Congo’s Bundibugyo Outbreak Passes 9,000 Cases Without a Vaccine

Congo’s public health institute on Tuesday put confirmed Bundibugyo Ebola cases at 9,066 and deaths at 4,381, with no licensed vaccine in use. The October 13 report also listed 2,389 recoveries and 88 new cases, a death rate of 48.3% among people whose infections have been lab-confirmed.

Those confirmed infections already dwarf every earlier Ebola wave inside the country. They are also the smaller number, because so many patients die at home and because officials say a large share of infections never make the confirmed list.

Congo’s Confirmed Caseload Passes 9,000

The National Institute of Public Health’s Tuesday tally is the first to clear 9,000 confirmed infections in this outbreak, which was declared in May and named the country’s 17th Ebola event. The World Health Organization had counted 8,728 confirmed cases and 4,205 confirmed deaths as of October 6, before the institute’s later update.

THE OCTOBER 13 COUNT

• Confirmed cases: 9,066, from Congo’s public health institute.
• Confirmed deaths: 4,381, a 48.3% death rate among known cases.
• Recoveries: 2,389 people recorded as having survived.
• New cases that day: 88, with community spread still listed as a concern.

WHO’s October 6 notice placed infections in 64 health zones across seven of the country’s 26 provinces: Bas-Uélé, Haut-Uélé, Ituri, North Kivu, South Kivu, Sud-Ubangi and Tshopo. Forty-eight of those 64 zones had at least one new case in the preceding 21 days. Over three completed epidemiological weeks, new weekly cases rose 2.5%, from 475 to 487, while weekly deaths moved from 222 to 224.

On October 6 itself, 62 new confirmed cases were logged, 33 in Ituri and 30 in North Kivu, and the seven-day average had reached 72 cases a day. Health officials have said the confirmed total accounts for only about a third of all cases, with many infections going undetected.

Most Recorded Deaths Happen Outside Treatment Centers

The death rate is high even next to earlier Bundibugyo outbreaks, which WHO puts at 30% and 50% case fatality. What is driving the current rate is delay. People are being identified late, or not at all, and they are dying before they reach a bed built for this disease.

In the window covered by WHO’s latest Disease Outbreak News, 264 of 372 reported deaths occurred in communities and 108 in treatment centers. Contact tracing is also short of its own target. Follow-up coverage stood at 80.4% as of October 4, with 23,741 of 29,535 listed contacts reached, against a goal of 85%. Coverage had hit 87.6% on September 16, then fallen to 74.7% by September 25.

Samuel Buju, a resident of Bunia, the Ituri capital and one of the outbreak’s hot spots, put the political complaint in plain terms.

I feel that the government is overwhelmed by events. But there is nothing else to say. The government needs to fully shoulder its responsibilities to ensure the effectiveness of the response against Ebola.

Samuel Buju, resident of Bunia, Ituri

Fighting has cut access in Ituri health zones including Fataki, Drodro and Lita, delayed sample transport to Bunia, and disrupted transfers of confirmed patients, according to UN officials. A transit center in a displacement camp also burned in early October, knocking out a link in the isolation chain.

A Stockpile Built for the Zaire Strain

The operational hole is medical as well as military. There is no licensed vaccine and no approved specific treatment for Bundibugyo virus disease. Outbreak control, WHO says, still rests on finding cases, isolating patients, tracing contacts, burying the dead safely, and keeping communities willing to use clinics.

That is the pre-2018 method. In the North Kivu and Ituri epidemic of 2018 to 2020, responders had a licensed shot for Zaire ebolavirus and used it at scale, vaccinating over 303,000 people with rVSV-ZEBOV-GP (Ervebo). That outbreak, the previous record inside Congo, ended with 3,481 cases and 2,299 deaths. The current Bundibugyo wave has already reached 2.6 times as many cases and about 1.9 times as many deaths, in a much shorter span, without that tool.

HOW THE THREE BIGGEST EBOLA WAVES COMPARE

Ervebo, the Zabdeno and Mvabea regimen, and the antibody drugs Inmazeb and Ebanga were all built around the Zaire virus surface protein. Bundibugyo is a different species. WHO has said there is no approved vaccine or specific treatment for it, and the agency’s advisers have asked for randomized trial data before anyone treats Ervebo as a Bundibugyo shot.

