals":["cross-border signal","novel or unusual signal","severity signal","WHO high-risk wording","response escalation"]}},{"id":"2025-DON587","title":"Broader transmission of mpox due to clade Ib MPXV – Global situation","disease":"Broader transmission of mpox due to clade Ib MPXV","locations":["Global situation"],"riskLevel":"high-attention","signalClass":"Potential international public-health emergency","url":"https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON587","summary":"The purpose of this report is to raise awareness about the local transmission of clade Ib monkeypox virus (MPXV) among men who have sex with men (MSM) in countries previously unaffected or to date reporting only cases linked to travel. This report summarizes recent epidemiological developments, response activities, and the associated global public health risk. The second declaration of a public health emergency of international concern (PHEIC) for mpox was lifted on 5 September 2025. As both MPXV clades I and II and their subclades continue to circulate globally, leading to substantial outbreaks in African countries, WHO continues to advise emergency preparedness and response activities. Multiple modes of transmission underlie ongoing virus circulation, with sexual contact remaining the primary amplifier of transmission in most settings. Since 5 September 2025, several countries across four of six WHO regions have confirmed clade Ib MPXV infection in individuals with no recent travel reported (WHO African Region, Region of the Americas, the European Region and the Western Pacific Region), most of which are being detected among men who have sex with men, suggesting local transmission, particularly given that infections often manifest with few or no symptoms (paucisymptomatic or asymptomatic cases) leading to undetected onward transmission. Overall, the surveillance data in most countries is sufficient to detect and respond effectively to mpox outbreaks. However, thorough epidemiological investigation, contact tracing and implementation of public health interventions to control spread remain challenging. Mpox is known to resolve on its own over two to four weeks in most cases. However, timely access to quality healthcare is essential to identify, prevent and manage secondary bacterial infections and other complications. Individuals living with immune suppressive conditions remain at high risk of more severe mpox disease and death, most notably people living with undetected and/or untreated, uncontrolled human immunodeficiency virus (HIV) infection. Men who have sex with men with new and/or multiple partners remain at increased risk of clade Ib and also IIb MPXV infection. WHO assesses the public health risk posed by clade Ib MPXV to men who have sex with men as moderate and the risk to the general population as low in most countries.","overview":"Since the lifting of the second PHEIC for mpox on 5 September 2025, and as of 24 November 2025, 43 new confirmed cases of clade Ib MPXV have been reported across six WHO regions outside areas where sustained community transmission of this virus strain has been occurring. In four of these regions (Region of the Americas, South-East Asia Region, European Region and the Western Pacific Region), 24 cases had reported no recent international travel, suggesting local transmission. Based on this, Italy, Malaysia, the Netherlands, Portugal, Spain, and the United States of America are now considered to be experiencing community transmission of clade Ib MPXV. In addition, travel-related cases continue to be reported in many countries. Among the 43 cases, half (22) were documented among men who have sex with men, while other cases were linked to travel to countries with known community transmission of clade Ib, or secondary to travel-related cases (household contacts and/or sexual partners). This report provides an overview of these recent cases of mpox confirmed to be due to clade Ib MPXV, by WHO region and country, summarizing key available epidemiological information, followed by WHO&rsquo;s rapid risk assessment and public health advice. Summary of reported mpox due to clade Ib MPXV in WHO Regions and countries from 5 September to 24 November 2025 WHO African Region Since the lifting of the PHEIC on 5 September 2025 and as of 24 November 2025, one country, Namibia, has reported clade Ib MPXV cases for the first time. Community transmission persists in Burundi, the Democratic Republic of the Congo, Kenya, Malawi, Mozambique, Republic of Congo, Rwanda, South Africa, the United Republic of Tanzania, Uganda, and Zambia. Namibia Namibia notified WHO of one probable and two confirmed cases of mpox due to clade Ib MPXV. The index (probable) case linked to travel within the African Region and the two confirmed cases were his household contacts. No further cases have been reported following detection of this cluster. These are the first cases of mpox reported in the country. WHO Region of