The totals place this event second only to the 2014–2016 West African epidemic — which killed more than 11,300 people across Guinea, Sierra Leone, and Liberia — in the history of Ebola outbreaks. But the trajectory of the current outbreak is, by one critical measure, worse than any predecessor: CDC and WHO have noted that case accrual has been faster for this outbreak than for any prior Ebola event on record.

The DRC is no stranger to Ebola; this is the country’s seventeenth declared outbreak. What distinguishes the 2026 event is the viral species at its center. Bundibugyo virus (BDBV) caused two previous, far smaller outbreaks — Uganda in 2007–2008, and DRC’s Orientale Province in 2012 — and has never before triggered a PHEIC. Critically, the Bundibugyo strain sits outside the reach of Ervebo (rVSV-ZEBOV), the only licensed Ebola vaccine, which is indicated solely against Zaire ebolavirus. WHO’s Strategic Advisory Group of Experts on Immunization has explicitly stated it does not recommend Ervebo outside controlled research settings for this outbreak. No licensed vaccine and no approved specific treatment exist for Bundibugyo virus disease; clinical management relies on supportive care, isolation, and contact tracing.

Ituri Province in northeastern DRC is the epicenter, with 916 confirmed cases across 22 health zones; North Kivu has logged 84 confirmed cases across 11 health zones, and South Kivu has reported 3 cases. The geographic spread across multiple provinces and an international border underscores the operational challenge facing response teams.

In the United States, CDC issued a Health Alert Network notice (HAN 00530) to alert clinicians and public health practitioners. A formal risk assessment published in the Morbidity and Mortality Weekly Report (MMWR, Vol. 75, No. 22) rated the risk to the general U.S. population as low, contingent on sustained public health resources controlling the outbreak at its source.

On June 21, 2026, CDC renewed a 30-day public health entry restriction under Title 42 authority, barring specified foreign nationals who have been present in DRC, Uganda, or South Sudan within the prior 21 days from entering the United States. U.S. citizens and lawful permanent residents traveling from those countries are not barred but are subject to enhanced public health screening upon arrival. Air travel for affected individuals is rerouted through four designated U.S. airports — Washington-Dulles (IAD), Hartsfield-Jackson Atlanta (ATL), George Bush Intercontinental Houston (IAH), and John F. Kennedy New York (JFK) — where enhanced screening infrastructure is in place.

Public health officials in the United States emphasize that domestic transmission risk remains extremely low and that existing hospital infection-control capacity would contain any imported case. The outbreak’s severity is concentrated in a region where surveillance infrastructure, isolation capacity, and community trust in health workers remain severely strained.

The Elimination Threshold

The United States achieved measles elimination status in 2000, defined by PAHO and the CDC as the absence of continuous endemic transmission for 12 or more months. Maintaining that designation requires sustained vaccination coverage high enough to interrupt transmission chains and case counts consistent with sporadic, importation-driven outbreaks rather than sustained local spread.

Two consecutive years above 2,000 confirmed cases — 2025’s final count of 2,288 was already the highest since the pre-elimination era — have accelerated the timeline for a formal PAHO review. PAHO has announced a postponement of that review while the situation is assessed, but the postponement itself signals institutional concern about the trajectory.

What Is Driving the Outbreak

The 2026 outbreak, like its 2025 predecessor, is concentrated in communities with vaccination coverage below the 95% threshold needed to prevent sustained community transmission. CDC contact investigation data consistently identify a high proportion of confirmed cases in unvaccinated or incompletely vaccinated individuals. School exemption policies, vaccine hesitancy, and importation from countries where measles remains endemic are contributing factors across multiple affected jurisdictions.

The MMR vaccine provides approximately 97% protection against measles after two doses. Where coverage drops below 90–95%, a single imported case can seed clusters that sustain transmission locally.

The 2026 mid-year figure of 2,104 — already matching the level that defined 2025’s record year before the end of June — suggests the annual total could materially exceed 2,288 if the pace continues through autumn.

What Elimination Loss Would Mean

A formal loss of elimination status would not change clinical management of measles or vaccination schedules. The MMR program would continue; outbreak response protocols would remain in place. What it would change is the U.S.'s standing within the PAHO Americas elimination framework, with implications for international reporting, cross-border outbreak response coordination, and the country’s position in global vaccination benchmarking.

CDC measles surveillance data, June 21, 2026. PAHO measles situation report 5, Americas, June 2026.

Correction (June 21, 2026): The original dek referred to the PAHO elimination status review as “the federal review.” PAHO (Pan American Health Organization) is a regional office of the World Health Organization, not a U.S. federal agency. The dek has been corrected.

Of the $910 million pledged, $80 million was committed by African Union member states — a contribution the AU described as progress toward its internal $100 million fundraising target — and $830 million was pledged by external partners, including bilateral donors, multilateral development banks, and international humanitarian organizations.

A Disease Without a Licensed Vaccine

The ongoing outbreak is caused by Bundibugyo ebolavirus, one of six known species of Ebola virus. No vaccine is licensed specifically for BDBV. The two vaccines that have received regulatory approval — rVSV-ZEBOV (Ervebo) and the heterologous prime-boost Ad26.ZEBOV/MVA-BN-Filo regimen (Zabdeno/Mvabea) — were developed and approved on the basis of Zaire ebolavirus data. Their cross-protective efficacy against BDBV is not established in controlled efficacy trials, though investigational use under compassionate protocols has been explored.

Monoclonal antibody countermeasures evaluated in prior Zaire ebolavirus outbreaks were similarly developed against ZEBOV antigens. A licensed BDBV-specific product does not exist.

Response Status

The WHO Public Health Emergency of International Concern (PHEIC) declared for this outbreak remains active. Pledge funds are directed toward supply chains, field hospital capacity, cross-border surveillance between DRC and Uganda, and community engagement. The International Health Regulations Emergency Committee is scheduled to reconvene within 90 days of its May 22 meeting.

AU High-Level Presidential Meeting on BDBV Ebola Response, June 16, 2026. Africa CDC. WHO Disease Outbreak News DON608, June 18, 2026.

The World Health Organization’s International Health Regulations Emergency Committee declared a Public Health Emergency of International Concern (PHEIC) on May 17, 2026. The IHR Emergency Committee first met on May 19, 2026; temporary recommendations were issued on May 22, 2026. The second scheduled review falls within 90 days of that initial meeting.

No licensed vaccine for BDBV

No vaccine licensed specifically for the Bundibugyo strain of Ebola virus disease is currently available. The licensed Ebola vaccines — Ervebo (rVSV-ZEBOV, Merck) and the two-dose Zabdeno/Mvabea regimen (Johnson & Johnson) — target the Zaire strain (EBOV). Both are ineffective against BDBV because the viral surface glycoprotein, the primary vaccine antigen, differs substantially between strains. Cross-protection has not been established.

