The machine was right
When people in Ituri started dying with high fever and bleeding, their samples went to the Provincial Public Health Laboratory in Bunia and into a . The machine said negative.
Days later the same samples came back positive on a that looks for every filovirus at once, run in a reference laboratory. On 22 May the World Health Organization wrote the sentence flat: the GeneXpert platform cannot detect Bundibugyo virus.
The cartridge was not broken. It was looking for sequences from Zaire ebolavirus, because Zaire ebolavirus is what it was designed for, and the samples from Bunia did not contain Zaire ebolavirus. Confirmation and isolation were delayed. The outbreak was found so late that it began with more cases than any Ebola outbreak on record.
The GeneXpert platform cannot detect Bundibugyo virus.World Health Organization, Disease Outbreak News, 22 May 2026
Three doors
Behind these doors sit the three defences the world has against Ebola: a test, a vaccine, a drug. Choose which kind of Ebola arrives.
| Species | Routine field test | Licensed vaccine | Approved drug |
|---|---|---|---|
| Zaire | yes | yes | yes |
| Sudan | no | no | no |
| Bundibugyo | no | no | no |
| Taï Forest | no | no | no |
The flat line is the negative result, the same trace as in the plot at the top.
Four kinds of Ebola make people ill. One of them has all three doors open.
The routine field test is the GeneXpert Ebola cartridge, built for Zaire. For Bundibugyo, the regulatory door stays shut: Ervebo is not licensed and clinical protection has not been demonstrated. On 7 August 2026, WHO recommended taking it directly into a Phase III study in the current outbreak after new non-human-primate, ferret and pseudovirus-neutralisation evidence suggested possible cross-protection. On 20 August, WHO and Africa CDC allocated 70,000 doses: 20,000 for the Phase III study and 50,000 for health and frontline workers, in line with SAGE recommendations at the time; protection in humans remains unknown, and informed consent is required. On 27 August, Ervebo vaccination began in Kisangani. AP describes the 50,000 doses as a compassionate-use programme, separate from the randomized study cohort. The WHO guidance published on 1 September and dated 31 August says the evidence remains insufficient to establish clinically meaningful protection in humans and recommends using Ervebo against Bundibugyo only within research protocols. The approved drugs are Inmazeb and Ebanga, both for Zaire only. The BRAVO follow-up study, launched in Bunia on 19 September, follows 20,000 frontline workers over time; MSF does not present it as a randomized Phase III study, and the sources do not say whether it is the announced study or a separate one.
A drug is only proved during an outbreak
Ervebo, Inmazeb and Ebanga were approved on the strength of studies run on people during outbreaks. That is how anyone finds out whether an Ebola vaccine or treatment works: you give it to people who have the disease or are about to be exposed to it, and you compare what happens to them. There is no other place and no other moment to do it.
Ervebo exists because the West African epidemic between 2013 and 2016 left more than 11,000 dead and, with them, enough sick people for a trial. Inmazeb and Ebanga came out of the 2018 to 2020 outbreak in DR Congo.
Both previous Bundibugyo outbreaks were too small for that. The first, in Uganda in 2007 and 2008, had 131 reported cases and 42 deaths. The second, in DR Congo in 2012, had 62 cases and 34 deaths. There were never enough sick people to prove anything, and never enough well people for a manufacturer to sell to.
There is a European document that says this out loud. When the European Medicines Agency recommended the two-dose Ebola vaccine Zabdeno and Mvabea in May 2020, it wrote that the authorisation was granted under exceptional circumstances „because the applicant was able to demonstrate that it is not possible to conduct a randomised controlled study that might generate comprehensive clinical data on the efficacy of the new Ebola vaccine even after authorisation”. The regulator wrote down the trap in 2020 and licensed the product anyway.
