The Weekly Epidemiological Record (WER) was first issued in 1926 by the Health Office of the League of Nations. It was entrusted to the World Health Organization (WHO) when it was created in 1948 and has appeared every week since then.
It serves as an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the IHR and on other communicable diseases of public health importance, including emerging or re-emerging infections.
An electronic version of the WER is accessible every Friday and can be downloaded free of charge.
Inside this issue
Highlighted Signals and Events
During epidemiological week 35 (24 August to 30 August 2026), WHO Public Health Intelligence (PHI) teams conducted digital event-based surveillance (DEBS) to support the early detection and assessment of potential public health threats. During the reporting period, approximately 621 233 raw signals were scanned and triangulated through DEBS. From this large pool of signals, 35 signals and/or events met assessment thresholds and underwent further analysis and categorization. Of the 35 categorized signals, 31 represented unique signals. 23 signals and/or events were escalated for operational attention.
During the reporting week, WHO published one Rapid Risk Assessment and one Disease Outbreak News item. A summary of identified raw signals, assessed signals, and published outputs is presented in the tables below.
| Signals Screened1 | Signals Categorized2 | Unique Signals3 | Signals Escalated4 |
|---|---|---|---|
| 621 233 | 35 | 31 | 23 |
1 Signals screened: Total volume of raw signals reviewed from across multiple sources during the reporting period.
2 Signals categorized: Number of signals categorized for further detailed WHO assessment and actions during the reporting period.
3 Unique signals: Count of distinct signals after removing duplicate or repeated entries from different sources within the same epidemiological week.
4 Signals escalated: Subset of categorized signals that triggered escalation actions.
| Region | Hazard |
|---|---|
| Africa | Cholera Diphtheria Gastroenteritis of presumed infectious origin Landslide and other earth movements HIV infection-AIDS |
| Americas | Chikungunya virus disease Dengue Influenza due to identified avian or animal influenza virus Substandard or falsified medical product |
| Eastern Mediterranean | Gastroenteritis of presumed infectious origin |
| Europe | Cutaneous Anthrax Measles West Nile fever |
| South-East Asia | Flash floods |
| Western Pacific | Dengue Flash floods Mpox Zika virus disease |
5 The absence of listed signals indicates that no publicly available signals were identified during the reporting period and does not imply absence of signal activity overall.
6 Only new events registered during the defined period are included, accordingly changes to disease/condition that occur after the data cut off of 23:59 on 30 August 2026 will not be reflected in the description. The absence of events indicates that no publicly available newly reported events were identified during the reporting period and does not imply absence of event activity overall.
| Type | Information product |
|---|---|
| Rapid Risk Assessment | WHO Rapid Risk Assessment-Mpox, Global v.7 |
| Disease Outbreak News | Ebola disease caused by Bundibugyo virus - Democratic Republic of the Congo |
Global Respiratory Virus Activity: Weekly Update
The findings below are based on surveillance conducted through the WHO Global Influenza Surveillance and Response System (GISRS). More details can be found on the Global Influenza Programme’s surveillance and monitoring page.
Overview
In week 34 2026, and during the past few weeks, both influenza and SARS-CoV-2 positivity remained stable and low globally. Influenza positivity remained below 10% overall in the southern hemisphere temperate and subtropical areas, tropical areas and northern hemisphere temperate and subtropical areas. RSV positivity also remained low globally.
Influenza
Globally, influenza detections remained low in week 34 with influenza A and B viruses detected in similar proportions.
In the southern hemisphere, influenza percent positivity was elevated (>10%) in single countries in Tropical and Temperate South America and South-East Asia. Percent positivity was over 30% in one country in Oceania where a small increase in activity was observed. A small increase in activity was also observed in one country in Tropical South America.
In the northern hemisphere, influenza percent positivity was elevated (>10%) in some countries in Central America and the Caribbean, Tropical South America, Western Africa, Western, Southern, South-East and Eastern Asia and in single countries in Middle Africa, South West and Northern Europe.
Percent positivity was over 30% in a single country in Western Africa and two countries in Southern Asia. Increases in activity were observed in some countries in Western Africa and Southern Asia and in single countries in Northern Europe and South-East Asia.
