GeoSentinel report: Increase in dengue cases reported in Bangui, Central African Republic

Acknowledgement
BEACON thanks the GeoSentinel network for sharing case information and for providing information for this report. GeoSentinel is a cooperative agreement U01CK000632-01-00 between the US Centers for Disease Control and Prevention (US CDC) and the International Society of Travel Medicine (ISTM).

Key findings

• Several signals in recent months suggest sustained dengue transmission in the Central African Republic (CAR). These include a hospitalized, travel-associated case detected in Brescia, Italy through the GeoSentinel network; nine imported cases with a history of travel to CAR recorded by French surveillance between 01 May and 11 Oct 2026; a ministerial statement on 20 Oct 2026 reporting an increase in dengue cases in Bangui; and a fatal, confirmed case of dengue virus serotype 1 (DENV-1) infection in Bimbo, as detailed below.
• GeoSentinel reported a case of a 50-year-old Italian tourist who traveled in CAR from 01 Sep to 02 Oct 2026 and developed fever, sweating, vomiting, and abdominal pain. On return to Brescia, Italy, on 16 Oct 2026, the tourist was diagnosed with dengue with warning signs (NS-1 antigen- and IgM-positive) and required hospitalization.
• French national arbovirus surveillance (in French) recorded nine imported dengue cases among individuals who stayed in CAR between 01 May and 11 Oct 2026.
• CAR’s Ministry of Health (in French) publicly confirmed on 20 Oct 2026 a rise in dengue cases in Bangui, identified through hemorrhagic fever surveillance activities triggered by proximity to the DRC Ebola outbreak, and called for reinforced environmental sanitation and the continuation of Operation Kwa ti Kodro (”work for the country” in Sango).
• Local news outlet Oubangui Médias (in French) reports that a 29-year-old merchant who regularly traveled between Zongo (DRC) and Bimbo/Bangui/Ouango (CAR) developed fever and hemorrhagic symptoms starting on 14 Sep 2026. He was seen at Bimbo District Hospital on 23 Sep 2026 and admitted to Maman Élisabeth Domitien University Hospital Center (CHUMED) in Bimbo on 27 Sep 2026. He tested negative for Ebola and positive for DENV-1 at the Pasteur Institute in Bangui on 28 Sep 2026, and subsequently died.

Epidemiological analysis and public health impact

• Travel-associated detections over several months, together with the reported increase in Bangui, support an assessment of ongoing dengue transmission in CAR and raise concern about increased transmission in the capital and surrounding areas.
• Hemorrhagic fever investigations triggered by the Bundibugyo virus disease outbreak in neighboring DRC may be identifying dengue infections that would otherwise have remained undiagnosed. The reported increase in cases in Bangui could therefore reflect a genuine rise in infections, improved ascertainment, or a combination of both.
• When confirmation requires referral to the Institut Pasteur in Bangui, specimen transport and laboratory turnaround may delay detection. Limited access to testing, overlapping febrile presentations, and mild or asymptomatic infections likely contribute to under-ascertainment.
• The clinical overlap between dengue and viral hemorrhagic fevers, such as Ebola, explains why robust laboratory differentiation remains essential wherever Ebola circulates regionally.
• According to CAR’s Ministry of Health, reaching remote populations with public health messaging on vector control remains a challenge, prompting the Minister’s call for broader community radio broadcasts of interactive programs, alongside continued environmental sanitation under Operation Kwa ti Kodro.

Comparative analysis and future outlook

• Over the past 11 years, GeoSentinel has documented four probable and two confirmed dengue cases linked to CAR—one in 2015, one in 2023, and four in 2024.
• CAR reported a dengue outbreak in 2024/25 with 107 confirmed cases and no deaths between 13 Jul 2024 and 09 Feb 2025 across five districts, including Bangui and Bimbo. DENV-1 and DENV-2 were confirmed at the Institut Pasteur Bangui Laboratory. The reported identification of DENV-1 in the recent fatal case is consistent with a serotype identified during 2024/25, but testing of additional samples is needed to determine which serotypes are currently circulating.
• An expanding dengue outbreak in neighboring Chad, as reported by BEACON, heightens concern about regional dengue activity and reinforces the value of cross-border surveillance and information sharing.
• The near-term outlook remains uncertain because recent case counts, testing volumes, and geographic coverage are incomplete.