Reporter from NTV Uganda, 'local transmission' I'm assuming linked to recent healthcare worker cases. Though the 500+ contacts is the first number I've seen regarding contact tracing efforts in Uganda:

Sure why not 🤦‍♂️

In the face of the fastest growing and likely among the worst Ebola outbreaks in history, this is really, really pathetic from the U.S.:

Suspected case of Ebola reported in Bengaluru, India in traveller returning from Kampala. This is precautionary like other suspected cases recently in Italy and the Netherlands, and good in that monitoring protocols are working:

Two more confirmed Ebola cases in Uganda among health workers in a private hospital in Kampala, guessing these were hospital-acquired infections: apnews.com/article/ugan...

Wrote this thread last night to help add context and explain how the U.S. Ebola response is failing right now:

State made another announcement Saturday on Ebola response, mostly bluster, but key points: • Deployed disaster assistance response team • $32M in bilateral assistance to partners (UN + IMC, FHI 360, Medair, Samaritan's Purse) • $50M for OCHA emergency response • $300M for OCHA global pooled fund

Uganda's MoH apparently unaware of US State Department funding Ebola treatment clinics in Uganda through @unocha.org (I'll also believe that when I see it, 'up to' is the operative term)

Estimating the current size of the 2026 DRC Bundibugyo virus outbreak: a joint Bayesian re-analysis of the McCabe et al. report w/ @kathsherratt.bsky.social Sam Brand and @sbfnk.bsky.social

IFRC announced three volunteers tragically were among the first deaths after contracting Ebola while on an unrelated humanitarian mission on March 27, prior to recognition of the outbreak:

I'm sure this will make the rounds, but when it does remember that this is why building and maintaining local trust is so vital. This is the hard, unsung work of int'l and local health NGOs. Similar outbursts happened at the height of COVID in US hospitals, this is a human problem:

Uganda's Ministry of Health confirms 3 additional cases of Ebola, presumably at least one currently in Kampala (health worker).

More Ebola updates: • 2 people quarantined in Kisoro, Uganda, symptoms consistent with Ebola, samples sent to Kasese for analysis • WHO reported an American w/ high risk contact transferred to Czechia • 1 person admitted to hospital in the Netherlands, 'low suspicion', in high level isolation unit

Anyone seen any follow up here? EFE is a reputable newswire service, and a suspected case across the border in South Sudan is a big deal:

Great piece here on role of US foreign assistance in outbreak prevention, w/ comments from @kgandersen.bsky.social: 'allowing anyone to die “needlessly of a disease that can be stopped is immoral, and we are living in a world where we don’t have to allow infectious diseases to spread unchecked."'

Suspected case of Ebola in South Sudan per EFE: "The case was announced yesterday by officials [in Yambio county, Western Equatoria state]... where local authorities indicated that a patient in the Nabiapai area tested positive for Ebola in preliminary tests."

A little out of date, but WHO published known geographic distribution of suspected Ebola cases and deaths in this May 18 SITREP. Still very early, likely doesn't capture true geographic extent. That one confirmed case in Goma is very troubling: iris.who.int/server/api/c...

This is why this outbreak really worries me. It's far further advanced before it being identified, which means way more cases yet to develop and transmission chains yet to be interrupted. For those who have closely followed previous Ebola outbreaks those are the exact ingredients for a big epidemic.

🆕🚨 WHO AFRO releases its 1st situation report on the ongoing #Ebola outbreak: 🔹 528 suspected cases, 132 deaths (CFR 25%) 🔹 35 confirmed cases, 5 deaths (CFR 14.3%) 🔹 2 of 12 suspected cases in Uganda confirmed 🔹 668 contacts, though tracing remains challenging iris.who.int/server/api/c...

1. #WHO updated today on the #Ebola #Bundibugyo outbreak in DRC: @drtedros.who.int was asked about Marco Rubio's claim that WHO was slow in identifying the outbreak. Tedros diplomatically suggested Rubio may not understand countries detect outbreaks. www.statnews.com/2026/05/20/w...

People really need to understand why this is happening. Even in the event the US shovels money at implementing partners now, you can't just flip a switch, most of these partners dramatically reduced or shuttered operations, no infrastructure, no staff, no local trust, these are the consequences.

Suspected cases and deaths rising quickly. It's a sort of backhanded credit to the incredible past work of state governments, WHO, Africa CDC, USAID, CDC, and groups like MSF, and Save the Children, that people in the US/Europe (wrongly) view Ebola as a non-threat beyond sub-Saharan Africa.

CDC confirms one American infected with Ebola: "The CDC did not name the individual, but the Serge Christian mission organization said one of its medical missionaries... was exposed while treating ​patients at Nyankunde Hospital in the DRC."

Implicating tests that don't detect BVD here, sample mishandling, and lack of escalation, it's possible-- but that's a lot of failures over quite a long time if it started between January and early March, I worry this might be slightly more transmissible

This is all complicated by lack of vaccine for BVD, so ring vaccination isn't possible. DRC, Uganda, Africa CDC, WHO, and local partners are going to have to work quickly to determine true extent of geographic spread.

