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Most Recent Epi Alert

19 May - Epi Report

Highlights: 19 May 2026

Ebola virus disease — Africa (DRC)
On 15 May 2026, the DRC Ministry of Health declared the country's 17th Ebola outbreak following laboratory confirmation of Bundibugyo virus disease (BVD) in samples from Ituri Province, where an unknown high-mortality illness had been reported since 5 May — including four health worker deaths within four days. As of 15 May, 246 suspected cases and 80 deaths have been recorded across three health zones (Rwampara, Mongbwalu, and Bunia), with 24 cases currently in isolation; index case onset dates back to 24 April. Uganda confirmed two imported BVD cases from DRC, both in Kampala, with no evidence of local transmission to date. On 16 May, WHO declared this event a Public Health Emergency of International Concern (PHEIC). No licensed vaccine or specific therapeutics exist for BVD; case fatality rates in prior outbreaks ranged from 30–50%. Ituri Province's proximity to Uganda and South Sudan and its role as a migration and trade hub heighten regional exportation risk.

Hantavirus disease - Global
Eleven cases (nine confirmed, two probable) of Andes virus, including three deaths, have been reported so far among passengers and crew of the MV Hondius cruise ship. Infected individuals have been diagnosed or medically evacuated across multiple countries, including South Africa, the Netherlands, Switzerland, France, Spain, and Canada, with all cases remaining limited to ship passengers and crew. In Chile, where the virus is endemic, as of 9 May 2026, 41 cases and 14 deaths of Andes virus infection have been reported during the 2026 season. Affected areas include the Aysén, Los Lagos, Valparaíso, and Biobío regions.

Diphtheria - Oceania
Australia has recorded its first diphtheria death in almost a decade amid an ongoing increase in cases across four jurisdictions. 83 confirmed toxigenic cases have been reported nationwide. This follows an outbreak declaration in March 2026 prompted by four respiratory diphtheria cases in the Northern Territory.

Crimean-Congo hemorrhagic fever — Middle East 
Since the start of 2026, 48 confirmed human cases of CCHF, including four deaths, have been reported in Iraq. Recent localized activity includes nine laboratory-confirmed cases and two deaths reported in April 2026 from Dhi Qar Governorate, occurring amid urban livestock-control challenges.

Summary

The Democratic Republic of the Congo declared its 17th Ebola outbreak following the confirmation of Bundibugyo virus disease in Ituri Province, where 246 suspected cases and 80 deaths have been recorded. Uganda confirmed two imported cases in Kampala, prompting the WHO to declare a Public Health Emergency of International Concern. Globally, eleven cases of Andes virus, including three deaths, occurred among passengers and crew of the MV Hondius cruise ship, with medical evacuations spanning multiple countries. In Australia, an ongoing diphtheria increase across four jurisdictions has resulted in 83 confirmed cases and the country's first related death in nearly a decade. Iraq reported 48 confirmed cases of Crimean-Congo hemorrhagic fever, including four deaths, since the start of 2026.

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About

The ESCMID-AUMC Epi Alert, a strategic collaboration between the ESCMID Emerging Infections Subcommittee and the Center of Tropical Medicine and Travel Medicine of Amsterdam University Medical Center (AUMC) that integrates expertise and resources to advance emerging infectious diseases surveillance and intelligence sharing. This collaboration integrates ESCMID's extensive international network and emerging infections expertise with AUMC's proven surveillance capabilities, led by Dr. Abraham Goorhuis and the AUMC team. 

The Epi Alert aims for weekly publication, with frequency adapted to emerging threats. The briefings are curated by infectious disease specialists prioritising data from trusted sources (WHO, ECDC, CDC, ProMED) based on potential impact, geographic region and urgency/relevancy to clinical practice. It aims to provide concise summaries for busy healthcare professionals with direct links for further investigation and transparency. 

This integrated collaboration represents a significant milestone in ESCMID's commitment to emerging infections preparedness, strengthening our collective capacity to detect, analyse, and respond to infectious disease threats through international cooperation.

Disclaimer: The information in this epi-alert is a weekly summary of the information that is available on the internet, mainly the websites of WHO, ECDC, CDC, and others. For this summary, we consider issues that are most relevant to the ESCMID members involved in clinical patient care. Therefore, this report is not comprehensive, but we strive to include all major global issues in this report on a weekly basis.

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2026


Situation update on the 2026 Ebola Bundibugyo outbreak

21 May 2026
This document provides an ESCMID Emerging Infections Subcommittee situation update on the 2026 Ebola Bundibugyo outbreak in the Democratic Republic of the Congo and Uganda. Its purpose is to inform healthcare professionals, microbiologists, public health authorities, and ESCMID members about the current epidemiological situation, major clinical and public health challenges, regional and international risks, and recommended preparedness measures. The document also highlights the importance of surveillance, infection prevention, healthcare worker protection, laboratory readiness, and international coordination while emphasising the urgent need for research and development of vaccines, diagnostics, and therapeutics for non-Zaire ebolaviruses.