Nobody ever bought it. On 1 May 2026 the European Commission withdrew the authorisation at the manufacturer’s request, for commercial reasons. Fourteen days later, DR Congo declared an Ebola outbreak.
| Product | Species covered | Status |
|---|---|---|
| Ervebo | Zaire | authorised in the EU since November 2019 |
| Zabdeno and Mvabea | Zaire | EU authorisation withdrawn on 1 May 2026 |
| Inmazeb | Zaire | approved in the United States, not in the EU |
| Ebanga | Zaire | approved in the United States, not in the EU |
The world’s filovirus kit is not a map of the dangerous viruses. It is a register of the outbreaks that grew large enough to be used as proof.
The window
A treatment can only be proved while there are patients who can enter a trial.Every dot is one reported case.The first two outbreaks ended at 131 and 62 cases.There is no universal threshold: the number needed depends on the treatment, mortality and trial design.
2 July 2026PARTNERS opened in Bunia on 2 July 2026. The epidemiological situation reported for 1–2 July contained 1,481 confirmed cases in DR Congo, Uganda and France.
131 reported cases. 42 deaths.
62 reported cases. 34 deaths.
8,067 cases, 3,901 deaths and 2,070 recoveries across seven provinces, according to the 26 September tally published by NICD. Africa CDC warns that local slowing does not establish control of the outbreak.
2 July: PARTNERS begins enrolling patients.
The third outbreak created the first window in which a trial could begin.
The 2007 and 2012 figures are reported cases from the US CDC. The current NICD tally of 26 September is 8,067 cases, 3,901 deaths and 2,070 recoveries across seven provinces. As an earlier reference, the DRC report with data through 16 September, relayed by ECDC on 18 September, gives 7,475 confirmed cases and 3,605 deaths across seven provinces. The government considers the peak reached in August, but the independent Africa CDC assessment of 17 September says the data do not yet allow that conclusion. The daily series may be revised retrospectively.
Success destroyed the evidence
4years between the drug and the question still unanswered
In 2022 Uganda had an outbreak of Sudan ebolavirus. There was no approved treatment for Sudan either, so some patients were given MBP134, a pair of antibodies designed to cover several ebolavirus species at once. It was given , outside any trial, because there was nothing else to give.
Uganda stopped the outbreak faster than anyone expected. The outbreak ended before anyone could find out whether the drug had worked.
In July 2026 MBP134 entered the first trial that tests it in patients, in Bunia. Same drug. Same question. Four years in between, and it took another outbreak.
24 August · first published human clinical data. A confirmed Bundibugyo case received MBP134, remdesivir and supportive care, recovered and was discharged. Separately, five contacts, one adult and four children, received MBP134 after exposure and remained free of disease with negative PCR tests during 21 days of follow-up. These are the first published clinical observations of MBP134 in Bundibugyo, but they do not yet show efficacy. There were no control groups, and randomized trial results are not available.
What remains at Day 100
Day 100of 100Day 0 · 17 May 2026Day 100 · 25 August 2026
Day 100 · 25 August 2026. The 100 Days Mission clock for Bundibugyo has reached its final milestone. The table below preserves the historical Day 98 snapshot; IPPS’s official Day 100 assessment is summarised in the block that follows.
| Species | Rapid test in the field | Licensed vaccine | Approved treatment |
|---|---|---|---|
| Zaire | GeneXpert cartridge | Ervebo | Inmazeb, Ebanga |
| Sudan | none | none | none |
| Bundibugyo | RADI kit, under validation | none | none |
| Taï Forest | none | none | none |
The flat line is the negative result, the same trace as in the plot at the top. Here it means nothing exists.
- On 2 July the first patient was enrolled in Bunia into PARTNERS, the trial testing MBP134 and remdesivir, separately and together.
- On 14 July EBO-PEP began, giving obeldesivir, a drug taken by mouth, to people who have been exposed to the virus.
- On 1 June, CEPI put money behind three candidate vaccines: up to 3.2 million dollars for IAVI, 8.6 million for Oxford with the Serum Institute of India, 50 million for Moderna.
- On 13 July the University of Oxford announced the world’s first human trial of a Bundibugyo vaccine. Fifty healthy volunteers between 18 and 55, in Oxford. The announcement counts 57 days since the emergency was declared.
- On 7 August WHO’s technical group recommended taking Ervebo directly into a Phase III study in the current outbreak to test possible cross-protection. Ervebo is not yet licensed for Bundibugyo.