The only BDBV-specific candidate in human testing is VSV-BDBV, a vesicular stomatitis virus vector analogous to Ervebo but encoding the Bundibugyo glycoprotein. Phase I data are limited; no Phase 2 or 3 efficacy data exist. Investigational ring vaccination protocols using VSV-BDBV were assessed at the time the PHEIC was declared; uptake and outcomes have not been publicly reported.

Outbreak context

The BDBV strain was first identified in Bundibugyo District, Uganda, in 2007 (approximately 56 laboratory-confirmed cases out of approximately 149 suspected cases total, with 37 deaths; CFR approximately 25%). A second outbreak occurred in DRC’s Isiro, Orientale Province, in 2012 (approximately 57 confirmed cases, approximately 25–34 deaths). The current outbreak represents the largest BDBV event in recorded history by confirmed case count.

Case fatality rates in prior BDBV outbreaks ranged from approximately 25% (2007 Uganda) to approximately 50% (2012 DRC Isiro). The WHO has not published a case fatality rate for the current outbreak in the public DON.

Case management relies on supportive care and experimental therapeutics evaluated under compassionate use or expanded access protocols. The monoclonal antibody cocktail Inmazeb (atoltivimab, maftivimab, odesivimab-ebgn), licensed in the United States for Zaire EBOV, has binding affinity for BDBV glycoprotein, but clinical data in BDBV-infected patients are limited.

Correction (2026-06-19): Four errors corrected by post-publication fact-check. (1) The 2007 Uganda BDBV outbreak was reported as “186 confirmed cases”; primary literature and CDC/WHO records consistently cite approximately 56 laboratory-confirmed cases (approximately 149 suspected/putative total); the figure 186 does not correspond to any recognised case classification for that outbreak. (2) The 837-case figure reflects DRC-confirmed cases as reported in the ECDC Week 25 data; Uganda had approximately 19 additional confirmed cases separately — the article now clarifies the geographic attribution. (3) The IHR Emergency Committee was said to have “convened for the first time on May 22”; the committee first met May 19, 2026, and May 22 is when temporary recommendations were issued. (4) The 2012 DRC Isiro outbreak deaths were stated as 36; sources variously cite 25–34 deaths; the article has been corrected to reflect the range. The CFR range for prior outbreaks has also been corrected: the 2012 DRC outbreak CFR was approximately 50%, not capped at 34%.

The Pan American Health Organization (PAHO) announced this week that it is postponing its planned re-evaluation of U.S. individual measles elimination status, citing the sustained transmission observed in the U.S. and several other member states. Context: in November 2025, PAHO’s Regional Verification Commission had already announced that the Region of the Americas as a whole had lost its regional measles elimination status, primarily due to endemic transmission established in Canada. The deferred 2026 review concerns U.S. individual country status specifically. The WHO defines measles elimination as interruption of endemic transmission for ≥12 months. The U.S. has maintained individual-country elimination status since 2000, though the PAHO review process now classifies the U.S. as “sustained with major concerns.”

Outbreak characteristics

The 2026 cases are concentrated in communities with lower vaccination coverage, including several with documented vaccine hesitancy and organised exemption networks. Measles is caused by a paramyxovirus with a basic reproduction number (R₀) of 12–18, meaning herd immunity requires vaccination coverage above 95% to prevent outbreak spread. National MMR coverage has declined below 95% in some age cohorts and geographic areas.

The MMR (measles-mumps-rubella) vaccine is two-dose, with the first dose administered at 12–15 months and the second at 4–6 years. Two doses provide approximately 97% protection against measles. The vaccine has been in routine use in the United States since 1963 (original measles vaccine) and the combined MMR since 1971.

PAHO elimination re-evaluation postponed

PAHO’s decision to defer the U.S. individual country review reflects the sustained character of the 2026 U.S. outbreak. Measles spreads efficiently across national borders; sustained transmission in a large member state undermines elimination status across the region. The timing of the next re-evaluation has not been announced.

Correction (2026-06-19): Two errors corrected by post-publication fact-check. (1) The previous modern-era record was stated as 1,282 cases set in 2019; the official CDC final count for 2019 is 1,274 confirmed cases. (2) The article stated PAHO is “postponing its planned Americas-wide elimination re-evaluation” without noting that the Americas region had already lost its regional measles elimination status in November 2025 (due to endemic transmission established in Canada); what PAHO deferred is the review of U.S. and Mexico individual country elimination status, not a first-time regional assessment. The article has been updated throughout to reflect these distinctions.

Uganda, which recorded 19 confirmed cases and 2 confirmed deaths among imported cases since the outbreak began, has reported no new confirmed cases since June 10, a six-day stretch of silence that health officials are monitoring cautiously. One additional probable case with a fatal outcome has been recorded in Uganda.

WHO Director-General Tedros Adhanom Ghebreyesus determined the outbreak constitutes a Public Health Emergency of International Concern (PHEIC) on May 17, 2026, under Article 12 of the International Health Regulations. The IHR Emergency Committee convened May 19 and issued temporary recommendations to member states on May 22.

The outbreak’s pathogen, Bundibugyo virus (BDBV), is one of six known Ebola species. It is a critical distinction: the approved vaccines and several targeted therapeutics were developed against Zaire ebolavirus, not Bundibugyo. No licensed vaccine exists for the Bundibugyo strain, leaving supportive care as the primary intervention available at scale.

That gap makes Wednesday’s WHO announcement all the more consequential. On June 17, 2026, WHO released what it describes as its first comprehensive clinical management guidelines for filovirus disease, covering all Ebola strains and Marburg virus. The document sets out 16 evidence-based recommendations developed through global expert consultations and grounded in lessons from recent Ebola and Marburg outbreaks. Central themes include early intravenous fluid resuscitation, management of shock with vasoactive agents, prompt antibiotic therapy for secondary bacterial infections, laboratory monitoring for metabolic complications, and structured survivor follow-up. WHO says early supportive care can significantly improve survival even where curative treatments are unavailable.

For European public health agencies, the outbreak’s scale raises questions about cross-border risk—though current estimates place that risk very low. The European Centre for Disease Prevention and Control modeled the probability of at least one Bundibugyo virus importation into the EU or European Economic Area during the June 11–25 window at 0.45% (90% uncertainty interval: 0.20%–0.85%), conditioned on an assumption of 100 travelers from the outbreak region during that window — which ECDC describes as a conservative upper estimate, meaning the true importation probability is likely lower. The per-traveler figure translates to roughly one importation per 23,000 travelers from the primary outbreak zones in North Kivu and Ituri.

The outbreak trajectory and the absence of a licensed BDBV vaccine underscore why the new WHO guidelines are being received as urgent rather than merely timely. For clinicians in Ituri’s treatment units, sixteen evidence-based recommendations may now be the sharpest tool available.

