Organised by the ESCMID Emerging Infections Subcommittee and Amsterdam University Medical Center

Epi Alert

About Epi Alert

Summary: 01 September 2026

A major Bundibugyo virus outbreak in the Democratic Republic of the Congo has reached ~ 6000 cases, marked by widespread community transmission but infrequent haemorrhagic signs. In Australia, diphtheria cases have surged to 538, primarily affecting Indigenous communities through skin lesions. Measles cases in the United States have climbed to 2,777 across 47 jurisdictions, with the first associated deaths reported in Pennsylvania. In Asia, an H1N1 influenza outbreak in Delhi has caused 1,777 cases, while Japanese encephalitis in Nepal has resulted in 80 cases and 21 deaths, predominantly among older, unvaccinated individuals. In Europe, a malaria cluster among baggage handlers at Frankfurt Airport has expanded to six cases, including two deaths. Additionally, locally acquired chikungunya and dengue cases have been confirmed in France, and a fatal yellow fever case was reported in French Guiana.

Highlights

Ebola virus disease, D.R. Congo
WHO reports continued expansion of the outbreak, with 5815 confirmed cases and 2788 deaths: 5794 (2786 deaths) in DRC (CFR 48.1%), 20 (2 deaths) in Uganda, 1 in France. Ituri remains the epicentre (4802 cases); North Kivu is second (775) with the highest CFR (68%). Contact follow-up reached 82.3% (22,091/26,850). The 42-day countdown has been completed in Uganda. On 27 August, vaccination of health-care workers began in DRC; efficacy against Bundibugyo virus in humans is unknown, so a randomised trial is being launched alongside the wider use. Risk: very high in DRC, high in bordering states (notably Uganda, CAR, South Sudan), low regionally and globally. This is now the largest Ebola outbreak recorded in DRC across any species.

Measles, global updates
In the United States, 2777 confirmed cases across 47 jurisdictions have already surpassed the full 2025 total. The first measles deaths of 2026 occurred in Pennsylvania, amid active outbreaks in at least four states. Bulgaria reports 502 confirmed cases by early August, with ~20 new infections weekly. An investigation found 60% of children registered as vaccinated lacked antibodies, revealing falsified vaccination records. The practice is reportedly spreading to Sofia, driven by parents seeking daycare access amid declining national coverage. Peru reports over 1780 confirmed cases, with Puno most affected. A health emergency was declared in May 2026, and spread has since reached Arequipa and Cusco regions. South Africa reports 891 confirmed cases across all nine provinces amid nationwide immunization challenges.

Diphtheria, Australia and Nigeria
Australia reports 38 cases in 2026, primarily in the Northern Territory and Western Australia, a 17-fold increase from the 2022 peak of 31 cases. The outbreak predominantly affects indigenous communities and manifests largely as cutaneous disease (skin lesions), attributed to waning immunity and poor housing conditions. Cases peaked between late May and early June, with 26 additional cases reported in the last two weeks. In Nigeria, between 2022 and July 2026, 65,759 suspected diphtheria cases and 2229 deaths were reported. Recent August 2026 localized reports include 124 cases and 17 deaths in Niger State, alongside more than 50 suspected pediatric deaths in Kano. The ongoing outbreak coincides with low national vaccination coverage: only 62% of children have received the recommended three DTP doses.

Malaria, Germany
As of August 2026, a malaria cluster among baggage handlers at Frankfurt Airport has increased to six cases, including two deaths. The cluster was initially reported in July 2026 with four cases that were linked to an imported Anopheles mosquito.

West Nile virus, Europe
A person has died after contracting the virus in the Netherlands. It is the country's third locally acquired case in 2026. According to ECDC data as of 26 August 2026, 124 affected areas have been identified across 15 European countries this transmission season. In total, 877 locally acquired human cases have been reported: Italy (428), Greece (222, eight with location unknown), Spain (79), North Macedonia (49), Romania (45), France (28), Serbia (11), Croatia and the Netherlands (3 each), Austria, Cyprus and Germany (2 each), and Albania, Hungary and Kosovo (1 each).

Japanese encephalitis, Nepal
This year, 80 cases and 21 deaths have been reported across 25 districts, with Jhapa, Kailali, and Morang being the worst affected. Infections have predominantly impacted older, unvaccinated populations; 86% of confirmed cases and all deaths occurred in unvaccinated individuals. Furthermore, 64% of confirmed cases are in people over 15 years of age, and 81% of deaths occurred in those over 50.

Anthrax
Bulgaria
Europe
Anthrax
Bulgaria
Europe

Outbreak in a buffalo herd causes nine animal deaths; four probable human cases reported.

Source: BEACON - 27 Aug 2026
Cholera
The Democratic Republic of the Congo
Africa
Cholera
The Democratic Republic of the Congo
Africa

Multi-province outbreaks reach 39,483 cases, with elevated case fatality rates in non-endemic western zones.

Source: BEACON - 25 Aug 2026
Cyclosporiasis
United States
North America
Cyclosporiasis
United States
North America

Multistate outbreak linked to iceberg lettuce reaches 17,180 confirmed cases and two deaths.

Source: BEACON - 28 Aug 2026
Dengue
Ecuador
Central & South America
Dengue
Ecuador
Central & South America

28,652 confirmed cases and 35 deaths reported through mid-August amid high insecticide resistance.

Source: Outbreak News Today - 28 Aug 2026
Dengue
Kenya
Africa
Dengue
Kenya
Africa

1583 reported and 95 confirmed cases, with five suspected deaths, in Garissa and Wajir

Source: BEACON - 30 Aug 2026
Dengue
Marshall Islands
Oceania
Dengue
Marshall Islands
Oceania

Outbreak declared in Majuro Atoll prompting a public health response; viral serotype remains pending.

