Atlas Outbreak Intelligence

Powered by HELIOS
PHEIC Active WHO Grade 3 Updated: 2026-05-30 | Sources: WHO, ECDC, INRB-UMIE, Pathoplexus
BDBV: No approved vaccine or therapeutic
Diagnostics: Standard Ebola RDTs do not detect BDBV
Cross-border: 9 confirmed cases in Uganda (Kampala)
Genomics: 16 sequences available on Pathoplexus (not yet in local analysis)
Total Cases (DRC INSP, 05-27)
1,025
119 confirmed / 906 suspected
21 health zones reporting
Deaths (DRC INSP, 05-27)
228
5 confirmed / 223 suspected
Raw death proportion, not final CFR
Confirmation Rate
11.6%
119 of 1,025 lab-confirmed (DRC)
36 PCR machines across 19 zones
Contacts Traced
2,417
Cumulative as of 2026-05-27 (INSP)
Contact tracing active
Health Zones Affected
21
Across Ituri, Nord-Kivu, Sud-Kivu
+9 Uganda confirmed (not in INSP data)
Highest Attack Rate
425.8
per 100,000 in Rwampara (n=261, pop=61k)
Mongbalu: 225.6/100k
Data source: INSP SitRep MVE 001-012 via INRB-UMIE GitHub (accessed 2026-05-30). DRC data only; Uganda (9 confirmed) from Uganda MOH via Reuters. INSP data manually transcribed from PDF; ND = not declared. WHO DON603 snapshot (2026-05-28) reports 125 confirmed -- difference reflects reporting lag between INSP and WHO.
Death proportion caveat: Confirmed-case death proportion 13.6% is a raw ratio, not finalised CFR; likely underestimated due to right-censoring. All-reported proportion 23.3% is confounded by unconfirmed suspected cases. WHO has separately estimated 30-50% fatality among confirmed infections (Reuters citing WHO, 2026-05-29). None should be cited as definitive CFR. Source: WHO DON603, Reuters.

Decision Layer: What Requires Immediate Action

  • No BDBV-specific countermeasures. Vaccine candidates under evaluation (WHO expert consultation 2026-05-28). rVSV-ZEBOV cross-protection unestablished.
  • Diagnostic gap. Standard Ebola RDTs do not detect BDBV. PCR available at INRB Kinshasa and Bunia field lab only.
  • Active conflict zone. Armed groups limit access to multiple health zones in Ituri and Nord-Kivu.
  • Genomic sequences not yet in local analysis. 16 Pathoplexus genomes available; pipeline update required.
  • Cross-border coordination gaps. DRC-Uganda joint surveillance active but incomplete at informal border crossings.

Risk Assessment (WHO/ECDC)

LevelRatingSource
National (DRC)Very HighWHO DON603
Regional (Africa)HighWHO DON603
GlobalModerateWHO DON603
EU/EEALow-ModerateECDC TAB
Key risk factors: No approved countermeasures, confirmed cross-border transmission, conflict zone, high population mobility, low diagnostic capacity.

Data Quality Traffic Light

Case counts
60%
Geographic detail
50%
Demographics
15%
Lab confirmation
13%
Genomic coverage
12%
Contact tracing
--
Timeliness
~40%
Quality scores estimated from aggregate WHO/ECDC reporting. Individual-level data would improve all metrics.
Linelist data not available. All analysis derived from aggregate WHO/ECDC situation reports. Individual case records require access from DRC Ministry of Health. The table below shows the operational linelist schema and aggregate-derived summaries.

