The Democratic Republic of the Congo (DRC) is battling the fastest-spreading Ebola epidemic ever recorded, according to UN Secretary-General Antonio Guterres. While the outbreak initially affected three health zones, it has since expanded to 63 health zones as of September 18, including areas in Haut-Uélé that border South Sudan.
Unprecedented Spread of Bundibugyo Ebola Virus
The scale of the crisis has grown rapidly. On May 15, the official count stood at eight cases and four deaths. By September 18, the national total reached 7,614 confirmed cases and 3,676 deaths, representing a case fatality rate of 48%. This represents nearly six times as many cases and five times as many deaths over the same time frame as the 2014 West Africa outbreak. The World Health Organization (WHO) has warned that the current outbreak is out of control and is on track to surpass the death toll of the 2014-2016 West Africa outbreak, which killed more than 11,000 people.
Regional Expansion and Fatality Rates
While new cases and deaths have declined in the epicenter of Ituri province—which remains the hardest hit with more than 5,400 cases—the virus is spreading rapidly into neighboring areas. In North Kivu, new cases more than doubled to 381 in a recent three-week period, up from 165 in the previous period. The virus recently reached two additional areas in North Kivu: Biena and Manguredjipa.
Fatality rates vary significantly by region. While the national average is 48%, the rate in North Kivu has risen to 69%. Health officials suggest this increase may be driven by difficulties in delivering supplies and medications to the area. The virus has also demonstrated its ability to travel long distances; on September 10, a man tested positive for the Bundibugyo virus in Sud-Ubangi, the province’s first recorded case, after traveling hundreds of miles from South Kivu over three weeks.
Containment Obstacles and Infrastructure Failures
Containment efforts are being hindered by a combination of insecurity, population displacement, and systemic institutional failures. The response in North Kivu has been specifically complicated by fighting between government forces and Rwanda-backed M23 rebels, who control the provincial capital, Goma. Additionally, a healthcare worker strike and mistrust within communities have posed significant challenges.
Vaccination Efforts and International Risk
There is currently no licensed vaccine or treatment specifically for the Bundibugyo strain. However, Congo has begun vaccinating frontline workers with the Ervebo vaccine. While Ervebo targets the more common Zaire strain, doctors believe it could help reduce the risk of infection in this outbreak. Congo has received 70,000 doses so far, though limited supply remains a key challenge. Clinical trials for a licensed Bundibugyo vaccine have started in the provinces of eastern Tshopo, Haut-Uele, and Bas-Uele.
The outbreak has caused cross-border transmission into Uganda, where 20 cases and two deaths were reported. The WHO declared Uganda’s outbreak over on August 26 after 42 consecutive days without a new confirmed case.
While the risk to the general population in the EU/EEA remains very low, healthcare workers returning from the region face a substantially higher risk of exposure.
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