the Americas Two countries in the WHO Americas Region have reported a total of four confirmed cases of mpox due to clade Ib MPXV. One case detected in Canada had recently travelled, while three cases in the United States of America had no recent travel history or known epidemiological links to travellers. Canada Canada notified WHO of one confirmed mpox case due to clade Ib MPXV in an adult male with recent travel outside of the country and reporting no sexual partners after returning to Canada. The case received counselling on preventing further transmission. United States of America The United States of America reported three unrelated cases of mpox due to clade Ib MPXV in Long Beach (one case) and Los Angeles (two cases) counties, California. All three occurred among men who have sex with men, none of whom had a history of recent international travel or known exposure to mpox cases. None of the individuals had a previous MPXV infection or prior orthopoxvirus vaccination, and one case was immunocompromised. All three individuals were hospitalized, received standard medical care, and have fully recovered. Prior to the lifting of the PHEIC, the United States of America had reported six cases of mpox due to clade Ib MPXV, all linked to travel. Public health authorities conducted contact tracing among household, healthcare-facility and social contacts. No additional cases of mpox due to clade Ib MPXV have been detected to date. Public health investigations suggest ongoing community transmission of clade Ib MPXV among men who have sex with men and their social networks in southern California. Viral genomic sequencing data indicate that the three California cases may be linked to a previously reported case in the country in August 2025. WHO South-East Asia Region From 5 September to 24 November 2025, five cases of mpox due to clade Ib MPXV have been reported in the WHO South-East Asia Region, all in Thailand. All cases had a recent history of international travel and three self-identified as men who have sex with men. Thailand Thailand notified WHO of five new cases of mpox cases due to clade Ib MPXV. The cases included four males, three of whom self-identified as men who have sex with men, and one female. Travel histories indicate associations with recent travel to the United Arab Emirates, Oman, and the Russian Federation, where exposure to infection is likely to have occurred. Prior to 5 September, Thailand had reported five cases of mpox due to clade Ib MPXV, all of which were associated with international travel. WHO Eastern Mediterranean Region Three countries in the WHO Eastern Mediterranean Region, Egypt, Lebanon and Qatar have reported six cases of mpox. Although the clade was not documented in Egypt and Lebanon, two cases attributed to clade Ib MPXV were reported in Qatar. Qatar Qatar notified WHO of two cases of mpox due to clade Ib MPXV. One adult male and one adult female, linked to travel within the Eastern Mediterranean Region. Prior to this period, Qatar had reported three cases of mpox due to clade Ib MPXV, all of which were associated with international travel. WHO European Region Countries in the WHO European Region have reported a total of 27 mpox cases due to clade Ib MPXV. Of these, 18 cases were classified as autochthonous, with no relevant history of recent international travel, suggesting undetected community transmission (Italy, the Netherlands, Portugal, and Spain). Two cases (reported from Belgium and the United Kingdom) were related to travel within Europe and five cases to travel outside of Europe (East Africa, Uganda, United Arab Emirates), either to or from countries experiencing community transmission of clade Ib MPXV but also to or from countries where no community transmission has been reported, including Angola, the United Arab Emirates, and Viet Nam. Furthermore, at least 15 of the 27 cases, and 14 of the 18 locally acquired cases occurred among individuals who self-identified as men who have sex with men. Belgium Belgium reported to WHO one case of mpox due to clade Ib MPXV with recent travel to the Netherlands. This individual reported having had multiple sexual contacts with other men while in the Netherlands. Prior to 5 September, Belgium had reported six mpox cases caused by clade Ib MPXV, all linked to travel. France France notified WHO of one case of mpox due to clade Ib MPXV in an adult male traveller who had returned from East Africa. Prior to this period, France had reported three cases of mpox due to clade Ib MPXV, all linked to travel. Germany Germany notified WHO of three cases of mpox due to clade Ib MPXV. All three cases had a recent history of international travel: one, an adult male who had travelled to Angola, another an adult female who had travelled to Uganda, and the third, an adult male who had travelled to Viet Nam. Uganda has community transmission of clade Ib and Viet Nam has not previously reported cases of this subclade. Prior to 5 