Operational Linelist Schema (WHO Outbreak Toolkit standard)

CategoryRequired FieldsData Status
IdentificationCase ID, household ID, cluster ID, reporting facilityNot available
DemographicsAge, sex, pregnancy, occupation, vulnerable statusNot available
LocationResidence, GPS/admin unit, health area, camp/blockHealth zone level only
TimeOnset, notification, consultation, sample, lab result, isolationAggregate weekly
ClinicalSymptoms, severity, hospitalisation, outcomeNot available
ClassificationSuspected / probable / confirmed / discardedAvailable (2 classes)
EpidemiologyExposure, travel, event, water source, contact to caseNot available
LaboratoryTest type, result, Ct, viral load, sequence IDPartial (PCR only)
ResponseIsolation, treatment, contact listing, vaccinationNot available
Data QualityMissing values, inconsistencies, duplicate suspectCannot assess

Case Classification Summary (from aggregate reports)

RegionConfirmedSuspectedTotalDeaths (all)Confirmation %
Ituri (DRC)~80~570650150~12%
Nord-Kivu (DRC)~45~30535080~13%
Sud-Kivu (DRC)~5~354011~13%
Uganda (Kampala)9090100%
Total1349061,04024112.9%
Province-level breakdown estimated from WHO DON603 and ECDC threat assessment. Exact per-province confirmed counts not published separately. Tilde (~) indicates estimate.

Epidemic Curve -- Daily New Cases (INSP SitRep, by notification date)

DateNew ConfirmedNew SuspectedTotal NewCum. ConfirmedCum. Suspected
2026-05-1402462460246
2026-05-1513809313326
2026-05-182019021033516
2026-05-1916597551575
2026-05-20119710857672
2026-05-21218510679745
2026-05-221312814183872
2026-05-2311334495905
2026-05-24426101893
2026-05-2519293100906
2026-05-26167086111906
2026-05-27505119906
Highlighted rows: peak daily totals Source: INSP SitRep MVE 001-012 via INRB-UMIE GitHub Note: 05-16/17 data not available (weekend gap)
Notification date, not onset date. INSP SitRep data reports by notification/reporting date. True onset-based epi curve requires individual case records (linelist) which are not in this dataset. Daily fluctuations partly reflect reporting patterns (weekends, batch reporting) rather than true transmission dynamics. Cumulative suspected counts can decrease due to reclassification.

Intervention Timeline

2026-04-24Index case onset (healthcare worker, Bunia)
2026-05-15DRC Ministry of Health declares outbreak
2026-05-17WHO declares PHEIC
2026-05-18First 3 genomes released on Pathoplexus
2026-05-19First Uganda cases confirmed (Kampala)
2026-05-206 additional Pathoplexus genomes (update 2)
2026-05-22WHO DG Member State information session
2026-05-28WHO expert consultation: therapeutics and vaccines
2026-05-285 additional Pathoplexus genomes (update 3)
2026-05-30Current: 1,040 total cases, 2 countries

Estimated Delays (aggregate-derived)

Onset to notification
~5 days
Notification to confirm
~4 days
Confirm to isolation
~2 days
Total: onset to isolation
~11 days
Delay estimates derived from aggregate reporting, not individual case data. Actual delays vary by health zone and security situation. Insecure areas likely have longer delays.

Cases by Health Zone with Attack Rates (INSP data, 2026-05-27)

Health ZoneConfirmedSuspectedTotalPopulationAttack Rate /100k
Mongbalu----359159,147225.6
Bunia----286715,16940.0
Rwampara----26161,295425.8
Fataki----31150,05520.7
Butembo----26286,9629.1
Rimba----14174,9268.0
Nyakunde----1094,51310.6
Kilo----938,31423.5
Nizi----8146,1195.5
Katwa----7621,9811.1
Bambu----5142,1103.5
Damas----588,5905.6
Mambasa----2164,1091.2
Goma----1277,1560.4
+ 7 additional zones with 0-1 cases: Aru, Kalunguta, Karisimbi, Kyondo, Miti-Murhesa, Nyankunde, Oicha
Source: INSP SitRep via INRB-UMIE GitHub. Population: WorldPop estimates. Per-zone confirmed/suspected breakdown not available (INSP reports combined totals by zone). Attack rates use combined case count as numerator. "--" = breakdown not published at zone level. Goma has 1 reported case -- status requires continued monitoring.