- 22 May–22 August · superseded version of the IHR Temporary Recommendations. The set issued by WHO on 22 May reached the automatic three-month limit under the International Health Regulations. The Emergency Committee met again on 18 August, and WHO published the updated set that replaces it on 24 August. The international emergency has a separate legal status and remains in force.
- 21 August · the first doses reach DR Congo. More than 16,000 Ervebo doses arrived in Kinshasa. The DRC Ministry of Health and ACP give 16,520; AP and AFP reported 16,250. ACP describes this shipment as part of 50,120 doses expected between 21 and 24 August. WHO allocated 70,000 doses in total: 20,000 for the Phase III trial and 50,000 for frontline and health workers.
- 22 August · available stock is smaller than the allocation. INSP’s director says the DRC currently has 20,750 doses available: 20,000 for the Phase III trial and 750 for frontline workers. The first announced strategy is a vaccination belt around Ituri to limit spread towards Tshopo, Haut-Uele and Bas-Uele. Ervebo remains unlicensed for Bundibugyo, and its clinical effectiveness against this species has not been demonstrated.
- 24 August · current WHO Temporary Recommendations. The new document details surveillance, case detection, diagnosis, clinical care and infection control, and adds measures for public gatherings, domestic mobility and inland water transport. WHO explicitly maintains that there is still no approved vaccine or treatment for Bundibugyo and calls for head-to-head comparisons of field PCR platforms and robust clinical trials of candidate vaccines and therapeutics.
- 27 August · administration begins. In Kisangani, the health minister officially launched vaccination for health workers and other frontline response workers; people who have had contact with patients are next. Ervebo is being used against Bundibugyo before efficacy for this species has been demonstrated: it remains licensed only for Zaire, and the Phase III study is meant to establish whether cross-protection exists. The BRAVO follow-up study, launched in Bunia on 19 September, follows 20,000 frontline workers over time; MSF does not present it as a randomized Phase III study, and the sources do not say whether it is the announced study or a separate one.
- 28 August · WHO publishes Disease Outbreak News no. 616. With data through 26 August, WHO reports 5,794 confirmed cases, 2,786 confirmed deaths and 60 affected health zones in the DRC. Biena and Manguredjipa are the two new zones in North Kivu.
- 28 August · WHO IHR Emergency Committee report. The outbreak remains a public health emergency of international concern and does not meet the criteria for a pandemic emergency. On 12 August, about 1,000 beds were available against an estimated need for 3,000; mortality-based modelling gave a 21-day doubling time and an Rt of 1.55. Models suggest three to four times as many infections as surveillance captures, with moderate confidence. WHO found no evidence of a fundamental change in the virus’s biology or modes of transmission.
- 30 August · SitRep N°108/MVEBDB/30/08/2026 from the DRC National Institute of Public Health, published on 31 August. The tally reaches 6,100 confirmed cases and 2,950 confirmed deaths across 60 affected health zones; no new health zone was affected in the previous 24 hours.
- 1 September · WHO tightens the Ervebo recommendation. The emergency guidance published on 1 September and dated 31 August says evidence remains insufficient to establish clinically meaningful protection against Bundibugyo and recommends using the vaccine only within research protocols.
- 2 September · the official tally passes 3,000 deaths. Covering data through 31 August, the latest DRC Ministry of Health and National Institute of Public Health report, cited by Actualité.cd and independently confirmed by AP and Reuters, gives 6,186 confirmed cases, 3,007 deaths and 1,409 recoveries; about 830 people remain in isolation or Ebola treatment centres.
- 3 September · ECDC updates its outbreak page. Congolese authorities reported 6,250 confirmed cases, including 3,039 deaths, with data through 1 September. ECDC gives 1,439 recoveries, 869 patients in isolation and 60 of 151 affected health zones, and notes that the figures remain under review and harmonisation.
- 4 September · ECDC and WHO publish the same official tally. With data through 2 September, the DRC report reaches 6,342 confirmed cases and 3,072 deaths; 1,475 people have recovered, 770 patients are hospitalised in isolation and 60 of 151 health zones are affected. WHO Africa also reports the launch in Kinshasa of a revised 180-day multisectoral response plan.