September, Germany had reported 12 mpox cases due to clade Ib MPXV, most of which were linked to travel. Greece Greece notified WHO of its first case of mpox due to clade Ib MPXV, in an adult male with a recent history of travel to the United Arab Emirates before arriving in Greece. Ireland Ireland reported two cases linked to a small cluster which was reported before 5 September 2025. The index case had history of recent travel outside Europe. The first locally acquired case was a child (<5 years) who contracted clade Ib MPXV through household transmission, and the second a healthcare worker who had cared for one of the earlier cluster cases. No additional cases have been identified following this localized clade Ib cluster. Prior to this period, Ireland had reported one confirmed case of mpox due to clade Ib MPXV, which was linked to a traveller who was a probable case and part of that same cluster. Italy Italy notified WHO of two cases of mpox due to clade Ib MPXV in adult males who had no history of recent international travel or known contact with mpox cases. There was no epidemiological link between these cases. Epidemiological investigations and contact tracing were conducted, and no additional cases were identified. The identification of these cases of mpox due to clade Ib MPXV in Italy, without any links to travel, suggests local community transmission of clade Ib MPXV in the country. Prior to this period, Italy had reported one case of mpox due to clade Ib MPXV, linked to travel the United Republic of Tanzania. The Netherlands The Netherlands has reported nine cases of mpox due to clade Ib MPXV, all without relevant history of recent travel. These are the first such cases of mpox reported in the country. Eight cases were reported among individuals who identify as men who have sex with men. Of these, six individuals reported visiting the same highly frequented sex-on-premises venue. These cases suggest local community transmission of clade Ib MPXV in the country. Prior to the 5 September, the Netherlands had not reported any cases of mpox due to clade Ib MPXV. Portugal Portugal notified WHO of its first confirmed case of mpox case due to clade Ib MPXV. The case is an adult male with no history of recent international travel, with an inconsistent exposure context, and no known link to a case. There were no identified contacts, and the case was provided with guidance on home isolation, suspension of all sexual contact, and adherence to hygiene measures until full lesion resolution. Subsequently, the case ceased communication with health authorities. In Portugal, outbreak prevention and control measures are still ongoing at national and subnational levels. Reinforcement of clinical, laboratory and epidemiological detection, as well as engagement with civil society and the most at-risk communities promoting vaccination, has been in place. No further cases of mpox due to clade Ib have been detected in Portugal. The identification of this case of mpox due to clade Ib MPXV in Portugal, without any link to travel, and although no other cases have been detected, suggests local community transmission of clade Ib MPXV in the country. Spain Spain reported six cases of mpox due to clade Ib MPXV in individuals with no recent history of international travel or known contact with mpox cases. Two additional I MPXV cases were reported without further subclade information. These are the first cases of mpox due to clade Ib MPXV reported in the country. All cases were among individuals who identify as men who have sex with men. The identification of cases of mpox due to clade Ib MPXV in Spain, without any link to travel, suggests local community transmission of clade Ib MPXV in the country. The United Kingdom of Great Britain and Northern Ireland The United Kingdom notified WHO of one case of mpox due to clade Ib MPXV with travel history within Europe. This patient was a man who reported having sex with other men. Prior to this case, the United Kingdom had reported 18 clade Ib cases, most of whom reported direct or indirect links to travel to countries where clade Ib MPXV is circulating. WHO Western Pacific Region From 5 September to 24 November 2025, three cases of mpox due to clade Ib MPXV have been reported in the WHO Western Pacific Region: one each in Australia, Japan, and Malaysia. Australia Australia notified WHO of one case of mpox due to clade Ib MPXV in an adult male who reported recent travel to China and to the Philippines, where he was most likely infected. The Philippines have not reported any cases of mpox due to clade Ib MPXV. Prior to 5 September, three cases of mpox due to clade Ib MPXV, all linked to travel, had been reported in Australia. Japan Japan notified WHO of its first case of mpox due to clade Ib MPXV in adult female who reported recent travel to Africa, where she was most likely exposed to the virus. Malaysia Malaysia notified WHO of its first case of mpox due to clade Ib MPXV in an adult