ESCMID EIS Situation report


Suspected hantavirus pulmonary syndrome cluster on an atlantic cruise vessel

Update - 06 May 2026

ESCMID EIS Day 3 update report

05 May 2026
This Situation Report,  provides a concise overview of a suspected cluster of hantavirus pulmonary syndrome (HPS) identified aboard a cruise vessel originating from Argentina. As of 04 May 2026, preliminary information from WHO and UN sources indicates a small number of severe respiratory cases, including fatalities, with one laboratory-confirmed hantavirus infection and several additional suspected cases.

The purpose of this report is to inform ESCMID members of the evolving situation, summarise the current epidemiological understanding, and highlight key clinical and public health considerations. While rodent-associated exposure remains the leading hypothesis, investigations are ongoing, and important uncertainties persist regarding the exact transmission dynamics, viral strain, and extent of risk.

Given the potential severity of HPS and the confined setting of a cruise vessel, this event underscores the importance of vigilance, rapid risk assessment, and continued monitoring.

Disclaimer: The information contained in this document reflects what was available as of 04 May 2026, 5 pm (CEST) and may be updated as further relevant information becomes available; the situation remains ongoing.

ESCMID EIS situation report 

ECDC Report


Update on Nipah virus cases in West Bengal, India, January 2026

Nipah virus is a highly pathogenic zoonotic virus that can be transmitted to humans through fruit bats, contaminated food, or close human-to-human contact, and is associated with severe encephalitis and high case-fatality rates. In January 2026, Nipah virus disease was reported in eastern India, with two confirmed cases identified among healthcare workers at a single hospital in West Bengal. This represents the seventh documented outbreak in India and the third reported in the state. According to an official update issued on 27 January 2026 by the Ministry of Health and Family Welfare of India, both cases were laboratory confirmed at the National Institute for Virology. A total of 196 contacts were identified, traced, monitored, and tested; all remain asymptomatic and have tested negative, with no additional cases detected to date, indicating no evidence of community transmission. Prompt and comprehensive public health measures, including enhanced surveillance, laboratory testing, and coordinated field investigations, have been implemented by national and state authorities, and the situation remains under close monitoring. While importation into Europe via infected travellers cannot be entirely excluded, the absence of Pteropus fruit bats in Europe limits the risk of onward transmission. No additional measures beyond monitoring, information sharing, and traveller advisories are expected at this stage.   


2025


Emergence of Marburg virus disease in Ethiopia: epidemiological shift in East Africa

On 14 November 2025, Ethiopia confirmed its first outbreak of Marburg virus disease (MVD) in the South Omo Zone, Southern Ethiopia. This outbreak represents a significant epidemiological shift: Ethiopia has never previously reported MVD. Genetic sequencing suggests the strain is closely related to East African lineages, pointing to a regional reservoir. Laboratory testing identified Marburg virus in samples from a cluster of suspected haemorrhagic fever cases. To date, 10 cases have been reported, including five fatalities (CFR 50%), two among healthcare workers, highlighting the risk of nosocomial transmission. A total of 57 suspected cases have been investigated, including four in the past 24 hours.

ESCMID EIS summary


Avian influenza: renewed threats in Asia

The recent re-emergence of avian influenza (H5N1) in parts of Asia, including isolated human cases in Cambodia and India, highlights the need for continued vigilance. While sustained human-to-human transmission has not been observed, the current situation warrants close monitoring. Strengthening surveillance, improving poultry vaccination strategies, and promoting regional One Health collaborations can support risk assessment and management, including early containment efforts.

WHO situation report


Saudi Arabia reports rise in MERS-CoV cases ahead of religious travel peak

Since the previous update on 05 May 2025, and as of 12 May 2025, nine new MERS-CoV cases—including two deaths—have been reported by health authorities in Saudi Arabia, bringing the total number of cases this year to ten.

Seven of the recent cases were part of the same cluster in Riyadh, including one patient with no history of contact with camels and six healthcare workers who acquired nosocomial infections from that patient in early May.

The risk of sustained human-to-human transmission in Europe remains very low. However, the current MERS-CoV situation is concerning, as this rise in cases comes just two weeks ahead of the Mecca pilgrimage—a period typically associated with high international travel.

Since April 2012, and as of 12 May 2025, a total of 2,638 confirmed MERS cases—including 957 deaths—have been reported globally.

WHO situation reportECDC weekly bulletin


2024


Commentary on the Marburg virus outbreak in Rwanda

A Marburg virus disease (MVD) outbreak is evolving in Rwanda, East Africa. As of 07 October 2024, over 40 confirmed MVD cases have been reported, mainly in healthcare facilities in Kigali, with many healthcare workers affected. This outbreak represents a spread from known endemic areas to urban settings, including nosocomial transmission in Kigali hospitals. While outbreaks are typically limited to remote areas, this one spans across Rwanda, with potential for satellite cases and further spread. No vaccines or treatments are currently available.

