In accordance with paragraph 2 of Article 12 of the International Health Regulations (2005) (IHR) concerning the determination of a public health emergency of international concern, including a pandemic emergency, the Director-General of the World Health Organization (WHO), following consultation with the States Parties where the event is currently occurring, has determined that the outbreak of Ebola disease caused by 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 under the IHR.

The Director-General commends the authorities of the Democratic Republic of the Congo and Uganda for their leadership and decisive measures to contain the outbreak, as well as for their transparency in evaluating and communicating the risks posed to other States Parties. This openness enables the international community to strengthen preparedness and response efforts.

In reaching this determination, the Director-General considered information shared by the Democratic Republic of the Congo and Uganda, relevant scientific principles, available evidence, and other pertinent data. The assessment included evaluation of the risk to human health, the likelihood of international spread, and the potential impact on international travel and trade.

The Director-General concludes that the event satisfies the definition of a PHEIC under Article 1 of the IHR for the following reasons:

1. The event is extraordinary for the following reasons:

• As of 16 May 2026, eight laboratory-confirmed cases, 246 suspected cases, and 80 suspected deaths have been reported in Ituri Province, Democratic Republic of the Congo, across at least three health zones—Bunia, Rwampara, and Mongbwalu. Additionally, two laboratory-confirmed cases, including one death, were identified in Kampala, Uganda, on 15 and 16 May 2026 among individuals who had travelled from the Democratic Republic of the Congo. On 16 May, a confirmed case was also reported in Kinshasa in a person returning from Ituri.

• Unusual clusters of community deaths presenting symptoms consistent with Bundibugyo virus disease (BVD) have been observed in several health zones in Ituri, with suspected cases also reported in Ituri and North Kivu. At least four healthcare workers have died in circumstances suggestive of viral haemorrhagic fever, raising serious concerns about healthcare-associated transmission, weaknesses in infection prevention and control (IPC), and the risk of amplification within medical facilities.

• Considerable uncertainty remains regarding the true number of infections and the geographical extent of the outbreak. Epidemiological links between confirmed and suspected cases are not yet fully understood.

• The high positivity rate among initial samples—eight positives out of 13 tested—together with confirmed cases in Kampala and Kinshasa, increasing reports of suspected cases and clusters of deaths in Ituri, indicate that the outbreak may be more extensive than currently detected. Factors such as insecurity, an ongoing humanitarian crisis, high population mobility, urban and semi-urban transmission areas, and widespread informal healthcare services increase the risk of further spread. Unlike Ebola-zaire strains, there are currently no approved vaccines or specific treatments for Bundibugyo virus disease. For these reasons, the event is considered extraordinary.

2. The outbreak presents a public health risk to other States Parties due to international spread. Cross-border transmission has already been documented, with two confirmed cases reported in Kampala following travel from the Democratic Republic of the Congo. Both patients required intensive care. Countries sharing land borders with the Democratic Republic of the Congo face elevated risk due to population movement, trade connections, and ongoing epidemiological uncertainties.

3. The event requires coordinated international action to determine the full scope of the outbreak, harmonize surveillance and response measures, strengthen operational capacity, and ensure effective implementation of control interventions.

Under the IHR, the Director-General will convene an Emergency Committee as soon as possible to provide advice, including recommendations for temporary measures to guide States Parties in responding to the outbreak.

The following WHO advice is provided and may be refined after review by the Emergency Committee and issuance of Temporary Recommendations.

WHO advice

For States Parties where the outbreak is occurring (the Democratic Republic of the Congo and Uganda)

Coordination and high-level engagement

• Activate national emergency management mechanisms and establish an emergency operations centre under the authority of the Head of State and relevant government bodies to coordinate response activities across sectors and partners. Comprehensive BVD control measures should include strengthened surveillance and contact tracing, infection prevention and control, risk communication and community engagement, laboratory testing, and case management. Coordination structures should function at national and subnational levels in affected and at-risk areas.

• If national capacities are exceeded, intensify collaboration with international partners to reinforce operations and ensure implementation of control measures in all affected and neighbouring areas.

