Epi Alert

Summary: 14 July 2026

A rapidly expanding Bundibugyo virus outbreak spans five Democratic Republic of the Congo provinces and Uganda, reaching 1,759 cases in the DRC, complicated by healthcare worker infections and an exported case to France. Mpox activity is intensifying across Africa, with clade Ib cases in Madagascar doubling to over 4,000 and Guinea-Bissau reporting its first confirmed case. Global measles resurgence continues, marked by 883 cases and three deaths in England, 121 cases threatening elimination status in the Maldives, and 14,470 suspected cases with 87 child deaths in Yemen. Aedes-borne arboviruses are surging, with dengue expanding in Singapore, Mexico, and the Dominican Republic, while chikungunya has re-emerged in Costa Rica and the Philippines. Elsewhere, Palestine reported over 9,000 varicella cases amid displacement, and a multi-country European salmonellosis outbreak linked to alfalfa sprouts caused 109 cases.

Highlights

Measles — Europe
Reports this week highlight continued global measles resurgence, with major signals from the UK, Maldives, and Yemen. England reported 883 confirmed cases and three deaths, underscoring renewed transmission in Europe. The Maldives recorded 121 cases, threatening its elimination status, while Yemen reported 14,470 suspected cases and 87 child deaths, reflecting severe impact in a fragile health-system setting.

Dengue — North America
Aedes-borne arboviral activity is intensifying across Asia and the Americas with the seasonal peak. Dengue is expanding in Singapore (135 cases, three Seletar "red zones"), Acapulco, Mexico (DENV-2 co-circulating with the predominant DENV-3, raising severity risk), and the Dominican Republic (153 cases, exceeding the 2015 total). Chikungunya has re-emerged in immunologically naïve populations — Playa Langosta, Costa Rica (first circulation since 2017) and two villages in Samar, Philippines, under "Code Red" with 84 cases.

Ebola virus disease — Africa
An outbreak of Bundibugyo virus continues spreading rapidly across five DRC provinces and Uganda, reaching 1759 cases in the DRC by 9 July 2026. Recent expansion includes possible local transmission in Kisangani and an exported case in a healthcare worker returning to France. Containment is challenged by a lack of approved vaccines, community resistance, and healthcare worker infections, though a clinical trial has opened and Uganda has approved galidesivir for compassionate use.

Mpox — Africa
Mpox activity is intensifying and shifting in Africa. In Madagascar, the clade Ib outbreak has roughly doubled — from about 2,000 to over 4,000 confirmed cases (15 deaths) across 39 districts in two weeks — with continued geographic expansion, including an eastward shift beyond the original Mahajanga cluster. Meanwhile, Guinea-Bissau has reported its first-ever confirmed case, clade differentiation still pending; as an initial detection it may represent the tip of the iceberg, signalling possible wider undetected spread.