Correction — June 18, 2026: An earlier version of this article reported 808 confirmed cases, 192 confirmed deaths, and 738 confirmed cases in Ituri province, citing WHO DON607. WHO DON607 (data as of June 15, 2026) reports 837 confirmed cases, 196 confirmed deaths, and 767 confirmed cases in Ituri; the original article inadvertently used figures from the prior WHO SitRep 05 (data as of June 14). The ECDC importation probability paragraph has also been updated to include the conditioning assumption (100 travelers from the outbreak region) that determines the 0.45% figure. Identified by The Vital Record’s post-publication fact-check.

The DRC caseload is concentrated in Ituri Province, which accounts for 738 of the 808 DRC confirmed cases across 20 health zones. North Kivu has recorded 67 confirmed cases across 10 health zones, and South Kivu has reported 3 confirmed cases from one health zone. The outbreak is already the largest Bundibugyo virus disease outbreak on record.

A critical gap: no licensed vaccine for this strain

Unlike the Zaire ebolavirus strain that drove the 2014–2016 West Africa epidemic, BDBV has no licensed vaccine. The two approved Ebola vaccines — including Ervebo (rVSV-ZEBOV) — target Zaire ebolavirus only. On May 28, 2026, WHO issued emergency guidance concluding that current evidence on cross-protection of licensed Ebola vaccines against BDBV is “very limited and insufficient” to support their use in this outbreak. The Coalition for Epidemic Preparedness Innovations announced funding on June 1, 2026, to fast-track three BDBV-specific vaccine candidates, but none are yet available for deployment.

In the absence of a BDBV vaccine, response teams are relying on established public health measures: surveillance, contact tracing, clinical management, infection prevention and control, and community engagement. WHO and partners are running clinical trials of MBP134 and REGN3479 for treatment, and obeldesivir for post-exposure prophylaxis among contacts of confirmed or probable cases.

Contact tracing running at half the needed rate

WHO Director-General Tedros Adhanom Ghebreyesus said at the June 3, 2026, media briefing that contact tracing was reaching only approximately 45% of contacts in the outbreak zone — less than half of the 90% threshold WHO considers necessary to bring a transmission chain under control. Insecurity, population displacement, and high cross-border mobility in the Ituri region are cited as compounding factors.

Africa CDC Director-General Jean Kaseya warned on June 16, 2026, that if the outbreak is not stopped quickly, “it will be worse than what we had in West Africa and eastern DRC.” The West Africa epidemic of 2014–2016 caused more than 11,000 deaths across Guinea, Sierra Leone, and Liberia, according to WHO historical records. Africa CDC declared the outbreak a Public Health Emergency of Continental Security on May 18, 2026.

Funding and response scale

WHO declared the outbreak a PHEIC on May 17, 2026 — the first time a WHO Director-General has declared a PHEIC before convening an IHR Emergency Committee. The Emergency Committee’s first meeting issued temporary recommendations on May 22, 2026. A joint Africa CDC and WHO continental preparedness and response plan, launched June 5, 2026, requests $518 million from international partners; as of mid-June a $115 million funding gap remains.

WHO had not published DON608 as of publication of this article. The IHR Emergency Committee is expected to reconvene within 90 days of the first meeting under standard PHEIC protocol.

The DRC accounts for 676 of those confirmed cases — concentrated in three eastern provinces — while Uganda has recorded 19 confirmed cases and 2 confirmed deaths, with evidence of limited local transmission beyond the initial imported cases.

Three Provinces, One Epicenter

Ituri Province remains the outbreak’s core, with 629 confirmed cases spanning 19 health zones, tracing back to an initial cluster in Mongbwalu Health Zone detected in early May. North Kivu Province has recorded 44 confirmed cases across nine health zones, and South Kivu has reported 3 confirmed cases from a single health zone. The spread across provincial boundaries — and into Uganda’s capital, Kampala, and the neighboring district of Wakiso — signals sustained cross-border movement of the virus.

The WHO was alerted to an outbreak of unknown high-mortality illness in Mongbwalu on 5 May 2026. Laboratory confirmation of Bundibugyo virus disease in eight samples followed on 15 May, and the DRC Ministry of Public Health officially declared the country’s 17th Ebola disease outbreak that same day. The WHO Director-General determined the situation constituted a Public Health Emergency of International Concern (PHEIC) on 17 May 2026.

Between 8 June and the DON607 reporting date of 13 June, an additional 161 confirmed cases and 45 confirmed deaths were recorded in the DRC — a five-day increment WHO attributes partly to the scale-up of testing capacity and clearance of a backlog of previously collected samples, as well as ongoing transmission. As of 10 June, 262 individuals were hospitalized in isolation across affected areas. The confirmed case fatality rate among laboratory-confirmed cases stands at approximately 19.9 percent (138 deaths among 695 confirmed cases).

“Contact tracing coverage is running at approximately 45 percent — well below the 90 percent threshold considered necessary to stay ahead of an outbreak of this nature.” — WHO Director-General Tedros Adhanom Ghebreyesus, media briefing, 3 June 2026 (this figure was from 10 days before DON607; by 13 June, coverage had improved to approximately 64 percent — see correction below)

No Licensed Countermeasures for This Strain

A critical gap shaping the response is the absence of any regulatory-approved vaccine or specific antiviral treatment for Bundibugyo ebolavirus. The vaccines licensed to date — including rVSV-ZEBOV (Ervebo) — target only the Zaire ebolavirus strain and offer no established cross-protection against BDBV. The two-dose Ad26.ZEBOV/MVA-BN-Filo regimen (Zabdeno/Mvabea) had its European Commission marketing authorisation withdrawn in May 2026 and is no longer a licensed product; rVSV-ZEBOV (Ervebo) remains the only currently licensed Ebola vaccine.

On 28 May 2026, WHO convened expert and advisory groups to assess candidate medical countermeasures. The groups identified the single-dose rVSV-BDBV vaccine candidate, under development by the International AIDS Vaccine Initiative (IAVI), as the most promising vaccine option — but estimated it will require seven to nine months before it is ready for clinical trial assessment. For post-exposure prophylaxis, the oral antiviral obeldesivir was designated a priority investigational candidate, though experts noted its effectiveness depends on robust contact tracing, which remains operationally constrained in parts of eastern DRC. WHO’s advisory groups recommended that all identified candidate products be deployed exclusively within clinical trials to generate rigorous safety and efficacy data.

Response measures currently in place include deployment of rapid response teams, establishment of safe and optimized treatment centers, reinforced surveillance and laboratory capacity, infection prevention and control assessments, and community engagement programs, implemented by national authorities in collaboration with WHO and partners.

What remains unknown: whether the diagnostic backlog clearance in DRC accounts for most of the recent confirmed-case acceleration or whether underlying transmission has itself increased; whether any of the individuals reported to have recovered carry meaningful protective immunity; and when clinical trials for investigational countermeasures could begin enrolling in affected areas.

