{
  "version": "0.4",
  "date": "8 October 2026",
  "reference": 47.25,
  "hoursPerDay": 24,
  "profiles": [
    {
      "id": "DEN",
      "name": "Dengue: acute symptoms",
      "days": 5,
      "intensity": 3,
      "durationBasis": "WHO describes acute symptoms lasting 2-7 days. Five days is a rounded representative choice inside that interval, not a measured mean for any listed outbreak. Later fatigue is excluded. [S2]",
      "intensityBasis": "Fever, headache, body/joint aches and nausea support a meaningful acute symptom burden. Assigned intensity 3 is a working average across the whole day, including relief and sleep. It is lower than a severe-pain peak. WHO does not establish the value 3 or its ratio to the reference. [S2]",
      "excludes": "Later fatigue, prolonged recovery, separate severe-case templates, caregiver distress, unreported infections and post-death loss.",
      "lowDays": 3,
      "lowIntensity": 2,
      "highDays": 7,
      "highIntensity": 4
    },
    {
      "id": "DIS",
      "name": "Flood displacement: initial distress",
      "days": 30,
      "intensity": 2,
      "durationBasis": "We assign the same 30-day initial course to each person in the selected flood-displaced cohort. Reports of continuing displacement and difficult living conditions support a multiweek scenario. None measures a 30-day cohort mean. This is a consistency choice, not evidence of equal recovery time or a month actually spent in a shelter. [S6, S10, S11, S12]",
      "intensityBasis": "WHO describes anxiety, sadness, sleep problems and other distress after emergencies. Assigned intensity 2 represents a modest whole-day average across the selected cohort, including relief and people with little distress. This provisional mapping to the pain reference is especially weak; WHO supplies no numeric conversion. [S7]",
      "excludes": "Injury and disease episodes, suffering before death, bereavement, later mental-health effects, distress outside the selected cohort and post-death loss.",
      "lowDays": 14,
      "lowIntensity": 1,
      "highDays": 60,
      "highIntensity": 3
    },
    {
      "id": "CHIK",
      "name": "Chikungunya: acute symptoms",
      "days": 8,
      "intensity": 4,
      "durationBasis": "CDC describes acute symptoms typically resolving within 7-10 days. Eight days is a rounded representative choice inside that interval, not the observed mean for this outbreak. Persistent joint symptoms are excluded. [S4]",
      "intensityBasis": "CDC describes potentially severe, debilitating joint symptoms; Paraguay's adult suspected-case definition included incapacitating joint pain or arthritis. These support testing a higher average than dengue. Assigned intensity 4, and the 4:3 ratio, remain model judgments rather than measured equivalence. [S3, S4]",
      "excludes": "Persistent/recurrent joint pain, rare complications as separate profiles, caregiver distress, unreported infections and post-death loss.",
      "lowDays": 7,
      "lowIntensity": 3,
      "highDays": 10,
      "highIntensity": 5
    },
    {
      "id": "EBO",
      "name": "Bundibugyo Ebola: other reported cases",
      "days": 14,
      "intensity": 5,
      "durationBasis": "The original all-case assumption of 14 days is retained for cases not reported dead at the cutoff. Historical series reported courses around 9-10 days in Uganda and 15-18 days in Isiro. Fourteen days is a rounded choice, not a pooled mean, a survivor-specific estimate or an observed 2026 average. Unresolved cases remain in this group; no future deaths are imputed. [S14, S15]",
      "intensityBasis": "The studies describe headache, muscle and abdominal pain, gastrointestinal symptoms and marked weakness. We assign intensity 5 as a provisional combined whole-day average, allowing for treatment, relief and sleep. Neither study measured USU intensity. Choosing 5 rather than the dengue value 3 or chikungunya value 4 is a model judgment, not a demonstrated clinical ratio. [S14, S15]",
      "excludes": "Incubation without symptoms, persistent post-Ebola symptoms, caregiver distress, bereavement, unconfirmed or unreported illness, and post-death loss. Individual severity and time to death or recovery are not reconstructed.",
      "lowDays": 7,
      "lowIntensity": 3,
      "highDays": 21,
      "highIntensity": 7
    },
    {
      "id": "EBO-F",
      "name": "Bundibugyo Ebola: fatal illness",
      "days": 12,
      "intensity": 6,
      "durationBasis": "We select 12 days between the historical median onset-to-death durations of 9 days in Uganda and 15 days in Isiro. It represents the complete symptomatic course ending at death, not an extra terminal period. It is not a pooled mean or an observed 2026 average; the studies were small and treatment settings differed. [S14, S15]",
      "intensityBasis": "We assign intensity 6 as a combined time-average of pain and other acute distress over the whole fatal course, including relief, sleep and intervals without experience. This is a provisional judgment above the existing value 5, not a measured USU mapping. Concurrent symptoms are represented together and are not added again. No intensity is assigned after death or to known absence of experience. [S14, S15]",
      "excludes": "Incubation without symptoms, caregiver distress, bereavement, death itself, lost life years and suffering after death. Individual trajectories and conscious time are not measured.",
      "lowDays": 9,
      "lowIntensity": 6,
      "highDays": 15,
      "highIntensity": 6
    }
  ],
  "events": [
    {
      "id": "E01",
      "name": "Brazil dengue outbreak",
      "short": "Brazil dengue",
      "period": "2024, epidemiological weeks 1-23",
      "count": 7866769,
