Second meeting of the IHR Emergency Committee on the epidemic of Ebola Bundibugyo virus disease in the Democratic Republic of the Congo – Temporary recommendations

On 18 August 2026, the Emergency Committee regarding the epidemic of Ebola Bundibugyo virus disease in the Democratic Republic of the Congo met for the second time to reassess the situation, in line with International Health Regulations (2005).

The Director-General, considering the advice of the Committee, issued the following updated temporary recommendations for States Parties. The recommendations for the Democratic Republic of the Congo provide more detailed guidance on surveillance, case detection and investigation, infection prevention and control, clinical care, risk communication and community engagement than those previously issued, and include a new section on social measures, mass gatherings and domestic mobility.

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Temporary recommendations

These temporary recommendations are issued by the Director-General of WHO for subsets of States Parties according to the public health risk associated with the Bundibugyo virus disease (BVD) epidemic they face.

All current WHO interim technical guidance can be accessed on this page of the WHO website. WHO evidence-based guidance has been and will continue to be updated in line with the evolving situation, updated scientific evidence, and WHO risk assessment.

The implementation of these temporary recommendations by States Parties shall be with full respect for the dignity, human rights and fundamental freedoms of persons, in accordance with the principles set out in Article 3 of the IHR.

Note: The text in backets next to each temporary recommendation indicates the status with respect to the set of temporary recommendations issued on 22 May 2026.
 

For States Parties with community transmission of Bundibugyo virus (Democratic Republic of the Congo) [Modified]

As of 14 August 2026, the WHO Secretariat assessed the risk for these States Parties as “Very high”. At the time these temporary recommendations are issued, only the Democratic Republic of the Congo falls in this group. [Modified]

The epidemic is caused by BDBV, a virus belonging to the Orthoebolavirus genus. Unlike Ebola virus causing Ebola virus disease, although clinical trials are ongoing, there are no currently approved therapeutics or vaccines against BDBV. Should effective BVD-specific vaccines and therapeutics become available, based on experience from the 2013–2016 Ebola virus disease epidemic in West Africa, they are likely to have a complimentary effect on transmission and mortality, but they will not be a substitute for effective, core public health interventions. [Modified]

Coordination and high-level engagement

• Declare, or maintain, the BDBV epidemic a health emergency, at national or sub-national level, in accordance with domestic laws, and as appropriate. [Extended with rephrasing]
• Scale-up national disaster or health emergency management mechanisms, including an activated emergency operation centre, under the authority of the Head of State or relevant government authority, to coordinate response and preparedness activities across Government sectors, administrative levels, and partners. [Modified]
• Establish, and maintain up to date, a single national plan (e.g., action plan, response plan) to guide response efforts, across Government sectors and partners, reflecting the role and responsibilities of Government entities and all partners involved in the response, to ensure efficient and effective implementation and monitoring of comprehensive BVD control measures. These measures must include: [New, resulting from splitting of temporary recommendation previously under “Coordination and high-level engagement]
• community protection, including risk communication and community engagement;
• enhanced surveillance and case identification;
• contact tracing;
• laboratory diagnostic testing;
• infection prevention and control (IPC);
• case management;
• safe and dignified burials;
• continuity of essential health services;
• logistics; and
• health workforce management and protection, including timely payment of salaries and, as appropriate, hazard pay.
[Modified]
• Negotiate, as applicable, and establish security corridors, including cross-border, to allow responders to safely reach affected communities, including in IDP camps and other humanitarian settings, as well as to allow communities to seek appropriate health care. [Extended]
• Establish immigration procedures to allow timely and fluid influx and outflux of international responders both, to cater for identified response needs and to allow for their rotation. [New]
• Establish customs clearance procedures, as well as other administrative and regulatory ones, to expedite the importation of supplies needed to sustain the response [New]
• Notify WHO, through the relevant WHO IHR Contact Point in the WHO Regional Office, of the detection of suspected, probable and confirmed BVD cases on a daily basis, as per WHO case definitions available here. [Extended]

