The 2026 Central Africa (Bundibugyo) Ebola Virus Outbreak—and Lessons Learned from Previous Ebola Virus Episodes

Dear Colleagues, 

An Ebola virus outbreak in Ituri Province, Democratic Republic of the Congo (DRC), was first announced on 15 May 2026 by the Africa CDC and constituted the 17th Ebola virus outbreak to occur in that country. The World Health Organization declared the outbreak to be a Public Health Emergency of International Concern (PHEIC) on 17 May 2026, at which time there were 246 suspected cases and 80 deaths from Ebola virus infection identified in Ituri Province of the northeastern DRC that involved at least three health zones. In addition, two confirmed cases of Ebola virus infection were identified in neighboring Uganda. Since then, the infection has spread to North Kivu and South Kivu provinces, and as of 29 May, there have been 112 confirmed cases including 17 confirmed deaths, and 906 suspected cases including 223 suspected deaths. Uganda has reported seven confirmed cases, three of which were imported from the DRC, and one death. In the outbreak thus far the case fatality rate appears to be approximately 21 percent. The Africa CDC has warned that 10 other countries on the continent—Angola, Burundi, the Central African Republic, Ethiopia, Kenya, Republic of the Congo, Rwanda, South Sudan, Tanzania and Zambia—are at risk for infection. The numbers of infected people and deaths will increase in the coming days and, possibly, weeks. 

The causative agent of this outbreak is the Bundibugyo ebolavirus (BDBV), a member of the Ebolavirus genus, with which there is little experience. There have only been two previous outbreaks caused by BDBV—one in 2007 in Uganda, and the other in DRC in 2012, which caused 36 deaths. The current methods for Ebola virus treatment, including monoclonal antibodies (Inmazeb (REGN-EB3) and Ebanga (mAb114)) and vaccines (Ervebo, Merck and Zabdeno/Mvabea, Johnson & Johnson), were all developed for use with the Zaire ebolavirus (EBOV), which caused the West Africa Ebola virus outbreak of 2014–2016 and 15 previous outbreaks in the DRC. However, BDBV differs from EBOV by approximately 30–45% at the nucleotide genomic sequence level, and this divergence creates significant differences in viral proteins, replication speed, interactions with the human immune defense system, immune evasion, and levels of morbidity and mortality. It also likely hinders the therapeutic efficacy of antiviral medications and vaccines designed for use with EBOV infections, and it cannot be assumed that the ring vaccination methods used for EBOV outbreaks will be effective in disrupting the transmission of BDBV. Further spread of the infection may be enhanced by human factors such as mining-based movement, insecurity, population displacement, mistrust, frequent cross-border travel, and active conflict zones. Pregnancy is an important risk factor for poor outcomes in Ebola virus infection, and the DRC has one of the highest total fertility rates globally. Additional high risk groups for Ebola virus infection include healthcare workers, infants and children. 

This Special Issue should be considered both a public health response and a clearinghouse for the rapid publication and dissemination of pertinent data on the ongoing Central Africa BDBV outbreak. It will consider all forms of communications dealing with the current BDBV outbreak, including articles, brief reports, communications, reviews, perspectives, editorials, conference reports and commentaries. Topics can be broad, including clinical, microbiological, molecular virology, epidemiological, immunological, therapeutic, diagnosis, pathology and vaccinology aspects of the infection, as well as demographic, sociological, anthropological and preventative issues. Submissions that discuss the infection among special groups, including healthcare workers, immunocompromised persons, pregnant persons, children, and others are encouraged. Illustrative and graphic materials including photographs are encouraged when possible. 

We will also consider submissions exploring previous Ebola virus outbreaks, including infections with EBOV and Sudan ebolavirus—“lessons learned” —that can provide some level of guidance on aspects of the current outbreak. 

Submissions from investigators working in the endemic and outbreak areas are encouraged to contribute to this Special Issue regardless of financial concerns—please contact Dr. Schwartz for more information.

Dr. David A. Schwartz
Guest Editor

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