      "unit": "reported cases",
      "profile": "DEN",
      "source": "S1",
      "scope": "Acute symptom courses assigned to reported cases",
      "countBasis": "PAHO/WHO, 18 June 2024, p. 6: 7,866,769 reported cases through EW 23. The regional surveillance series includes suspected cases; this is not a laboratory-confirmed-only count. No correction for missed or misclassified cases is applied.",
      "deaths": "3,643 reported fatal cases in the same source; separate from USU.",
      "cardNote": "One acute template across reported cases; later fatigue and distinct severe courses are unestimated.",
      "slug": "brazil-dengue-2024",
      "location": "Brazil",
      "category": "Disease outbreak",
      "periodShort": "2024 · weeks 1–23",
      "dateKey": 20240608,
      "scopeShort": "Acute dengue symptoms",
      "deathCount": 3643,
      "deathNote": "Same reporting period",
      "countShort": "7.87 million",
      "unitShort": "reported cases",
      "included": "A single acute symptom course for every reported case, combining fever, aches, headache and nausea.",
      "takeaway": "The model assigns about 7.6 USU to each reported case. Applied to 7.87 million reported cases, this produces a large aggregate estimate even though the assumed acute course lasts only five days.",
      "related": "/reports/dengue-in-the-americas/",
      "relatedTitle": "Dengue in the Americas: understanding the reported measures",
      "components": [
        {
          "id": "included-course",
          "label": "Acute dengue symptoms",
          "count": 7866769,
          "profile": "DEN",
          "days": 5,
          "intensity": 3,
          "usuPerCourse": 7.619047619047619,
          "estimatedUSU": 59937287.61904762
        }
      ],
      "aggregation": "One representative course per source-defined case or person.",
      "estimatedUSU": 59937287.61904762,
      "usuPerCourse": 7.6190476190476195,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions."
    },
    {
      "id": "E02",
      "name": "Rio Grande do Sul floods",
      "short": "Rio Grande do Sul floods",
      "period": "2024, displaced cohort reported 24 May",
      "count": 580000,
      "unit": "people displaced (approx.)",
      "profile": "DIS",
      "source": "S5",
      "scope": "Initial distress assigned to a reported displaced cohort",
      "countBasis": "UNHCR spokesperson, UN Geneva briefing, 24 May 2024: approximately 580,000 displaced people. The estimate uses the specific spoken figure rather than the rounded 600,000 headline. This is a dated population estimate, not new displacement episodes, an average daily population, or a final event total. People in shelters are a subset of this displaced cohort and are not added again.",
      "deaths": "163 deaths were cited in the 24 May briefing about floods and landslides. The source does not establish how many involved drowning or whether any selected suffering overlaps with the displacement allowance.",
      "cardNote": "30 days is an assumed course for the selected cohort, not measured person-time or the full flood burden.",
      "slug": "rio-grande-do-sul-floods-2024",
      "location": "Rio Grande do Sul, Brazil",
      "category": "Natural disaster",
      "periodShort": "24 May 2024 · cohort snapshot",
      "dateKey": 20240524,
      "scopeShort": "Initial displacement distress",
      "deathCount": 163,
      "deathNote": "Whole flood event, as of 24 May",
      "countShort": "About 580,000",
      "unitShort": "displaced people",
      "included": "One initial distress course for each person in the reported displaced cohort, combining anxiety, sadness and disrupted daily life.",
      "takeaway": "The model assigns about 30.5 USU per displaced person over an assumed 30-day course. Duration drives much of the estimate: a modest average intensity can accumulate over several weeks. This is a scenario for the named cohort; the source did not track each person for 30 days.",
      "related": "/reports/displacement-is-not-one-number/",
      "relatedTitle": "Displacement is not one number: understanding stocks and movements",
      "illustrativeFatalScenario": {
        "status": "Illustrative only; excluded from event estimatedUSU",
        "mechanism": "Conscious drowning experience",
        "minutes": 3,
        "intensity": 8,
        "eligibleCount": null,
        "actualAdditionalUSU": null,
        "revisedEventUSU": null,
        "hypotheticalCount": 163,
        "noOverlapAssumedForIllustration": true,
        "source": "S16",
        "countSource": "S5",
        "durationBasis": "Author-selected rounded three-minute window informed by surface struggle and time to unconsciousness; not a measured average for these deaths.",
        "intensityBasis": "Author-selected combined intensity 8 for air hunger, fear and pain; not an empirically established USU mapping.",
        "excluded": "Other fatal mechanisms, anticipation or entrapment before the selected window, injury outside it, later conscious suffering after resuscitation, and bereavement.",
        "hypotheticalUSUPerCourse": 0.008465608465608466,
        "hypotheticalAdditionalUSU": 1.37989417989418
      },
      "components": [
        {
          "id": "included-course",
          "label": "Initial displacement distress",
          "count": 580000,
          "profile": "DIS",
          "days": 30,
          "intensity": 2,
          "usuPerCourse": 30.476190476190474,
          "estimatedUSU": 17676190.476190474
        }
      ],
      "aggregation": "One representative course per source-defined case or person.",
      "estimatedUSU": 17676190.476190474,
      "usuPerCourse": 30.47619047619047,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions."
