Clinical profile and genomic characterization of the 2026 Bundibugyo virus index case in Uganda

@article{nsawotebba2026clinical,
  title = {{Clinical profile and genomic characterization of the 2026 Bundibugyo virus index case in Uganda}},
  author = {Andrew Nsawotebba and Isaac Ssewanyana and Alisen Ayitewala and Misaki Wayengera and Stephen Kanyerezi and Jonathan Kabazzi and Valeria Nakintu and Aloysius Ssemaganda and Rodney Kisuule and Steven Ssekyondwa and Hellen Rosette Oundo and Ronald Kasujja and Amable Ayebare and Stephen Karabyo Balinandi and Godfrey Pimundu and Tonny Muyigi and Godrine Byekwaso and Ibrahim Mugerwa and Francis Kakooza and Susan Nambozo and Aidah Namakula and Judith Kyokushaba and Moses Lutaakome Joloba and Winters Muttamba and Mudarshiru Bbuye and Bruce Kirenga and Pontiano Kaleebu and Wilber Sabiiti and Rony R. Bahatungire and Caroline Achola and Sulaiman Ikoba and Allan Niyonzima Muruta and Bernard Lubwama and Atek Atwiine Kagirita and Henry Kyobe Bosa and Jane Ruth Aceng and Susan Ndidde Nabadda and Charles Olaro and Diana Atwine},
  journal = {Nature Medicine},
  year = {2026},
  month = jun,
  doi = {10.1038/s41591-026-04510-7},
  url = {https://doi.org/10.1038/s41591-026-04510-7},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - Clinical profile and genomic characterization of the 2026 Bundibugyo virus index case in Uganda
AU  - Andrew Nsawotebba
AU  - Isaac Ssewanyana
AU  - Alisen Ayitewala
AU  - Misaki Wayengera
AU  - Stephen Kanyerezi
AU  - Jonathan Kabazzi
AU  - Valeria Nakintu
AU  - Aloysius Ssemaganda
AU  - Rodney Kisuule
AU  - Steven Ssekyondwa
AU  - Hellen Rosette Oundo
AU  - Ronald Kasujja
AU  - Amable Ayebare
AU  - Stephen Karabyo Balinandi
AU  - Godfrey Pimundu
AU  - Tonny Muyigi
AU  - Godrine Byekwaso
AU  - Ibrahim Mugerwa
AU  - Francis Kakooza
AU  - Susan Nambozo
AU  - Aidah Namakula
AU  - Judith Kyokushaba
AU  - Moses Lutaakome Joloba
AU  - Winters Muttamba
AU  - Mudarshiru Bbuye
AU  - Bruce Kirenga
AU  - Pontiano Kaleebu
AU  - Wilber Sabiiti
AU  - Rony R. Bahatungire
AU  - Caroline Achola
AU  - Sulaiman Ikoba
AU  - Allan Niyonzima Muruta
AU  - Bernard Lubwama
AU  - Atek Atwiine Kagirita
AU  - Henry Kyobe Bosa
AU  - Jane Ruth Aceng
AU  - Susan Ndidde Nabadda
AU  - Charles Olaro
AU  - Diana Atwine
PY  - 2026
DA  - 2026/06/11
JO  - Nature Medicine
DO  - 10.1038/s41591-026-04510-7
UR  - https://doi.org/10.1038/s41591-026-04510-7
AB  - Bundibugyo virus disease remains a high-consequence threat in Eastern and Central Africa, where cross-border mobility, nonspecific early symptoms and delayed recognition can obscure transmission. In this case report, we describe Uganda's 2026 Bundibugyo virus disease index case: a male patient who traveled from the Democratic Republic of the Congo to Uganda and was admitted to a private hospital in Kampala on 11 May 2026 after more than 2 weeks of vomiting and diarrhea, with epigastric pain, weakness and hiccups. He deteriorated rapidly, developing acute kidney injury, pulmonary edema, hepatic dysfunction, hypoxemia, delirium, atrial flutter, possible disseminated intravascular coagulation and multiorgan failure, and died on 14 May. A posthumous EDTA whole-blood specimen tested at the Central Emergency Response and Surveillance Laboratory was positive for orthoebolavirus RNA and confirmed as Bundibugyo virus by quantitative PCR with reverse transcription. Sequencing achieved 99% genome coverage at ≥100× depth. The 2026 Bundibugyo virus genome formed a distinct lineage approximately equidistant from the 2007-2008 Butalya and 2012 Isiro variants, differing by 216-227 nucleotides (~1.2% sequence divergence). Here, we demonstrate the value of fatality surveillance, private-sector surveillance, diagnostic optimization through national specimen referral and rapid molecular-genomic diagnostics for early detection, transmission chain interruption and public health response coordination.
SN  - 1078-8956
SN  - 1546-170X
SN  - 1744-7933
ER  -