Doses are still going into arms under study rules. WHO Director-General Tedros Adhanom Ghebreyesus said on October 10 that more than 9,000 frontline workers had received Ervebo in the government-led programme, including the first 100 in Haut-Uélé, and that Médecins Sans Frontières and partners had vaccinated at least 870 more in the BRAVO study.

There continues to be strong progress in the #Ebola response in the #DRC.

-In the Haut-Uele provincial capital of Isiro, yesterday 25 survivors of BVD (13 women and 12 men) were discharged following treatment at a WHO-supported Ebola Treatment Centre (ETC).

-The 10-bed… pic.twitter.com/Dpqzv8uZEs

— Tedros Adhanom Ghebreyesus (@DrTedros) October 10, 2026

Africa CDC has said Congo received 70,000 Ervebo doses. Those injections are a bet on partial cross-protection, not a licensed Bundibugyo campaign, and BRAVO vaccinations have been paused at times when supply ran short.

Why Bundibugyo Never Received a Licensed Shot

This is only the third recorded Bundibugyo outbreak. The virus was identified in 2007 in Bundibugyo District, Uganda, and it returned in Congo in 2012. Both earlier waves were small enough that drug makers had little commercial reason to finish a product.

The science did not stop. James Crowe, an immunologist at Vanderbilt University Medical Center, told Nature Africa that his group used blood cells from Ugandan survivors to isolate human antibodies that recognised several Ebola viruses, including Bundibugyo. The next bill was manufacturing and early safety testing.

At that point, you’re looking at a US$40-million bill. That’s where we always get stuck in these programmes around emerging infections. We can discover the candidate drugs, but we do not usually have the resources to move to the next step.

James Crowe, immunologist, Vanderbilt University Medical Center

Crowe’s later line was blunter: the work on Bundibugyo and Sudan was never finished, even though the technology existed. Zaire ebolavirus absorbed the money after West Africa. The rarer species did not. Incubation for Bundibugyo disease runs from 2 to 21 days, and early fever, fatigue, muscle pain, headache and sore throat look like malaria, which is one reason patients reach isolation late.

Ituri Remains the Epicenter as North Kivu Surges

Ituri still holds most of the known burden. As of October 6, it had 6,480 of the 8,728 confirmed cases then on WHO’s books, or 74%, and 2,989 deaths, with 28 of 36 health zones affected. North Kivu had 1,755 cases and 1,013 deaths, the highest provincial death rate at 57.7%, and 17 of 34 zones. The hottest zones were Beni and Katwa in North Kivu, and Rwampara, Bunia and Mandima in Ituri.

CONFIRMED CASES BY PROVINCE, OCTOBER 6

North Kivu is where the map is moving. MSF said the province’s share of newly confirmed cases had risen from 24% at the end of August to nearly 40% by late September, and that as of September 28 34 percent of confirmed patients were still being treated in ordinary health facilities because dedicated beds and lab confirmation lagged.

WHERE THE RESPONSE IS THIN

• Ordinary wards: A third of confirmed patients in North Kivu were outside specialist centers as of September 28.
• Bed history: On May 19, four days after the outbreak was declared, one 9-bed treatment center was operating.
• Bed count now: WHO’s Africa office has counted 59 facilities with 1,346 beds in affected provinces, including 974 beds across 25 Ituri sites as of September 1.
• Staff gap: Planners want 6,200 more staff and 2,071 more beds over the next three months; Bunia centers have run at 90% to 100% occupancy.

Stéphanie Hoffmann, who coordinates MSF’s Ebola treatment center in Butembo, described the North Kivu spread as a fire that keeps finding new ground.

It is like fighting a megafire.

Stéphanie Hoffmann, MSF Ebola treatment center coordinator, Butembo

Tedros also reported a 10-bed extension in Isiro, Haut-Uélé, taking that center to 50 beds, and 25 survivors discharged there on October 9. WHO has trained 211 health workers at a clinical hub in Bunia. The additions are real, and they are still chasing a caseload that has already passed 9,066 confirmed.