    },
    {
      "id": "E03",
      "name": "Paraguay chikungunya outbreak",
      "short": "Paraguay chikungunya",
      "period": "1 October 2022 - 11 March 2023",
      "count": 81037,
      "unit": "suspected, probable or confirmed cases",
      "profile": "CHIK",
      "source": "S3",
      "scope": "Acute symptom courses assigned to reported cases",
      "countBasis": "Torales et al., CDC MMWR, 9 June 2023: 81,037 suspected, probable or confirmed cases during 1 October 2022-11 March 2023. Discarded negative-tested cases are excluded by the source. This is an interim outbreak count, not the final 2023 total.",
      "deaths": "52 attributable deaths among 47,116 probable/confirmed cases, a narrower subset than the modeled case count; separate from USU.",
      "cardNote": "Acute symptoms only. Persistent joint pain, which can last months or years, is unestimated.",
      "slug": "paraguay-chikungunya-2022-2023",
      "location": "Paraguay",
      "category": "Disease outbreak",
      "periodShort": "1 Oct 2022 – 11 Mar 2023",
      "dateKey": 20230311,
      "scopeShort": "Acute chikungunya symptoms",
      "deathCount": 52,
      "deathNote": "Probable / confirmed subset",
      "countShort": "81,037",
      "unitShort": "reported cases",
      "included": "A single acute symptom course for each suspected, probable or confirmed case, with incapacitating joint symptoms represented within one combined intensity.",
      "takeaway": "The model assigns about 16.3 USU per reported case using eight days at intensity 4. Persistent joint pain is outside this estimate, so the report measures the acute course only.",
      "related": "/usu-research/",
      "relatedTitle": "Explore the USU research background",
      "components": [
        {
          "id": "included-course",
          "label": "Acute chikungunya symptoms",
          "count": 81037,
          "profile": "CHIK",
          "days": 8,
          "intensity": 4,
          "usuPerCourse": 16.253968253968253,
          "estimatedUSU": 1317172.8253968253
        }
      ],
      "aggregation": "One representative course per source-defined case or person.",
      "estimatedUSU": 1317172.8253968253,
      "usuPerCourse": 16.253968253968253,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions."
    },
    {
      "id": "E04",
      "name": "Peru dengue outbreak",
      "short": "Peru dengue",
      "period": "2024, epidemiological weeks 1-23",
      "count": 249843,
      "unit": "reported cases",
      "profile": "DEN",
      "source": "S1",
      "scope": "Acute symptom courses assigned to reported cases",
      "countBasis": "PAHO/WHO, 18 June 2024, p. 4: 249,843 reported cases through EW 23. The Andean series is described as suspected cases. No correction for missed or misclassified cases is applied.",
      "deaths": "207 fatal cases on p. 4, consistent with its reported case-fatality rate; the p. 1 summary instead says 203. This source inconsistency is retained here and does not enter USU.",
      "cardNote": "Uses exactly the same duration and intensity assumptions as Brazil dengue.",
      "slug": "peru-dengue-2024",
      "location": "Peru",
      "category": "Disease outbreak",
      "periodShort": "2024 · weeks 1–23",
      "dateKey": 20240608,
      "scopeShort": "Acute dengue symptoms",
      "deathCount": 207,
      "deathNote": "Source discrepancy: summary says 203",
      "countShort": "249,843",
      "unitShort": "reported cases",
      "included": "A single acute symptom course for every reported case, combining fever, aches, headache and nausea.",
      "takeaway": "The model assigns about 7.6 USU to each reported case. Peru and Brazil use exactly the same dengue assumptions, so the difference between these two estimates comes entirely from their reported case counts.",
      "related": "/reports/dengue-in-the-americas/",
      "relatedTitle": "Dengue in the Americas: understanding the reported measures",
      "components": [
        {
          "id": "included-course",
          "label": "Acute dengue symptoms",
          "count": 249843,
          "profile": "DEN",
          "days": 5,
          "intensity": 3,
          "usuPerCourse": 7.619047619047619,
          "estimatedUSU": 1903565.714285714
        }
      ],
      "aggregation": "One representative course per source-defined case or person.",
      "estimatedUSU": 1903565.714285714,
      "usuPerCourse": 7.619047619047619,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions."