male, who self-identified as a man who has sex with men. He had no history of recent international travel nor any link to a known case. The person reported sexual contact with at least one individual during the three weeks prior to symptom onset. Contact tracing identified 15 household and healthcare contacts who underwent monitoring and no additional cases followed. The identification of this case of mpox due to clade Ib MPXV in Malaysia, without any link to travel, suggests local transmission of clade Ib MPXV in the country. Table 1. Summary of mpox due to clade Ib MPXV, by country, 5 September to 24 November 2025. *One additional case is not yet confirmed; therefore, it is not included in the table. **Two additional cases of mpox due to clade I MPXV among MSM, with no recent travel, did not have subclade information available","assessment":"In light of the epidemiological developments presented above and confirmation of community transmission of clade Ib MPXV in all WHO regions, WHO assesses the public health risk posed by clade Ib MPXV as moderate for men who have sex with men with new and/or multiple partners, and the risk to the general population as low. The rationale for this assessment is outlined below. When timely and good quality care is available, mpox generally causes a mild to moderate disease characterized by systemic symptoms and localized skin and/or mucosal lesions. However, secondary bacterial infections and other complications can lead to severe illness and death. In most settings, the proportion of cases where death occurs (case fatality ratio) is below 1%. Risk factors for severe disease and death include immunosuppression from any cause, such as uncontrolled HIV, younger age (0-4 years) and pregnancy. In recent years, people living with untreated or uncontrolled HIV have experienced the highest burden of mpox-related mortality. In African countries, deaths have also occurred among young children, pregnant women and their unborn or newborn infants, and individuals with other immunocompromising conditions. WHO has twice declared a PHEIC for mpox in recent years. The first, in 2022, was linked to a multi-country outbreak of clade IIb MPXV spreading through sexual networks across all regions of the world, primarily among men who have sex with men who have more than one partner. Transmission beyond this group during the global outbreak remained very limited, and was brought under control in the second half of 2023, with low-level sporadic transmission persisting in the same population, likely due to mild, undetected or subclinical transmission through sexual contact. The second PHEIC for mpox was declared in 2024 due to the rising number of mpox cases reported in Africa and the spread of the newly identified clade Ib MPXV across several African countries, most of which were affected by mpox for the first time and noted both sexual and non-sexual contact transmission. These outbreaks have led to sustained community transmission of this strain in several countries primarily in Central and East Africa. In many settings, transmission was initially driven by heterosexual contact among people with multiple casual sexual partners in linked sexual networks which included but were not limited to sex workers, followed by secondary spread within households. In most of these settings, virus circulation persists through both recognized and cryptic (undetected or unreported) transmission. The locally acquired cases of mpox due to clade Ib MPXV described above in individuals in multiple countries and WHO regions suggest that undetected transmission of this subclade is occurring independently in these settings. This transmission is likely accelerated due to some infections with no or minimal symptoms (asymptomatic or paucisymptomatic cases), leading to further onward transmission, predominantly through sexual contact. This hypothesis is supported by the rising proportion of clade Ib MPXV cases among men who have sex with men. It is likely that clade Ib MPXV will continue to spread, and that community transmission will become established in more countries, primarily mediated by sexual contact in extended sexual networks. Men who have sex with men, particularly those with a high number of casual sexual contacts, remain at increased risk of mpox, including clade Ib MPXV infection. Currently, immunity to mpox in this population is a result of vaccination efforts since 2022 in some countries and immunity conferred by exposure to mpox during the clade IIb MPXV outbreak. However, many countries were not able to offer mpox vaccination, access was constrained in some countries where vaccine was available, and many individuals received an incomplete course of vaccination. In addition, since the peak of vaccination activities in late 2022, new cohorts of young individuals have entered the sexually active population. These individuals are more likely to be immunologically na&iuml;ve having neither had