In the zones with elevated positivity, influenza A(H3N2) was predominant in Western Africa, South West Europe, Eastern Asia and Oceania; influenza A(H1N1)pdm09 was predominant in Western, Southern and South-East Asia and influenza B was predominant in Tropical and Temperate South America. Influenza A and B were codominant in Central America and the Caribbean and influenza A(H1N1)pdm09 and influenza A(H3N2) were codominant in Middle Africa.
SARS-CoV-2
Globally, SARS-CoV-2 positivity remained stable and low across most reporting countries, with elevated positivity (>10%) reported in countries in Central America and the Caribbean and in single countries in Southern, South-East and Eastern Asia. Small increases in activity were observed in single countries in Central America and the Caribbean, South West and Northern Europe and Southern Asia.
Respiratory Syncytial Virus (RSV)
RSV positivity was elevated (>10%) in a few countries in Central America and the Caribbean and Temperate South America and in single countries in Eastern Africa and Southern Asia. Percent positivity was over 30% in a single country in Temperate South America. A small increase in activity was observed in a single country in Central America and the Caribbean. RSV and influenza activity were both elevated in single countries in Central America and the Caribbean, Temperate South America and Southern Asia.
Severity assessment
The severity assessments here are reported from countries, areas and territories. Assessments for transmissibility can be reported based on syndromic parameters and/or influenza-specific parameters. In the southern hemisphere temperate and subtropical areas, influenza-specific transmissibility was reported as low in a single country and extraordinary in a single country; transmissibility using syndromic data was reported as low in a single country.
In the northern hemisphere temperate and subtropical areas, influenza-specific transmissibility was reported as below seasonal threshold in ten countries and low in two countries; transmissibility using syndromic data was reported as below seasonal threshold in seven countries. Influenza-specific transmissibility was reported as low in a single country in the tropical areas.
Current update: Global Respiratory Virus Activity: Weekly Update N° 593
All past updates: Global respiratory virus updates
Multi-country outbreak of cholera
Data as of 26 July 2026
Global epidemiological update
In July 2026 (epidemiological weeks 27 to 30), a total of 57 652 new cholera and acute watery diarrhoea (AWD) cases were reported from 19 countries across four WHO regions, representing a 20% increase from the previous month and a 21% decrease compared with the same period last year (73 366 cases across 23 countries).
In July 2026, the African Region (35 630 cases; 13 countries) reported the highest number of cases, followed by the Eastern Mediterranean Region (22 002 cases; four countries), the Region of the Americas (19 cases; one country), and the South-East Asia Region (one case; one country). No cases were reported from the European Region or the Western Pacific Region.
During the same period, 471 cholera-related deaths were reported globally, representing a 38% increase compared with the previous month. The highest number of deaths was recorded in the African Region (405 deaths; eight countries), followed by the Eastern Mediterranean Region (66 deaths; two countries). No deaths were reported from the Region of the Americas, the South-East Asia Region, the European Region, or the Western Pacific Region.
From 1 January to 26 July 2026, a cumulative total of 221 365 cholera and AWD cases and 2153 deaths were reported from 28 countries across four WHO regions, representing a 44% decrease in cases and 56% decrease in deaths compared with the same period last year (396 098 cases and 4861 deaths; 32 countries). The region with the highest reported case count was the African Region (126 291 cases; 19 countries), followed by the Eastern Mediterranean Region (94 034 cases; five countries), the Region of the Americas (715 cases; one country), and the South-East Asia Region (325 cases; three countries). No cases were reported from the European Region or the Western Pacific Region. During the same period, cholera deaths were reported in the African Region (1929 deaths), the Eastern Mediterranean Region (222 deaths), and the Region of the Americas (two deaths). No deaths were reported in other regions.
The data presented here should be interpreted with caution. Potential underreporting and reporting delays may affect timeliness and accuracy, while variations in surveillance systems, standard case definitions, and laboratory capacities can limit direct comparability among countries. These factors also influence the global case fatality rate (CFR), requiring careful examination. Unless otherwise specified, the term ‘cholera cases’ includes both suspected and confirmed cases. Data in this report may be adjusted retrospectively as more information becomes available. For the latest data, please refer to the WHO Global Cholera and AWD Dashboard.
