Weekly Health Update | Bundibugyo Ebola Spread Undetected for Months; Cholera Hits Six Countries
Africa’s top health story this week was the Bundibugyo Ebola outbreak in the Democratic Republic of Congo, which passed 2,000 deaths and is threatening to surpass the toll from the 2014-2016 West Africa outbreak, still the deadliest Ebola epidemic in history. The World Health Organization said the virus had probably. . .
Africa’s top health story this week was the Bundibugyo Ebola outbreak in the Democratic Republic of Congo, which passed 2,000 deaths and is threatening to surpass the toll from the 2014-2016 West Africa outbreak, still the deadliest Ebola epidemic in history. The World Health Organization said the virus had probably been circulating since February, three months before the outbreak was officially declared, and said weakened surveillance systems had contributed to the delayed detection. Ervebo, an existing Ebola vaccine, is now being evaluated in a Phase 3 clinical trial. Cholera is also spreading across six countries in West and Central Africa, prompting UNICEF to launch a $15 million emergency appeal. In Uganda, two cases of Crimean-Congo hemorrhagic fever have been detected in Yumbe district, including one fatal case. Ebola in Congo: More than 2,061 deaths as WHO warns outbreak could surpass 2014-2016 recordThe Bundibugyo Ebola virus disease outbreak in Congo has caused more than 4,400 confirmed cases and more than 2,000 deaths, according to the WHO. It is the second-deadliest Ebola outbreak ever recorded. At an Aug. 12 news conference in Geneva following a visit to Congo, WHO Director-General Tedros Adhanom Ghebreyesus warned that, at the current pace, the outbreak could eventually surpass the 2014-2016 West Africa epidemic. That outbreak caused more than 28,000 cases and 11,000 deaths in Guinea, Liberia and Sierra Leone. The outbreak has spread across five provinces and 53 health zones, with Ituri accounting for about 90% of cases and 80% of deaths. Some chains of transmission have still not been traced. Between 60% and 70% of deaths are occurring in communities, outside treatment centers, and among people who were not on identified contact lists. The proportion of identified contacts being followed has risen to 80%, but the WHO says it needs to reach 95% to bring transmission under control. The agency plans to triple treatment capacity to 3,000 beds over the next 12 weeks. No virus mutation has been detected so far. WHO Chief Scientist Sylvie Briand said the outbreak was being driven by contextual factors including conflict, population displacement and barriers to healthcare access. Under the agency’s intermediate scenario, the outbreak could peak within six months. In a less favorable scenario, it could continue for nine to 12 months. Virus may have circulated since February as surveillance gaps delayed detectionThe WHO confirmed on Monday, Aug. 11, that the outbreak had probably begun in February, three months before it was officially declared on May 15. Early cases may have been mistaken for malaria or typhoid, while initial laboratory testing focused on the more common Zaire Ebola virus. A WHO-funded field study identified more than 500 suspected cases between mid-January and the official declaration of the outbreak. WHO Regional Director for Africa Mohamed Janabi said health authorities were still trying to catch up with transmission that had remained ahead of the response. The two- to three-month detection delay came amid the dismantling of U. S. -funded epidemiological surveillance systems. In testimony published by Physicians for Human Rights on May 21, 2026, a Congolese doctor working in the affected area said disruptions to USAID funding had severely reduced the ability of local teams to conduct proper epidemiological surveillance, forcing some health workers to use their own resources to continue the work. The U. S. Centers for Disease Control and Prevention and USAID had spent decades investing in early-detection capacity in Congo. That support included training through the Field Epidemiology Training Program, genomic sequencing at the National Institute for Biomedical Research, or INRB, and the development of a health intelligence network. The USAID mission in Congo was closed in 2025. Jeremy Konyndyk, a former senior USAID official, told NPR that the cuts had seriously weakened the country’s disease-detection and surveillance infrastructure. Africa CDC Director-General Jean Kaseya said the crisis underscored the need for African countries to build sustainable health-security capacity on the continent, backed by African governments, international partners and the private sector. Ervebo enters Phase 3 trial as researchers pursue