previous infection nor been reached by vaccination activities. Furthermore, available data on vaccine effectiveness, uncertainty around the duration of protection against mpox following vaccination or prior infection, uncertainty regarding cross-clade protection of prior immunity during outbreaks with ongoing virus strain evolution, together with emerging data on waning humoral immunity over time, all limit confidence that those vaccinated or infected in 2022 and 2023 continue to retain protective immunity. Furthermore, of all cases reported by the countries noted here from 5 September to 24 November, only half were among men who have sex with men, suggesting continuing risk in other groups. All cases reported here are clinically stable and in isolation or recovered from the disease. The known contacts for most of them were followed up for 21 days to ensure early recognition of symptoms and diagnosis. The clinical risk for these cases and their contacts is low, notably if they have been vaccinated and are not immunocompromised. Data from the global outbreak related to clade IIb, and the multiple importations of clade Ib MPXV in the last year, suggests that transmission of mpox outside sexual networks has been relatively limited in most high-income settings. In this context, the risk of community transmission of mpox across different population groups is still considered to be low. However, given the large outbreaks and extensive community transmission of clade Ib MPXV in Africa affecting different populations, including children, together with associated outbreaks in many countries, it remains critical to maintain vigilance in all regions, and most notably for population groups at higher risk of sexual transmission. While affected countries have developed the capacity to detect and respond effectively to mpox outbreaks, in-depth epidemiological investigation and contact tracing remain challenging. Individuals with mpox are often reluctant to disclose their exposure history or current sexual contacts, which hinders full mapping of transmission chains and raises the likelihood of undetected onward spread. Prompt isolation of cases, identification and monitoring of reported contacts, and timely administration of post‑exposure vaccination to at-risk contacts, ideally within four days of exposure, all help to reduce the immediate risk of secondary cases. However, given that sexual transmission of clade Ib is now occurring in many countries, the risk is high that clade Ib MPXV will continue to spread in newly affected countries and to other countries around the world. In light of these recent developments, WHO assesses the public health risk posed by clade Ib MPXV for men who have sex with men with new and/or multiple partners as moderate and to the general population as low. The risk for men is justified by the higher risk of exposure in this population, and the prevalence of advanced HIV infection in this group in many contexts compared to the general population. The higher risk is mitigated by residual protective benefit of previous natural infection and/or prophylactic vaccination in this group in some areas. The extent to which immunity in the group could indirectly benefit younger individuals or those not previously vaccinated or exposed is not known and will continue to diminish over time if access to vaccines is not sustained. All mpox outbreaks, including individual locally acquired cases, should be assessed in their local context to better understand the epidemiology, transmission patterns, risk factors for severe disease, viral reservoir and evolution, and relevance of strategic approaches and countermeasures for prevention and control. Regardless of geographic area, epidemiological context, gender identity or sexual behaviour, an individual&rsquo;s risk largely depends on factors such as exposure risk and immune status.","advice":"Community transmission of clade Ib MPXV is occurring in many countries within and beyond Africa. WHO strongly advises that countries continue to follow the Standing Recommendations issued in 2023 and extended through 20 August 2026, particularly concerning the epidemiological surveillance of mpox and the strengthening of laboratory diagnostic capacities in line with WHO guidance, together with all other elements of response including risk communication and community engagement and ensuring access to mpox vaccine for people at risk. Countries must have, or arrange access to, diagnostic capacities to detect both MPXV clades and subclades. Public health authorities are strongly encouraged to ensure access to genomic sequencing capacity for virus clade identification for new cases and clusters of cases as part of comprehensive prevention and response measures. The WHO Strategic framework for enhancing prevention and control of mpox (2024&ndash;2027) outlines a road map to prevent and control outbreaks characterized by human-to-human transmission in every context, advance