{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T03:15:57Z","timestamp":1788837357364,"version":"build-2803163510"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>The 2026 Bundibugyo virus disease outbreak in the Democratic Republic of the Congo (DRC) and Uganda occurred in a fragile cross-border setting marked by delayed recognition, diagnostic uncertainty, insecurity, population mobility, community mistrust, and healthcare-worker exposure. We conducted a retrospective operational epidemiology study using official situation reports, public health declarations, ministry statements, WHO and Africa CDC updates, cross-border communiqu\u00e9s, and selected partner statements. This analysis reflects publicly available data from the early outbreak period, with the primary DRC data lock on 27 May 2026 and Uganda and regional triangulation through 29 May 2026. We reconstructed the early timeline, described epidemiological and geographic progression, quantified response indicators, and applied a transparent health-zone prioritization framework. The earliest documented symptom onset was 24 April 2026. The Institut National de Recherche Biom\u00e9dicale (INRB) detected non-Zaire ebolavirus in eight of 13 samples on 14 May, giving a 20-day symptom-onset-to-first-laboratory-detection interval; species-level Bundibugyo virus confirmation and official declaration followed on 15 May. By the DRC data lock on 27 May, 125 confirmed cases and 17 confirmed deaths had been reported, giving a confirmed case fatality ratio of 13.6%. DRC also reported 906 suspected cases and 223 suspected deaths, giving a suspected fatality proportion of 24.6%. Confirmed cases expanded from three to 13 health zones across three provinces within 12 days. Ituri province accounted for 110 confirmed cases (88.0%); Bunia, Rwampara, and Mongbwalu health zones together contributed 90 cases (72.0%). Uganda reported nine confirmed cases and one death by 29 May. Operational pressure included 2,635 listed contacts in DRC, 436 contacts under follow-up in Uganda, and 126 of 774 collected samples (16.3%) pending testing in DRC. Healthcare workers represented 16 of 125 DRC confirmed cases (12.8%) and at least three of nine Uganda cases (33.3%). Applying the health-zone prioritization framework, Rwampara, Mongbwalu, and Bunia were classified as higher priority health zones. Excluding confirmed burden did not change any health-zone tier; data classification confidence was high for 10 zones and moderate for three. Within this early operational snapshot, outbreak visibility reflected both transmission and operational factors, particularly detection delay, laboratory backlog, cross-border movement, healthcare-linked exposure, and community trust or security incidents. The framework provides a transparent basis for rapid decision support during an outbreak\u2019s early phase by directing surveillance, laboratory, case-management, infection prevention and control, contact-tracing, and community-engagement resources toward health zones where multiple operational risks converge.<\/jats:p>","DOI":"10.1371\/journal.pgph.0006680","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:33:12Z","timestamp":1787851992000},"page":"e0006680","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Operational epidemiology of the early phase of the 2026 Bundibugyo virus disease outbreak in the Democratic Republic of the Congo and Uganda"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5699-8999","authenticated-orcid":true,"given":"Tambe","family":"Elvis Akem","sequence":"first","affiliation":[{"name":"Independent Consultant","place":["Yaound\u00e9, Cameroon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eta Calvin","family":"Oben","sequence":"additional","affiliation":[{"name":"Independent Consultant","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"issue":"11","key":"pgph.0006680.ref001","doi-asserted-by":"crossref","DOI":"10.1371\/journal.ppat.1000212","article-title":"Newly discovered ebola virus associated with hemorrhagic fever outbreak in Uganda","volume":"4","author":"JS Towner","year":"2008","journal-title":"PLoS Pathog"},{"issue":"12","key":"pgph.0006680.ref002","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.3201\/eid1612.100627","article-title":"Proportion of deaths and clinical features in Bundibugyo Ebola virus infection, Uganda","volume":"16","author":"A MacNeil","year":"2010","journal-title":"Emerg Infect Dis"},{"key":"pgph.0006680.ref003","unstructured":"World Health Organization. Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo & Uganda. 2026. [cited 2026 May 30]. https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/2026-DON602"},{"key":"pgph.0006680.ref004","unstructured":"World Health Organization. Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo & Uganda. 2026. [cited 2026 May 30]. https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/2026-DON605"},{"key":"pgph.0006680.ref005","unstructured":"Africa Centres for Disease Control and Prevention (Africa CDC)\/ Press release. Africa CDC Declares the Ongoing Bundibugyo Ebola Outbreak a Public Health Emergency of Continental Security \u2013 Africa CDC. 2026. 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[cited 2026 May 30]. https:\/\/alima.ngo\/en\/press-releases\/incident-health-facilities-rwampara-ebola-outbreak-response\/"},{"issue":"10","key":"pgph.0006680.ref018","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.0040296","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"4","author":"E von Elm","year":"2007","journal-title":"PLoS Med"},{"issue":"3","key":"pgph.0006680.ref019","first-page":"70","article-title":"A plan for community event-based surveillance to reduce Ebola transmission - Sierra Leone, 2014-2015","volume":"64","author":"Centers for Disease Control and Prevention","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pgph.0006680.ref020","doi-asserted-by":"crossref","DOI":"10.1093\/infdis\/jiy435","article-title":"Infection rates and risk factors for infection among health workers during ebola and marburg virus outbreaks: a systematic review","volume":"218","author":"SA Selvaraj","year":"2018","journal-title":"J Infect Dis"},{"issue":"1","key":"pgph.0006680.ref021","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1186\/s12889-021-11634-7","article-title":"A mixed-methods investigation to understand and improve the scaled-up infection prevention and control in primary care health facilities during the Ebola virus disease epidemic in Sierra Leone","volume":"21","author":"LS-Y Ho","year":"2021","journal-title":"BMC Public Health"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0006680","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:33:17Z","timestamp":1787851997000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0006680"}},"subtitle":[],"editor":[{"given":"Maria del Pilar","family":"Fernandez","sequence":"first","affiliation":[{"name":"Washington State University","place":["UNITED STATES OF AMERICA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":21,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0006680","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]}}}