In accordance with paragraph 2 of Article 12 of the International Health Regulations (2005) (IHR)—which addresses the determination of a public health emergency of international concern, including a pandemic emergency—the Director-General of the World Health Organization (WHO), following consultations with the States Parties where the event is currently known to be occurring, hereby determines that the Ebola disease caused by the Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern (PHEIC). However, it does not meet the criteria for a pandemic emergency as defined in the IHR.
The WHO Director-General extends his appreciation to the leadership of the Democratic Republic of the Congo and Uganda for their dedication to taking necessary and vigorous actions to bring the event under control, as well as for their transparency in assessing the risk this event poses to other States Parties, thereby enabling the global community to undertake essential preparedness measures.
In making this determination, the WHO Director-General has considered, among other factors, information provided by the States Parties—the Democratic Republic of the Congo and Uganda—scientific principles, available scientific evidence, and other relevant data. He has also assessed the risk to human health, the risk of international disease spread, and the risk of interference with international traffic.
The WHO Director-General considers that the event satisfies the criteria for a PHEIC definition, as outlined in Article 1 of the IHR, for the following reasons:
1. The event is deemed extraordinary due to the following factors:
As of 16 May 2026, eight laboratory-confirmed cases, 246 suspected cases, and 80 suspected deaths have been reported in Ituri Province of the Democratic Republic of the Congo, spanning at least three health zones, including Bunia, Rwampara, and Mongbwalu. Additionally, two laboratory-confirmed cases (including one death) with no apparent connection to each other were reported in Kampala, Uganda, within 24 hours of each other, on 15 and 16 May 2026, involving two individuals traveling from the Democratic Republic of the Congo. A further case reported on 16 May—an individual returning from Ituri to Kinshasa—tested negative for the Bundibugyo virus on confirmatory testing by the National Institute for Biomedical Research (INRB) and is therefore not classified as a confirmed case.
Unusual clusters of community deaths with symptoms consistent with Bundibugyo virus disease (BVD) have been reported across several health zones in Ituri, and suspected cases have been identified in Ituri and North Kivu. Moreover, at least four deaths among healthcare workers in a clinical setting suggestive of viral hemorrhagic fever have been reported in the affected area, raising concerns about healthcare-associated transmission, gaps in infection prevention and control measures, and the potential for amplification within health facilities.
Significant uncertainties exist regarding the true number of infected individuals and the geographic extent of this event at this time. Additionally, there is limited understanding of the epidemiological links with known or suspected cases.
Nevertheless, the high positivity rate of initial samples collected (eight positives out of 13 samples from various areas), the confirmation of cases in Kampala, the rising trends in syndromic reporting of suspected cases, and clusters of deaths across Ituri Province all indicate a potentially much larger outbreak than currently detected and reported, with substantial local and regional risks of spread. Furthermore, ongoing insecurity, the humanitarian crisis, high population mobility, the urban or semi-urban nature of the current hotspot, and the extensive network of informal healthcare facilities further amplify the risk of spread, as observed during the large Ebola virus disease epidemic in North Kivu and Ituri provinces in 2018–2019. However, unlike for Ebola-Zaire strains, no approved Bundibugyo virus-specific therapeutics or vaccines are currently available. As such, this event is considered extraordinary.
2. The event poses a public health risk to other States Parties through the international spread of disease. International spread has already been documented, with two confirmed cases reported in Kampala, Uganda, on 15 and 16 May following travel from the Democratic Republic of the Congo. Both confirmed cases were admitted to intensive care units in Kampala. Neighboring countries sharing land borders with the Democratic Republic of the Congo are considered at high risk for further spread due to population mobility, trade and travel linkages, and ongoing epidemiological uncertainty.
3. The event requires international coordination and cooperation to understand the outbreak's extent, coordinate surveillance, prevention, and response efforts, scale up and strengthen operations, and ensure the ability to implement control measures.
Under the provisions of the IHR, the WHO Director-General will convene an Emergency Committee as soon as possible to advise, among other matters, on proposed temporary recommendations for States Parties to respond to the event.
The WHO advice is outlined below and will be subject to further refinement as appropriate after considering the Emergency Committee's advice and issuing Temporary Recommendations.
* The statement was updated to clarify the status of a case reported on 16 May in Kinshasa.
WHO advice
For States Parties where the event is occurring (the Democratic Republic of the Congo and Uganda)
Coordination and high-level engagement
Activate national disaster or emergency management mechanisms and establish an emergency operations center under the authority of the Head of State and relevant government authority to coordinate response activities across partners and sectors, ensuring 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 the national level, as well as at subnational levels in affected and at-risk areas.