Affected Health Zones

ProvinceHealth ZonesStatus
IturiBunia, Rwampara, Mongwalu, Nyakunde, Hoho, LumumbaActive
Nord-KivuButembo, Mabalako, Katwa (Goma status under verification)Active
Sud-KivuBukavuLimited
UgandaKampala districtImport-linked

Cross-Border Risk

  • Bunia-Bundibugyo corridor: ~30 km to Uganda border. Primary trade route, multiple informal crossings.
  • Lake Albert crossings: Unmonitored informal border points. Fishing communities cross daily.
  • Kampala link: 6 of 9 Uganda cases travel-linked to DRC. 350 km from border zone.
  • Goma-Gisenyi: High-traffic DRC-Rwanda border crossing. Enhanced surveillance active.

Interactive Maps

Map precision: Case locations plotted at health zone centroid level, not individual GPS coordinates. Maps are interactive -- zoom, pan, and click markers for details. Source: Atlas geographic analysis (2026-05-29).
Demographic data not available from aggregate reports. Age/sex/occupation breakdown requires linelist access from DRC Ministry of Health. The information below reflects what is known from WHO and press reporting.

Known Demographic Factors

  • Healthcare workers: Index case was HCW in Bunia. Multiple HCW infections reported (exact count unavailable).
  • Children under 5: Cases reported in young children (count not published).
  • Pregnant women: Status unknown -- not reported in available sources.
  • IDPs/refugees: Ituri hosts significant displaced populations. Displacement camps may facilitate transmission.
  • Age/sex distribution: Not published. Required for targeted response planning.

Priority Demographic Data Needs

VariableWhy NeededStatus
Age groups (5-year bands)Age-specific attack rates, vaccination targetingMissing
SexGender-specific risk, care-seeking patternsMissing
OccupationHCW risk, market vendors, burial workersPartial
Pregnancy statusMaternal/neonatal risk, treatment decisionsMissing
IDP/refugee statusVulnerability, population denominatorMissing
Exposure historyTransmission chains, risk stratificationMissing
Confirmation Rate (INSP)
11.6%
119 of 1,025 (DRC, 2026-05-27)
BDBV-specific RDT
None
Standard Ebola RDTs do not detect BDBV
PCR Machines Deployed
36
Across 19 health zones (INRB-UMIE)
PCR Hub: Bunia
10
28% of all deployed capacity

PCR Machine Deployment by Health Zone (INRB-UMIE)

Bunia
10 machines
Mongbalu
2
Nyakunde
2
Aru
2
Mahagi
2
Beni
2
Butembo
2
Goma
2
Ibanda
2
10 other zones
1 each
Total: 36 machines across 19 zones. Source: INRB-UMIE testing_capacity dataset. Note: 2 of the 21 affected health zones (Karisimbi, Miti-Murhesa) have no PCR machines listed.
Testing cascade (samples collected/pending/rejected) still not published. PCR machine counts indicate capacity, not throughput. Actual turnaround depends on staffing, reagent supply, sample transport, and security access.

Diagnostic Limitations

  • No BDBV-specific RDT exists. Standard Ebola RDTs (SD Bioline, OraQuick) target Zaire ebolavirus GP and do not reliably cross-react with BDBV.
  • PCR capacity limited. Only 2 laboratories confirmed for BDBV PCR. Sample transport from remote health zones adds 2-5 days.
  • Sequencing turnaround. Pathoplexus releases suggest 2-3 week lag from sample collection to sequence availability.
  • Biosafety requirements. BDBV requires BSL-4 for culture. PCR and sequencing can be performed at BSL-3.
Sequences Available (Pathoplexus)
60
16 from 2026 outbreak + 44 historical
2026 Outbreak Genomes
16
DRC: 14, Uganda: 1, Germany: 1 (imported)
Genome Availability
~12%
16/134; not representative coverage (biased)
Local Analysis Status
34
Historical NCBI GenBank only -- update needed
Local analysis uses historical genomes only. 16 outbreak genomes are available on Pathoplexus (accessions PP_006XHL9 through PP_00712Q8) but have not yet been incorporated. Current figure and statistics reflect the 2007/2012 dataset only. Transmission inference is not possible without broader sampling, dates, metadata, and epidemiological links.
Sequence count note: Counts differ by source (Pathoplexus ~54-60 visible, Nextstrain ~45 displayed, local analysis 34). These are overlapping subsets reflecting different snapshots, access levels, and QC filters -- not additive totals. Pathoplexus is the primary repository for current outbreak sequences.

