[Comment] Ebola outbreak caused by Bundibugyo virus: challenges and priorities for epidemic preparedness and response

Ebola outbreak caused by Bundibugyo virus: challenges and priorities for epidemic preparedness and response Affiliations & Notes aBiomedical Research Institute, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa bEpidemiology, Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA, USA cClinical Research Center, Institut National de Recherche Biomédicale, Kinshasa, DR Congo dDepartment of Epidemiology and Global Health, Institut National de Recherche Biomédicale, Kinshasa, DR Congo eUniversity of Kinshasa School of Medicine, Kinshasa, DR Congo fImmunology Laboratory, Institut National de Recherche Biomédicale, Kinshasa, DR Congo gInternational Vaccine Institute Africa Regional Office, Kigali, Rwanda hInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA iDepartment of Viral Infection and International Public Health, Kanazawa University School of Medicine, Kanazawa, Japan jDivision of Medical Virology and National Health Laboratory Service Tygerberg, Faculty of Medicine and Health Sciences, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa kDepartment of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa lDivision of Pediatric Infectious Diseases, University of Minnesota Medical School, Minneapolis, MN, USA mInternational Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria nDepartment of Pediatrics and Child Health, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana oFondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo pMolecular Epidemiology of Infectious Diseases, University of Tübingen, Tübingen, Germany qCentre for Epidemic Response and Innovation, School for Data Science and Computational Thinking, Stellenbosch University, Cape Town, South Africa rInterdisciplinary Consortium for Epidemic Research, Kampala, Uganda sRear Public Health Laboratory, Kampala, Uganda tUganda Virus Research Institute, Entebbe, Uganda uDepartment of Immunology, London School of Hygiene & Tropical Medicine, London, UK vDepartment of Ophthalmology, Centre Médical de l’Alliance, Braine-l’Alleud, Belgium wWarwick Centre for Applied Health Research and Delivery, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK xMcMaster University, Hamilton, ON, Canada yDepartment of Medicine, University of California, San Francisco, CA, USA zUniversity College London Centre for Clinical Microbiology, Institute of Infection, Immunity and Transplantation, University College London, London, UK aaUniversity College London Hospitals NHS Foundation Trust, London, UK abInstitut National de Recherche Biomédicale, Kinshasa, DR Congo acVirology and Microbiology, University of Kinshasa School of Medicine, Kinshasa, DR Congo Article Info Publication History: Published June 9, 2026 DOI: 10.1016/S0140-6736(26)01141-4 External LinkAlso available on ScienceDirect External Link Copyright: © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. Linked Articles Download started OkSince WHO declared the ongoing outbreak of Ebola virus disease caused by Bundibugyo virus (species Orthoebolavirus bundibugyoense; BDBV) in DR Congo and Uganda a public health emergency of international concern and the Africa Centres for Disease Control and Prevention (Africa CDC) declared a public health emergency of continental security, the outbreak has continued to evolve rapidly. As of June 3, 2026, 344 laboratory-confirmed cases and 60 deaths had been reported in DR Congo, while Uganda had reported 15 confirmed cases and one death; cross-border transmission has prompted heightened preparedness and response measures across the region.1–3 The outbreak poses a substantial public health threat because diagnosis is often delayed by limited access to suitable point-of-care assays, and no licensed vaccine or approved virus-specific therapeutic currently exists for BDBV. Barriers to controlling the BDBV outbreak and priority response actions are summarised in the table. | Immediate priorities | Longer-term priorities | | |---|---|---| | Community mistrust, misinformation, and resistance to isolation and safe burial practices | Strengthen trusted community engagement, family communication, survivor involvement, community-led risk communication, and safe and dignified burial approaches | Build community-centred preparedness systems that prioritise trust, dignity, cultural legitimacy, and co-created public health solutions | | Armed conflict, insecurity, population displacement, and cross-border mobility | Protect health-care workers and facilities, maintain humanitarian access, strengthen cross-border coordination, surveillance, and real-time data sharing | Develop resilient regional surveillance and response systems for conflict-affected and mobile populations | | Delayed diagnosis and limited decentralised testing capacity | Expand near-patient molecular diagnostics, strengthen specimen transport systems, support regional laboratory networks, and invest in new assays for all