Health ministry data issued on Friday showed 3,532 confirmed cases and 1,556 deaths. The outbreak has expanded rapidly across five eastern provinces since it was formally declared on May 15, placing immense pressure on an already fragile health system affected by armed conflict, displacement and chronic funding shortages.
Only the 2013-2016 West Africa epidemic was larger. That emergency produced more than 28,600 cases and about 11,300 deaths, mainly in Guinea, Liberia and Sierra Leone. Congo’s previous largest outbreak, centred in North Kivu and Ituri between 2018 and 2020, recorded 3,481 cases and 2,299 deaths.
The current epidemic is caused by Bundibugyo virus, one of the species within the Ebola virus family. It is the largest known outbreak involving that strain and has spread faster than any previous Ebola emergency during its early months. The fatality rate is about 44 per cent, although the proportion could change as more infections are detected and patients complete treatment.
Unlike the Zaire species involved in the West Africa epidemic and Congo’s 2018-2020 outbreak, Bundibugyo virus has no licensed vaccine or specifically approved treatment. Existing Ebola vaccines and antibody therapies were designed principally for Zaire ebolavirus and cannot automatically be assumed to protect against the strain now circulating.
Early supportive care, including intravenous fluids, oxygen, treatment of secondary infections and management of organ complications, can improve survival. Several experimental medicines are being tested, including antiviral drugs and antibody-based therapies. Initial clinical trials have begun at a treatment centre in Bunia, the capital of Ituri province and one of the main centres of transmission.
Vaccine developers are also accelerating work on candidates directed at Bundibugyo virus. Pharmaceutical and global health organisations are preparing trial doses using technologies adapted from earlier Ebola vaccine programmes. Tens of thousands of experimental doses could be produced for studies, but widespread deployment would depend on evidence of safety and effectiveness.
Genetic analysis indicates that the outbreak may have begun in January or earlier, months before authorities identified the first recognised cluster. The delay allowed the virus to move through communities with limited surveillance and inadequate access to diagnostic laboratories.
The first case known to health authorities involved a healthcare worker who developed fever, bleeding, vomiting and severe weakness in April before dying at a medical centre in Bunia. Laboratory testing subsequently confirmed Bundibugyo virus, prompting the declaration of Congo’s 17th documented Ebola outbreak.
The epidemic was initially concentrated in Bunia, Mongwalu and Rwampara health zones but later reached additional areas through population movement, commercial activity and displacement. Mining centres and transport routes have created multiple opportunities for infected people or contacts to travel before developing symptoms.
Ebola does not spread through the air in the way influenza or measles does. Transmission occurs mainly through direct contact with blood and other bodily fluids from an infected person, contaminated materials or the body of someone who has died from the disease. Patients are generally not considered infectious before symptoms appear.
Containing the outbreak requires rapid diagnosis, isolation, contact tracing, safe burials and sustained community cooperation. Those measures have been weakened by violence, attacks on health facilities and difficulties reaching areas controlled by armed groups. Thousands of displaced families are living in crowded settlements where health services, clean water and reliable communications remain limited.
Health workers have also staged protests over unpaid wages, disrupting services at hospitals and Ebola treatment centres. Response teams face shortages of protective equipment, vehicles, laboratory supplies and trained personnel, while international funding remains far below estimated requirements.
Public health officials have warned that the real number of infections may be several times higher than the confirmed total. Many sick people die at home or in places where samples cannot be collected, while some families avoid treatment centres because of mistrust, fear of isolation or misinformation about the disease.
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