A few more Ebola updates before WHO update at World Health Assembly today: • U.S. Embassy in Kampala has paused all visa operations • Les Volcans reporting an American doctor infected with Ebola, not yet corroborated by non-DRC media • Africa CDC via BBC: >390 cases and >100 deaths

The more I look at this BVD Ebola outbreak, the math isn't aligning with historical R0, median serial interval, and now 336 suspected cases. Really only a few good explanations: • Much higher R0 (6.9), or • Early superspreader(s), or • Index case infected 14 - 18 weeks ago

Burying the lede a little there, among the six were three high contact exposures, one is symptomatic. Fastest declared PHEIC of any Ebola outbreak, already doubled count of all previously reported Bundibugyo cases ever. US leadership cannot fuck around with this, they need to take it seriously

The past monumental efforts of countries like DRC, multilaterals like Africa CDC, WHO, and agencies like CDC and (formerly) USAID, are the reason we haven't yet experienced an Ebola pandemic. It's not a coincidence or intrinsic property of the virus that it just magically disappears each time.

Glad to see @drtedros.who.int & @who.int taking decisive action to declare the #Ebola outbreak in #DRC a #PHEIC. Per the IHR, the criteria are 1. Serious event 2. Risk of international spread 3. Requires a coordinated international response 4. The event is unusual www.who.int/news/item/17...

Highly encourage folks to listen to Dr. Topol's conversation with @donmilton.bsky.social and read that NYT piece. Spillover events will continue happening with increasing frequency, public health must adapt and adopt maximally cautious approaches to transmission to contain future outbreaks.

Africa's top public health body on Friday confirmed a new Ebola outbreak in Congo's remote Ituri province, with 246 suspected cases and 65 deaths recorded so far. https://to.pbs.org/43aMNu6

This and the other passenger who flew San Francisco to Tahiti (now quarantined on Pitcairn) are failures of whatever we're calling US state/local 'monitoring' protocols for MV Hondius passengers who had disembarked April 24.

A team at U of N Medical Center has developed an ANDV specific PCR test in limited quantities. CDC doesn't have a diagnostic PCR test for ANDV, with interim guidance instead recommending IgM/IgG antibody testing. Serology generally not good for early detection. www.wired.com/story/race-t...

Maryland DoH's statement regarding the two under monitoring, and I now think this is instead referring to KL592 where Case 2 had been onboard before deplaning:

Really really good editorial, excellent argument for being proactive versus reactive for this and future outbreaks:

I can't imagine how your average person navigates the raging dumpster fire hell site formerly known as Twitter, conspiracy aside I see even the more 'credible' anonymous outbreak accounts (followed by experts!) unsourced citing far-right rags

An Italian man onboard KL592 but not in 'close proximity', where Case 2 (WHO numbering) was onboard before being deplaned, who had been under monitoring by Italian authorities and self-quarantining, is being screened for Andes virus.

Two Maryland residents being monitored for potential exposure to ANDV-infected passenger of MV Hondius while onboard a flight. Based on Dr. Lyke's comments and re-reading available timelines I think this is one of the flights where Case 7 traveled back to Switzerland via South Africa and Qatar.

1 of the 14 Spanish citizens evacuated from MV Hondius has tested provisionally positive (via PCR) for ANDV, not currently experiencing symptoms and has been transferred to a High-Level Isolation and Treatment Unit: www.rtve.es/noticias/202...

Taken together, these findings support a scenario of initial zoonotic introduction followed by subsequent human‑to‑human transmission during the outbreak. virological.org/t/preliminar...

Something I haven't seen addressed, but are any health authorities aware of the whereabouts or status of every person on that KLM flight out of OR Tambo, and not just those within 2 rows? And have there been further contact tracing attempts for anyone present at the time in that terminal generally?

Excellent brief today from the WHO, particularly from Dr. Olivier le Polain, doesn't preclude the possibility of presymptomatic transmission, acknowledges imperfect understanding/limited prior study, emphasizes the importance of quarantine prior to symptom onset: www.youtube.com/live/G6Boffh...

Another study characterizing viral shedding and viremia in 131 ANDV cases, 2008 to 2022, found "ANDV is present in the blood of infected individuals for up to two weeks before the onset of symptoms and during symptomatic disease" pmc.ncbi.nlm.nih.gov/articles/PMC... ANDV-positive fluids as % pop:

1 of 5 French passengers flown back from the MV Hondius, now in isolation in Paris, tested positive after not feeling well Sunday night. The 4 other French passengers from the ship tested negative, but French health minister says will be re-tested. 22 hantavirus contact cases in France IDd so far.

A U.S. passenger of the MV Hondius has tested positive for Andes virus (hantavirus), while a second has mild symptoms. www.reuters.com/business/hea...

Also highlighting that the lead author of the 2018 NEJM ANDV study went on record with CBC on May 8, noting that "we saw that the window of infectiousness in that setting was essentially 48 hours before the onset of symptoms and 48 hours after the onset of symptoms" www.cbc.ca/listen/live-...

WHO has issued clarification around the definition of 'contact': An improvement, but 2m/15min seems rooted in droplet vs aerosol dichotomy, is >2m and/or <15min insufficient? Multiple days also seems to imply common exposure in a setting like a plane (if not in 'proximity') is somehow invalid

My criticism of the WHO's ANDV response, and calm-mongering generally, isn't out of some desire to incite panic, it's simply that every possible precaution should be taken to prevent onward transmission. This should be the ultimate goal of public health authorities.