Bundibugyo Ebola in Uganda, 2026: 90% of Confirmed Patients Survived

Ebola disease is a viral hemorrhagic fever caused by orthoebolaviruses. One of the four that sicken people is Bundibugyo virus, first identified in 2007 in Bundibugyo District, Uganda. Only two earlier outbreaks of Bundibugyo virus disease (BVD) had been documented, with case-fatality rates of 32% to 55%. It spreads through direct contact with infected blood or body fluids and typically causes fever, abdominal pain, diarrhea, vomiting, weakness and bleeding from body openings and injection sites. There is no licensed vaccine or specific treatment; care is mainly supportive.

A team from Uganda's Ministry of Health, its National Institute of Public Health, CDC and WHO, led by Michael Mutegeki and Rony R. Bahatungire, described Uganda's 2026 outbreak.

How it was found

A 59-year-old man from the Democratic Republic of the Congo (DRC) came to Uganda for medical care and was admitted to a private hospital in Kampala on May 11, 2026, with fever, breathing difficulty, upper abdominal pain and nausea. He died in intensive care on May 14. At the time, no outbreak had been identified in DRC.

After his death, a Congolese resident of Kampala told health officials about unexplained deaths in DRC. His stored blood was tested, and on May 15 Uganda's Central Emergency Response and Surveillance Laboratory confirmed Bundibugyo virus. DRC confirmed its outbreak the same day. Uganda declared its outbreak over on August 26, 2026, with 20 confirmed cases and one probable; DRC's outbreak continued.

The patients

The four Ugandan health workers were exposed while trying to resuscitate a patient with probable BVD, who died and was embalmed before testing was complete. A Ugandan driver was infected by the body of one of the Congolese patients.

Eighteen patients were treated at the Ebola treatment unit at Mulago National Referral Hospital. Their most common symptoms were fever (100%), headache (83%) and muscle aches (78%). On admission, every one had low blood albumin, low blood sodium and a raised liver enzyme (AST); many also had low white-cell counts (72%) and raised ALT (78%).

Remdesivir

With no proven antivirals, Uganda gave all 18 treatment-unit patients remdesivir — an antiviral approved for COVID-19 — under a compassionate-use protocol; it is also being used off-label in DRC's outbreak. One patient developed a severe rash and liver and kidney toxicity; the drug was stopped after 3 days, and the patient recovered.

Outcomes

18 of 20 confirmed patients survived (90%), a case-fatality rate of 10%. Both deaths were in people whose infections were recognized late. That compares with 32%–55% in earlier BVD outbreaks and 48% in DRC's 2026 outbreak as of September 2, 2026.

Lessons

• Seek care early. The low death rate may reflect patients who got care promptly; telling the public about the benefits of prompt care when BVD is suspected could save lives.
• Watch the labs. Low albumin, low sodium and raised liver enzymes in every patient suggest these may be hallmarks of early BVD, and routine lab tests could guide treatment.
• Test remdesivir. The contrast with DRC suggests clinical trials of remdesivir for BVD, alongside optimized supportive care, may be warranted.
• Strengthen surveillance in border areas and in health facilities used by people from affected communities, and keep coordinating early diagnosis, rapid isolation and infection control.

Sources

Based on Mutegeki M, Bahatungire RR, Wagobera C, et al., "Notes from the Field: Clinical Characteristics of Patients with Ebola Disease Caused by Bundibugyo Virus — Uganda, 2026," MMWR, Centers for Disease Control and Prevention; in the public domain.