2026 Outbreak Sequences (Pathoplexus)

AccessionCountryLocationDate
PP_006XHL9.1DRCBunia, Ituri2026-05-03
PP_006XHKB.1DRCBunia, Ituri2026-05
PP_006XCJJ.1UgandaKampala2026-05-14
PP_006XXY5.1GermanyImported2026-05
PP_006Y8NC.1DRCKatwa, Nord-Kivu2026-05-06
PP_006Y8PA.1DRCHoho, Ituri2026-05-03
PP_006Y8Q8.1DRCLumumba, Ituri2026-05-03
+ 9 additional DRC sequences (May 2026, Ituri province)
Data use: Pathoplexus "Restricted" licence. Contact Prof. Mbala-Kingebeni (INRB) / Dr. Ssewanyana (CPHL) before publication.

Preliminary Findings (Virological.org / Nextstrain)

  • tMRCA: Late February to late April 2026 (rate-dependent). Source: Virological.org rapid communication.
  • Distinct clade: 2026 genomes form separate cluster from 2007 Uganda and 2012 DRC lineages. Source: Nextstrain ebola/bdbv.
  • ADAR editing: Evidence of host ADAR editing in 1 genome (4 T-to-C mutations).
  • Pipeline: RACCOON (MAFFT + IQ-TREE2, HKY+gamma). Not yet reproduced locally.
These findings are from external analyses (Amuri-Aziza et al., Virological.org 2026) and have not been independently verified in the local Atlas pipeline.

Phylogenetic Analysis

Four-panel QC assessment of the local 34-genome NCBI GenBank dataset. Includes geographic distribution, temporal coverage, sequence length QC, and genetic distance QC.

BDBV Genome Dataset QC
Local dataset: 34 NCBI GenBank sequences (2007 Uganda, 2012 DRC-Isiro). 16 Pathoplexus 2026 sequences not yet incorporated. This figure is QC only and must not be interpreted as evidence for current transmission patterns.
Nextstrain view: Live ML phylogeny maintained by nextstrain.org, combining historical and 2026 outbreak genomes from GenBank and Pathoplexus (including Restricted Use sequences). Requires internet connection. The local QC tab shows the Atlas-internal historical dataset assessment (offline-capable). Nextstrain is a cross-check source, not the sole primary data source.

Sequencing Coverage and Bias Assessment

Confirmed sequenced
16/134 (12%)
Ituri coverage
~14/80 est.
Nord-Kivu coverage
~1/45 est.
Uganda coverage
1/9
Sequencing bias: Coverage concentrated in Ituri (INRB Bunia lab). Nord-Kivu and Sud-Kivu severely underrepresented. Temporal bias: all sequences from first 2 weeks of May 2026. Later transmission phases unsampled.
Contact tracing data now available from INSP SitRep via INRB-UMIE GitHub. Daily cumulative totals for contacts traced and isolated. Individual follow-up rates and secondary case attribution not available from this source.

Contact Tracing Cascade (INSP data)

DateCum. TracedCum. IsolatedNew Listed
05-1482----
05-18541----
05-19847----
05-201,261----
05-211,427----
05-221,674----
05-231,817----
05-242,231----
05-272,417----
Source: INSP SitRep MVE 001-012. "--" = not declared (ND) in INSP reports. Isolation and daily follow-up counts mostly ND in current data. Contacts-to-case ratio: ~20:1 (2,417 contacts / 119 confirmed).

Transmission Indicators

  • Unknown-source cases: Proportion not reported. Critical indicator for hidden transmission chains.
  • Nosocomial transmission: Index case was HCW; healthcare facility transmission documented but not quantified.
  • Household clusters: Reported but not enumerated. Linelist data required.
  • Cross-border contacts: DRC-Uganda joint tracing active. 6 of 9 Uganda cases linked to DRC travel.
  • Rt estimate: Not published. WHO/ECDC note incidence exceeds expected secondary infections. Modelling groups have not yet published estimates.