- 14 September · ECDC updates its outbreak page again. With data through 12 September, the DRC report reaches 7,200 confirmed cases and 3,475 deaths. There are 923 patients hospitalised in isolation, 88% of identified contacts are under follow-up, and 62 of 167 health zones are affected across seven provinces. ECDC notes that the figures remain under review and harmonisation.
- 15 September · the tally and its interpretation separate. The UN/WHO briefing gives 7,258 confirmed cases and 3,510 deaths across seven provinces. The government says daily cases have fallen from about 120 to 80 and considers the peak passed, but WHO cautions that it is too early to declare a turning point. Some areas are improving while others continue to rise.
- 17 September · Africa CDC says the peak is not yet demonstrated. The Emergency Consultative Group completes an independent scientific review: declines in some hotspots, including Ituri, are encouraging, but transmission is rising in some zones, especially North Kivu, and the available data do not confirm that the peak has been reached. The Group recommends keeping the continental emergency and intensifying the response.
- 18 September · ECDC relays the new DRC tally. With data through 16 September, the report reaches 7,475 confirmed cases and 3,605 deaths, 71 cases and 32 deaths more than the previous report. There are 905 patients hospitalised in isolation, 1,798 recoveries, 87.6% of contacts under follow-up and 62 of 167 zones affected across seven provinces. ECDC notes that the figures remain under review and harmonisation.
- 19 September · the BRAVO study begins in Bunia. MSF and Epicentre, with the DRC Ministry of Health, Africa CDC and INRB, launch BRAVO, a follow-up study for frontline workers in Ituri and North Kivu, covering 20,000 people over nine to twelve months: three months of Ervebo vaccination and at least six months of follow-up. The study gathers real-world data on the effect of Ervebo against Bundibugyo; participation and vaccination are voluntary. Ervebo remains licensed only for Zaire virus, and any benefit against Bundibugyo remains to be demonstrated. MSF does not present BRAVO as a randomized Phase III study, and the sources do not say whether it is the announced study or a separate one.
- 26 September · NICD reports 8,067 cases, 3,901 deaths and 2,070 recoveries across seven provinces. No vaccine or treatment is approved for Bundibugyo virus.
- 29 September · the UN Geneva briefing cites WHO as reporting more than 1,600 beds across 50 centres and nearly 400 trained workers; it does not state the observation date.
- 30 September · a WHO Africa feature gives a dated series: 929 beds on 27 July and 1,510 on 21 September across 54 facilities in 34 health zones. On 21 September, 326 more beds were being installed and 146 were planned; the expansion needed more than 1,400 additional health professionals.
On that same 13 July, at Rwampara general hospital inside the epicentre, epidemiologists, case investigators, drivers and gravediggers went on strike because they had not been paid since the outbreak began. On Wednesday staff at Bunia general hospital struck too and blocked the entrance. Confirmed cases were passing 2,000 that week, with 754 dead.
The Oxford trial runs on healthy volunteers in a country with no Ebola. It shows whether that candidate is safe and whether it raises an immune response. Whether it protects anyone can only be learned where the disease is, which means Ituri, during the outbreak. Ervebo is at a different stage: on 20 August, WHO/SAGE supported limited use outside the study for health and frontline workers, while WHO recommended testing it directly in this outbreak. The WHO guidance published on 1 September and dated 31 August now recommends using it against Bundibugyo only within research protocols; it is not licensed or proven for Bundibugyo. If the outbreak is stopped before the Oxford study can answer the protection question, that candidate remains unlicensed. Oxford delivered in 57 days. The structure it delivered into is the part that does not hold. A Correspondence published in Nature Medicine on 26 August quantified that pressure using INSP data from 2 August: Ebola treatment centres in North Kivu were operating at 131.9% capacity, with 186 patients for 141 declared beds, while some centres in Ituri were above 200%; Nizi had reached 278%. The authors warn that overcrowding makes rapid, safe isolation harder and may sustain transmission. These figures describe operations on 2 August. The article is a Correspondence; it quantifies operational pressure without establishing how many infections overcrowding caused.