Correction — 2026-06-14: An earlier version of this article attributed the 45 percent contact tracing figure to “WHO situation monitoring, as reported by outbreak trackers citing DON series data.” The figure originates from WHO Director-General Tedros Adhanom Ghebreyesus’s 3 June 2026 media briefing — ten days before the DON607 report cited — and by the DON607 date (13 June) coverage had improved to approximately 64 percent. The blockquote attribution has been corrected and a caveat added. Additionally, an earlier version described the Ad26.ZEBOV/MVA-BN-Filo regimen (Zabdeno/Mvabea) as a “licensed” vaccine; the European Commission withdrew its marketing authorisation for that product in May 2026. The vaccine paragraph has been corrected above. Desk: Public Health.

The organism in question, Cochliomyia hominivorax, is a fly whose larvae burrow into the living tissue of warm-blooded animals, consuming healthy flesh from the inside. Untreated infestations are fatal to livestock. The parasite was first eliminated from the continental United States by 1966 through an eradication campaign that became a model for pest control worldwide; a 2016–2017 resurgence in the Florida Keys was also eliminated.

Six Confirmed Animal Cases; No Locally Acquired Human Cases

As of June 9, 2026, the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service had confirmed six animal infestations in two states: four cattle and two goats in Texas, and one dog in New Mexico. Texas confirmations span Zavala, La Salle, Gillespie, and Edwards counties; New Mexico’s single confirmed case involves a dog in Lea County. USDA has designated an Infested Zone covering ten Texas counties — Edwards, Gillespie, Kerr, Kimble, La Salle, Sutton, Uvalde, Val Verde, Webb, and Zavala — with quarantine and movement controls in place.

No locally acquired human infestations have been confirmed in the United States. One travel-associated human case was confirmed in 2025 in a Maryland resident who had returned from El Salvador, and human cases continue in Mexico and Central America, where a northward-moving outbreak has been active since 2023. Those cases are distinct from the current U.S. animal detections.

Sterile Fly Program Reactivated

USDA began releasing sterile screwworm flies on June 4, the day after the first confirmed detection in a three-week-old calf in Zavala County, Texas. The program deploys approximately 2 million sterile flies twice weekly by air and an additional 4 million per week through 24 ground release chambers within and around the detection zone. The sterile insect technique — which works because female screwworms mate only once, ensuring offspring from a sterile male cannot survive — was the same approach that achieved eradication in 1966, a program developed by USDA scientists Edward Knipling and Raymond Bushland.

The CDC’s Level 3 EOC activation formalizes coordination with USDA and the Texas Department of State Health Services and positions the agency to scale surveillance should human health risks change. While C. hominivorax can infest humans — particularly targeting open wounds or mucous membranes — human cases in the United States have historically been rare and confined to travel-associated exposures. Clinicians are advised to consider screwworm myiasis in patients presenting with wound infestations and a history of travel to affected regions.

Correction — 2026-06-14: An earlier version of this article stated that New World screwworm had not been confirmed in U.S. animals since the 1966 eradication program, and the dek described this as “the first time since a landmark 1966 eradication program.” Both are incorrect: a confirmed outbreak occurred in the Florida Keys in 2016–2017 before being eradicated. The article has been corrected to reflect the accurate history. Additionally, the original article reported “four cattle and one goat in Texas”; confirmed case data as of June 9 show four cattle and two goats in Texas (one in Edwards County and one in Gillespie County). The Texas animal breakdown has been corrected above. Desk: Public Health.

The largest investigation — reopened after new brands were implicated — has reached 119 confirmed cases and 32 hospitalizations across 36 states. A separate, smaller probe linked to Mogo brand moringa capsules has added 18 cases and 7 hospitalizations across 14 states.

A third, now-closed outbreak of 10 cases involving Rosabella brand moringa powder capsules carries a more alarming distinction: CDC confirmed it is the first outbreak in the United States in which Salmonella harbors the NDM-1 carbapenemase gene — a resistance mechanism that can defeat nearly all standard and backup antibiotics used to treat serious Salmonella infections. Three people in that cluster were hospitalized.

What NDM-1 means — and what it does not

NDM-1 (New Delhi metallo-beta-lactamase-1) renders bacteria resistant to carbapenems, a class of last-resort antibiotics. The Rosabella strain resisted all first-line and alternative antibiotics commonly used for Salmonella.

Critically, the NDM-1 resistance applies only to the Rosabella strain. The 119-case and 18-case moringa outbreaks involve different serotypes without NDM-1, and those infections can still be treated with standard antibiotics.

What consumers should do right now

The FDA has issued recalls covering multiple moringa-containing products. Consumers should:

• Check the FDA recall list at FDA.gov for affected brands, including Rosabella, Mogo, TNVitamins, Doctor’s Pride, Live it Up, and Why Not Natural moringa products.
• Do not eat, sell, or serve recalled products. Throw them away or return them to the place of purchase, even if no one has gotten sick.
• See a doctor if you have eaten moringa supplements and develop diarrhea with fever above 102°F, bloody diarrhea, or symptoms lasting more than two days.
• Recalled products may still be in homes — moringa capsules have a long shelf life.

CDC, FDA, and state health departments are continuing to investigate all three outbreaks. Updates are posted at cdc.gov/salmonella.

The current count is the highest annual total since 1992, when 2,126 cases were reported. The country was declared free of endemic measles transmission in 2000, a status defined as the absence of continuous transmission chains lasting 12 months or more. The 2026 outbreak has now logged cases in 40 of 50 states plus the District of Columbia and several territories, driven primarily by unvaccinated individuals in under-immunised communities concentrated in parts of the Midwest, West, and Northeast.

The outbreak crossed the 1,000-case threshold in March — a psychological and epidemiological milestone — prompting the first formal PAHO advisory on North American elimination status since Canada’s 2011 setback. At the current trajectory, the 2026 total will rank among the ten highest annual figures in the post-elimination era globally.

The two-dose MMR vaccine remains highly effective, with population-level studies consistently reporting effectiveness above 97% against clinical measles in fully vaccinated individuals. Neither the CDC nor the American Academy of Pediatrics has altered the childhood vaccination schedule in response to the outbreak.

The implications of losing elimination status are primarily formal and diplomatic rather than immediately clinical: the PAHO designation affects trade and travel health advisories and carries significant public health signal value. The November assessment is not an automatic decertification; PAHO considers trajectory, geographic concentration, and control measures alongside case count. But at 2,073 cases and rising, U.S. public health authorities have limited margin.

The outbreak has prompted vaccination exemption legislation in at least six states, with two measures having passed their respective legislative chambers as of mid-June.

As of June 9, 2026, the Centers for Disease Control and Prevention (CDC) has recorded nine cases of the outbreak strain across three states — Maryland, New York, and Virginia, each reporting three illnesses — spanning a collection window from March 6, 2023, through May 10, 2026. That three-year range indicates low-level, ongoing contamination at the source rather than a single-batch event.