| WHO Region | Country, territory, area | 1 January to 26 July 2026 | Last 28 days | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Cases | Deaths | CFR (%) | Cases per 100 000 | Cases | Deaths | CFR (%) | Monthly cases % change | Monthly deaths % change | ||
| African Region | Angola | 5 586 | 118 | 2.1 | 15 | 260 | 2 | 0.8 | -45 | -90 |
| Burundi | 1 588 | 4 | 0.3 | 12 | 91 | 0 | 0.0 | -73 | - | |
| Cameroon | 925 | 27 | 2.9 | 3 | 808 | 21 | 2.6 | 591 | 250 | |
| Central African Republic | 716 | 45 | 6.3 | 14 | 330 | 14 | 4.2 | -9 | -55 | |
| Chad | 208 | 7 | 3.4 | 1 | 99 | 4 | 4.0 | -9 | 33 | |
| Congo | 881 | 49 | 5.6 | 14 | 114 | 0 | 0.0 | 16 | - | |
| Democratic Republic of the Congo | 36 514 | 1 090 | 3.0 | 31 | 4 365 | 185 | 4.2 | 22 | 106 | |
| Ethiopia | 50 | 2 | 4.0 | 0 | - | - | - | - | - | |
| Kenya | 40 | 0 | 0.0 | 0 | - | - | - | - | - | |
| Malawi | 3 213 | 30 | 0.9 | 18 | 3 | 0 | 0.0 | -98 | - | |
| Mozambique | 7 979 | 70 | 0.9 | 28 | 409 | 4 | 1.0 | 484 | - | |
| Namibia | 213 | 0 | 0.0 | 7 | - | - | - | - | - | |
| Nigeria | 54 306 | 348 | 0.6 | 25 | 26 960 | 167 | 0.6 | 33 | 72 | |
| Rwanda | 273 | 0 | 0.0 | 2 | 58 | 0 | 0.0 | 66 | - | |
| South Africa | 2 | 0 | 0.0 | 0 | 2 | 0 | 0.0 | - | - | |
| South Sudan | 12 649 | 118 | 0.9 | 102 | 2 131 | 8 | 0.4 | -21 | -53 | |
| United Republic of Tanzania | 113 | 2 | 1.8 | 0 | - | - | - | - | - | |
| Zambia | 999 | 17 | 1.7 | 5 | - | - | - | - | - | |
| Zimbabwe | 36 | 2 | 5.6 | 0 | - | - | - | - | - | |
| Eastern Mediterranean Region | Afghanistan† | 80 968 | 45 | 0.1 | 248 | 19 444 | 13 | 0.1 | 7 | -7 |
| Pakistan§ | 4 804 | 0 | 0.0 | 2 | 714 | 0 | 0.0 | 9 | - | |
| Somalia | 233 | 0 | 0.0 | 1 | - | - | - | - | - | |
| Sudan | 2 042 | 170 | 8.3 | 5 | 1 195 | 53 | 4.4 | 273 | -5 | |
| Yemen¥ | 5 987 | 7 | 0.1 | 18 | 649 | 0 | 0.0 | 24 | - | |
| Region of the Americas | Haiti | 715 | 2 | 0.3 | 6 | 19 | 0 | 0.0 | -24 | - |
| South-East Asia Region | Bangladesh | 17 | 0 | 0.0 | 2 | 1 | 0 | 0.0 | - | - |
| India# | 36 | 0 | 0.0 | 0 | - | - | - | - | - | |
| Myanmar† | 272 | 0 | 0.0 | 1 | - | - | - | - | - | |
* Case and death numbers presented are not directly comparable due to differences in case definitions, reporting systems, and general underreporting. All data are subject to verification and change due to data availability and accessibility. Respective figures and numbers will be updated as more information becomes available. The data in Table 1 include suspected, rapid diagnostic test (RDT) positive, and culture-confirmed cholera cases. As multiple countries report only total data on deaths, the reported CFR is calculated throughout based on the total number of deaths reported. The Global Task Force on Cholera Control (GTFCC) recommends that CFR be calculated using only facility deaths, with the number of community deaths reported separately.
** Missing data in this report do not imply the absence of cholera or AWD cases or deaths in the respective country. The data presented in this report are based on the latest available information and may not reflect the current situation.
† Afghanistan and Myanmar report AWD cases.
§ The reported number of suspected cholera and AWD cases is based on the available Public Health Bulletin published by the National Institute of Health of Pakistan.
¥ Includes all reported suspected cholera and AWD cases from Yemen.