If too few people have your disease, nobody can prove a treatment works, so nobody makes one. Ebola is the most violent version of the logic that decides whether a drug exists for a rare disease on a children’s ward in Bucharest or in Bristol.
Sources
What this is and what it is not
Evidence was searched through 30 September 2026. The latest tally used is the NICD report of 26 September: 8,067 cases, 3,901 deaths and 2,070 recoveries across seven provinces. ECDC data from 16–21 September remain historical references. Africa CDC cautions that local slowing does not establish control of the outbreak. The text covers the regulatory position in the European Union and United States. There was no clinical review.
What is written here is public information, not medical advice. Anyone who develops a fever after travelling in an area with Ebola should call ahead and say where they have been before walking into a waiting room.
What kinds of claim are here
- documented facthas a primary source, listed below
- a number that movescarries its date beside it
- editorial inferencejoins documented facts and is written as such
The outbreak
- World Health Organization, Disease Outbreak News no. 603, 22 May 2026The GeneXpert platform cannot detect Bundibugyo virus. DR Congo’s 17th Ebola outbreak.
- World Health Organization, External Situation Report 13, 9 August 20264,381 confirmed cases and 2,011 confirmed deaths in the DRC; transmission remains intense and expanding.
- European Centre for Disease Prevention and Control, Ebola situation, updated 21 August 2026Relays DRC data through 19 August and identifies the national authority as the source; the page is updated every weekday.
- DRC government and INSP, situation report no. 98, data through 20 August 20265,375 confirmed cases and 2,557 confirmed deaths; figures published by the Congolese authorities and relayed by news agencies.
- DRC National Institute of Public Health, SitRep N°108/MVEBDB/30/08/2026, published 31 August 20266,100 confirmed cases, 2,950 confirmed deaths, 1,383 recoveries, 60 affected health zones and 86.3% of contacts followed, with data through 30 August 2026. The primary source is now identified; its official page lists the report and PDF.
- European Centre for Disease Prevention and Control, page updated 3 September 2026Relays the DRC report of 2 September: 6,250 confirmed cases, including 3,039 deaths, with data through 1 September; 1,439 recoveries, 869 patients in isolation and 60 of 151 affected health zones. ECDC notes that the figures remain under review and harmonisation.
- European Centre for Disease Prevention and Control, page updated 4 September 2026Relays the DRC report of 3 September: 6,342 confirmed cases and 3,072 deaths, with data through 2 September; 1,475 recoveries, 770 patients hospitalised in isolation and 60 of 151 affected health zones. ECDC notes that the figures remain under review and harmonisation.
- European Centre for Disease Prevention and Control, page updated 14 September 2026Relays the DRC report through 12 September: 7,200 confirmed cases and 3,475 deaths; 923 patients hospitalised in isolation, 88% of identified contacts under follow-up and 62 of 167 affected health zones across seven provinces. ECDC notes that the figures remain under review and harmonisation.
- NICD, Bundibugyo virus disease update, 26 September 2026Reports 8,067 cases, 3,901 deaths and 2,070 recoveries across seven DRC provinces; no vaccine or treatment is approved for Bundibugyo virus.
- UN Geneva briefing, WHO on Ebola patient care, 29 September 2026The briefing cites more than 1,600 beds in 50 treatment centres and nearly 400 trained health workers, but does not state the observation date or define capacity in terms comparable with the WHO Africa feature published the following day.
- WHO Regional Office for Africa, 30 September 2026Between 27 July and 21 September, capacity rose from 929 to 1,510 beds across 54 health facilities in 34 health zones. On 21 September, 326 additional beds were being installed and 146 more planned, with a goal of around 1,830 by month-end; more than 1,400 additional health professionals were needed.
- European Centre for Disease Prevention and Control, page updated 18 September 2026Relays the DRC report with data through 16 September: 7,475 confirmed cases and 3,605 deaths, 71 cases and 32 deaths more than the previous report; 905 patients hospitalised in isolation, 1,798 recoveries, 87.6% of contacts under follow-up and 62 of 167 zones affected across seven provinces. ECDC notes that the figures remain under review and harmonisation.