Genomic link established

The New York State Department of Agriculture and Markets collected requesón samples from a store where ill patients had shopped. Whole genome sequencing (WGS) confirmed the cheese harbored the identical strain isolated from clinical cases, providing the definitive epidemiological link that triggered the June 3, 2026 voluntary recall and, days later, the Maryland Department of Health’s suspension of Clover Hill Dairy’s operating license.

Who is at risk

Listeriosis disproportionately affects specific populations: pregnant individuals (in whom infection can cause miscarriage, stillbirth, premature delivery, or life-threatening newborn infection), adults aged 65 and older, and people with weakened immune systems. The general healthy adult population faces much lower risk of serious illness, though anyone who has consumed the recalled product and develops fever, muscle aches, or stiff neck should contact a healthcare provider.

What was sold and where

Recalled products were distributed from May 4 through May 30, 2026, across Maryland, Virginia, New York, New Jersey, North Carolina, and Washington, D.C. Retail clamshell containers of 10, 12, and 14 ounces carry the Clover Hill Dairy brand and plant number 24-128. Bulk cheese sold in two- and five-gallon pails may have been repackaged under distributor labels including KESSO, QUESOS LA RICURA, IZALCO, DE MI PUEBLO, and RIO LINDO. A separate distributor recall — Nelson & Isa Lacteos, LLC of Bay Shore, N.Y. — covers one-pound clamshells sold at New York retail locations between May 15 and May 28, 2026.

Action for consumers: Do not eat any Clover Hill Dairy requesón or soft ricotta cheese, or any soft cheese sold under the distributor brand names listed above purchased within the distribution window. Return the product to the place of purchase or discard it. Clean and sanitize any refrigerator surfaces that may have contacted the cheese. If you have eaten any of these products and feel ill, contact your healthcare provider.

The CDC and FDA investigation remains ongoing. Additional products may be implicated as environmental and product testing continues.

Correction, June 10, 2026: The original headline described this as a “Nine-State Cluster.” Post-publication fact-check against CDC and FDA primary sources confirmed that confirmed cases span three states (Maryland, New York, and Virginia); the recall distribution footprint covers five states plus Washington, D.C. No source supports a nine-state figure for either cases or distribution. The headline has been corrected to “Three-State Outbreak.”

The U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS) confirmed the first U.S. case of the current outbreak on June 3 in Zavala County, Texas. By June 8, the total had climbed to five: four in Texas — spanning Zavala, La Salle, and Gillespie counties — and one in a dog in Lea County, New Mexico, the first confirmed case in a companion animal and the first case outside Texas.

Cochliomyia hominivorax (Latin: “man-eater”) lays eggs in open wounds of warm-blooded animals; larvae burrow into living tissue, causing severe injury and death if untreated. The United States declared the country free of indigenous screwworms in 1966 following a cooperative sterile-insect program with Mexico in which more than 94 billion sterile flies were released from 1962 to 1975. The pest was subsequently pushed south through Mexico by 1991. The current outbreak has moved northward through Central America and Mexico since late 2024, with Mexico recording more than 28,200 cases since November of that year.

On June 9, Mexico announced the suspension of most live-animal imports from the United States — covering cattle, horses, pigs, sheep, and goats — citing a need to protect screwworm-free northern states. In response, the United States paused planned reopenings of border ports to livestock trade.

The Centers for Disease Control and Prevention classifies human-infestation risk as low; no locally acquired human cases have been reported in the current outbreak. However, any open wound — including scratches, insect bites, or surgical incisions — can attract egg-laying flies in affected counties. Residents and travelers in Zavala, La Salle, Gillespie, and Lea counties should keep wounds cleaned and covered, use insect repellent, and wear long-sleeved clothing outdoors. Healthcare providers who suspect an infestation should report immediately to their state or local health department.

Correction, June 10, 2026: The original headline, dek, and body described this as the “first U.S. re-emergence since 1966” and stated the fly had “not been found in the United States since 1966.” Post-publication fact-check confirmed a prior re-emergence in the Florida Keys from September 2016 through March 2017, when the fly infested and killed approximately 135 endangered Key deer before being eradicated. The headline, dek, and body have been updated to specify “mainland” or “continental” U.S. and to acknowledge the 2016–17 Florida Keys episode.

The DRC carries almost the entire burden: 515 confirmed cases and 91 deaths, a 17.7% case-fatality rate, concentrated in the eastern provinces of Ituri, North Kivu and South Kivu. Uganda has reported 19 confirmed cases, including two deaths among imported cases, plus one probable case who has died. Sixteen confirmed cases have occurred among health and care workers — a marker of strained infection control that has recurred across past Ebola responses.

WHO assessed the risk as very high at the national level in the DRC, high in Uganda and bordering countries, and low at the global level.

No licensed countermeasures

Bundibugyo virus is one of the species that causes Ebola disease, and it is a harder target than the more familiar Zaire strain. WHO notes that no approved vaccines or specific treatments currently exist for Bundibugyo virus disease, leaving supportive care as the mainstay of management. The licensed Ebola vaccine and monoclonal-antibody therapeutics were developed against Zaire ebolavirus; after a May 28 expert consultation, WHO concluded that evidence on cross-protection to other Ebola virus species “remains limited and inconclusive,” and its advisory groups recommended that candidate products be used only within clinical trials.

CDC assessed the risk posed by this ongoing outbreak to the U.S. population during the next 3 months as low. — CDC, MMWR, June 5, 2026

For the United States, CDC reached a measured conclusion. In a Morbidity and Mortality Weekly Report published June 5, the agency rated the risk to the US population over the next three months as low, with no cases reported domestically. As of June 2 — the CDC’s slightly earlier data cutoff — 378 confirmed cases and 63 confirmed deaths had been reported, none in the United States. CDC put the likelihood of importation via an infected traveler from the DRC at very low, based on modeling.

The agency has nonetheless tightened the border. Since May 18, air passengers from the DRC, South Sudan and Uganda have been routed to four US airports — Washington-Dulles, Atlanta, Houston’s Bush Intercontinental and New York’s JFK — for enhanced entry screening, the report said.

The two datasets are not contradictory; the gap reflects different cutoff dates, with the WHO figures four days more current. The trajectory bears watching.

Published June 8 in Nature Medicine, the study drew on 4,524,895 adults with a conventional smoking history enrolled in the Korean National Health Screening Program in 2018, with prior records from 2012–2014. Participants were classed as current smokers, short-term quitters or long-term quitters, and daily e-cigarette use at baseline defined post-cessation vaping. Researchers tracked lung-cancer incidence and lung-cancer-specific death through December 2023 using multivariable Cox models.

