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Evidence last reviewed: 21 Apr 2026
Topic last updated: 21 May 2026
21 May 2026

WHO declares DRC and Uganda outbreak a global public health emergency

The World Health Organization (WHO) has declared the Ebola outbreak in the Democratic Republic of the Congo (DRC) and Uganda a public health emergency of international concern (PHEIC). PHEIC status aims to accelerate funding, research, and international public health measures and co-operation to contain a disease.

This outbreak is caused by the Bundibugyo virus (Orthoebolavirus bundibugyoense), one of three species of orthoebolaviruses known to cause disease in humans. Prior to this outbreak, there have only been two outbreaks of the disease caused by Bundibugyo virus: Uganda in 2007 and the DRC in 2012.

The first currently known suspected case in this outbreak was a health worker who first reported symptoms on 24 April 2026. The WHO was alerted to an outbreak of an unknown illness with high mortality in the Ituri Province on 5 May 2026. Subsequent laboratory testing confirmed Bundibugo virus in 8 out of 13 samples on 15 May 2026. This is the seventeenth Ebola outbreak in the DRC.

As of 19 May 2026, at least 536 suspected cases, 105 probable cases, 34 laboratory-confirmed cases, and 134 deaths have been reported by the DRC and Uganda Ministries of Health. This includes 2 confirmed cases in Uganda in people who traveled from the DRC. No further spread has been reported in Uganda.[31]

The situation is rapidly developing, and you should consult your local public health authority for current information on the situation. Information is available from the WHO, the Centers for Disease Control and Prevention (CDC), and the UK Health Security Agency (UKHSA).

There are a number of reasons for the WHO declaring a PHEIC for this outbreak including:[32]

  • Significant uncertainty about the true number of infected people and geographic spread at the present time. Also, there is limited understanding of the epidemiologic links with known or suspected cases. Early data point toward a potentially much larger outbreak than what is being detected and reported.

  • Cases have already been reported in Uganda; therefore, neighboring countries such as South Sudan are considered to be at high risk of further spread.

  • There is ongoing insecurity and a humanitarian crisis in the region.

  • There are currently no known vaccines or specific therapeutics for Bundibugyo virus.

The case fatality rate for disease caused by the Bundibugyo virus ranges from 30% to 50%, according to the WHO, although data vary based on whether laboratory-confirmed cases or suspected cases were used to calculate the rate.

The WHO has not advised any travel restrictions. However, travel notices are in place for the DRC and Uganda in some countries, and you should check your local government guidance for more information before traveling to these regions. Enhanced travel screening and entry restrictions have been instituted in countries outside of East and Central Africa.

See Epidemiology

Original source of update

Summary

Definition

History and exam

Key diagnostic factors

  • exposure to an orthoebolavirus in previous 21 days
  • fever
  • myalgia
  • conjunctival injection

Other diagnostic factors

  • fatigue
  • anorexia
  • diarrhea
  • vomiting
  • severe headache
  • abdominal pain or heartburn
  • cough, dyspnea, chest pain
  • sore throat
  • prostration
  • tachypnea
  • maculopapular rash
  • bleeding
  • hepatomegaly
  • lymphadenopathy
  • hiccups
  • tachycardia
  • hypotension
  • neurologic signs

Risk factors

  • living or working in, or arrival from, endemic area in previous 21 days
  • contact with infected body fluids
  • occupational exposure
  • butchering or consumption of meat from infected (or potentially infected) animals
  • bioterrorism

Diagnostic tests

1st tests to order

  • reverse transcriptase-polymerase chain reaction (RT-PCR)
  • malaria investigations

Tests to consider

  • serum electrolyte levels
  • BUN/serum creatinine
  • blood lactate
  • ABG
  • CBC
  • coagulation studies
  • urinalysis
  • LFTs
  • serum amylase level
  • blood cultures
  • serum blood glucose
  • antigen-capture enzyme-linked immunosorbent assay (ELISA)
  • serology
  • chest x-ray

Emerging tests

  • rapid diagnostic tests

Treatment algorithm

Contributors

Authors

Catherine F. Houlihan, MSc, MB ChB, MRCP, DTM&H

Clinical Lecturer

University College London

Honorary Clinical Lecturer

London School of Hygiene and Tropical Medicine

London

UK

Disclosures

CFH declares that she has no competing interests.

Manuel Fenech, MD, MRCP, DTM&H

Specialist Trainee in Infectious Diseases

Royal Liverpool University Hospital

Liverpool

UK

Disclosures

MF declares that he has no competing interests.

Tom E. Fletcher, MBE, MBChB, MRCP, DTM&H

Wellcome Trust/MoD Research Fellow

Liverpool School of Tropical Medicine

Liverpool

UK

Disclosures

TEF is an author of a number of references cited in this monograph. TEF is a consultant/expert panel member to the World Health Organization, and is funded by the UK Surgeon General and the Wellcome Trust. TEF has received research grants from the Medical Research Council and the UK Public Health Rapid Support Team (UK-PHRST).

Acknowledgements

Dr Catherine F. Houlihan, Dr Manuel Fenech, and Dr Tom E. Fletcher would like to thank Dr Nicholas J. Beeching, a previous contributor to this topic, and Dr Colin Brown (Infectious Disease Lead, Kings Sierra Leone Partnership) for his helpful comments and insights.

Disclosures

NJB was partially supported by the National Institute of Health Research Health Protection Unit in Emerging and Zoonotic Infections at the University of Liverpool and Public Health England. NJB is an author of references cited in this topic. CB declares that he has no competing interests.

Peer reviewers

William A. Petri, Jr, MD, PhD, FACP

Wade Hampton Frost Professor of Epidemiology

Professor of Medicine, Microbiology, and Pathology

Chief

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Luis Ostrosky-Zeichner, MD, FACP, FIDSA, FSHEA

Professor of Medicine and Epidemiology

UT Health Medical School

Medical Director of Epidemiology

Memorial Hermann Texas Medical Center

Houston

TX

Disclosures

LO-Z declares that he has no competing interests.

Stephen Mepham, MRCP (UK), FRCPATH, DTM&H, MD

Consultant in Microbiology and Infectious Diseases

Royal Free London NHS Foundation Trust

London

UK

Disclosures

SM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

World Health Organization. Clinical care for survivors of Ebola virus disease: interim guidance. Apr 2016 [internet publication].Full text

World Health Organization. Guidelines for the management of pregnant and breastfeeding women in the context of Ebola virus disease. 2020 [internet publication].Full text

World Health Organization. Infection prevention and control guideline for Ebola and Marburg diseases. May 2026 [internet publication].Full text

World Health Organization. Optimized supportive care for Ebola virus disease. July 2019 [internet publication].Full text

Lamontagne F, Fowler RA, Adhikari NK, et al. Evidence-based guidelines for supportive care of patients with Ebola virus disease. Lancet. 2018 Feb 17;391(10121):700-8.Full text  Abstract

World Health Organization. Clinical management of patients with viral haemorrhagic fever: a pocket guide for front-line health workers. Feb 2016 [internet publication].Full text

World Health Organization. Therapeutics for Ebola virus disease - Democratic Republic of the Congo. Aug 2022 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available here.

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