Global Outbreak Intelligence

EBOLA (BUNDIBUGYO) — DRC & UGANDA · 543 suspected cases and 131+ deaths as of 19 May 2026. Caused by Bundibugyo virus — the third recorded BDBV outbreak globally (previous outbreaks: Uganda 2007–8, DRC 2012). Index death: 24 April 2026, Bunia, Ituri Province, DRC. Body repatriated to Mongbwalu mining zone, seeding wider spread before outbreak was detected. Initial testing used Zaire Ebola assays (came back negative) — Bundibugyo-specific tests only confirmed positive on 14 May 2026, allowing weeks of undetected community spread. WHO declared PHEIC on 16 May 2026. Outbreak does NOT meet the criteria of a pandemic emergency. Spread: Ituri Province (Bunia, Rwampara, Mongbwalu health zones), North Kivu (Goma — 1 confirmed case 17 May), Kinshasa (1 suspected case, later ruled negative), Uganda — Kampala (2 confirmed cases, 1 death, 15–16 May). No approved Bundibugyo-specific vaccine or treatment. Ervebo (Zaire-strain vaccine) is being assessed but would take 2+ months to receive emergency approval. Complicating factors: armed conflict in eastern DRC, high population mobility, overwhelmed hospitals in Bunia, poor infrastructure (1,000+ km from Kinshasa). US: 1 American (physician/missionary Peter Stafford) confirmed positive 18 May. US entry ban in effect for anyone from DRC, Uganda or South Sudan within 21 days. CFR for Bundibugyo virus historically 25–40%. Current 24% CFR likely under-counted due to suspected cases far exceeding confirmed.

ANDES HANTAVIRUS — MV HONDIUS · 11 cases (9 confirmed, 2 probable) and 3 deaths as of 12 May 2026. MV Hondius, a Dutch-flagged expedition vessel, departed Ushuaia Argentina on 1 April 2026 carrying 149 people from 23 countries. Index case: Dutch national, believed to have contracted ANDV during a pre-voyage road trip through Argentina, Uruguay and Chile. Subsequent transmission aboard ship attributed to human-to-human spread — ANDV is the only known hantavirus capable of H2H transmission. Ship docked Tenerife 10 May; full disembarkation and repatriation completed 11 May across 6+ countries. 16 US passengers arrived at University of Nebraska Medical Center biocontainment unit; 2 at Emory University Hospital, Atlanta. WHO DG Tedros briefed press in Madrid 12 May: "This is not another COVID." Global public health risk: LOW. CDC Level 3 emergency response. 12 US residents under monitoring across TX, GA, VA, AZ, CA, NJ, MD.

MPOX CLADE IB · 1,202 confirmed Clade Ib records globally Jan–Apr 2026 (Global.health tracking). EU/EEA: 264 Clade I cases across 15 countries since Aug 2024 — Spain (103), Germany (47), Italy (34), France (18), Netherlands (17), Belgium (14), Sweden (8), Ireland (7), Austria (6), others. UK: 48 Clade Ib cases as of 30 April 2026; community transmission among GBMSM networks ongoing since Oct 2025. Novel recombinant MPXV (Clade Ib + IIb genetic elements) confirmed in UK and India Jan 2026 — ongoing phenotypic characterisation. DRC lifted national mpox emergency 2 April 2026 ("victory against the epidemic, not the virus"). WHO PHEIC lifted Sept 2025; Standing Recommendations extended to August 2026. Risk: MODERATE for MSM/sex workers; LOW for general population (ECDC/WHO).

DENGUE — TONGA · 56 confirmed dengue cases in Tonga, primarily Tongatapu Island. Dengue is endemic in Pacific Island nations and seasonal outbreaks are routine. No licensed dengue vaccine available in most Pacific countries for general travellers. Aedes aegypti mosquito vector active year-round.

MEASLES — BANGLADESH · 5,467 confirmed and 41,793 suspected measles cases with 259 deaths in Bangladesh in 2026 to date (as of 5 May). Driven by critically low MMR vaccination coverage, particularly in Rohingya refugee camps and rural areas. WHO coordinating emergency vaccination response. Measles basic reproduction number (R0) is 12–18 — among the most contagious human pathogens known.