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Pandemics and Biosecurity
24AUG

Guatemala's measles outbreak outgrew Mexico

3 min read
17:07UTC

Guatemala has 30,371 confirmed measles cases and 26 deaths, two and a half times Mexico's outbreak, and the region's framing never followed the numbers. DR Congo's Bundibugyo outbreak is now the largest ever reported in that country, and the science arriving to fight it reports out after it ends. WHO, FAO and WOAH warn that a new MERS lineage may be establishing in Nile Basin camels.

Key takeaway

Guatemala now carries the Americas' largest measles burden while DR Congo's Ebola response races a spreading outbreak.

This briefing mapped
Humanitarian
Regulatory

PAHO's 8 August table puts Guatemala at 30,371 confirmed measles cases, two and a half times Mexico's count and a fivefold rise in about a month.

Sources profile:This story draws on neutral-leaning sources

Through week 28 ending 18 July, the Pan American Health Organization counted 30,371 confirmed measles cases and 26 deaths in Guatemala.

The country now leads the Americas, but figures ending 18 July leave the outbreak's direction after that date harder to judge. 

WHO's 14 August bulletin puts DR Congo past the 3,317 cases of its 2018-2020 epidemic, a record set on a species no licensed vaccine was built for.

Sources profile:This story draws on neutral-leaning sources from Switzerland
Switzerland

By 12 August, the World Health Organization counted 4,665 Bundibugyo Ebola cases in DR Congo, passing the country's 3,317-case record from 2018-2020.

The national record combines expanding transmission with better detection across six provinces, increasing the burden on treatment and contact-tracing teams. 

WHO's Africa office says DR Congo's Ebola response has scaled from one laboratory to 19 and from ten beds to 1,300, and that transmission is still winning.

Sources profile:This story draws on neutral-leaning sources from Switzerland
Switzerland

By 24 August, the World Health Organization said DR Congo had 19 Ebola laboratories, more than 1,300 beds and over 5,200 cases.

Transmission still outruns expanded capacity because access barriers, late care and deaths in the community keep patients beyond the response's reach. 

DR Congo has been sent 70,000 doses of a vaccine licensed against a different Ebola species, and a fifth of them go into a trial arm rather than into arms that need protecting.

Sources profile:This story draws on neutral-leaning sources from Belgium
Belgium

On 20 August, the International Coordinating Group released 70,000 Ervebo doses to DR Congo, including 20,000 for a Bundibugyo Phase 3 trial.

The split turns an unproven cross-species vaccine into both an emergency tool for exposed workers and a source of human effectiveness evidence. 

A bioRxiv preprint posted on 10 August gives Bundibugyo virus its first primate natural-history model, four months into the outbreak it will be used to fight.

Sources profile:This story draws on neutral-leaning sources

In a 10 August preprint, researchers reported 67% lethality after exposing 21 cynomolgus macaques to Bundibugyo virus under controlled study conditions.

The animal model gives vaccine and drug developers a defined disease course for testing countermeasures; it does not predict human survival. 

Sources:bioRxiv

CEPI awarded US$4.17 million on 20 August to four teams reading stored blood, to find out whether Zaire-species Ebola vaccines raise antibodies that recognise Bundibugyo.

Sources profile:This story draws on neutral-leaning sources

On 20 August, the Coalition for Epidemic Preparedness Innovations awarded US$4.17 million to four studies of Zaire-vaccine responses against Bundibugyo.

Stored samples can produce antibody evidence within months, but recognition in a laboratory cannot establish whether the vaccines protect people from disease. 

A volunteer in Truro, Nova Scotia received mRNA-1469 on 3 August, the first person ever given a vaccine designed for the Bundibugyo species.

Sources profile:This story draws on neutral-leaning sources

On 3 August in Truro, Nova Scotia, a volunteer received Moderna's mRNA-1469, the first human dose of a Bundibugyo-matched vaccine candidate.