- European Centre for Disease Prevention and Control, outbreak page with data through 21 September 2026Cited here only as a limit of the tally used: the DRC report had reached 7,773 confirmed cases and 3,759 deaths; that later tally is not adopted as this page’s reference.
- Africa CDC, Emergency Consultative Group assessment, 17 September 2026Independent scientific review: the data do not yet confirm that the peak has been reached; declines in some hotspots, including Ituri, but rises in some zones, especially North Kivu. Recommends keeping the continental emergency and intensifying the response.
- UN/WHO Geneva briefing, 15 September 2026The update used here gives 7,258 confirmed cases and 3,510 deaths across seven provinces and records WHO’s warning that declaring a turning point is premature. WHO’s outbreak situation page provides the official context; the briefing transcript was not yet separately indexed when this page was written.
- WHO Africa, revised response plan release, 4 September 2026The DRC government and partners launched a revised 180-day multisectoral response plan in Kinshasa. WHO reports 6,342 cases and 3,072 deaths in the DRC, with data through 2 September, and 60 affected health zones across six provinces.
- Actualité.cd, 2 September 2026, citing the INSP situation reportWith data through 31 August, the report gives 6,186 confirmed cases, 3,007 deaths, 1,409 recoveries, 86 new cases and 57 deaths in the previous 24 hours, 43 of them in communities.
- Associated Press, outbreak tally on 2 September 2026Independently confirms 6,186 cases and 3,007 deaths from DRC Ministry of Health data; the outbreak has passed 3,000 deaths.
- Reuters, outbreak tally on 2 September 2026Independently confirms 6,186 cases and 3,007 deaths in DRC government data; the outbreak has become the largest and deadliest in the country’s history.
- Xinhua, outbreak tally on 2 September 2026Reports, from the official situation report, 1,409 recoveries and about 830 people in isolation or Ebola treatment centres, with data through 31 August.
- Associated Press, outbreak count through 25 August 20265,713 confirmed cases and 2,744 deaths in the DRC, according to government figures reported by AP.
- Associated Press, outbreak count on 28 August 20265,794 confirmed cases, 2,786 confirmed deaths and 60 affected health zones, according to the DRC Ministry of Health figures. Biena and Manguredjipa are the two new zones in North Kivu.
- World Health Organization, Disease Outbreak News no. 616, 28 August 20265,794 confirmed cases, 2,786 confirmed deaths and 60 affected health zones in the DRC, with data through 26 August. WHO is the primary source for the current outbreak count.
- Bloomberg News, outbreak count and Africa CDC estimate, 27 August 20265,713 confirmed cases and 2,744 deaths in the DRC through 25 August; the Africa CDC under-detection estimate is kept separate from the official count.
- World Health Organization and Africa CDC, 100-day assessment, 25 August 2026The emergency continues in Ituri and five other provinces; the authors call for a two- to threefold increase in response capacity and report 158 health workers infected and 45 dead by 20 August.
- World Health Organization, IHR Emergency Committee meeting report, 28 August 2026The Committee keeps the outbreak at public health emergency of international concern status and says it does not meet the criteria for a pandemic emergency. On 12 August, WHO reported about 1,000 beds for BVD patients against an estimated need for 3,000; mortality-based modelling gave an Rt of 1.55 and a 21-day doubling time. Triangulation estimated true infections may be three to four times the number captured by surveillance, with moderate confidence. The report found no evidence of a fundamental change in the virus’s biology or modes of transmission.
- Nature Medicine, Correspondence · operational data from SitRep 80, 2 Aug 2026 · published 26 August 2026Ebola treatment centres were over capacity in North Kivu at 131.9% (186 patients for 141 declared beds); in Ituri, Nizi was at 278%, ISTM Nyakunde at 123%, CME Bunia at 104%, Lita and Fataki at 100%, and the Fataki transit centre at 200%. The authors link overcrowding to more difficult isolation and the possibility of sustained transmission. The operational data are from 2 August.