Risk communication and community engagement

• Integrate, at the lowest level designated to coordinate response activities, the implementation of risk communication and community engagement interventions (community networks, workforce capacity, community intelligence and feedback systems, and accountability processes). [New]
• Scale up trust-building and community engagement through trusted communication channels and local actors, including local leaders, religious leaders, traditional healers and survivors, to support community participation in fostering the acceptance of public health measures, including early detection, case referral, contact tracing, safe and dignified burial practices, and adoption of protective behaviours. [Extended with rephrasing, including merging of one temporary recommendation previously under “Risk communication and community engagement”]
• Strengthen community awareness, engagement and participation, to establish and strengthen trust, by identifying and addressing cultural norms and beliefs that may serve as barriers to their full participation in the response; and by integrating interventions and community feedback, within the wider response, to address the needs of the population, particularly in contexts of the protracted humanitarian crisis in the Eastern provinces of the Democratic Republic of Congo. [Extended]
• Activate and train local networks, including community health workers, Red Cross volunteers, and other trusted community actors to promote protective behaviours; facilitate early detection and referral of suspected BVD cases; support contact tracing activities; and collect and relay community feedback to enhance the acceptance of public health measures. [Extended with rephrasing]
• Enable adherence to movement restrictions, associated with the application of control measures, by providing food, water, communication, financial and psychosocial support. [Extended]

Surveillance and laboratory

• Establish and maintain up to date a register of signals consistent with BVD (“alerts”, e.g., including for clusters of unexplained illness or deaths), including status of their investigation. [Extended with rephrasing, previously under “Coordination and high-level engagement”]
• Establish and maintain an up to date a line list of suspected cases, probable cases, and confirmed BVD cases, including a consolidated one at the national level, while building chains of transmission. [Extended, previously under “Coordination and high-level engagement”]
• Establish and maintain up to date the list of contacts of all confirmed and probable BVD cases, monitor, on a daily basis, each contact for 21 days after the date of last known exposure, and record their status. Both the evolution of the epidemic and resources available may require reiterative risk-based prioritization of contacts requiring identification and monitoring. [Extended with rephrasing, including merging of two temporary recommendations previously under “Coordination and high-level engagement” and “Surveillance and laboratory”]
• Establish a mechanism to monitor the evolution of indicators related to the performance of contact tracing activities. [Extended]
• Strengthen surveillance and laboratory capacity, decentralized across sub-national administrative levels (e.g., provinces and districts/health zones) with community BDV transmission, as well as in their neighbouring sub-national administrative levels, through: [Extended with rephrasing]
• dedicated surveillance and response teams within each health zone and in neighbouring health zones determined to be at high-risk for the introduction of BVD; [Extended]
• active case finding and enhanced community surveillance; [Modified]
• the investigation of “alerts” within 24 hours from detection; and [Extended]
• scale-up and strengthen decentralized RT-PCR laboratory capacities for quality, safe and timely testing for BDBV, including sample collection, rapid referral and transportation of samples and timely dissemination of laboratory test results; and train laboratory personnel accordingly. [Modified]

Safe and dignified burials

• Implement protocols, including for their recording and monitoring, in all areas with community BVD transmission, as well as neighbouring areas, ensuring funerals and burials are conducted by well-capacitated, -trained and appropriately PPE-equipped personnel, including safe handling and disinfection of the burial sites with provision made for the presence of the family and cultural practices, and in accordance with relevant national laws and regulations. [Extended with rephrasing]
• Investigate each death, occurring outside BVD isolation and treatment centers, to identify or link to BVD chains of transmission and to better understand the reasons underpinning the community’s reluctance to accept safe and dignified burials. [New]

Patient referral pathway and access to safe and optimized intensive care

• Establish dedicated BVD isolation and treatment centers or units for suspected, probable, and confirmed BVD cases, located within, or close to, areas with community BVD transmission, with sufficient staff who are specifically trained and equipped to implement optimized intensive supportive care. [Extended]
• Establish protocols for early identification and transferring suspected BVD patients safely to dedicated health care facilities for their isolation, assessment and treatment in a humane and patient-centred approach. This includes trained ambulance teams, mechanisms to notify the receiving health care facility, the application of appropriate IPC precautions during transfer, and decontamination protocols for vehicles and equipment. [Extended with rephrasing]
• Establish protocols for the handling and disposal of medical waste, including segregation at point of generation, safe collection and storage, and decontamination by autoclaving or incineration prior to final disposal, in accordance with international guidance. [Modified]
• Establish survivor follow-up programmes, including counselling, psychosocial support and stigma-reduction programmes, clinical care, as well as sexual health advice, semen testing, and condoms as appropriate. [Extended]
• Maintain the provision of essential health services package – through implementing infection, prevention and control measures to protect healthcare workers –, and monitor any disruption thereof. This package of essential health services includes, at minimum, malaria diagnosis and treatment, and maternal and child health services. [Extended with rephrasing]