    },
    {
      "id": "E05",
      "name": "Bangladesh dengue outbreak",
      "short": "Bangladesh dengue",
      "period": "1 January – 7 August 2023",
      "count": 69483,
      "unit": "laboratory-confirmed cases",
      "profile": "DEN",
      "source": "S9",
      "scope": "Acute symptom courses assigned to reported cases",
      "countBasis": "WHO reported 69,483 laboratory-confirmed cases from 1 January to 7 August 2023. The surveillance system is hospital-based. This is an interim snapshot, not a full-year count or an estimate of all infections.",
      "deaths": "WHO reported 327 related deaths for the same period; separate from USU.",
      "cardNote": "Uses the shared dengue course. Laboratory-confirmed, hospital-based surveillance has a different coverage from the Americas series.",
      "slug": "bangladesh-dengue-2023",
      "location": "Bangladesh",
      "category": "Disease outbreak",
      "periodShort": "1 Jan – 7 Aug 2023",
      "dateKey": 20230807,
      "scopeShort": "Acute dengue symptoms",
      "deathCount": 327,
      "deathNote": "Same reporting period",
      "countShort": "69,483",
      "unitShort": "lab-confirmed cases",
      "included": "A single acute symptom course for every reported case, combining fever, aches, headache and nausea.",
      "takeaway": "The same five-day, intensity-3 dengue course gives about 7.6 USU per reported case. This entry covers laboratory-confirmed cases from hospital-based surveillance; the estimate cannot be read as the full outbreak burden.",
      "related": "/events/methodology/#templates",
      "relatedTitle": "The shared dengue assumptions",
      "components": [
        {
          "id": "included-course",
          "label": "Acute dengue symptoms",
          "count": 69483,
          "profile": "DEN",
          "days": 5,
          "intensity": 3,
          "usuPerCourse": 7.619047619047619,
          "estimatedUSU": 529394.2857142857
        }
      ],
      "aggregation": "One representative course per source-defined case or person.",
      "estimatedUSU": 529394.2857142857,
      "usuPerCourse": 7.619047619047619,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions."
    },
    {
      "id": "E06",
      "name": "Pakistan floods",
      "short": "Pakistan floods",
      "period": "2022 floods, displaced population reported 7 October",
      "count": 7900000,
      "unit": "people displaced (approx.)",
      "profile": "DIS",
      "source": "S10",
      "scope": "Initial distress assigned to a reported displaced cohort",
      "countBasis": "UNHCR’s 7 October 2022 briefing reported approximately 7.9 million people displaced. We assign one initial course to that source-defined population. It is not measured person-time or a count of new daily movements. The nearly 600,000 people in relief sites are a subset and are not added again.",
      "deaths": "At least 1,700 deaths were cited in the 7 October briefing for the flood event as a whole. This is a reported threshold, not an exact final death count; it is separate from USU.",
      "cardNote": "30 days is an assumed course for the selected cohort, not measured person-time or the full flood burden.",
      "slug": "pakistan-floods-2022",
      "location": "Pakistan",
      "category": "Natural disaster",
      "periodShort": "7 Oct 2022 · population snapshot",
      "dateKey": 20221007,
      "scopeShort": "Initial displacement distress",
      "deathCount": 1700,
      "deathNote": "Whole flood event, as reported 7 Oct",
      "countShort": "About 7.9 million",
      "unitShort": "displaced people",
      "included": "One initial distress course for each person in the reported displaced cohort, combining anxiety, sadness and disrupted daily life.",
      "takeaway": "Applying the same initial displacement course used for Rio Grande do Sul gives about 30.5 USU per person. The large population drives the result. Injury, disease and lasting psychological effects remain outside this estimate; 30 days is assumed, not observed follow-up.",
      "related": "/reports/displacement-is-not-one-number/",
      "relatedTitle": "Displacement is not one number: understanding stocks and movements",
      "deathDisplay": "At least 1,700",
      "components": [
        {
          "id": "included-course",
          "label": "Initial displacement distress",
          "count": 7900000,
          "profile": "DIS",
          "days": 30,
          "intensity": 2,
          "usuPerCourse": 30.476190476190474,
          "estimatedUSU": 240761904.76190475
        }
      ],
      "aggregation": "One representative course per source-defined case or person.",
      "estimatedUSU": 240761904.76190475,
      "usuPerCourse": 30.476190476190474,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions."