What the numbers show

Across 24,182,543 person-years, 35,887 lung cancers and 12,807 lung-cancer-specific deaths occurred. Compared with complete quitters, post-cessation e-cigarette users had an adjusted hazard ratio of 1.56 (95% CI 1.24–1.97) for lung-cancer incidence and 2.00 (95% CI 1.28–3.15) for lung-cancer death. The association held in both short- and long-term quitters and was strongest in a high-risk subgroup (incidence aHR 1.91, 95% CI 1.44–2.53).

“These findings suggest that e-cigarette use after smoking cessation may attenuate the benefits of complete cessation for lung cancer prevention,” the authors write.

Two caveats matter. This is an observational cohort, so association is not causation — the authors state plainly that causality cannot be established, and residual confounding by smoking intensity or duration is hard to fully rule out. And vaping status was measured only at baseline. Still, at this scale, the signal is hard to dismiss: trading cigarettes for a vape may not erase the cancer risk that quitting does.

The trajectory is the story, and it holds on a like-for-like read. When the CDC and the DRC and Ugandan health ministries first described the outbreak in an MMWR Notes from the Field, the DRC’s confirmed count stood at 363 cases and 62 deaths as of June 2, part of a region-wide total of 378 cases and 63 deaths. Four days later, the DRC count had climbed to 515. The European Centre for Disease Prevention and Control (ECDC), working from a slightly earlier Ministry of Health update, recorded 381 DRC cases and 64 deaths as of June 3 and flagged “18 new confirmed cases and 2 new deaths” reported on a single day. The numbers are still moving in one direction.

This is a hard pathogen to fight. Bundibugyo is one of four orthoebolaviruses that cause Ebola disease in humans, and the CDC is blunt about the toolkit: “There is no vaccine for Bundibugyo virus, and treatment consists of supportive care.” The rVSV-ZEBOV vaccine and the monoclonal-antibody therapeutics that reshaped responses to Zaire ebolavirus do not target this species. The MMWR authors put the broader uncertainty plainly.

“The scope of the outbreak is likely larger than that represented by available data and might prove challenging to contain and control.” — MMWR, Notes from the Field

Where it is, and where it has gone

The DRC epicenter is Ituri province, which ECDC mapped at 359 confirmed cases across 17 health zones, with smaller clusters in North Kivu (19 cases) and South Kivu (3 cases). Describing the early case mix, the MMWR reported cases primarily among adults aged 18 to 49, roughly evenly split between women and men, with initial clusters among health care workers — the signature of a pathogen amplifying inside the health system itself. As the DRC caseload has grown, that profile has shifted: the CDC’s current page says most DRC cases are now in people aged 20 to 39, and “two-thirds have been in female patients.”

The cross-border spread is what raises the regional stakes. Uganda’s cases, per the MMWR, “primarily involved travelers arriving from DRC, with secondary transmission to health care workers.” ECDC reports that of the 19 Ugandan cases, eight with known geographic information were in the capital, Kampala, plus one in the neighboring district of Wakiso. Urban transmission in a capital city is a different containment problem than rural Ituri.

The data itself has been turbulent. CIDRAP reported that the WHO and the U.S. CDC sharply revised an early figure of nearly 1,000 cases down to 321 confirmed cases across the DRC and Uganda — a reminder that suspected and confirmed counts diverge widely early in an Ebola response, and that the surveillance picture has shifted as case definitions firmed up.

The case-fatality rate computed from the CDC’s latest figures is about 17.4% region-wide — below the 25% to 90% range historically seen across Ebola species, though early case-fatality rates understate the eventual toll because recent cases have not yet resolved. The CDC assesses the risk to the U.S. public as low; one American health care worker who tested positive on May 17 after caring for patients in the DRC is in stable condition in Germany. ECDC likewise rates the likelihood of infection for people in the EU/EEA as “very low.”

What the surveillance does not yet show is a peak. With no countermeasures licensed against Bundibugyo, the response rests on the oldest tools in outbreak control: case finding, isolation, contact tracing, and safe burials — against a virus the MMWR warns may already be more widespread than the line lists suggest.

The agencies call it a “One Response” approach, built on a principle that WHO Director-General Dr Tedros Adhanom Ghebreyesus summarized as “one plan, one budget, one team.” The news release describes the plan’s workstreams as spanning emergency coordination, disease surveillance, laboratory testing, infection prevention and control, clinical care, community engagement, research, logistics and support for essential health services.

The urgency is in the numbers. At the 3 June media briefing, Tedros reported that the Democratic Republic of the Congo had confirmed 344 cases, including 60 deaths, across 24 health zones in three provinces, with the outbreak also reaching Uganda, where there were 15 confirmed cases and one death. Taken together, the two country figures the director-general cited sum to 359 confirmed cases and 61 deaths; WHO did not report a combined total. There were early signs of progress: suspected cases had fallen to 116, from more than 1,000 the previous week. But contact tracing remained a gap, with only about 45% of contacts followed up against a target above 90%.

A fight without the usual tools

What sets this outbreak apart from recent Ebola emergencies is the absence of medical countermeasures. The licensed Ebola vaccine and monoclonal-antibody therapeutics target the Zaire species; this outbreak is caused by Bundibugyo virus, for which no such products are approved.

“[W]e are fighting this outbreak without vaccines or therapeutics.” — Dr Tedros Adhanom Ghebreyesus, WHO Director-General

That makes the classic public-health toolkit — case finding, contact tracing, isolation and safe care — the front line, and helps explain why the plan leans so heavily on surveillance and community engagement. WHO assessed the risk as very high at the national level, high regionally and low globally.

Africa CDC Director-General Dr Jean Kaseya framed the launch as a test of continental speed. “Ebola moves fast. Africa must move faster,” he said, describing the joint plan as “a clear path to act with speed and unity: to save lives, support the affected countries and protect neighbouring communities.”

The US$518 million figure is an appeal, not secured funding; how much donors commit will shape whether the 10-country response can stay ahead of a virus that, Tedros conceded, “had a big head start.”

The geographic spread is wide. CDC says 2,020 cases were reported by 40 jurisdictions, with a further 10 cases recorded among international visitors. The agency counts 30 new outbreaks in 2026, defining an outbreak as three or more linked cases.

What the clustering signals

The outbreak share is the number to watch. When most cases trace to defined chains rather than one-off travel infections, it indicates the virus is finding pockets of susceptibility and circulating once it arrives — the pattern that strains containment and pushes case counts higher.

93% of confirmed cases (1,890 of 2,030) are outbreak-associated.

Measles remains among the most transmissible human pathogens. CDC notes that measles was declared eliminated in the United States in 2000, meaning the absence of continuous year-round transmission; a year with thousands of confirmed cases tied largely to sustained outbreak chains runs against that status. The agency’s page also maintains tables for hospitalizations, deaths, age distribution, and vaccination status, but those breakdowns were not legible in the data captured for this report, so no figures for them are printed here.