The 80-person Phase 1 trial can test safety and immune response, but a later field study must measure protection during transmission. 

A joint WHO, FAO and WOAH assessment puts the Arabian MERS lineage in African camel herds, and says in the same document that its sequences cannot prove it.

Sources profile:This story draws on neutral-leaning sources

On 7 August, three global agencies reported Middle East Respiratory Syndrome (MERS) clade B fragments in Nile Basin camel populations.

Human spillover could carry high consequences if the lineage establishes, but incomplete sequences make whole-genome confirmation the next decision point. 

Africa CDC's 9 August table gives Somalia 730 confirmed measles cases and 42 deaths, a lethality nothing like the Americas outbreaks.

Sources profile:This story draws on neutral-leaning sources

WHO's week-31 record gives Afghanistan 18,232 of the 19,729 cholera and watery-diarrhoea cases reported across four Eastern Mediterranean countries in June.

Sources profile:This story draws on neutral-leaning sources

During June, Afghanistan recorded 18,232 of the Eastern Mediterranean region's 19,729 new cholera and acute watery diarrhoea cases, with 14 deaths.

The concentration puts regional rehydration and surveillance demand in one country, while mixed suspected and confirmed reporting limits comparisons of severity. 

CSIRO deposited the complete sequence of Australia's H5N1 detection in GISAID on 14 August, handing every laboratory on the flyway a strain to test its assays against.

Sources profile:This story draws on neutral-leaning sources from Switzerland
Switzerland

On 14 August, Australia's national science agency released the country's first complete H5N1 genome from migratory birds in Western Australia.

The sequence gives laboratories a local test reference as the World Organisation for Animal Health counted 1,528,120 birds dead or culled worldwide in July. 

UKHSA's 207 Salmonella Enteritidis cases are one organism spread over twelve months, and the people who caught it were almost all eating out.

Sources profile:This story draws on neutral-leaning sources

By 13 August, the UK Health Security Agency had linked 207 Salmonella Enteritidis cases in one five-marker genomic cluster.

Food eaten outside the home connects most interviewed patients, pushing investigators towards caterers and wholesalers while the exact source remains under investigation. 

Closing comments

WHO's 14 August bulletin recorded 4,665 confirmed Bundibugyo Ebola cases, a 46.8% case-fatality ratio, across 54 health zones in six DR Congo provinces, including Ituri. Its Africa office reported more than 5,200 cases on 24 August. This is an active human-to-human regional containment race, with geographic expansion and community deaths carrying greater escalation weight than the rise from one laboratory to 19.

Different Perspectives
Pan American Health Organization
Pan American Health Organization
PAHO rated regional measles risk very high after recording 47,459 confirmed cases and 44 deaths through week 28. It names vaccination coverage, accumulated susceptibles and mass gatherings with broad international participation as general risk factors.
People in Guatemala
People in Guatemala
Guatemala's population now carries the region's largest reported measles burden, with 30,371 confirmed cases and 26 deaths. The scale shifts practical attention from the Mexico-centred frame that followed the World Cup's travel consequences.
WHO Regional Office for Africa
WHO Regional Office for Africa
WHO's Africa office said transmission in DR Congo is outpacing control efforts after laboratory capacity reached 19 sites and treatment capacity exceeded 1,300 beds. The assessment puts access, insecurity, community deaths and late care-seeking ahead of a simple equipment shortage.
GLEWS+
GLEWS+
GLEWS+ assessed spillover risk from clade B MERS in Nile Basin camels as high if the clade establishes, while rating evidence for spread in camel populations low confidence. The joint assessment makes whole-genome sequencing the next test of the threat.
UK Health Security Agency
UK Health Security Agency
UKHSA said egg consumption remains the strongest signal in its 207-case Salmonella Enteritidis investigation. The genomic cluster and 38% hospitalisation among people with available information make exposure identification a public-health priority.