Risk communication and community engagement

• Implement sustained community engagement strategies involving local, religious, and traditional leaders and healers to ensure community participation in case detection, contact tracing, and risk awareness. Communities should understand the importance of seeking early treatment.

• Address cultural norms and beliefs that may hinder response efforts and integrate outbreak control within broader humanitarian support activities, particularly in eastern Democratic Republic of the Congo.

Surveillance and laboratory

• Enhance surveillance and laboratory capacity in affected and neighbouring provinces by establishing dedicated surveillance and response units, expanding community-based surveillance—particularly for unexplained deaths—and decentralizing laboratory testing for Bundibugyo virus.

Infection prevention and control in healthcare settings

• Strengthen measures to prevent healthcare-associated infections through systematic mapping of facilities, effective triage systems, targeted IPC interventions, and continuous supervision.

• Provide healthcare workers with adequate IPC training, including correct use of personal protective equipment (PPE), ensure facilities are properly equipped, and guarantee timely payment of salaries and, where appropriate, hazard allowances.

Patient referral and access to optimized care

• Establish safe referral systems so suspected cases can be transferred to specialized units for isolation and patient-centred care.

• Develop treatment centres near outbreak epicentres, staffed and equipped to deliver advanced supportive care.

Research and development of medical countermeasures

• Support and implement clinical trials to evaluate potential therapeutics and vaccines in collaboration with partners.

Border health, travel, and mass gatherings

• Strengthen cross-border and internal road screening to ensure early detection of suspected cases, supported by effective information-sharing with surveillance teams.

• Confirmed cases should be isolated and treated in designated centres and should not travel nationally or internationally until two negative diagnostic tests taken at least 48 hours apart are obtained.

• Contacts should undergo daily monitoring, avoid international travel, and restrict national travel until 21 days after exposure.

• Suspected and probable cases should be isolated promptly, and travel restrictions applied according to their classification.

• Conduct exit screening at international airports, seaports, and major land crossings, including health questionnaires, temperature checks, and risk assessment for febrile individuals. Those with illness consistent with BVD should not travel except for approved medical evacuation.

• Consider postponing mass gatherings until transmission is halted.

Safe and dignified burials

• Ensure that burials are conducted safely by trained personnel, respecting family presence and cultural practices while adhering to health regulations. Cross-border transport of remains of suspected, probable, or confirmed cases should be prohibited unless authorized under international biosafety standards.

Operations, supplies, and logistics

• Establish reliable supply chains to maintain adequate stocks of medical supplies, laboratory materials, and PPE.

For States Parties sharing land borders with affected countries

• Enhance preparedness through active surveillance with zero reporting, strengthened community monitoring of unexplained deaths, access to qualified laboratories, healthcare worker training in IPC, and establishment of rapid response teams.

• Ensure coordination mechanisms are operational at national and subnational levels to detect, investigate, and manage cases, including isolation and laboratory confirmation capacity.

• Treat any newly detected suspected or confirmed case, contact, or cluster of unexplained deaths as an emergency and initiate investigation, isolation, diagnosis, and contact tracing within 24 hours.

• If transmission is confirmed, implement the full set of recommendations applicable to affected States Parties and notify WHO immediately.

• Intensify risk communication and community engagement, particularly at points of entry.

• Expedite authorization processes for investigational therapeutics as part of preparedness planning.

For all other States Parties

• Countries should not close borders or impose travel and trade restrictions, as such measures lack scientific justification and may drive unmonitored cross-border movement, harm economies, and hinder response operations.

• Governments should collaborate with transport and tourism sectors to ensure compliance with WHO guidance on international travel.

• Provide travelers to affected and at-risk areas with information on risks, preventive measures, and steps to take in case of exposure.

• Ensure the public receives accurate and timely information about the outbreak and protective measures.

• Be prepared to facilitate medical evacuation and repatriation of nationals who may have been exposed.

• Entry screening outside the affected region is not considered necessary for travelers returning from at-risk areas.