Earlier DGHS data cited by the Center for Infectious Disease Research and Policy (CIDRAP) indicated 70,936 suspected cases and 585 deaths since mid-March, with 9,049 lab-confirmed infections and 90 confirmed fatalities. United Nations situation reports from May 5 noted 42,979 suspected cases, 5,729 lab-confirmed cases, and at least 263 suspected and 54 confirmed deaths, acknowledging that mortality is likely underreported due to diagnostic constraints and incomplete reporting, especially in remote areas.

According to the Directorate General of Health Services (DGHS), the outbreak began in mid-March 2026 and has since resulted in at least 652 child deaths, including 560 with measles-like symptoms and 92 laboratory-confirmed cases, as reported by Prothom Alo on May 12.

Health officials have identified children under five as the most affected group, with a particular concentration among those aged 6 to 59 months. Early outbreak data reported by Al Jazeera showed 6,476 suspected cases and 826 confirmed pediatric cases in that age range during the initial weeks, with 16 confirmed deaths. The outbreak has been concentrated in densely populated urban and peri-urban districts, with the government designating approximately 30 worst-affected areas for priority vaccination. DGHS figures shared with CIDRAP revealed that 56,886 patients required hospitalization, placing significant strain on pediatric and infectious disease services; of those hospitalized, 93%—or 52,841 patients—had been discharged as recovered. UN reports described the outbreak as intensifying pressure on the health system, particularly in facilities serving vulnerable and hard-to-reach populations.

In response, Bangladesh’s government launched a nationwide emergency mass vaccination campaign on April 5, 2026, targeting children aged 6 to 59 months. The campaign aimed to vaccinate between 18 and 20 million children, according to government statements and NPR reporting. UNICEF’s country representative, Rana Flowers, told Al Jazeera that the campaign had successfully reached 18 million children within roughly the first month, with ongoing efforts to identify and immunize those missed initially. NPR coverage confirmed that officials had met their initial vaccination target and were now focusing on locating unvaccinated children. CIDRAP reported that while the campaign intended to administer two doses of measles-containing vaccine for durable immunity, most children had received only the first dose to date, leaving a gap in full protection.

WHO and UNICEF have provided emergency support since early April, including vaccine supplies, cold-chain logistics, and technical guidance for the campaign’s rollout. WHO’s disease outbreak guidance for measles emphasizes rapid response teams, intensive surveillance in border areas, and maintaining at least 95% coverage with two doses of measles vaccine. It also recommends post-exposure prophylaxis for health workers and other high-risk groups and ensuring sufficient stocks of measles-rubella (MR) or measles-mumps-rubella (MMR) vaccines and injection supplies. UNICEF representatives confirmed that emergency measles-rubella vaccination was conducted in high-risk settings, such as camps for displaced populations.

Bangladesh’s health minister announced the cancellation of Eid holidays for medical staff treating measles patients and confirmed the ongoing nationwide vaccination drive to curb the outbreak. DGHS briefings reported by Prothom Alo detailed the increasing death toll and the government’s intensified response. UN situation reports emphasized that the official death figures likely underestimate the true mortality burden due to underreporting and diagnostic limitations.

Health authorities and international agencies have expressed concern about the risk of regional spread, given the high transmissibility of measles and the large number of suspected cases. WHO guidance stresses strengthening epidemiological surveillance in high-traffic border areas and among mobile populations to detect and contain cross-border transmission. UN reports describe the outbreak as a public health emergency with regional implications, noting that under-vaccinated communities and displacement in border districts increase the risk of exported cases. International media have highlighted the crisis’s potential to fuel renewed measles transmission in South Asia, calling attention to low global awareness. WHO recommends ensuring vaccination access for international travelers, transport workers, and displaced populations along travel and migration corridors.

Officials and experts attribute the outbreak to immunity gaps created by disruptions in routine immunization services, including those caused by the COVID-19 pandemic, and pockets of low measles vaccine coverage. Overcrowding, poverty, and malnutrition in some communities have also increased children’s vulnerability to severe disease and complications, contributing to the high death toll, according to UN and media analyses. WHO advises sustaining at least 95% two-dose measles vaccine coverage nationwide after the emergency phase, combined with strengthened case-based surveillance and rapid response teams, to prevent measles from becoming endemic again. Health officials and international partners emphasize that continued emergency vaccination, enhanced surveillance, and targeted outreach to hard-to-reach and border populations will be necessary to reduce mortality, close immunity gaps, and mitigate the risk of ongoing regional spread.