- World Health Organization, Disease Outbreak News no. 612, 3 July 20261,481 confirmed cases in the situation reported for 1–2 July.
- World Health Organization, Disease Outbreak News no. 613, 17 July 2026Figures to 15 July, health workers infected, cases treated in France and Germany.
- World Health Organization, Disease Outbreak News no. 614, 1 August 2026Data through 30 July: 3,605 cases and 1,587 deaths in the DRC, 3,626 and 1,589 across the outbreak; the largest Ebola outbreak recorded in the DRC. Uganda declared local transmission over.
- World Health Organization, emergency declaration, 17 May 2026The date of the public health emergency of international concern.
- World Health Organization, IHR Temporary Recommendations, 22 May–22 August 2026 · superseded versionThe Temporary Recommendations issued after the Emergency Committee’s first meeting; they reached the automatic three-month limit and were replaced by the set published on 24 August.
- World Health Organization, questions and answers on the IHR and Emergency CommitteesTemporary Recommendations automatically expire three months after issuance.
- World Health Organization, opening of the second Emergency Committee meeting, 18 August 2026The Director-General asks the committee for advice on the recommendations needed for the continuing epidemic.
- World Health Organization, temporary recommendations after the second IHR Emergency Committee meeting, 24 August 2026 · current setAlthough clinical trials are ongoing, there are still no approved treatments or vaccines against Bundibugyo virus. The document calls for head-to-head comparison of field PCR platforms and robust clinical trials of candidate countermeasures.
- World Health Organization, rapid risk assessment, 20 August 2026Risk remains very high in the DRC, high for neighbouring countries, and low at regional and global levels.
- Africa CDC, continental emergency declaration, 18 May 2026Public health emergency of continental security.
- Médecins Sans Frontières, outbreak response pageFigures as of 21 July 2026 and the May timeline.
- Associated Press, via Euronews Health, 24 July 2026Patients isolated or hospitalised, contact tracing, the words of Trish Newport.
- Al Jazeera, 15 July 2026The strike at Rwampara and Bunia, and that week’s figures.
- Social Science in Humanitarian Action Platform, Ituri context 2026Armed conflict, displacement, gold mining, health system capacity.
The detection gap
- IPPS, Ebola (Bundibugyo) Day 15, 1 June 2026The negative results at the Bunia laboratory, Altona pan-filovirus tests, the RADI kit, the Africa CDC review of rapid antigen tests.
- IPPS, Ebola (Bundibugyo) Day 45, 1 July 2026Current status of diagnostics, therapeutics and vaccines, and what still does not exist.
- IPPS, Ebola (Bundibugyo) Day 100, 25 August 2026The official countermeasure assessment: three molecular diagnostics on the EUL, two products under review, PARTNERS at participant 200, and progress on candidate vaccines.
Vaccines and treatments
- World Health Organization, emergency guidance on the licensed vaccine, initial position, 28 May 2026WHO’s initial position was that Ervebo should not be used outside carefully designed research settings; the specific 20 August allocation subsequently added use for health and frontline workers.
- World Health Organization, guidance on Ervebo, B09772Ervebo is authorised for Zaire ebolavirus, not Bundibugyo; the 28 May guidance said animal data did not justify programmatic use before the SAGE decision and the specific 20 August allocation.
- World Health Organization, Technical Advisory Group on Candidate Vaccine Prioritization, 7 August 2026Ervebo is recommended for direct inclusion in a Phase III study in the current outbreak to test possible cross-protection.
- World Health Organization, emergency guidance on Ervebo in Bundibugyo outbreaks, published 1 September 2026 and dated 31 August 2026Normative guidance: evidence remains insufficient to establish clinically meaningful protection in humans, and Ervebo is recommended only within research protocols.
- World Health Organization and Africa CDC, Ervebo allocation, 20 August 202670,000 doses allocated: 20,000 for the Phase III trial and 50,000 for frontline and health workers, in line with SAGE recommendations at the time; protection in humans remains unknown, and informed consent is required.