    },
    {
      "id": "E07",
      "name": "Mexico dengue outbreak",
      "short": "Mexico dengue",
      "period": "2024, epidemiological weeks 1-23",
      "count": 83997,
      "unit": "reported cases",
      "profile": "DEN",
      "source": "S1",
      "scope": "Acute symptom courses assigned to reported cases",
      "countBasis": "PAHO/WHO, 18 June 2024, pp. 2–3: 83,997 reported cases through EW 23. The regional surveillance series includes suspected cases; it is not laboratory-confirmed only. No correction for missed or misclassified cases is applied.",
      "deaths": "PAHO reported 26 fatal cases through EW 23 on p. 3; separate from USU.",
      "cardNote": "One acute template across reported cases; later fatigue and distinct severe courses are unestimated.",
      "slug": "mexico-dengue-2024",
      "location": "Mexico",
      "category": "Disease outbreak",
      "periodShort": "2024 · weeks 1–23",
      "dateKey": 20240608,
      "scopeShort": "Acute dengue symptoms",
      "deathCount": 26,
      "deathNote": "Same reporting period",
      "countShort": "83,997",
      "unitShort": "reported cases",
      "included": "A single acute symptom course for every reported case, combining fever, aches, headache and nausea.",
      "takeaway": "The same five-day, intensity-3 dengue course gives about 7.6 USU per reported case. Mexico, Peru and Brazil share both the source update and condition template; their differences here are driven by reported counts, not country-specific intensity judgments.",
      "related": "/reports/dengue-in-the-americas/",
      "relatedTitle": "Dengue in the Americas: understanding the reported measures",
      "components": [
        {
          "id": "included-course",
          "label": "Acute dengue symptoms",
          "count": 83997,
          "profile": "DEN",
          "days": 5,
          "intensity": 3,
          "usuPerCourse": 7.619047619047619,
          "estimatedUSU": 639977.1428571428
        }
      ],
      "aggregation": "One representative course per source-defined case or person.",
      "estimatedUSU": 639977.1428571428,
      "usuPerCourse": 7.619047619047619,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions."
    },
    {
      "id": "E08",
      "name": "Rasuwa floods, Nepal",
      "short": "Nepal floods",
      "period": "26 August 2026 floods; displacement-site population in the 4-9 September situation report",
      "count": 3629,
      "unit": "people in 37 displacement sites",
      "profile": "DIS",
      "source": "S11",
      "scope": "Initial distress assigned to the reported displacement-site cohort",
      "countBasis": "UNFPA Nepal reported 3,629 people in 37 displacement sites in its 4-9 September 2026 situation report. We use that fixed site population, not the much broader affected population, all people ever displaced, or a cumulative count of movements. The source does not measure person-days; a standard course is assigned to the selected cohort. Later changes in site occupancy do not revise this dated snapshot.",
      "deaths": "The same report gives 1,367 confirmed deaths across the broader flood event. These are not deaths among the selected 3,629 site residents. Missing people are not added to the death count; mortality is separate from USU.",
      "cardNote": "Only people in the reported displacement sites are modeled. It is not an estimate for everyone affected by the floods.",
      "slug": "nepal-rasuwa-floods-2026",
      "location": "Rasuwa flood response, Nepal",
      "category": "Natural disaster",
      "periodShort": "4–9 Sep 2026 · site snapshot",
      "dateKey": 20260909,
      "scopeShort": "Distress in displacement sites",
      "deathCount": 1367,
      "deathNote": "Broader flood event, same report",
      "countShort": "3,629",
      "unitShort": "people in 37 sites",
      "included": "One initial distress course for each person in the reported displacement-site cohort, using the same duration and intensity as the other flood entries. People staying outside these sites are outside the calculation.",
      "takeaway": "The shared flood template gives about 30.5 USU per person, or about 111,000 USU for this site population. The scope is narrow: it covers distress assigned to the 3,629 people in the reported displacement sites, not the full human impact of the floods.",
      "coverageNote": "This estimate covers the reported site residents only. A smaller result than another flood entry can reflect narrower population coverage, not a less severe disaster.",
      "related": "/reports/displacement-is-not-one-number/",
      "relatedTitle": "Displacement is not one number: understanding stocks and movements",
      "heroScope": "Initial distress among people living in 37 reported displacement sites.",
      "components": [
        {
          "id": "included-course",
          "label": "Distress in displacement sites",
          "count": 3629,
          "profile": "DIS",
          "days": 30,
          "intensity": 2,
          "usuPerCourse": 30.476190476190474,
          "estimatedUSU": 110598.09523809524
        }
      ],
      "aggregation": "One representative course per source-defined case or person.",
      "estimatedUSU": 110598.09523809524,
      "usuPerCourse": 30.476190476190474,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions."