orthoebolaviruses | Invest in resilient laboratory infrastructure, validated pan-filovirus assays, biosafety capacity, and integrated surveillance systems | | Fragile health systems and infection prevention and control gaps | Strengthen triage, isolation capacity, personal protective equipment supply chains, health-care worker protection, and supportive clinical care | Embed infection prevention and control, workforce protection, and outbreak readiness within broader health-system strengthening strategies | | Absence of licensed Bundibugyo virus vaccines or therapeutics and limited outbreak research capacity | Accelerate genomic surveillance, operational research, prospective cohort studies, and preparedness for adaptive clinical trials | Strengthen Africa-led vaccine, therapeutic, manufacturing, clinical trial, and regulatory capacity for filoviruses other than Ebola virus (Orthoebolavirus zairense) | | Episodic financing and reactive preparedness | Sustain financing for surveillance, laboratories, infection prevention and control, case management, and community engagement during the current outbreak | Establish durable preparedness financing mechanisms and strengthen Africa Centres for Disease Control and Prevention, national public health institutes, and One Health preparedness systems | Key barriers to controlling the Bundibugyo virus outbreak and priority response actions References 1. WHO Epidemic of Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda determined a public health emergency of international concern https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON603 Date: May 21, 2026 Date accessed: May 27, 2026 2. Africa Centres for Disease Control and Prevention Ebola response: statement from the Director General, Africa CDC https://africacdc.org/news-item/ebola-response-statement-from-the-director-general-africa-cdc/ Date: May 17, 2026 Date accessed: May 27, 2026 3. WHO WHO Director-General's opening remarks at the media briefing—3 June 2026 https://www.who.int/news-room/speeches/item/who-director-general-s-opening-remarks-at-the-media-briefing—3-june-2026 Date: June 3, 2026 Date accessed: June 3, 2026 4. UN High Commissioner for Refugees Democratic Republic of the Congo https://www.unhcr.org/where-we-work/countries/democratic-republic-congo Date accessed: June 3, 2026 5. Ilunga Kalenga, O ∙ Moeti, M ∙ Sparrow, A ∙ et al. The ongoing Ebola epidemic in the Democratic Republic of Congo, 2018–2019 N Engl J Med. 2019; 381:373-383 6. Aylward, B ∙ Barboza, P ∙ Bawo, L ∙ et al., the WHO Ebola Response Team Ebola virus disease in West Africa—the first 9 months of the epidemic and forward projections N Engl J Med. 2014; 371:1481-1495 7. Bedson, J ∙ Jalloh, MF ∙ Pedi, D ∙ et al. Community engagement in outbreak response: lessons from the 2014–2016 Ebola outbreak in Sierra Leone BMJ Glob Health. 2020; 5, e002145 8. Vinck, P ∙ Pham, PN ∙ Bindu, KK ∙ et al. Institutional trust and misinformation in the response to the 2018-19 Ebola outbreak in North Kivu, DR Congo: a population-based survey Lancet Infect Dis. 2019; 19:529-536 9. Blair, RA ∙ Morse, BS ∙ Tsai, LL Public health and public trust: survey evidence from the Ebola Virus Disease epidemic in Liberia Soc Sci Med. 2017; 172:89-97 10. Nyemba, B Congo protesters set fire to Ebola treatment tents in dispute over victim's body https://www.reuters.com/business/healthcare-pharmaceuticals/congo-police-fire-warning-shots-burial-dispute-after-suspected-ebola-death-2026-05-21/ Date: May 21, 2026 Date accessed: May 26, 2026 11. Carroll, R WHO calls for community cooperation to contain Ebola outbreak in DRC https://www.theguardian.com/world/2026/may/31/who-calls-for-community-cooperation-to-contain-drc-ebola-outbreak Date: May 31, 2026 Date accessed: June 3, 2026 12. Malvy, D ∙ McElroy, AK ∙ de Clerck, H ∙ et al. Ebola virus disease Lancet. 2019; 393:936-948 13. Henao-Restrepo, AM ∙ Camacho, A ∙ Longini, Jr, IM ∙ et al. Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomised trial (Ebola Ça Suffit!) Lancet. 2017; 389:505-518 14. Mulangu, S ∙ Dodd, LE ∙ Davey, Jr, RT ∙ et al., the PALM Writing Group, the PALM Consortium Study Team A randomized, controlled trial of Ebola virus disease therapeutics N Engl J Med. 2019; 381:2293-2303 15. Abdool Karim, S ∙ Mahomed, S ∙ Lewis, L ∙ et al. Urgent need for a reliable rapid diagnostic test for the Ebola epidemic caused by Bundibugyo virus in Africa Lancet. 2026; published online June 2. https://doi.org/10.1016/S0140-6736(26)01093-7 16. Mbala-Kingebeni, P ∙ Amuri-Aziza, A ∙ Tandele, PA ∙ et al. Initial genomes from May 2026 Bundibugyo virus disease outbreak in the Democratic Republic of the Congo and Uganda reveal a new spillover event https://virological.org/t/initial-genomes-from-may-2026-bundibugyo-virus-disease-outbreak-in-the-democratic-republic-of-the-congo-and-uganda/1032 Date: May 18, 2026 Date accessed: May 27, 2026 17. Gire, SK ∙ Goba, A ∙ Andersen, KG ∙ et al. Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak Science. 2014; 345:1369-1372