- Agence Congolaise de Presse, first Ervebo shipment, 22 August 202616,520 doses reached Kinshasa; 50,120 doses expected between 21 and 24 August.
- Associated Press, first Ervebo shipment reaches DR Congo, 22 August 2026AP and AFP report 16,250 doses; the difference from the Congolese figure of 16,520 remains unresolved.
- Le Potentiel, remarks by the INSP director, 22 August 2026First available stock of 20,750 doses: 20,000 for the trial and 750 for frontline workers; vaccination-belt strategy around Ituri.
- Agence Congolaise de Presse, vaccination launched in Kisangani, 27 August 2026The Ervebo vaccination campaign officially began in Kisangani; frontline health workers are prioritised, followed by people who have had contact with patients. The health minister says studies continue to establish the level of protection.
- Associated Press, vaccination begins and compassionate use in DR Congo, 27–28 August 2026Confirms that people began receiving vaccination in Kisangani and that health and other frontline workers are prioritised. Describes the 50,000 doses for workers as a compassionate-use programme, separate from the clinical study; efficacy against Bundibugyo remains under study.
- Médecins Sans Frontières, launch of the BRAVO vaccination study, 19 September 2026MSF and Epicentre, with the DRC Ministry of Health, Africa CDC and INRB, launch a follow-up study in Bunia for 20,000 frontline workers in Ituri and North Kivu over nine to twelve months; participation and vaccination are voluntary, and Ervebo remains licensed only for Zaire virus.
- World Health Organization, expert advice on candidates, 28 May 2026The prioritised therapeutics and vaccines.
- World Health Organization, PARTNERS trial opens, 2 July 2026First patient enrolled; adaptive trial of MBP134 and remdesivir, separately and together.
- ANRS Maladies infectieuses émergentes, INRB and ALIMA, EBO-PEP launch, 14 July 2026Obeldesivir as post-exposure prophylaxis.
- University of Oxford, world’s first Phase I trial, 13 July 2026ChAdOx1 BDBV, fifty volunteers, 57 days after the emergency was declared.
- University of Oxford, first participant vaccinated, 24 July 2026The first participant received a dose in the Phase I ChAdOx1 BDBV trial, the first human trial of a Bundibugyo-specific vaccine.
- Nature Medicine, case treated with MBP134 and remdesivir, 24 August 2026A 39-year-old healthcare worker with confirmed infection received MBP134, remdesivir and supportive care; viral RNA became undetectable in blood, throat swabs, urine and stool by day 13, and the patient was discharged on day 22. The authors call for larger studies to assess efficacy.
- Nature Medicine, post-exposure prophylaxis with MBP134, 24 August 2026One adult and four children received MBP134 5–6 days after medium- to high-risk exposures; administration was well tolerated, and all remained free of disease with negative PCR tests during 21 days of follow-up. There was no control group.
- ClinicalTrials.gov, NCT07737717, Moderna trial registryClinical trial of the mRNA-1469 vaccine candidate against Bundibugyo virus disease.
- CEPI, funding for three candidate vaccines, 1 June 2026The amounts for IAVI, Oxford with the Serum Institute of India, and Moderna.
- European Medicines Agency, Ervebo pageIndication for disease caused by Zaire Ebola virus.
- European Medicines Agency, Zabdeno and Mvabea pagesAuthorisation withdrawn on 1 May 2026 at the holder’s request, for commercial reasons.
- European Medicines Agency, press release, 29 May 2020Authorisation under exceptional circumstances and the regulator’s written reason.
History and virology
- US CDC, History of Ebola OutbreaksUganda 2007: 131 reported cases, 42 deaths. DR Congo 2012: 62 cases, 34 deaths.
- Towner JS et al., PLOS Pathogens 4(11): e1000212, 2008The surface glycoprotein differs between Bundibugyo and Zaire by more than 35% at the amino acid level.
- Mbala-Kingebeni P., Ssewanyana I. et al., Virological.org, from 18 May 2026The initial genomes from this outbreak and the species identification.
Updated 29 September 2026. Outbreak figures are tied to the date written beside them and may be revised.