Ebola disease outbreak in the Democratic Republic of the Congo and Uganda (Bundibugyo virus)
This is an urgent public health message to all NHS and independent healthcare providers regarding the current Ebola disease outbreak in the DRC and Uganda.
Actions for NHS and independent providers of healthcare
Ensure relevant teams within your organisation are aware of the information in this urgent public health message (UPHM). This particularly applies to microbiology, virology or infectious disease teams but also infection prevention and control (IPC), urgent care, emergency departments, acute medicine, obstetrics, paediatrics and primary care.
Remind clinicians to consider Ebola disease (EBOD) in any patient who is acutely unwell with a history of fever and who has left the Democratic Republic of the Congo (DRC) or Uganda in the previous 21 days, while investigating common alternative diagnoses such as malaria urgently, as per the ACDP viral haemorrhagic fever (VHF) risk assessment algorithm.
Ensure clinical services have pathways in place for assessment and management of suspected EBOD cases within their setting. These should be aligned with the ACDP guidance on the management of patients with VHF.
Ensure staff know how to access local infection specialist advice (infectious diseases, microbiology or virology) and the Imported Fever Service (IFS) for VHF testing advice.
IPC teams to ensure adequate stocks of personal protective equipment (PPE) and that relevant staff are trained in its use for the assessment and treatment of suspected EBOD cases.
Remind clinicians that EBOD and other VHFs are notifiable diseases and must be reported urgently to the local UK Health Security Agency (UKHSA) health protection team by telephone.
Clinical assessment
Assess any patients with a history of fever if they have become unwell within 21 days of leaving the DRC or Uganda using the national ACDP VHF risk assessment algorithm and associated ACDP VHF guidance. Patients with no fever but have an acute severe illness such as unexplained haemorrhage, multi-organ failure, or reduced GCS, who have travelled to these areas, should be discussed with the IFS.
Move the patient immediately to an empty room. The number of staff in contact with the patient should be restricted and relatives and visitors must not enter the room.
Use PPE and safe systems of work appropriate to the risk assessment and setting. Refer to IPC advice in the ACDP VHF guidance and NIPCM addendum on HCID PPE.
Discuss suspected cases urgently with the local infection specialist (microbiology, virology or infectious disease service).
EBOD and other VHFs are notifiable diseases. Suspected cases must be reported immediately by telephone to your local UKHSA health protection team if the IFS recommends testing to ensure prompt public health risk assessment.
Malaria, common bacterial and viral infections, and other imported infections remain more likely in most returning travellers and should be assessed and treated in parallel according to clinical need. Investigation into these should not be delayed. See ACDP VHF guidance for advice on how these can be investigated safely.
Background
The World Health Organization (WHO) designated the current outbreak of EBOD caused by Bundibugyo virus (BVBD) a Public Health Emergency of International Concern on 17 May 2026. For further information see Ebola and Marburg haemorrhagic fevers: outbreaks and case locations.
UKHSA currently assesses the risk to the UK public as low. Imported EBOD cases are extremely rare in the UK.
EBOD is transmitted through direct contact with blood, secretions or other body fluids of an infected person, or indirect contact with contaminated environments or materials. There is no evidence for natural airborne transmission.
EBOD presents with a wide range of symptoms, with an incubation period of between 2 to 21 days post-exposure (average 4 to 10 days). The onset of symptoms can be sudden and may initially include fever, malaise, myalgia, and headaches. Some patients may not have a fever when they present. Symptoms may progress to include rash, nausea, vomiting, diarrhoea, abdominal pain and subsequent multi-organ failure, neurological sequelae and death. Internal and/or external bleeding may occur late in the illness course of a minority of cases; this should not be used as the sole indicator for suspicion of EBOD.
In the UK, EBOD is considered a contact high consequence infectious disease (HCID).
Primary care, community and adult social care settings
If EBOD is considered in primary care or another non-acute setting, isolate the patient immediately in a room away from others, minimise contacts, seek urgent local infection specialist advice, and arrange specialist transfer if EBOD remains possible. Adult social care providers in England should also refer to the principles for managing suspected HCID cases in adult social care.