If national capacities are overwhelmed, collaboration with partners should be strengthened to enhance operations and ensure the ability to implement control measures in all affected and neighboring areas.
Risk communication and community engagement
Ensure a large-scale and sustained effort to fully engage the community—through local, religious, and traditional leaders and healers—so that communities play a central role in case identification, contact tracing, and risk education. The population should be fully informed of the benefits of early treatment.
Strengthen community awareness, engagement, and participation, particularly to identify and address cultural norms and beliefs that hinder full participation in the response. Integrate the response within the broader efforts needed to address the population's needs, especially in the context of the protracted humanitarian crisis in Eastern DRC.
Surveillance and laboratory
Strengthen surveillance and laboratory capacity across affected and neighboring provinces by establishing (1) dedicated surveillance and response cells within affected health zones and key at-risk neighboring health zones, (2) enhanced community surveillance, particularly focused on community deaths, and (3) decentralized laboratory capacity for testing Bundibugyo virus.
Infection prevention and control in health facilities and care settings
Strengthen measures to prevent nosocomial infections, including systematic mapping of health facilities, triage, targeted IPC interventions, and sustained monitoring and supervision.
Ensure healthcare workers receive adequate training on IPC, including proper use of personal protective equipment (PPE), and that health facilities have appropriate equipment to ensure staff safety and protection, timely salary payments, and, where appropriate, hazard pay.
Patient referral pathways and access to safe, optimized intensive care
Ensure that suspected cases can be safely transferred to specialized clinical units for isolation and management in a humane, patient-centered approach.
Establish specialized treatment centers or units near outbreak epicenters, staffed and equipped to deliver optimized intensive supportive care.
Research and development of medical countermeasures
Implement clinical trials to advance the development and use of candidate therapeutics and vaccines, supported by partners.
Border health, travel, and mass-gathering events
Conduct cross-border screening and screening at major internal roads to ensure no suspected cases are missed, and enhance screening quality through improved information sharing with surveillance teams.
There should be no international travel for 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 be immediately isolated and treated in a Bundibugyo virus disease treatment center, with no national or international travel until two Bundibugyo virus-specific diagnostic tests conducted at least 48 hours apart are negative.
Contacts (excluding properly protected health workers and laboratory staff with 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 be immediately isolated, and their travel should be restricted in accordance with their classification as either a confirmed case or contact.
Implement exit screening for all persons at international airports, seaports, and major land crossings for unexplained febrile illness consistent with potential Bundibugyo virus disease. The exit screening should include, at a minimum, a questionnaire, temperature measurement, and, if fever is present, 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 that funerals and burials are conducted by well-trained personnel, with provisions for family presence and cultural practices, and in accordance with national health regulations, to reduce the risk of Bundibugyo virus infection. The cross-border movement of human remains of deceased suspect, probable, or confirmed Bundibugyo virus disease cases should be prohibited unless authorized under recognized international biosafety provisions.
Operations, supplies, and logistics
Establish a robust supply pipeline 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.
For States Parties with land borders adjoining States Parties 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. This includes active surveillance across health facilities with active zero reporting, enhanced community surveillance for clusters of unexplained deaths, access to a qualified diagnostic laboratory, ensuring health workers are aware of and trained in appropriate IPC procedures, and establishing 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 levels in all unaffected States Parties with land borders adjoining States Parties with documented Bundibugyo virus disease cases. States should be prepared to detect, investigate, and manage Bundibugyo virus disease cases, including assured access to a qualified diagnostic laboratory for Bundibugyo virus disease, isolation and case management capacity, and activation of rapid response teams.
Any State Party newly detecting a suspected or confirmed Bundibugyo virus disease case or contact, or clusters of unexplained deaths, should treat this as a health emergency, taking immediate steps within 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, at either the 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 prioritize putting in place approvals for investigational therapeutics as an immediate preparedness measure.
For all Other States Parties
No country should close its borders or impose any restrictions on travel and trade. Such measures are typically implemented out of fear and lack scientific basis. They push the movement of people and goods to informal border crossings that are not monitored, thereby increasing the chances of disease spread. 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 they do not exceed WHO'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 is not considered necessary for passengers returning from areas at risk.
Editor’s note
On 17 May 2026, this statement was updated as follows:
"On 16 May, a laboratory confirmed case has also been reported in Kinshasa, the Democratic Republic of the Congo, among someone returning from Ituri."
was replaced with:
"A further case reported on 16 May, an individual returning from Ituri to Kinshasa, has tested negative for Bundibugyo virus on confirmatory testing by INRB, and is therefore not considered a confirmed case."