Infection prevention and control in health facilities and communities [Modified]

• Strengthen measures to prevent health-care associated infections (HAIs), including systematic mapping and assessment of public and private health facilities – that are not BVD isolation and treatment centers –, the establishment, dissemination and implementation of protocols for standards and transmission-based precautions, including screening, triage, isolation, targeted IPC interventions and sustained monitoring and supervision [Modified]
• Provide regularly scheduled IPC training to, and assessments of health workers supervision in their proper use of personal protective equipment (PPE) supported by designated IPC focal points at facility-level, and standardized supportive-supervision checklists (e.g. WHO IPC scorecard). [Modified]
• Provide health facilities with sufficient and uninterrupted supplies, including PPE, safe injection equipment, with monitoring of stock out rates. [Modified, including moving part of previous temporary recommendation under “Coordination and high-level engagement”]
• Establish channels for health workers to report and be assessed following exposures, and have access to psychosocial support and, when possible post-exposure prophylaxis under compassionate use or clinical trial. All BVD cases occurring among health workers must be investigated promptly to implement timely corrective actions within health facilities and mitigation measures as appropriate at the community level. [Extended with rephrasing]
• Build community IPC capacity by training community leaders and emphasizing that hand hygiene not only contributes to bringing the BVD epidemic under control but also reduces the risk of transmission of other communicable diseases present in the same areas. Hand hygiene shall be facilitated at critical spots, such as schools, churches, bars, markets, local gatherings sites, points of entry, etc. [Extended with rephrasing]

Social measures, mass-gathering events, and domestic mobility [New]

• Postpone mass gatherings in areas with ongoing community BDV transmission. For mass gathering events planned in other areas, the decision to hold them shall be based on event-specific risk assessment. [Modified, previously under “Border health, international travel and mass-gathering events”]
• Enact and implement measures reducing crowding in food and drink establishments and nightclubs. [New]
• Enact and implement measures limiting to one the number of passengers motorbikes. [New]
• Enact and implement measures for the safe opening of schools. [New]
• Establish 24/7 health check points along the roads connecting areas with community BVD transmission and areas determined to be at high-risk for the introduction of BVD, as informed by the analysis of population mobility patterns. [New]
• Establish BVD surveillance on vessels navigating inland waterways, connecting areas with community BVD transmission with major urban centers, including the Capital Kinshasa. [New]

International travel and border health [Modified]

• Establish arrangements with States Parties adjacent to areas experiencing community BVD transmission and characterised by substantial cross border movement and trade activities, to enhance surveillance at ground crossings and along bordering areas. This includes establishing coordination mechanisms for sharing of information regarding contacts who have, or may have, crossed the border, thus enabling continuity of follow-up; as well as the identification and follow up of contacts following the detection of a BVD case in the. [Extended with rephrasing]
• Implement measures, in accordance with national laws and regulations, to prevent suspected, probable, and confirmed BVD cases, as well as their contacts, based on the assessment of exposure, from undertaking international travel, unless the travel is part of an appropriate medical evacuation. [Extended]
• Prevent the cross-border movement of the human remains of deceased suspected, probable or confirmed BVD cases, unless authorized through bilateral arrangements. [Extended]
• Implement exit screening at all points of entry – airports, ports and ground crossings – consisting of, at a minimum, a questionnaire encompassing history of potential exposure to BVD, a temperature measurement and, in case of fever, an in-depth assessment of the risk of BVD, by personnel trained and adequately equipped with PPE. [Extended with rephrasing]
• Report to WHO, through the relevant WHO IHR Contact Point in the WHO Regional Office, the implementation of any international traffic related measure adopted. [Extended]

Operations, supplies and logistics

• Report to WHO, through the relevant WHO IHR Contact Point in the WHO Regional Office, the implementation of any international traffic related measure adopted. [Extended]
• Establish and maintain a timely, robust and monitored end-to-end emergency supply chain to ensure needs-based forecasting, procurement, importation, storage, transportation and distribution of all relevant commodities and countermeasures, including PPE, diagnostics, therapeutics, IPC materials, medical supplies and essential non-medical equipment, while ensuring visibility of stocks, pipelines, consumption and potential gaps. [New, replacing terminated temporary recommendation previously under “Operations, supplies and logistics”]
• Establish and coordinate the capacity to rapidly construct, rehabilitate, equip and maintain isolation and treatment facilities and other health infrastructure, ensuring their safe and functional operation in accordance with the standards and technical IPC and case management international guidance. [New, replacing terminated temporary recommendation previously under “Operations, supplies and logistics”]
• Establish, operationalize and steer a national health logistics partners coordination cell that provides shared visibility of needs, stocks and partner pipelines of relevant health products; identifies gaps, bottlenecks and duplications; and facilitates the prioritization and mobilization of logistics resources in line with national response priorities. [New, replacing terminated temporary recommendation previously under “Operations, supplies and logistics”]