# Among the total of 36 cases reported from India, 27 cases were confirmed.
WHO regional overviews
African Region
In July 2026, the African Region reported 35 630 new cholera cases across 13 countries, marking a 26% increase compared with the previous month. During this period, the highest numbers of cases were reported from Nigeria (26 960), the Democratic Republic of the Congo (4365), and South Sudan (2131). The increase in reported cholera cases is primarily driven by sustained high transmission in Borno State, Nigeria, where the outbreak is being exacerbated by ongoing conflict, population displacement, and inadequate water, sanitation, and hygiene (WASH) conditions.
Additionally, there were 405 cholera-related deaths, a 49% increase compared with the previous month. The highest numbers of deaths were reported from the Democratic Republic of the Congo (185), Nigeria (167), and Cameroon (21).
From 1 January to 26 July 2026, a total of 126 291 cholera cases were reported across 19 countries in the African Region. The highest numbers of cases were reported from Nigeria (54 306), the Democratic Republic of the Congo (36 514), and South Sudan (12 649). During the same period, a total of 1929 deaths were reported from 15 countries. The highest numbers of deaths were reported from the Democratic Republic of the Congo (1090), Nigeria (348), and South Sudan (118).
Eastern Mediterranean Region
In July 2026, the Eastern Mediterranean Region reported 22 002 new cholera and AWD cases across four countries, marking a 12% increase compared with the previous month. During this period, cases were reported from Afghanistan (19 444), Sudan (1195), Pakistan (714) and Yemen (649). Additionally, there were 66 cholera-related deaths reported from Sudan (53) and Afghanistan (13).
From 1 January to 26 July 2026, a total of 94 034 cholera and AWD cases were reported across five countries in the Eastern Mediterranean Region. The highest numbers of cases were reported from Afghanistan (80 968), Yemen (5987), and Pakistan (4804). During the same period, a total of 222 deaths were reported from three countries: Sudan (170), Afghanistan (45) and Yemen (7).
Region of the Americas
In July 2026, the Region of the Americas reported 19 new cholera cases in Haiti, marking a 24% decrease compared with the previous month. No deaths were reported during this period.
From 1 January to 26 July 2026, a total of 715 cholera cases and two deaths were reported in Haiti.
South-East Asia Region
In July 2026, the South-East Asia Region reported one new cholera or AWD cases in Bangladesh, marking a 99% decrease compared with the previous month. No deaths were reported during this period.
The decline in reported cholera cases should be interpreted with caution, as it likely reflects, at least in part, delays in case reporting and data consolidation rather than a confirmed reduction in transmission.
From 1 January to 26 July 2026, a total of 325 cholera or AWD cases were reported across 3 countries in the South-East Asia Region. Cases were reported from Myanmar (272), India (36), Bangladesh (17). No deaths were reported during this period.
* The epidemic curve of the Western Pacific Region is not included due to limited available weekly data. This does not imply the absence of cholera or AWD cases in the Region.
** Spikes in the Region of the Americas are likely due to batch reporting.
Focus on selected subregions and countries
Central African Republic
Between 1 January 2026 and 26 July 2026, the Central African Republic reported a total of 716 cases and 45 deaths (CFR: 6.3%).
In July 2026, the Central African Republic reported 330 new cholera cases and 14 associated deaths (CFR: 4.2%). This represents a 9% decrease in cases and a 55% decrease in deaths compared with the previous month.
The most affected villages are located along the Ubangi River, at the border with the Democratic Republic of the Congo. Cholera transmission is ongoing on both sides of the border, affecting communities in both countries.
The epidemic curve indicates a rapidly evolving cholera outbreak, with a sharp increase in reported cases from epidemiological week 24 and a peak in week 26. Cases subsequently declined progressively, suggesting a reduction in transmission. Continued surveillance is required to confirm this downward trend and detect any potential resurgence.
Democratic Republic of the Congo
Between 1 January and 26 July 2026, the Democratic Republic of the Congo reported a total of 36 514 cases and 1090 deaths (CFR: 3%).
In July 2026, the Democratic Republic of the Congo reported 4365 new cholera cases and 185 associated deaths (CFR: 4.2%). This represents a 22% increase in cases and a 106% increase in deaths compared with the previous month. Overall, 16 out of 26 provinces have been affected, with the highest proportions from Sud-Kivu (30%), Nord-Kivu (24%), and Sud-Ubangi (14%).