    },
    {
      "id": "E09",
      "name": "DR Congo: Bundibugyo Ebola outbreak",
      "short": "DR Congo Ebola",
      "period": "2026 outbreak, cumulative confirmed cases through 7 September",
      "count": 6757,
      "unit": "confirmed cases",
      "profile": "EBO",
      "source": "S13",
      "scope": "Acute illness courses partitioned into reported fatal cases and other reported cases",
      "countBasis": "WHO reported 6,757 confirmed cases in DR Congo through 7 September 2026, including two cases diagnosed there and subsequently treated in Germany. We retain WHO’s country attribution. Cases reported in Uganda and France, contacts under monitoring, and suspected or unreported cases are excluded. This is a cumulative outbreak snapshot, not the number currently ill. Some outcomes were still unresolved at the cutoff.",
      "deaths": "WHO reported 3,267 deaths among the 6,757 confirmed cases attributed to DR Congo through 7 September 2026. These deaths identify the cases assigned a fatal illness course. They are removed from the ordinary group and are not added as extra cases. The mortality count remains visible as a separate measure.",
      "cardNote": "Reported fatal cases receive a complete fatal course in place of the ordinary allowance. Other cases include unresolved outcomes.",
      "slug": "dr-congo-ebola-2026",
      "location": "Democratic Republic of the Congo",
      "category": "Disease outbreak",
      "periodShort": "Through 7 Sep 2026",
      "dateKey": 20260907,
      "scopeShort": "Acute illness, including fatal cases",
      "deathCount": 3267,
      "deathNote": "Confirmed-case population",
      "countShort": "6,757",
      "unitShort": "confirmed cases",
      "included": "One complete acute illness course per confirmed case, combining pain, gastrointestinal symptoms and other acute distress. The 3,267 cases reported dead receive a 12-day, intensity-6 fatal course; the other 3,490 cases retain the 14-day, intensity-5 assumption. These are disjoint groups, not extra cases. Other reported cases include unresolved outcomes and are not all known survivors.",
      "takeaway": "About 243,568 USU is assigned to the 6,757 confirmed cases in this snapshot. The estimate combines ordinary illness allowances for 3,490 other reported cases with complete fatal illness courses for 3,267 reported deaths. This models suffering before death. It does not assign a value to death itself or to lost life years.",
      "coverageNote": "This template draws on small studies of earlier Bundibugyo-virus outbreaks. It does not use patient-level duration or pain measurements from the 2026 outbreak. Persistent symptoms after the acute illness are unestimated.",
      "related": "/events/methodology/#before-death",
      "relatedTitle": "How suffering before death is included",
      "components": [
        {
          "id": "other-cases",
          "label": "Other reported cases",
          "count": 3490,
          "profile": "EBO",
          "days": 14,
          "intensity": 5,
          "usuPerCourse": 35.55555555555556,
          "estimatedUSU": 124088.88888888889
        },
        {
          "id": "fatal-cases",
          "label": "Reported fatal cases",
          "count": 3267,
          "profile": "EBO-F",
          "days": 12,
          "intensity": 6,
          "usuPerCourse": 36.57142857142857,
          "estimatedUSU": 119478.85714285713
        }
      ],
      "aggregation": "Sum of mutually exclusive case groups. Reported fatal cases are removed from the ordinary group; each confirmed case receives exactly one course.",
      "fatalSensitivity": [
        {
          "label": "Shorter fatal course",
          "days": 9,
          "intensity": 6,
          "estimatedUSU": 213698.03174603175
        },
        {
          "label": "Central assumption",
          "days": 12,
          "intensity": 6,
          "estimatedUSU": 243567.74603174604
        },
        {
          "label": "Longer fatal course",
          "days": 15,
          "intensity": 6,
          "estimatedUSU": 273437.4603174603
        },
        {
          "label": "Lower fatal intensity",
          "days": 12,
          "intensity": 5,
          "estimatedUSU": 223654.6031746032
        },
        {
          "label": "Higher fatal intensity",
          "days": 12,
          "intensity": 7,
          "estimatedUSU": 263480.8888888889
        }
      ],
      "estimatedUSU": 243567.74603174604,
      "usuPerCourse": 36.04672873046412,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions.",
      "previousEstimatedUSU": 240248.88888888888,
      "changeUSU": 3318.8571428571595,
      "changePercent": 1.3814245544303332
    },
    {
      "id": "E10",
      "name": "Mozambique floods",
      "short": "Mozambique floods",
      "period": "January 2026 floods; accommodation-centre population as of 29 January",
      "count": 100730,
      "unit": "people in 112 temporary accommodation centres (reported as over 100,730)",
      "profile": "DIS",
      "source": "S12",
      "scope": "Initial distress assigned to the reported accommodation-centre cohort",