mpox research and access to countermeasures, and minimize zoonotic transmission where relevant in some African countries. Countries and communities are strongly encouraged to enhance preparedness, foster community ownership, widen access to vaccination for people at risk, and ensure cross-border coordination, especially in regions with mobile and vulnerable populations. In terms of risk communication, community engagement and infodemic management (RCCE-IM), countries are encouraged to: continue to engage closely with communities who may be at risk, such as men who have sex with men, sex workers and other groups at risk, to promote uptake of protective measures; expand outreach to include diaspora populations from and travellers to countries where mpox is currently circulating, including public health advice at points of entry; ensure that all communication and interventions are delivered in a stigma-free, respectful and inclusive manner, avoiding messaging that reinforces negative stereotypes or discrimination. Mpox vaccines formulated with vaccinia virus provide protection against mpox. WHO recommends vaccination against mpox in the context of an outbreak for people most at risk of exposure to mpox and for preventive use for laboratory personnel working with orthopoxviruses, in line with recommendations of the WHO Strategic Advisory Group of Experts on Immunization (SAGE) and the WHO position paper on mpox vaccines. Two vaccines currently in use for mpox are recommended. MVA-BN (non-replicating vaccine) has been prequalified by WHO and broadly used in outbreak response and LC16m8 (minimally replicating vaccine) has received a WHO emergency use listing (EUL) and is used in Japan and the DRC and has also been used in Colombia. LC16 is contraindicated for use in pregnancy, immunocompromised individuals, and those suffering from a proliferative skin condition. WHO recommends a vaccination for people at risk or where relevant in geographic areas at risk to interrupt transmission. National authorities are encouraged, as a temporary outbreak response measure, to administer MVA-BN vaccine via intradermal injection at one fifth of the dose normally administered subcutaneously (also known as fractional dosing) to protect individuals at risk of exposure and facilitate reaching four to five times as many people. Intradermal vaccination with MVA-BN has been shown to be effective and safe. Anyone with a clinical or laboratory-confirmed diagnosis of mpox should follow the instructions of local health authorities, including isolation in a health facility or at home for the duration of the infectious period. Persons with mpox should avoid travel, including local and international travel, unless the reason for travel is to seek medical care, until they do not present any mpox symptoms and the scabs have fallen off and a fresh layer of skin has formed underneath. Contacts of a confirmed case are asked to limit their movements (and to abstain from sexual relations) for 21 days, the maximum incubation and monitoring period for the appearance of possible symptoms. WHO strongly recommends implementation of optimized clinical care for patients with mpox, to reduce the risk of medical complications and long-term sequelae and improve health outcomes. Mpox disproportionally affects people living with HIV, with a higher risk of severe disease, hospitalization or death in people with advanced HIV disease. WHO strongly recommends early HIV testing for all patients with suspected or confirmed mpox and rapid initiation of antiretroviral therapy (ART) in people living with untreated HIV who are diagnosed with mpox. Health authorities at all levels should provide travellers with information to protect themselves and others before, during and after travel to mpox-affected countries or attending events or gatherings where mpox may present a risk. WHO does not recommend any restriction on travel to or trade with the countries named in this report. For additional information on WHO public health advice to reduce the risk of mpox please see the resources listed below in the further information section.","publishedAt":"2025-12-05T19:00:00.000Z","lastModified":"2025-12-07T11:20:03.000Z","sourceId":"who-disease-outbreak-news","metadata":{"donId":"2025-DON587","response":"WHO maintains global mpox surveillance and continues to provide response guidance for all countries and support to access diagnostics and vaccines through multi-partner coordination. WHO and partners have established the International Coordinating Group for mpox vaccine provision (ICG) to further accelerate timely outbreak response and ensure sustainable support for the future. Furthermore, WHO continues to evaluate available rapid diagnostic tests for field use. Public health response measures taken in the affected WHO Regions include: WHO African Region A continental mpox response is ongoing in the region, including all main response pillars . Surveillance activities