Bundibugyo-specific vaccinesWith no licensed vaccine specifically targeting Bundibugyo virus, the WHO’s Technical Advisory Group on Candidate Vaccine Prioritization, or TAG-CVP, recommended on Aug. 7 that Ervebo, or rVSV-ZEBOV, be given priority for evaluation in a Phase 3 clinical trial in Congo. The Merck-made vaccine is licensed against Zaire Ebola virus. Preclinical data published in the New England Journal of Medicine suggest that it may also provide cross-protection against Bundibugyo virus. No major safety concerns were reported in the available preclinical data. Gavi, the Vaccine Alliance, committed $40 million to the response and confirmed that doses were available from the global Ebola vaccine stockpile it funds. At the same time, Phase 1 trials of vaccine candidates specifically targeting Bundibugyo virus are underway in Canada, with Moderna, and in Britain at the University of Oxford. Tedros cautioned at the Aug. 12 news conference that there was still no evidence that Ervebo was effective against Bundibugyo virus disease in humans and said a vaccine designed specifically for the virus remained the preferred option. The PARTNERS trial, sponsored by the WHO and INRB, is evaluating treatments intended to reduce the risk of death. It is primarily testing MBP134, a pan-ebolavirus monoclonal antibody cocktail, either alone or in combination with remdesivir. More than 100 patients have been enrolled. Cholera: UNICEF launches $15 million appeal across six countriesUNICEF launched a $15 million emergency appeal on Aug. 12, 2026, to strengthen the cholera response in West and Central Africa, where outbreaks are occurring simultaneously in six countries: Democratic Republic of Congo, Republic of the Congo, Nigeria, Chad, Cameroon and Central African Republic. Seasonal rains, flooding, population displacement and cross-border transmission along the Lake Chad and Congo River basins are accelerating the spread. Children account for a large share of cases in several affected countries. In Central African Republic, children under 10 represent 44% of cases. In Chad, nearly two-thirds of infections involve children under 15. In Cameroon, the median patient age is 10. Nigeria has the largest outbreak in the region, with more than 50,000 cumulative cases and 338 deaths since Jan. 1, 2026. Cases are concentrated in Borno state. In Congo, Kwilu province has recorded 419 cases and 30 deaths since early June across four health zones. Consumption of untreated water from the Kasai River has been identified as the main driver of transmission. Since the beginning of 2026, Africa CDC has recorded more than 33,000 cholera cases and 943 deaths across the continent. UNICEF Regional Director for West and Central Africa Gilles Fagninou said the outbreak was increasingly crossing national borders through shared rivers, trade routes and population movements. Uganda: Crimean-Congo hemorrhagic fever detected in Yumbe districtUgandan health authorities reported two confirmed cases of Crimean-Congo hemorrhagic fever, or CCHF, in Yumbe district in northern Uganda. One patient, a 9-year-old boy, died. The other, an 18-year-old man, is receiving treatment. CCHF is a viral disease transmitted by ticks or through contact with the blood of infected animals. It can also spread from person to person through contact with infected bodily fluids. Among hospitalized patients, reported case-fatality rates range from 9% to 50%. Sporadic outbreaks are reported every year in Uganda. Yumbe district lies near the border with South Sudan, in an area with substantial cross-border movement by herders and traders. The cases were detected shortly after Uganda declared the end of its Ebola outbreak on July 29. That outbreak recorded 20 cases and two deaths. The country is continuing heightened surveillance along its borders with Congo. Nigeria: Lagos accelerates universal health coverageLagos state has surpassed 1. 5 million enrollees in its mandatory Ilera Eko health insurance program. The state government announced the launch of the EasyPay platform, which allows premiums to be paid in installments, as well as the creation of an equity fund for vulnerable households. An integrated digital health system, the Smart Health Information Platform, or SHIP, now centralizes medical records and supports disease surveillance. The expansion comes as the WHO praised Nigeria during the week of Aug. 11 for progress in health financing as the country works toward universal health coverage. Lagos, with more than 20 million residents, is the largest urban population center in sub-Saharan Africa. The expansion of health coverage there could offer lessons for other major metropolitan areas across the continent. Ayi Renaud Dossavi