Disease outbreak
Experimental estimate · v0.3Acute Bundibugyo Ebola illness
Confirmed-case population. Source context
confirmed cases
Approximate, assumption-based USU for the included experience. Deaths are a separate measure.
Reading the result
A 14-day course at average intensity 5 gives about 35.6 USU per confirmed case, or about 240,000 USU for this snapshot. The case count is sourced; the duration and intensity are provisional assumptions. The separate death count captures an essential aspect of this outbreak that the USU estimate does not value.
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.
The calculation
35.6 USU per modeled course, before multiplying by the reported count. The calculation uses unrounded values; only the headline is rounded.
Intensity is assigned on a 0–10 scale and averaged over the whole elapsed course, including relief and sleep. Why divide by 47.25?
Small studies of Bundibugyo virus illness reported median courses of about 9-10 days in Uganda and 15-18 days in Isiro, DR Congo. We choose 14 days as one rounded representative course across fatal and surviving cases. It is not a pooled mean or an observed average for the 2026 outbreak. Incubation is excluded. [S14] [S15]
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]
At 7 days and intensity 3, the result is about 0.07 million USU. At 21 days and intensity 7, it is about 0.50 million USU.
These are alternative input scenarios, not confidence intervals or bounds on all uncertainty. Some cross-condition orderings change under these choices. The headline uses the single shared template above.
Coverage
A single representative acute illness course for each confirmed case, combining physical pain, gastrointestinal symptoms and other acute discomfort in one intensity. The assumed average course represents lived symptomatic time across fatal and surviving cases; it is not an individual timeline.
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. [S13]
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.
Omitted experiences are unestimated, not known to be zero. This is not a complete event total or a guaranteed lower bound.
Whole representative courses are assigned to the source-defined cases or cohort. Course time can extend beyond the reporting dates. Individual trajectories, fatal-case truncation and a causal baseline are not reconstructed; no suffering after death is assigned.
Deaths remain separate
WHO reported 3,267 deaths among the 6,757 confirmed cases attributed to DR Congo through 7 September 2026. The deaths are part of the confirmed-case population and are not added as extra cases or converted to USU. [S13]
USU estimates experienced suffering during lived time. The death count is shown alongside it and is not converted into USU.
Trace the estimate
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.
Small historical Bundibugyo-virus clinical series informs symptom and duration context. It does not validate a 2026 average or a numeric USU intensity.
Historical Bundibugyo-virus series informs duration and symptom context. Small samples, documentation limitations and different treatment settings limit transfer to 2026.
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.