Source: BEACON - 25 Aug 2026
Dengue
Mexico
North America
Dengue
Mexico
North America

4,152 cases and seven deaths reported across 29 states as of August 17.

Source: H-Radar - 28 Aug 2026
Dengue
Vietnam
Asia
Dengue
Vietnam
Asia

More than 78,000 cases and 13 deaths recorded by mid-August, a 20% increase.

Source: H-Radar - 28 Aug 2026
Diphtheria
Australia
Oceania
Diphtheria
Australia
Oceania

538 cases reported in 2026, primarily affecting Indigenous communities via skin lesions.

Source: H-Radar - 25 Aug 2026
Diphtheria
Nigeria
Africa
Diphtheria
Nigeria
Africa

65,759 suspected cases and 2,229 deaths reported nationally since 2022 amid low vaccination coverage.

Source: BEACON - 27 Aug 2026
Ebola virus disease
The Democratic Republic of the Congo, Uganda, France
Africa
Ebola virus disease
The Democratic Republic of the Congo, Uganda, France
Africa

5863 cases reported amid widespread transmission, while Uganda declares its outbreak over.

Source: WHO - 29 Aug 2026
Influenza
India
Asia
Influenza
India
Asia

1,777 cases reported in Delhi this year, an almost eightfold increase compared to 2015.

Source: H-Radar - 24 Aug 2026
Influenza
Japan
Asia
Influenza
Japan
Asia

Early season onset reported in late August, marking the second-earliest start since 1999.

Source: BEACON - 30 Aug 2026
Japanese encephalitis
Nepal
Asia
Japanese encephalitis
Nepal
Asia

80 cases and 21 deaths reported across 25 districts, with all fatalities in unvaccinated individuals.

Source: H-Radar - 24 Aug 2026
Leishmaniasis
Tunisia
Africa
Leishmaniasis
Tunisia
Africa

Cluster of 28 imported cutaneous cases in Toulouse, France, among returning travelers.

Source: BEACON - 26 Aug 2026
Malaria
Germany
Europe
Malaria
Germany
Europe

Six cases and two deaths reported in a cluster among Frankfurt Airport baggage handlers.

Source: BEACON - 26 Aug 2026
Measles
Bulgaria
Europe
Measles
Bulgaria
Europe

502 confirmed cases reported by early August, linked to widespread falsification of vaccination records.

Source: H-Radar - 26 Aug 2026
Measles
Peru
Central & South America
Measles
Peru
Central & South America

Outbreak exceeds 1780 confirmed cases, with Puno recording the highest number of cases.

Source: BEACON - 25 Aug 2026
Measles
South Africa
Africa
Measles
South Africa
Africa

3,891 confirmed cases reported across all nine provinces amid suboptimal routine vaccination coverage

Source: BEACON - 28 Aug 2026
Measles
United States
North America
Measles
United States
North America

Confirmed cases reach 2,777 across 47 jurisdictions, with first 2026 deaths reported in Pennsylvania.

Source: BEACON - 24 Aug 2026
Poliomyelitis
Afghanistan, Malawi, Nigeria, Pakistan, Somalia, Togo
Asia
Poliomyelitis
Afghanistan, Malawi, Nigeria, Pakistan, Somalia, Togo
Asia

WHO IHR Emergency Committee reviewed epidemiological data on WPV1 and cVDPV from six countries.

Source: H-Radar - 29 Aug 2026
Primary amoebic meningoencephalitis (PAM)
United States
North America
Primary amoebic meningoencephalitis (PAM)
United States
North America

Child hospitalized following likely exposure in Lake Claiborne; teenager critically ill in North Carolina.

Source: BEACON - 29 Aug 2026
Rabies
Türkiye
Europe
Rabies
Türkiye
Europe

Laboratory-confirmed case in a three-year-old child following a cat scratch, alongside cattle cases.

Source: BEACON - 29 Aug 2026
West Nile virus disease
Netherlands
Europe
West Nile virus disease
Netherlands
Europe

One death and two hospitalizations reported across three provinces following local virus detection.

Source: RIVM - 26 Aug 2026
Yellow fever
French Guiana
Central & South America
Yellow fever
French Guiana
Central & South America

One confirmed fatal case reported in Cayenne, with possible infection in Oiapoque, Brazil.

Source: H-Radar - 25 Aug 2026

About

The ESCMID-AUMC Epi Alert, a strategic collaboration between the ESCMID Emerging Infections Subcommittee and the Center of Tropical Medicine and Travel Medicine of Amsterdam University Medical Center (AUMC) that integrates expertise and resources to advance emerging infectious diseases surveillance and intelligence sharing. This collaboration integrates ESCMID's extensive international network and emerging infections expertise with AUMC's proven surveillance capabilities, led by Dr. Abraham Goorhuis and the AUMC team and other collaborators form European Institutions. 

The Epi Alert aims to be a weekly publication. The briefings are curated by infectious disease specialists prioritising data from trusted sources (such as Beacon, H-Radar, Outbreaknews, WHO, ECDC, CDC) based on potential impact, geographic region and urgency/relevancy to clinical practice. It aims to provide concise summaries for busy healthcare professionals with direct links for further investigation and transparency. 

This integrated collaboration represents a significant milestone in ESCMID's commitment to emerging infections preparedness, strengthening our collective capacity to detect, analyse, and respond to infectious disease threats through international cooperation.

Disclaimer: The information in this epi-alert is a weekly summary of the information that is available on the internet, mainly the websites of Beacon, H-Radar, Outbreaknews, WHO, ECDC, CDC, and others. For this summary, we consider issues that are most relevant to the ESCMID members involved in clinical patient care. Therefore, this report is not comprehensive, but we strive to include all major global issues in this report on a weekly basis.