ESCMID EIS summary


Update on Mpox: 02 September 2024

This compilation includes the latest news, publications, and resources, covering recent developments such as vaccine distribution in Africa and WHO policy updates. It provides links to '2022-2024 Mpox Outbreak: Global Trends,' which features interactive dashboards and epidemiological data. This update offers a brief overview of the developments of the mpox situation for healthcare professionals, researchers, and policymakers.

ESCMID EIS update report


Commentary on the recent mpox outbreak

As of August 2024, the world is facing a significant mpox outbreak, primarily affecting countries in Central and East Africa, particularly the Democratic Republic of the Congo (DRC) and neighbouring countries, with cases reported across several regions. The outbreak is characterised by the sustained human-to-human transmission of the clade I monkeypox virus (MPXV). 

This commentary provides up-to-date, evidence-based information on mpox (formerly known as monkeypox) for healthcare professionals, researchers, and public health officials. 

ESCMID EIS Commentary on Mpox

WHO declaration

Andes hantavirus outbreak on a cruise ship - an ESCMID Emerging Infections Subcommittee rapid assessment

Marta Mora-Rillo, Nitin Gupta, Effrossyni Gkrania-Klotsas, Jan Felix Drexler, Pikka Jokelainen, Sotirios Tsiodras, Galadriel Pellejero-Sagastizabal, Aleksandra Barac1, Jose-Ramon Pano-Pardo,∙ F-Xavier Lescure,∙ Martin P. Grobusch

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Past, present and future of dengue in Europe

Jan Felix Drexler, Anna-Bella Failloux, Didier Fontenille, Thomas Jaenisch, Jolyon M. Medlock, Xavier N. de Lamballerie, F. Xavier Lescure, Sotirios Tsiodras, Martin P. Grobusch

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Endemic avian influenza landscape in Asia: sustained zoonotic risks

Nitin Gupta, Martin P Grobusch, Jan Felix Drexler, José Ramón Paño-Pardo, Galadriel Pellejero-Sagastizabal, Sotirios Tsiodras, Aleksandra Barac, F-Xavier Lescure, Pikka Jokelainen for the Emerging Infectious Subcommittee, European Society of Clinical Microbiology and Infectious Disease

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Yellow fever in South America in 2025: a concerning increase, but a true resurgence?

Aleksandra Barac, Nitin Gupta, Pikka Jokelainen , Sotirios Tsiodras, Marta Mora-Rillo, Effrossyni Gkrania-Klotsas, José Ramón Paño-Pardo, Casandra Bulescu, Galadriel Pellejero-Sagastizabal, Abraham Goorhuis, Maria Paquita Garcia Mendoza, Jacob Van der Ende, François-Xavier Lescure, Martin P Grobusch, Jan Felix Drexler

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Delayed correct diagnoses in emerging disease outbreaks: historical patterns and lessons for contemporary responses

Galadriel Pellejero-Sagastizábal, Casandra Bulescu, Nitin Gupta, Pikka Jokelainen, Effrossyni Gkrania-Klotsas, Aleksandra Barac, Abraham Goorhuis, Shevin T Jacob, Selidji T Agnandji, Francine Ntoumi, Marta Mora-Rillo, José Ramón Paño-Pardo, F-Xavier Lescure, Martin P Grobusch

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Is a human highly pathogenic avian influenza A H5N1 pandemic inevitable?

Effrossyni Gkrania-Klotsas, Pikka Jokelainen, Anne L Wyllie, Nitin Gupta, Aleksandra Barac, José Ramón Paño-Pardo, Marta Mora-Rillo, Martin P Grobusch, Charles B Holmes, Marion Koopmans, Francois-Xavier Lescure

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Marburg virus disease outbreak in Rwanda, 2024'-author's response

Martin P Grobusch, Galadriel Pellejero-Sagastizábal, Pikka Jokelainen, F-Xavier Lescure, Marta Mora-Rillo, Nitin Gupta

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Marburg virus disease outbreak in Rwanda, 2024

Martin P Grobusch, Pikka Jokelainen, Anne L Wyllie, Nitin Gupta, José Ramón Paño-Pardo, Aleksandra Barac, Casandra Bulescu, Galadriel Pellejero-Sagastizábal, Abraham Goorhuis, F-Xavier Lescure, Effrossyni Gkrania-Klotsas, Marta Mora-Rillo

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Poliomyelitis in Gaza

Nitin Gupta, Martin P Grobusch, Pikka Jokelainen, Anne L Wyllie, Aleksandra Barac, Marta Mora-Rillo, Effrossyni Gkrania-Klotsas, Galadriel Pellejero-Sagastizabal, José Ramón Paño-Pardo, Erwin Duizer, François-Xavier Lescure

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Complex mpox situation, 2024

Pikka Jokelainen, Anne L Wyllie, Nitin Gupta, Aleksandra Barac, Effrossyni Gkrania-Klotsas, Casandra Bulescu, José Ramón Paño-Pardo, Marta Mora-Rillo, Martin P Grobusch, F-Xavier Lescure

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