The surveillance count is provisional and is revised as jurisdictions confirm and report additional cases. This is a public-health surveillance report, not medical advice; readers with questions about immunization should consult a clinician.

The CDC’s Morbidity and Mortality Weekly Report states it plainly: “As of June 2, 2026, a total of 378 confirmed cases (363 in DRC and 15 in Uganda) and 63 confirmed deaths (62 in DRC and one in Uganda) have been recorded.” The vast majority of illness and death remains in the DRC, where this is the country’s 17th declared Ebola outbreak. Those figures put the case-fatality rate among confirmed cases at roughly 17 percent, though both the numerator and the denominator are likely to shift as suspected cases are confirmed or discarded. (Working from its own confirmed denominator, the World Health Organization has separately reported a case-fatality rate of 14 percent.)

The trajectory has been steep. In its Disease Outbreak News of May 29, WHO counted 134 confirmed cases and 18 confirmed deaths across both countries, including nine confirmed cases in Uganda. As of an earlier cutoff of May 27, the DRC alone had logged 906 suspected cases and 223 suspected deaths still under investigation. WHO described an outbreak that “continues to evolve rapidly, with increasing case numbers, geographic spread, and ongoing cross-border transmission,” and assessed the risk as very high nationally in the DRC, high regionally, and low globally.

The case for speed

What makes the CDC analysis sobering is not the current count but the math behind it. The report estimates a median reproduction number of 2.51, with an interquartile interval of 2.27 to 2.82 — each case, on average, seeding more than two others. The authors then modeled the next three months under different assumptions about how quickly patients are isolated after symptoms begin.

The fork in the road is patient isolation. In scenarios where only 20 percent of patients enter isolation, a majority of simulations — 65 percent — projected the outbreak exceeding 20,000 cases within three months. Push isolation to 70 percent, and 94 percent of simulations projected fewer than 10,000 cases over the same period — roughly a one-in-17 chance (about 6 percent) of still reaching 10,000 or more.

The report warns that if large-scale and sustained public health interventions are not rapidly implemented to reduce transmission, the outbreak could become as large as the 2014–2016 West Africa Ebola epidemic.

In a June 5 briefing, the CDC’s Dr. Pillai cautioned that real-world isolation appeared to sit “in one of the lower end” of the modeled scenarios — the dangerous end. He also stressed that “the numbers are not completely known” and will change as diagnostics are reviewed.

A central complication: there is no licensed countermeasure. Both the CDC and WHO state that no approved vaccine or specific treatment currently exists for Bundibugyo virus. That leaves classic public-health tools at the front line. The MMWR names “rapid identification of cases, contact tracing, isolation and treatment of persons with BVD, community engagement, and use of safe and dignified burial” as the measures “necessary to control the outbreak.”

For the United States, the CDC assessed the overall risk to the general public as low, with a low likelihood of importation and a low risk of sustained transmission if a case were imported. One exposure has already crossed borders: WHO reported that a U.S. physician tested positive on May 17 after treating patients in the DRC and is receiving care in Germany.

The figures here are surveillance counts subject to revision, and the projections are modeled scenarios, not forecasts of what will happen.

The plan covers June to November 2026 and is anchored on the ongoing outbreak in Ituri Province in the Democratic Republic of the Congo. According to WHO, the money would “support African countries together with partners to prepare for, rapidly detect and respond to the outbreak,” spanning emergency coordination, surveillance, laboratory testing, infection prevention and control, clinical care, community engagement, research and logistics.

The harder problem sits in the virology. The outbreak is caused by the Bundibugyo species of Ebola — and, as WHO put it plainly, “there are no licensed vaccines or therapeutics specifically approved for the Bundibugyo species.” The licensed Ebola vaccines and monoclonal-antibody treatments that reshaped the 2018–2020 response were developed against the Zaire species; they are not approved for Bundibugyo. That leaves the classic public-health tools — case finding, isolation, safe care and community trust — carrying the response.

A continental, not national, footprint

The plan complements national response plans launched by the governments of the Democratic Republic of the Congo and Uganda, and says critical measures are being strengthened in 10 priority countries to enhance preparedness and ensure early detection and swift response. WHO did not name those 10 countries in the announcement.

“Ebola moves fast. Africa must move faster,” said Dr Jean Kaseya, Director-General of Africa CDC.

WHO Director-General Dr Tedros Adhanom Ghebreyesus framed the joint structure as the operative bet: “The only way to beat this outbreak is through close partnership, working together under the leadership of the affected countries.” Containment, he added, “depends on political commitment, sustained financing, and the trust and engagement of communities.”

The $518 million is a target to be raised, not money in hand. WHO’s announcement did not break out funds already secured against the gap, nor did it publish confirmed case or death counts for the Ituri outbreak — figures typically tracked through separate situation reports. For now, the headline is the architecture: two continental health bodies pooling a single appeal and a single plan against a strain for which no vaccine or treatment exists.

Of this year’s cases, 2,020 are among U.S. residents spread across 40 jurisdictions, with 10 more in international visitors. That geographic spread, more than any single number, is what worries public health officials: measles is no longer confined to one or two stubborn clusters.

An outbreak-driven year

The CDC attributes 1,890 of the 2,030 cases (93%) to outbreaks and reports 30 new outbreaks in 2026. Of the outbreak-associated infections, the agency traces 1,332 to outbreaks that began in 2025 and 558 to chains that started in 2026 — meaning much of this year’s burden carries over from 2025 outbreaks that have not fully burned out, on top of the newly reported ones. Sustained, rolling transmission, rather than a series of discrete, contained importations, is a defining feature of the current picture.

Measles was declared eliminated from the United States in 2000. Continuous spread across dozens of jurisdictions is precisely the pattern that elimination status was meant to rule out.

That elimination designation, earned in 2000, rests on the absence of continuous domestic transmission. The CDC attributes the rise in activity to decreased vaccination coverage and increased global measles activity. As outbreaks carry from one calendar year into the next, the practical question is whether the chain of transmission ever truly breaks.

The agency’s detailed breakdowns of vaccination status, hospitalizations, age distribution, and deaths are published in interactive tables on the same page; the figures cited here are the headline counts the CDC states directly. For prior years, the agency has reported that the large majority of cases occur in people who are unvaccinated or whose vaccination status is unknown — a pattern it reports for earlier years, not specifically for 2026.

This is a surveillance snapshot, updated weekly, and the count will keep moving. With more than half the year remaining, 2026 is on pace to approach or exceed the 2025 total. This is journalism, not medical advice; readers with questions about vaccination should consult a clinician.

The ship, identified by European authorities as the M/V Hondius, departed Ushuaia, Argentina, on April 1, 2026. Citing WHO, the CDC put the manifest at 147 people (86 passengers and 61 crew) from 23 countries; the ECDC counts 149 (88 passengers and 61 crew). The vessel called at Antarctica, South Georgia, Tristan da Cunha, St Helena and Ascension Island; the ECDC itinerary also lists Nightingale Island. WHO confirmed ANDV as the cause on May 6.