Kenya’s Imported Case Crossed Two Borders

WHO was told on October 5 of a lab-confirmed imported Bundibugyo case in Kenya, in an adult Kenyan citizen who had been living in Congo. He had been ill for about a month and treated in several Congolese hospitals. WHO’s notice says the month-long course makes it likely he caught Bundibugyo while seeking care for something else, because this disease does not usually run that long from infection to death.

THE NAIROBI IMPORT

1. October 2, 2026: Travels by road from eastern Congo to Kampala, Uganda.
2. October 3, 2026: Boards Jambo Jet flight 8523 and lands at Jomo Kenyatta International Airport at 1:10 p.m., then goes straight to Nairobi Hospital.
3. October 5, 2026: Samples test positive for Bundibugyo virus at the National Virology Reference Laboratory and at the Kenya Medical Research Institute; he dies the same night.
4. October 6, 2026: Kenya’s Ministry of Health confirms the country’s first imported case and lists contacts.

Health Cabinet Secretary Aden Duale said the ministry had identified 28 contacts, including family and health workers, and was tracing 23 passengers and four crew from the flight. Since May, Kenya had screened 652,584 travellers and tested 267 samples at five labs, with one positive, and had trained 4,971 health workers. Duale told Kenyans not to panic and to use the 719 health line.

Uganda had already recorded 20 confirmed cases and two deaths earlier in the year and was declared Ebola-free in late August. The Kenyan traveler spent less than 24 hours in transit through Kampala, Ugandan officials said, and left Entebbe with a normal temperature. WHO’s Africa director, Dr Mohammed Janabi, said Kenya does not have an Ebola outbreak, and neither does Uganda.

The naming still lands. Uganda is the road and air bridge between eastern Congo and Nairobi, so a single dying passenger puts a closed outbreak back on the map. France recorded one imported case earlier, later released, and on October 1 the Netherlands reported a medical evacuation of a health worker who had tested positive while working on the Congo response. WHO’s weekly notice called Kenya the fourth country touched by this outbreak. Risk inside Congo remains very high, and high for countries that share its land borders, with the rest of Africa and the wider world still assessed as low. WHO advises against travel and trade bans.

Tumaini Is Weeks Away From First Doses

The Coalition for Epidemic Preparedness Innovations said on October 13, the same day the institute posted 9,066 confirmed cases, that final preparations are underway for a pivotal Tumaini Phase 2/3 trial in Congo. Tumaini means hope in Swahili. The Institut National de Recherche Biomédicale and the University of Antwerp will lead and co-sponsor it, subject to ethical and regulatory approval, with a start expected in the coming weeks.

VACCINES NOW IN PLAY

• Ervebo in Tumaini: Likely the first candidate in the Congo efficacy trial, even though it is licensed only for Zaire ebolavirus.
• Oxford ChAdOx1 BDBV: A Bundibugyo-specific shot that entered Phase 1b dosing in Uganda on October 6.
• Moderna candidate: Ethical approval for Phase 1b in Uganda on October 7, after a Phase 1a start in Canada.
• Obeldesivir: Gilead’s experimental antiviral pill, already in a Congo prevention trial that had enrolled more than 250 people by early October.

WHO’s Technical Advisory Group on Candidate Vaccine Prioritisation has said Bundibugyo-specific shots should enter Tumaini as soon as they are ready. Until those results exist, isolation, contact tracing, and supportive care remain the response, in provinces where tracing is below target and where a large share of deaths never reach a treatment center.

The institute’s confirmed count is already 9,066, with 4,381 dead, and the trial that might close the vaccine gap is still waiting on approvals.

Disclaimer: This article is news reporting on an active public-health emergency and is for information only. It is not medical advice, a diagnosis, or guidance on travel, vaccination, or treatment. Anyone who has symptoms, or who may have had contact with a patient, should speak to a qualified physician or the local health authority and follow official isolation rules. Case counts, deaths, trial dates, and response measures change as Congo’s public health institute, WHO, and partner agencies issue new figures.