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The Lancet - Correspondence - Congolese hospital staff cohort admitted with infectious symptoms in the setting of the Bundibugyo virus outbreak, April

Pathfinder

Editor, Senior Moderator
​Correspondence

Online first August 03, 2026


Congolese hospital staff cohort admitted with infectious symptoms in the setting of the Bundibugyo virus outbreak, April and May 2026, Bunia, DR Congo

Patrick LaRochellea,b,c Send email to larochelle.patrick@gmail.com ∙ Melinda McKnighta,b,d ∙ Ufoymungo Ucama Patricka,b ∙ Musungufu Ambitapio Davina,b
Affiliations & Notes
Article Info
Linked Articles (1)

...
For over 3 weeks before the May 15 outbreak announcement CME-Bunia had been undergoing a wave of illnesses among hospital staff. Starting around April 20, three nurses in CME-Bunia's internal medicine service became ill. They were hospitalised in rooms adjacent to the paediatric service and cared for by paediatric nurses. Within a week, two paediatric nurses also became ill. By May 15, at least 15 staff members had been admitted to hospital. In total, between April 20 and May 28, 37 (24%) of 157 hospital staff, including 20 nurses, eight doctors, two pharmacists, one laboratory technician, one nurse anaesthetist, one midwife, one physical therapist, two administrative personnel, and one other staff member were admitted to hospital, generally with high fevers, myalgias, and headaches (figure and appendix pp 2–3).
...
In the aftermath of the May 15 announcement, the pressing question for CME-Bunia has been whether the outbreak among hospital staff and the intense pruritus that so many staff had was part of the Bundibugyo virus infection, or whether it could represent a co-occurring outbreak of another pathogen.... In total, 11 of 37 in our cohort eventually tested positive for Bundibugyo virus. 12 of 37 tested negative... Pruritus was reported by 83% of staff who tested negative and 73% of staff who tested positive to Bundibugyo virus (figure).

The other notable feature of this cohort is that only two staff members died.
...
Before May 15, Ebola seemed an improbable diagnosis given the high incidence of pruritus and the low mortality among our unwell staff. However, we now hypothesise that this intense pruritus might represent a previously unrecognised characteristic of this Bundibugyo virus variant.2 ...This raises the question of whether many of our negative tests might be false negatives, perhaps owing to delayed testing. ... If this hypothesis about false negative results is correct, our data suggests a case–fatality rate that is considerably lower than reported case–fatality ratios for this Bundibugyo virus outbreak (39%)4 and for outbreaks in 2007 (32·1%) and 2012 (36·1%).5
...

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00420-2/fulltext
 
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