continue, and most countries have mpox diagnostic capacity in place Sixteen countries have received mpox vaccines and are vaccinating people at risk to contain the outbreaks. WHO Region of the Americas WHO supports Member States with surveillance, preparedness, and outbreak response in activities for mpox in affected countries. WHO provides information through situation reports and the mpox dashboard. Vaccines remain available to countries through the PAHO Revolving Fund. The response is focused on communication and engagement of at-risk communities, timely detection of cases and treatment of patients, laboratory confirmation, surveillance, and containment of transmission chains, securing access to critical health supplies and protection of health workers. WHO South-East Asia Region WHO provides weekly briefings and technical guidance to Member States to enhance preparedness, including laboratory diagnostics and access to medical countermeasures (MCM). Access to MCM is facilitated through allocation and supply chain coordination for diagnostics and support to regulatory preparedness through a regional regulatory network. WHO provides guidance on clinical management and infection prevention and control to strengthen capacity for safe and scalable care. A collaborative surveillance mechanism for early detection and reporting includes coordination between HIV/STI and emergency programmes. Support includes genomic sequencing, reagent supply, training, and bioinformatics to improve regional capacity. Community protection and communication strategies are being scaled up, with targeted outreach to high-risk groups, social listening, rumour tracking, and regional adaptation of messaging, alongside efforts to improve genomic sequencing capacity and regulatory preparedness for diagnostics. WHO Eastern Mediterranean Region WHO continues to support coordination, reporting, and information sharing between countries through the IHR mechanism. WHO continues advocating with national stakeholders to integrate mpox prevention and care in routine STI services. WHO supports countries to access mpox diagnostics services through facilitating procurement and distribution of kits. WHO works closely with national health authorities to strengthen surveillance and ensure inclusion of mpox in lists of diseases for routine surveillance. WHO European Region WHO and the European Centre for Disease Prevention and Control (ECDC) have asked all Member States to report mpox due to clade I MPXV through official International Health Regulations (IHR) and/or surveillance mechanisms. WHO has conducted modelling to better understand drivers of mpox transmission in the region. ECDC published a threat assessment brief following the detection of local transmission of clade Ib MPXV in the EU/EEA. A Risk Communication, Community Engagement, and Infodemic Management package for health workers and travel advice has been shared with Member States through IHR focal points. Questions and answers documents on mpox have been updated. WHO and ECDC are planning a community briefing on the situation to understand community perceptions. WHO Western Pacific Region Following notification of a locally acquired case due to clade Ib in the Region, and exportation of clade Ib from the Region, WHO has been working with national authorities on epidemiological investigation, contact follow-up up and assessment of potential transmission settings and continues to monitor for additional cases and offer cross-border support. WHO continues to support countries with surveillance, preparedness, and investigation of suspected mpox events, including rapid risk assessments, technical advice on case management and IPC, and verification of event information through IHR channels. WHO provides targeted support to strengthen diagnostic capacity, including guidance on clinical sampling, access to PCR testing for clade I and clade II MPXV, and coordination with national laboratories to increase genomic sequencing capability for clade and subclade identification. WHO is working to integrate mpox preparedness within services for HIV and sexually transmitted infections, promoting early HIV testing and prompt antiretroviral therapy (ART) initiation for any person with mpox, in line with WHO guidance for clinical care and infection prevention and control. WHO supports clinical readiness through regional webinars, technical exchanges, and Communities of Practice, enabling countries to access updated clinical management guidance, peer support, and context-specific tools for managing suspected and confirmed cases. Risk communication and community engagement activities focus on social listening, information, education and communication (IEC) material production and close collaboration with health workers and key population networks, including men who have sex with men, sex workers, and community-based organizations, to strengthen awareness of symptoms, promote early care seeking, and