Vaccination

  • No approved BDBV vaccine. rVSV-ZEBOV (Ervebo) targets Zaire ebolavirus; cross-protection not established.
  • Candidate evaluation: WHO expert consultation 2026-05-28. Multiple candidates under review.
  • Timeline: Africa CDC estimates BDBV-specific vaccine by end of 2026.

Therapeutics

  • No approved BDBV therapeutic.
  • Candidates: MBP134 (broad-spectrum mAb), Maftivimab, Remdesivir (investigational).
  • Supportive care: Primary treatment approach. IV fluids, electrolyte management, symptom control.

IPC / Case Management

  • IPC active in major health facilities in affected zones.
  • ETU capacity: Status not quantified in public reports.
  • Conflict limitation: Armed groups restrict access to multiple health zones.

Response Actions and Progress

ActionTimelineResponsibilityStatus
Incorporate Pathoplexus genomes into local analysisImmediateAtlas pipelinePending
Enhanced border surveillance (50km radius)0-7 daysDRC-Uganda jointIn progress
Deploy BDBV-specific PCR to Nord-Kivu1-2 weeksWHO, Africa CDCPlanned
BDBV vaccine candidate trial initiation4-8 weeksWHO R&D BlueprintUnder review
Community engagement in Ituri IDP campsOngoingMSF, UNICEFActive
Lab capacity: sample-to-result <48h target2-4 weeksINRB, WHOGap

Coordination Structure

LevelLeadKey Activities
InternationalWHO (Grade 3), GOARNPHEIC coordination, R&D Blueprint, technical guidance
RegionalAfrica CDCRegional surveillance, vaccine development coordination
National (DRC)MoH / INRBOutbreak response, laboratory confirmation, genomic surveillance
National (Uganda)MoH / CPHLBorder surveillance, case management, contact tracing
FieldMSF, UNICEF, WHO COETU operations, community engagement, IPC training

Data Completeness by Category (updated with INRB-UMIE data)

Case counts (daily)
85%
Case classification
60%
Geographic (health zone)
90%
Population denominators
100%
Attack rates
90%
Testing capacity (PCR)
80%
Contact tracing (cum.)
50%
Lab confirmation rate
12%
Genomic availability
~12%
Demographics
5%
Testing cascade
10%
Geographic (village/GPS)
0%
Completeness improved significantly with INRB-UMIE data integration (health zone level daily reporting, WorldPop denominators, PCR deployment). Remaining critical gaps: individual-level demographics, testing throughput cascade, village-level geographic precision.

Known Data Biases

  • Surveillance bias: Conflict zones in Ituri underreported. True case count likely higher than reported 1,040.
  • Diagnostic bias: Only 12.9% confirmed. Suspected cases may include non-Ebola febrile illnesses.
  • Reporting delay: Estimated 3-7 days from onset to notification. Recent weeks may be underestimated (right-truncation).
  • Sequencing bias: 12% coverage, concentrated in Ituri/early May. Not representative of outbreak diversity.
  • Denominator uncertainty: Population estimates from WorldPop. Conflict displacement makes denominators unreliable.

Data Source Status

SourceLast AccessData TypeStatus
INRB-UMIE GitHub2026-05-30Daily cases, contacts, hospitalisation, PCR, population, travel time Active
WHO DON602/6032026-05-29National case counts, risk assessment
ECDC TAB2026-05-29EU/EEA risk, preparedness
Pathoplexus2026-05-30BDBV genome sequences
Virological.org2026-05-30Phylogenetic interpretation
WorldPop (via INRB-UMIE)2026-05-30Population denominators (519 zones)
DRC MoH linelist--Individual case records Not accessible
Contact tracing detail--Individual follow-up, outcomes Cumulative totals only

Privacy and Governance

  • Case data: All data from aggregate public reports. No individual-level data in this dashboard.
  • Genomic data: Pathoplexus "Restricted" licence. Contact lead investigators before publication use.
  • Map data: Case locations at health zone centroid level (not individual GPS). No geomasking needed at current precision.
  • Dashboard access: Self-contained HTML file. No data transmitted to external services. Offline-capable.