      "countBasis": "UNICEF Flash Update #2, published 2 February 2026, reports over 100,730 displaced people in 112 temporary accommodation centres as of 29 January. We use 100,730 as the arithmetic anchor because a more precise count is not supplied, and retain the qualifier in the displayed population. This excludes people displaced outside those centres. The broader affected population is not substituted or added. Occupancy is a dated population, not measured person-time.",
      "deaths": "The selected UNICEF Flash Update #2 does not provide a death count. This report therefore leaves mortality unavailable rather than treating it as zero or importing a count from a different period or event definition.",
      "cardNote": "Uses the same flood course, applied to an accommodation-centre population. The source’s over qualifier is preserved.",
      "slug": "mozambique-floods-2026",
      "location": "Mozambique",
      "category": "Natural disaster",
      "periodShort": "29 Jan 2026 · centre snapshot",
      "dateKey": 20260129,
      "scopeShort": "Distress in accommodation centres",
      "deathCount": null,
      "deathDisplay": "Not available",
      "deathNote": "Not given in selected report",
      "countShort": "Over 100,730",
      "unitShort": "people in 112 centres",
      "included": "One initial distress course for each person represented by the 100,730-person arithmetic anchor, using the same duration and intensity as the other flood entries. People outside the selected centres are not modeled.",
      "takeaway": "The shared flood template gives about 30.5 USU per person. Applied to an arithmetic anchor of 100,730 centre residents, the result is about 3.1 million USU. The source reports more than that many residents; neither the exact population nor its actual duration of distress is known from this report.",
      "coverageNote": "This estimate covers the selected accommodation-centre population only. It is not the full flood burden, and the source’s population threshold does not make the USU result a guaranteed lower bound.",
      "related": "/reports/displacement-is-not-one-number/",
      "relatedTitle": "Displacement is not one number: understanding stocks and movements",
      "heroScope": "Initial distress among people living in 112 temporary accommodation centres.",
      "components": [
        {
          "id": "included-course",
          "label": "Distress in accommodation centres",
          "count": 100730,
          "profile": "DIS",
          "days": 30,
          "intensity": 2,
          "usuPerCourse": 30.476190476190474,
          "estimatedUSU": 3069866.6666666665
        }
      ],
      "aggregation": "One representative course per source-defined case or person.",
      "estimatedUSU": 3069866.6666666665,
      "usuPerCourse": 30.476190476190474,
      "usuPerCourseMeaning": "Mean across the assigned courses; use components for group-specific assumptions."
    }
  ],
  "sources": [
    {
      "id": "S1",
      "title": "PAHO/WHO. Epidemiological Update: Increase in dengue cases in the Region of the Americas. 18 June 2024, pp. 2–4 and 6.",
      "url": "https://www.paho.org/sites/default/files/2024-06/2024-june-18-phe-epi-update-dengue-en2.pdf",
      "role": "Reported cases, deaths and coverage for Brazil, Peru and Mexico. These counts do not establish USU intensities."
    },
    {
      "id": "S2",
      "title": "WHO. Dengue. Fact sheet, 21 August 2025, Symptoms section.",
      "url": "https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue",
      "role": "Acute symptom descriptions and 2-7-day duration context; does not estimate an average USU intensity."
    },
    {
      "id": "S3",
      "title": "Torales M et al. Chikungunya Outbreak - Paraguay, 2022-2023. CDC MMWR 2023;72:636-638. 9 June 2023.",
      "url": "https://www.cdc.gov/mmwr/volumes/72/wr/mm7223a5.htm",
      "role": "81,037 reported cases, reporting dates and case definitions; mortality subset distinction."
    },
    {
      "id": "S4",
      "title": "CDC. Clinical Signs and Symptoms of Chikungunya Virus Disease. 15 May 2024.",
      "url": "https://www.cdc.gov/chikungunya/hcp/clinical-signs/index.html",
      "role": "Severe/debilitating joint symptoms and typical 7-10-day acute course; no USU conversion."
    },
    {
      "id": "S5",
      "title": "UN Geneva / UNHCR-WMO. Brazil floods briefing. 24 May 2024, UNHCR spokesperson soundbite.",
      "url": "https://www.unognewsroom.org/story/en/2183/brazil-floods-unhcr-wmo/6577",
      "role": "Approximately 580,000 displaced people and 163 deaths reported on 24 May 2024. Uses the specific spoken population rather than the rounded headline. Deaths cover floods and landslides; no mechanism-specific count or overlap information is supplied."
    },
    {
      "id": "S6",
      "title": "UNICEF. Brazil Humanitarian Situation Report No. 1, Rio Grande do Sul Floods. 26 June 2024, pp. 1-2 and 9.",
      "url": "https://www.unicef.org/documents/brazil-humanitarian-situation-report-rio-grande-do-sul-floods-26-june-2024",
      "role": "Continuing displacement and delayed returns support investigating a multiweek window, not a measured mean duration."