Cholera cases are increasing in Sud-Ubangi Province, which borders the Central African Republic along the Ubangi River, raising the risk of cross-border transmission to the Central African Republic and the Republic of Congo. Key drivers of transmission include the consumption of untreated water from the Ubangi River and inadequate water, sanitation, and hygiene (WASH) conditions.
Transmission remains high in the east, particularly in lakeside communities, where limited access to safe water, inadequate WASH conditions, and population movements continue to drive transmission. Response efforts are further hampered by insecurity and conflict, which restrict access to affected hotspot areas.
In addition, the provinces of Nord-Kivu, Sud-Kivu, Ituri, Tshopo, and Haut-Uele are affected by the ongoing Bundibugyo virus disease outbreak, further straining already limited resources and compounding challenges related to healthcare delivery, sanitation, population displacement, and insecurity.
Nigeria
Between 1 January and 26 July 2026, Nigeria reported a total of 54 306 cases and 348 deaths (CFR: 0.6%).
In July 2026, Nigeria reported 26 960 new cholera cases and 167 associated deaths (CFR: 0.6%). This represents a 33% increase in cases and a 72% increase in deaths compared with the previous month.
Borno State accounts for over 97% of the cases reported across the country in 2026, with Maiduguri, Monguno, and Jere Local Government Areas (LGAs) being the most affected areas. Challenges persist in hard-to-reach LGAs due to insecurity, access limitations and limited logistical support. In addition, limited access to safe water and inadequate chlorination capacity continue to increase the risk of cholera transmission.
South Sudan
Between 1 January and 26 July 2026, South Sudan reported a total of 12 649 cases and 118 deaths (CFR: 0.9%).
In July 2026, South Sudan reported 2131 new cholera cases and eight associated deaths (CFR: 0.4%). This represents a 21% decrease in cases and a 53% decrease in deaths compared with the previous month. During this period, cases were reported from Unity (94%), Upper Nile (4.5%), Jonglei (1%), and Central Equatoria (0.5%) states. Rubkona County in Unity State continues to drive the cholera caseload, reporting 1537 cases and seven deaths in July (CFR: 0.5%). The majority of new cases have been reported among internally displaced persons (IDPs).
Rubkona County hosts the largest IDP camps in the country and continues to experience sustained community transmission of cholera. Transmission is likely being driven by inadequate WASH conditions, possibly compounded by waning population immunity against cholera.
Annex 1. Data, table, and figure notes
Caution must be taken when interpreting all data presented. Differences are to be expected between information products published by WHO, national public health authorities, and other sources using different inclusion criteria and different data cut-off times. While steps are taken to ensure accuracy and reliability, all data are subject to continuous verification and change. Case definitions, laboratory testing strategies, reporting practices, and lag times differ across countries, territories, and areas. These factors, among others, influence the counts presented, with variable underestimation of the true case and death counts, and variable delays in reflecting these data at the global level.
‘Countries’ may refer to countries, territories, areas, or other jurisdictions of similar status. The designations employed, and the presentation of these materials do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Countries, territories, and areas are arranged under the administering WHO region. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted; the names of proprietary products are distinguished by initial capital letters.
Annex 2. Technical guidance and other resources
General
Global cholera strategic preparedness, readiness, and response plan 2023/24
WHO’s Call for urgent and collective action to fight cholera
Disease Outbreak News: Cholera – Multi-country with a focus on countries experiencing current surges
Training
GTFCC Laboratory training on Sample collection and testing with Rapid Diagnostic Tests for cholera for health care workers available in English, French, Arabic and Portuguese. - GTFCC Laboratory job aids and fact sheets available in English, French, Arabic and Portuguese.
GTFCC Cholera surveillance for health care workers. These courses are available in English and French.
GTFCC Cholera surveillance for health authorities. These courses are available in English and French.
Countries are encouraged to periodically self-assess their cholera surveillance systems using the GTFCC surveillance assessment method to identify priority activities for strengthening surveillance in line with GTFCC recommendations.
Technical guidance
Public health surveillance for cholera - Guidance document (2024), including tools and job aids. These recommendations are available in English, French, Arabic and Portuguese.
GTFCC updated recommendations for cholera reporting to the regional and global levels, accompanied by an Excel reporting template, are available in English, French, Arabic and Portuguese.