Research and development of medical countermeasures

• Engage, when feasible, with research partners and international institutions to: [Extended]
• define a robust laboratory strategy, urgently implement head-to-head comparison studies of PCR diagnostics to validate or invalidate the PCR platforms currently used in the field and other upcoming products. [Extended]
• conduct in-depth investigations to identify and characterize BDBV transmission dynamics associated with specific settings, including related modes of BDBV transmission (e.g. caretaking at home, hospital, or at traditional healers, re-use of needles), as well as exposure to animal populations. [New]
• implement ethically approved, scientifically robust clinical trials to advance the development and use of candidate therapeutics for treatment and post-exposure prophylaxis, as well as for candidate vaccines. [Extended]
• establish, with a view to support research, expedited and efficient national regulatory and ethics reviews, community engagement, pharmacovigilance (where applicable), data sharing and equitable access arrangements. [Extended]

Reporting on the implementation of temporary recommendations

• Report to WHO, on a monthly basis, on the status of, and challenges related to, the implementation of these temporary recommendations, using a standardized tool and channels that will be made available by WHO, also allowing for the monitoring of progress and the identification of gaps in the national response. [Modified]

For States Parties with land borders adjoining States Parties with community BVD transmission [Modified]

As of 14 August 2026, the WHO Secretariat assessed the regional risk “High”. At the time these temporary recommendations are issued, these States Parties include Angola, Burundi, Central African Republic, Republic of Congo, Rwanda, South Sudan, Tanzania, Uganda and Zambia: [Modified]

• Establish, or maintain, a national coordination mechanism articulated with subnational levels. [Extended with rephrasing]
• Enhance and maintain operational readiness respond to BVD cases, focusing on gaps identified through BVD-specific readiness assessments, and including, but not limited to:
• identifying areas at highest risk of importation of BVD cases;
• raising community awareness regarding BVD;
• raising awareness among health workers regarding BVD;
• enhancing community-based surveillance for and investigations of clusters of unexplained deaths;
• establishing weekly zero reporting of suspected BVD cases across health facilities;
• establishing timely access to laboratories, at national and, if needed, at subnational levels, qualified to perform test for BDBV and relevant differential testing. Considerations may be given to shipment to an international reference laboratory for inter-laboratory comparison as part of external quality assurance implementation;
• establishing rapid response teams for the investigation and management of BVD patients and their contacts;
• establishing a mechanism for the identification and monitoring of contacts;
• training health workers in infection, prevention and control (IPC) measures and interventions, including standards and transmission-based precautions for the isolation and treatment of BVD cases;
• identifying and training workforce should a rapid scale-up of response operations be necessary, including the identification of resources for hazard pay; and
• conducting simulation exercises.
  [Modified, including merging of two temporary recommendations previously under this Section]
• Provide the general public with accurate and up to date information regarding the BVD epidemic, as well as measures to reduce the risk of exposure; and, where the risk of importation is assessed as highest, engage community leaders, community health workers, and trusted community actors to promote protective behaviours, conduct surveillance, facilitate referral of suspected BVD cases, collect and respond to community feedback [Modified]
• Establish, with a view to support research, expedited and efficient national regulatory and ethics reviews, community engagement, pharmacovigilance (where applicable), data sharing and equitable access arrangements. [Extended]
• Border health and international travel
• Provide travellers with accurate and up to date information regarding the BVD epidemic and measures to reduce the risk of exposure, including discouraging travel to areas with community BVD transmission. [Modified with rephrasing]
• Establish arrangements with States Parties with adjacent areas experiencing community BDV transmission and characterised by substantial cross border movement and trade activities, to enhance surveillance at ground crossings and along bordering areas. This includes establishing coordination mechanisms for the detection and assessment of travellers with unexplained febrile illness; and the timely sharing of information regarding contacts who have, or may have, crossed the border, thus enabling continuity of follow-up. [Extended with rephrasing]
• Pre-position PPE, other IPC materials, sample collection kits, case investigation forms, and safe burial supplies in border areas and points of entry, prioritizing those where the risk of importation is assessed as highest. [Extended with rephrasing]
• Activate health contingency plans at airport, ports, and ground crossings, involving conveyance operators, to detect, assess, and manage travellers from States Parties with community BDV transmission, presenting with symptoms compatible with BVD, and the identification of their contacts, according to established protocols. This entails the availability of trained personnel, referral mechanisms, and the application of IPC measures. [Extended with rephrasing]
• Coordinate with conveyance operators to facilitate timely communication, prior to arrival, of any suspected BVD cases on board conveyances, and to identify contacts associated with conveyances on an international voyage. Conduct international contact tracing operations as necessary, including by obtaining relevant information from the operators; identifying contacts associated with conveyances on an international voyage; and communicating with States Parties known as transit or final destination of those contacts. [Modified, including merging of one temporary recommendation previously under this Section]
• Neither the suspension of flights or waterways routes with States Parties with community BDV transmission, nor denial of entry to travellers and conveyances arriving from those States Parties, are recommended. [Extended with rephrasing]
• Report to WHO, through the relevant WHO IHR Contact Point, the implementation of any international traffic related measure adopted. [Extended]
• Treat as a health emergency, including, when warranted or necessary, through a formal declaration according to domestic laws, the detection of a suspected or confirmed BVD case, of a contact thereof, or of a cluster of unexplained deaths. This includes investigating any of those events within 24 hours and, by instituting case isolation and management; establishing a definitive diagnosis; and undertaking the identification and monitoring of contacts. [Extended with rephrasing]
• Notify to WHO immediately, through the relevant WHO IHR Contact Point in the WHO Regional Offices, any suspected, probable or confirmed BVD case, as per WHO case definitions available here. [Extended]
• Report to WHO, on a quarterly basis, on the status of, and challenges related to, the implementation of these temporary recommendations, using a standardized tool and channels that will be made available by WHO, also allowing for the monitoring of progress and the identification of gaps in the national response. [Modified]