What sets this cluster apart is the pathogen. ANDV “is the only type of hantavirus that has been documented to spread from person-to-person,” the CDC notes, adding that such spread “has typically required close, prolonged contact with a symptomatic person.” Among patients with severe respiratory symptoms, the CDC says, the case fatality rate “has been estimated at approximately 38%.”

A widening, sequenced outbreak

By the ECDC’s Communicable Disease Threats Report for week 22, the count had risen to 13 cases (11 confirmed, two probable) as of May 29, with no new deaths. The two newest cases — a Dutch citizen in home quarantine after close contact with ANDV cases aboard the ship, and a former passenger evacuated to Spain who was asymptomatic — were both classified as confirmed asymptomatic cases after the ECDC revised its case definition to align with WHO (laboratory confirmation by PCR and/or serology). The ECDC’s working hypothesis is that some passengers were exposed to ANDV in Argentina before boarding and may have transmitted it to others onboard.

Andes virus is the only hantavirus documented to spread person-to-person — though the CDC says such spread is uncommon and has typically required close, prolonged contact with a symptomatic person. The ECDC’s preliminary cruise sequencing “likely” indicates human-to-human transmission, with further results pending.

On the genomics, the ECDC wrote that preliminary analysis “confirmed a high level of genetic similarity between isolates, likely indicating an initial zoonotic spillover event followed by human-to-human transmission,” with further sequencing pending. The CDC advises airborne isolation for suspected cases and including HPS in the differential for symptomatic travelers with relevant exposure in the prior 42 days. The ECDC rates the risk to the general EU/EEA population from this outbreak as very low. This is a public-health alert, not medical advice.

The numbers are moving fast. WHO’s 29 May bulletin counted 134 confirmed cases and 18 confirmed deaths across the two countries, a 14% case fatality rate among confirmed cases, with a much larger pool of suspected cases still under investigation. By the European Centre for Disease Prevention and Control’s data cut on 1 June — a later, separate snapshot — the confirmed tally had reached 359 cases and 61 deaths: 344 cases and 60 deaths in the DRC, and 15 cases and one death in Uganda. The DRC’s Ituri province remains the epicentre.

One feature worries responders: WHO reported 16 confirmed infections among health and care workers, a marker of transmission within healthcare settings. There are no approved vaccines or specific treatments for Bundibugyo virus disease — the licensed Ebola vaccine and monoclonal antibody therapies target the Zaire species, not this one.

Europe tightens hospital defences

On 18 May the ECDC activated the EU Health Task Force, deploying an expert to Africa CDC headquarters to support coordination, alongside partners including DG ECHO and the Global Outbreak Alert and Response Network. Then, on 2 June, the agency issued rapid infection prevention and control advice for EU/EEA healthcare settings.

“Strict multi-level IPC measures are warranted for Ebola disease, including the use of high-level isolation units if possible.” — ECDC rapid advice, 2 June 2026

The advice says assessment of suspected cases should be conducted as soon as possible, “even prior to physical contact with symptomatic individuals.” It frames the span “from the time of symptom onset through hospitalisation” as the window in which transmission must be prevented. ECDC’s message to the public is measured: it assesses the likelihood of infection for people living in the EU/EEA as “very low.”

That mirrors WHO’s own gradient — risk judged very high at the national level in the DRC, high regionally, and low globally. The story now hinges on whether case-finding and isolation can outpace a virus that, unlike its better-known cousin, still has no vaccine and no drug.

The 2026 caseload is concentrated in outbreaks rather than scattered travel-linked infections. The CDC counts 30 new outbreaks this year, and 93% of confirmed cases — 1,847 of 1,983 — are outbreak-associated. That clustering is the signal epidemiologists watch most closely, because elimination status hinges on whether sustained, homegrown transmission has taken hold.

What November decides

Elimination, as U.S. and Pan American health authorities use the term, means the absence of continuous domestic transmission of a single measles strain. CIDRAP reports that “the country will likely lose its measles elimination status — which it gained in 2000 — in November, when officials assess the data.”

93% of 2026’s confirmed cases are tied to outbreaks — the clustering that puts continuous transmission, and elimination status, in question.

Losing the designation would be a symbolic and surveillance milestone rather than an immediate change in vaccine policy or clinical guidance. It would, however, formalize what the case curve already suggests: that measles is again circulating widely in pockets of the country. The CDC’s count includes only confirmed cases notified to the agency, excluding probable cases, so the true reach may be larger. Measles is vaccine-preventable, and the CDC attributes the 2000 elimination milestone to sustained MMR vaccination coverage above roughly 95%. This report is not medical advice; questions about measles risk or MMR vaccination should go to a clinician.

WHO’s Director-General made the PHEIC determination on 17 May 2026, finding that “the event meets the criteria of the definition of PHEIC, contained in Article 1 - Definitions of the IHR.” By the agency’s 29 May Disease Outbreak News update, 134 cases had been laboratory-confirmed — 125 in the DRC and 9 in Uganda — with 18 confirmed deaths, a case fatality ratio of 14%. The DRC has also logged 906 suspected cases and 223 suspected deaths. Ituri Province accounts for 88% of confirmed cases, with further spread to North Kivu and South Kivu and, across the border, to Kampala and Wakiso in Uganda.

A different Ebola, and no shot for it

The central complication is biology. This outbreak is caused by Bundibugyo virus, a distinct Orthoebolavirus species — not the Zaire strain targeted by the licensed Ebola Zaire vaccine, ERVEBO. As WHO put it, “unlike for Ebola-zaire strains, there are currently no approved Bundibugyo virus-specific therapeutics or vaccines.”

“No approved vaccines or specific treatments currently exist for BVD.” — WHO Disease Outbreak News, 29 May 2026

The US Centers for Disease Control and Prevention echoed that gap in a 19 May Health Alert (HAN-00530), noting “there is currently no Food and Drug Administration (FDA)-licensed or authorized vaccine to protect against Bundibugyo virus infection,” and that ERVEBO targets only a different species. CDC said some candidate therapies “have shown some efficacy in animal models” — a preclinical signal, not a licensed product — and put mortality in prior Bundibugyo outbreaks at roughly 25% to 50%. The incubation period runs 2 to 21 days.

The exported case is a US clinician. According to WHO’s 29 May Disease Outbreak News, “a medical doctor from the United States of America who was exposed as part of their work caring for patients in the Democratic Republic of the Congo tested positive on 17 May and was transported to Germany for treatment and care.” NBC News reported the physician was flown to Germany while his wife and four children, who remained in Congo, were being monitored.

CDC advises against nonessential travel to Ituri and North Kivu and recommends 21-day symptom monitoring after departure. As of 18 May, it reported no US cases linked to the outbreak.