The World Health Organization continues to classify tuberculosis, including multidrug-resistant (MDR) and extensively drug-resistant (XDR) forms, as a global health crisis, but it has not issued a new global health emergency declaration specifically tied to drug-resistant tuberculosis (DR-TB) strains linked to U.S. travelers, officials confirmed. WHO’s ongoing response to DR-TB is framed through sustained strategies such as the End TB Strategy and targeted crisis management rather than a single-event emergency alert, according to WHO and Centers for Disease Control and Prevention (CDC) sources.

WHO’s most recent major action on DR-TB was the release of updated consolidated guidelines on April 15, 2025, which introduced new treatment recommendations for MDR and rifampin-resistant TB, including shorter, all-oral regimens designed to improve patient outcomes and reduce treatment duration.

Records from WHO and the CDC show no evidence of a Public Health Emergency of International Concern (PHEIC) or equivalent declaration related to a rapidly spreading DR-TB strain in U.S. travelers as of mid-2025. These guidelines recommend a six-month all-oral regimen known as BDLLfxC (bedaquiline, pretomanid, linezolid, levofloxacin, and clofazimine) for MDR/RR-TB cases and modified nine-month regimens when fluoroquinolone resistance is excluded, WHO officials said.

Historical records indicate that WHO has issued formal disease-outbreak communications concerning DR-TB in relation to air travel, such as a 2007 notice about an XDR-TB patient who traveled on commercial flights between the United States and Europe. That incident prompted passenger contact tracing but did not result in a PHEIC or global emergency declaration. WHO’s guidance on TB and air travel emphasizes that the risk of transmission during flights is relatively low and increases primarily on long-haul flights lasting eight hours or more, particularly for passengers seated close to an infectious individual, according to WHO and CDC documents.

CDC officials noted that most travelers are at low risk of acquiring TB through casual travel, with pre- and post-travel testing recommended mainly for those planning extended stays or work in high-transmission environments such as healthcare facilities, prisons, refugee camps, or homeless shelters. The agency also stated that individuals with active infectious TB, especially drug-resistant forms, should generally avoid commercial air travel until they are non-infectious to prevent potential transmission.

Epidemiological analyses show that while TB cases occur among non-immigrant visitors to the United States—one study documented 14,134 incident TB cases among visitors over multiple years—these cases are managed individually and have not been linked to a newly emergent DR-TB strain associated specifically with U.S. travelers. CDC and WHO sources emphasized that drug-resistant TB remains a significant global health challenge, with hundreds of thousands of MDR/RR-TB cases reported worldwide annually, but the presence of such cases in the U.S. does not constitute a new or rapidly spreading global strain.

Domestically, drug-resistant TB is relatively uncommon compared to the global burden. Highly publicized cases of drug-resistant TB in the United States, including the first documented case of a highly drug-resistant strain in a particular jurisdiction, are managed through case isolation, tailored treatment regimens, and public health follow-up rather than triggering international emergency mechanisms, according to CDC and local health department sources.

WHO’s current activities against DR-TB focus on supporting countries to scale up rapid molecular diagnostics, ensuring access to second-line medications, and strengthening infection prevention and control measures. These efforts reflect a sustained crisis response rather than the activation of a new emergency framework. The agency’s technical and programmatic work, including the 2025 guideline updates, aims to improve treatment outcomes and reduce the burden of DR-TB globally.

Past incidents involving MDR or XDR TB patients traveling internationally by air have led to international collaboration between WHO, CDC, and national health authorities for passenger notification and risk communication. However, these events have been managed as isolated incidents without escalation to a global health emergency. WHO and CDC records do not indicate any recent emergency committee meetings or press releases declaring a new global health emergency related to DR-TB strains detected in U.S. travelers.

Tuberculosis, including drug-resistant forms, continues to be a major public health priority worldwide, requiring ongoing surveillance, diagnosis, and treatment scale-up. WHO and CDC officials stress that the global response to DR-TB involves long-term strategies and technical support rather than single-event emergency declarations. The agencies continue to monitor TB epidemiology closely and update guidelines as new evidence emerges.

The advisory groups also supported evaluating combination therapy using a monoclonal antibody plus remdesivir to determine whether dual-agent regimens improve patient outcomes. None of these treatments is currently licensed specifically for Bundibugyo Ebola, but they were selected based on promising preclinical or prior clinical data against Ebola viruses, according to WHO.