In the presence of a probable or confirmed BVD case, take actions based on the temporary recommendations for States Parties with community BDV transmission. [Modified]

For all other States Parties

As of 14 August 2026, the WHO Secretariat assessed the risk for these States Parties as “Low”.

• Make arrangements to detect, assess, report and manage travellers with unexplained febrile illness arriving from areas with community BDV transmission. These include, but are not limited to, disseminating accurate and up to date information regarding the BVD epidemic and the definition of BVD cases to public and private health care facilities, including travel clinics, general practitioners, and authorities at points of entry; identifying laboratories to conduct testing for BDBV; identifying isolation facilities allowing for safe assessment and clinical care. [Extended with rephrasing, incorporating a temporary recommendation previously under this Section]
• Provide non-governmental organizations and other entities deploying personnel internationally to respond to the BVD epidemic with information on risk, measures to minimize the risk of exposure, and advice for managing a potential exposure. [Extended]
• Prepare to facilitate the evacuation and repatriation of nationals (e.g., health workers) who have been exposed to BVD cases. [Extended]
• Provide the general public with accurate and up to date information regarding the BVD epidemic and measures to reduce the risk of exposure, including discouraging travel to areas with community BDV transmission. [Extended with rephrasing]
• Provide, at points of entry, incoming travellers from areas with community BDV transmission, with information about measures to take should they develop symptoms compatible with BVD within 21 days after arrival. [Extended with rephrasing]
• Coordinate with conveyance operators to facilitate timely communication, prior to arrival, of any suspected BVD cases on board conveyances, and to identify contacts associated with conveyances on an international voyage. Conduct international contact tracing operations as necessary, including by obtaining relevant information from the operators; identifying contacts associated with conveyances on an international voyage; and communicating with States Parties known as transit or final destination of those contacts. [Modified]
• At the time these temporary recommendations are issued, neither the suspension of flights from States Parties with community BDV transmission, nor denial of entry to travellers and conveyances arriving from those States Parties, are recommended. [Extended]
• Report to WHO, through the relevant WHO IHR Contact Point, the implementation of any international traffic related measure adopted. [Extended]
• Notify to WHO immediately, through the relevant WHO IHR Contact Point in the WHO Regional Offices, any suspected, probable or confirmed BVD case, as per WHO case definitions available here.

In the presence of a probable or confirmed BVD case, take actions based on the temporary recommendations for States Parties with community BDV transmission. [Modified]