reduce stigma associated with mpox. WHO continues to assist countries in reviewing and strengthening national preparedness measures, including support for intra-action reviews and integration of mpox within all-hazards emergency preparedness and response frameworks.","epidemiology":"Mpox is an infectious disease caused by the MPXV, divided into two clades, clade I (including subclades Ia and Ib), and clade II (including subclades IIa and IIb. Historically associated with zoonotic transmission in tropical rainforest regions of East, Central and West Africa, mpox has in recent years predominantly spread through human-to-human transmission and has rapidly emerged across all WHO regions. Subclades Ia and Ib have been following the emergence of clade Ib in South Kivu province of the Democratic Republic of the Congo in 2023. Clade Ia is currently considered to encompass all other strains of Clade I that are not Ib. Clade IIb continues to circulate in all WHO regions since 2022. The virus is primarily transmitted through close physical contact with a person who has mpox, through sexual contact or other forms of direct skin-to-skin contact, for example from parent to child. Other documented routes include indirect contact with contaminated materials, occasionally non-physical contact such as close-range inhalation of infectious respiratory particles, and vertical transmission from mother-to-child during pregnancy or childbirth. In historically endemic areas transmission can also occur from animals to humans through contact with live animals or consumption of contaminated bushmeat. Emerging evidence indicates that exposure to MPXV can result from subclinical infection in another person and silent shedding of the virus, particularly in genital and anal secretions, which can facilitate further transmission during sexual contact. Mpox causes signs and symptoms which usually begin within 3-7 days of exposure and can start as soon as one or rarely up to 21 days later. Symptoms typically last for two to four weeks but may last longer in someone with a weakened immune system, for example as a result of advanced untreated HIV infection. Fever, muscle aches and sore throat may appear first, followed by an evolving skin rash and/or mucosal lesions, or appearance of such lesions may precede systemic symptoms. Lymphadenopathy (swollen lymph nodes) is also a typical feature of mpox, present in most cases. Transmission through sexual contact has been observed to lead to the appearance sometimes of only genital lesions. Children, pregnant women and people with weak immune systems, most commonly due to advanced HIV infection, are at risk of developing complications and dying of mpox. Laboratory testing is necessary to confirm mpox, particularly for the first cases in an outbreak or new geographic area. The primary diagnostic test for MPXV infection is polymerase chain reaction (PCR). The best diagnostic specimens are taken directly from lesion material &ndash; on skin or mucosae, such as lesion fluid or crusts &ndash; collected by vigorous swabbing. In the absence of skin or mucosal lesions, testing can be done on oropharyngeal, anal or rectal swabs. However, while a positive result of oropharyngeal, anal or rectal sample confirms mpox, a negative result is not enough to rule out MPXV infection. Testing of blood is not recommended as any viremia is usually brief and individuals can test negative just a few days after infection. Serology does not distinguish between different orthopoxviruses and is therefore restricted to reference laboratories where antibody detection methods may be applied for retrospective case classification or in special studies. Treatment is based primarily on managing clinical symptoms, ensuring skin care, eye care, reducing pain, and preventing and managing secondary bacterial infections and other complications. Where available through clinical studies or emergency access protocols, specific antiviral medications may also be used in the treatment of mpox, particularly for severe cases or individuals at higher risk of complications. Vaccines for use to prevent mpox are available to all countries. WHO recommends use of MVA-BN (non-replicating) or LC16m8 (minimally replicating) vaccine as indicated, or ACAM2000 (replicating) vaccine based on an individual risk-benefit assessment when the others are not available. In the context of an outbreak, vaccination is recommended by WHO for individuals at high risk of exposure to mpox, such as sex workers; gay, bisexual or other men who have sex with men; or other individuals with multiple sexual partners; health workers and frontline workers, contacts of known mpox cases, and other affected groups in a geographically defined area or community (based on local epidemiology).","formattedDate":"2025-12-05T17:52:36Z","matchedSignals":["PHEIC language","cross-border signal","transmission concern","severity signal","WHO high-risk wording","response escalation"]}}]}