WHO expert groups recommended prioritizing three candidate therapeutics for clinical trials among confirmed Bundibugyo virus disease (BVD) cases: the monoclonal antibodies MBP134 and Maftivimab®, as well as the antiviral remdesivir, the agency said in a May 28 statement.

WHO officials emphasized that these candidate therapies must be administered exclusively within structured clinical trials that include standardized protocols, data collection, and ethical oversight, rather than as part of routine care. Access to these investigational treatments will be limited to patients with laboratory-confirmed BVD in affected areas of the Democratic Republic of the Congo (DRC) and Uganda, the two countries currently experiencing cases, WHO said.

On the vaccine front, WHO experts identified a single-dose recombinant vesicular stomatitis virus (rVSV) Bundibugyo vaccine developed by the International AIDS Vaccine Initiative (IAVI) as the most promising candidate for prevention. According to WHO, this vaccine is expected to require approximately seven to nine months before doses are ready for clinical efficacy trials. A second candidate vaccine, ChAdOx1 Bundibugyo, developed by Oxford University in collaboration with the Serum Institute of India, could be available for efficacy assessment in about two to three months, pending additional animal data to support further prioritization, WHO officials said.

WHO cautioned that the only currently licensed Ebola vaccine, Ervebo (rVSV-ZEBOV-GP), which targets the Zaire Ebola virus species, is not approved for Bundibugyo virus disease. Evidence for cross-protection against Bundibugyo is limited and inconclusive, so WHO advised restricting its use to carefully designed research settings during the current outbreak.

For post-exposure prophylaxis (PEP) among contacts of confirmed or probable BVD cases, WHO experts prioritized the oral antiviral obeldesivir for evaluation in clinical trials. Planned research involves administering obeldesivir tablets to identified contacts and monitoring whether the treatment prevents disease development. WHO noted, however, that effective PEP implementation depends on strong contact-tracing systems, which remain operationally challenging in some affected areas of the DRC.

WHO is working closely with the governments of the DRC and Uganda to facilitate and implement clinical research evaluating the prioritized treatments and vaccines during the ongoing Bundibugyo outbreak. The agency convened multiple expert and advisory groups focusing on epidemic-prone diseases, ethics, regulatory issues, and clinical management to review evidence and recommend a research strategy, according to WHO.

The current approach builds on lessons learned from previous Ebola vaccine trials. Notably, Uganda’s Ministry of Health and WHO launched the first-ever clinical efficacy trial for a Sudan-species Ebola vaccine on February 3, 2025, in Kampala. That trial used a ring-vaccination cluster-randomized design to evaluate a single-dose rVSV candidate vaccine among contacts and contacts-of-contacts of confirmed Sudan virus disease cases. Prior Phase 1 safety and immunogenicity data supported the trial design.

WHO’s Global Advisory Committee on Vaccine Safety has reported reassuring safety profiles for licensed Ebola vaccines, including Ervebo and the Ad26.ZEBOV/MVA-BN-Filo regimen, with more than 6,500 adults and 649 children vaccinated in various studies. The rate of grade 3 fever in children within seven days post-vaccination was less than 1.5%, according to WHO records. Earlier trials such as the “Ebola ça Suffit” study demonstrated high protection with rVSV-EBOV in West Africa, establishing ring vaccination and rapid deployment as effective outbreak strategies.

The rVSV Bundibugyo vaccine candidate is under development by IAVI, an international nonprofit organization with prior experience in rVSV-based Ebola vaccines. The ChAdOx1 Bundibugyo vaccine is being developed by Oxford University in collaboration with the Serum Institute of India, leveraging adenovirus-vector platforms similar to those used in other viral vaccines. Animal studies for the ChAdOx1 candidate are already underway, with WHO describing it as a promising candidate if animal data support further advancement.

WHO noted that the new Bundibugyo trials are planned amid an ongoing outbreak in the DRC, with cross-border spread to Uganda prompting an accelerated research response. While the licensed Ervebo vaccine is available for Zaire Ebola virus, no proven or licensed vaccine exists for Bundibugyo virus disease, underscoring the need for new, species-specific vaccine and therapeutic trials.

According to WHO briefings and external reports, doses of the ChAdOx1 Bundibugyo vaccine could be ready for clinical trials within two to three months, while the rVSV Bundibugyo candidate may take approximately seven to nine months to reach trial readiness. WHO and collaborating scientists have stressed that the effectiveness of these new products is not yet known, making formal clinical trials essential both to manage the current outbreak and to build an evidence base for future responses.