    },
    {
      "id": "S7",
      "title": "WHO. Mental health in emergencies. Fact sheet, 6 May 2025.",
      "url": "https://www.who.int/news-room/fact-sheets/detail/mental-health-in-emergencies",
      "role": "Qualitative basis for distress inclusion. Neither numeric intensity nor transfer from pain is established; conflict-specific disorder prevalence is not used."
    },
    {
      "id": "S8",
      "title": "WSI event list v0.4: USU reference convention (unchanged from v0.1).",
      "url": "/events/methodology/#reference",
      "role": "Stipulated six-hour kidney-stone reference: 47.25 modeled intensity-hours, with linear weighting. This convention defines the unit; it is not a measured equivalence between conditions."
    },
    {
      "id": "S9",
      "title": "WHO. Disease Outbreak News: Dengue: Bangladesh. 11 August 2023.",
      "url": "https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON481",
      "role": "69,483 laboratory-confirmed cases and 327 related deaths, 1 January–7 August 2023. Describes hospital-based surveillance."
    },
    {
      "id": "S10",
      "title": "UNHCR. Appeal for communities devastated by Pakistan floods. Briefing note, 7 October 2022.",
      "url": "https://www.unhcr.org/au/news/briefing-notes/unhcr-urgently-seeks-us-66-million-communities-devastated-pakistan-floods",
      "role": "Approximately 7.9 million people displaced and at least 1,700 deaths. Describes continuing disruption; no measured average duration or intensity."
    },
    {
      "id": "S11",
      "title": "UNFPA Nepal. Situation Report on Nepal Floods, 4-9 September 2026.",
      "url": "https://www.unfpa.org/resources/situation-report-nepal-floods-4-%E2%80%93-9-september-2026",
      "role": "3,629 people in 37 displacement sites and 1,367 deaths across the broader flood event. Site residents are a selected population, not all affected or displaced people."
    },
    {
      "id": "S12",
      "title": "UNICEF Mozambique. Flood Response, Flash Update #2. 2 February 2026, p. 1; population as of 29 January.",
      "url": "https://www.unicef.org/mozambique/en/media/9901/file/Floods_Flash-Update-2_02022026.pdf.pdf",
      "role": "Over 100,730 people in 112 temporary accommodation centres. We use 100,730 as the arithmetic anchor and preserve the qualifier. This report supplies no death count."
    },
    {
      "id": "S13",
      "title": "WHO. Ebola disease caused by Bundibugyo virus: Democratic Republic of the Congo. Disease Outbreak News, 10 September 2026.",
      "url": "https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON617",
      "role": "6,757 confirmed cases and 3,267 deaths in DR Congo through 7 September 2026. Country count includes two cases diagnosed there and subsequently treated in Germany; excludes Uganda and France."
    },
    {
      "id": "S14",
      "title": "Roddy P et al. Clinical manifestations and case management of Ebola haemorrhagic fever caused by a newly identified virus strain, Bundibugyo, Uganda, 2007-2008. PLOS ONE 2012;7:e52986.",
      "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0052986",
      "role": "Small historical clinical series: median onset-to-death duration 9 days in 11 fatal cases, range 3-20. Informs a representative fatal course; it does not establish a 2026 mean or USU intensity."
    },
    {
      "id": "S15",
      "title": "Kratz T et al. Ebola virus disease outbreak in Isiro, Democratic Republic of the Congo, 2012: signs and symptoms, management and outcomes. PLOS ONE 2015;10:e0129333.",
      "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129333",
      "role": "Small historical clinical series: median onset-to-death duration 15 days, range 4-28. Documentation and setting limitations restrict transfer to 2026; it does not calibrate USU intensity."
    },
    {
      "id": "S16",
      "title": "Tipton MJ, Montgomery H. The experience of drowning. Medico-Legal Journal 2022;90:17-26.",
      "url": "https://doi.org/10.1177/00258172211053127",
      "role": "Review with survivor accounts and video evidence about surface struggle and time to unconsciousness. Supports examining a short conscious-experience window, not a measured three-minute flood-death average or intensity 8."
    }
  ],
  "revisionDate": "2026-10-08",
  "siteVersion": "2.12.0",
  "mortalityPolicy": {
    "deathItselfUSU": null,
    "deathItselfTreatment": "Not assigned USU; reported deaths remain a separate measure.",
    "bereavement": "Excluded and unestimated.",
    "fatalIllnessRule": "Replace the ordinary allowance for the same case with one complete fatal illness course. Never add both.",
    "eligibilityRule": "A separate fatal experience requires a source-supported mechanism-specific count and no duplicated experience or person-time. Unknown eligibility remains null, not zero.",
    "coverage": "USU describes experienced suffering during lived time. No suffering is assigned after death or to known absence of experience. Full representative courses may extend beyond source cutoff dates. No future deaths are imputed."
  }
}