分类： health

In the eastern Congolese city of Bunia, the epicenter of the Ebola outbreak declared in mid-May, 26-year-old expectant mother Esther Lutula made a fateful decision not long after public health authorities announced the crisis: she halted all her routine prenatal checkups. Like many residents across Ituri province, Lutula clung to a widespread dangerous misconception—she believed any visit to a health facility that resulted in a fever reading would lead to immediate involuntary isolation. That fear has kept her away from care, with Lutula telling the Associated Press she will only resume checkups once the virus is no longer circulating widely.

But public health experts warn this choice is far from harmless; it can be deadly. New data from the United Nations Population Fund (UNFPA) reveals that maternal mortality across Ituri has doubled in the months since the outbreak began, a devastating secondary crisis unfolding alongside the rapidly spreading Ebola epidemic. Before the outbreak was declared in May, the province recorded an average of 3.1 maternal deaths per week. From May 25 to July 19, that average surged to 5.8 deaths weekly. Most alarmingly, the share of maternal deaths that occur outside of formal health facilities has nearly doubled too, jumping from 9.1% to 17.4% over the same period.

This public health catastrophe is unfolding against a grim global backdrop: sub-Saharan Africa already bears 70% of the world’s maternal deaths, with roughly 180,000 preventable pregnancy-related deaths recorded across the continent each year. Congo, for its part, ranks among the most dangerous countries in the world to give birth. The latest United Nations data shows 19,000 Congolese women died from pregnancy complications in 2023, putting the country second only to Nigeria globally, tied with India.

As Congo battles the fastest-growing Ebola outbreak on record, which has already claimed more than 1,600 confirmed lives, aid and health workers are sounding the alarm about this largely unreported shadow crisis: widespread fear and misinformation have driven thousands of pregnant women to avoid hospital care entirely, pushing an already catastrophic maternal mortality rate even higher. Noemi Dalmonte, UNFPA’s deputy country representative in Congo, explained that while avoidance of health facilities during public health emergencies is not uncommon across the continent due to safety concerns, Ebola’s unique reputation and the flood of misinformation surrounding it have amplified this trend dramatically.

Many residents in the remote, conflict-riven region question whether Ebola even exists, while overstretched health workers struggle to mount an effective response with extremely limited supplies. For pregnant women, this has translated to a drastic reduction in access to life-saving care. Violence targeting outbreak response operations has only deepened fears: multiple Ebola treatment centers have been attacked by local residents fueled by misinformation and anger over strict public health measures, leaving many women afraid to seek care even for life-threatening pregnancy complications.

The impact of this avoidance is visible on the ground at local health facilities. At Bénédicte Clinic in Bunia, Dr. Sonny Mwembo, the clinic’s medical director, reports that the number of women registering for prenatal care has plummeted from an average of 60 per month to just around 10. Even after weeks of targeted outreach to correct misinformation, many residents still cling to false beliefs about the outbreak. Elodie Yabiri, a heavily pregnant Bunia resident, summed up the common fear: “Right now, if you feel sick and go to the hospital, they say it’s Ebola and they put you in quarantine right away. That’s what scares people.” Yabiri added that she is avoiding hospitals as much as possible, relying only on the movement of her unborn child to gauge that her pregnancy is progressing safely.

Compounding the crisis, Congo’s already overburdened, underfunded healthcare system has shifted most of its limited resources to Ebola response operations, leaving even fewer services for pregnant women who are still willing to seek care. Health facilities across the five provinces affected by the outbreak have redirected staff and medical supplies to Ebola containment efforts, cutting access to routine and emergency maternal care. The crisis has also gutted the local health workforce: at least 44 health workers have died from Ebola infection, and many more have walked off the job over unpaid salaries. Since the outbreak was declared in mid-May, at least 12 attacks on health facilities and response teams have been recorded across the region. Dr. Ghislain Maneba, an epidemiologist and community investigator working in Ituri’s Rwampara health zone, described the impossible conditions frontline workers face: “We are doing everything we can to make the public understand how dangerous this disease is. We are working day and night without being paid.”

Pregnant women face uniquely elevated risks throughout this outbreak, on multiple fronts. Ebola is a rare but highly contagious, often fatal virus that spreads through contact with bodily fluids and contaminated materials. Women make up the majority of family caregivers when a loved one falls ill, and many are also serving on the frontlines of the outbreak response—including many pregnant health workers, AP journalists reporting on the outbreak have observed. “It is very important that they know how to protect themselves, that they have the right information,” Dalmonte said.

The U.S. Centers for Disease Control and Prevention notes that pregnant women who contract Ebola face a significantly increased risk of life-threatening complications, including miscarriage. But for many women in eastern Congo, the greatest threat is not the virus itself—it is the lack of access to the care that could save their lives. Dalmonte summed up the dual crisis: “Pregnant women who delay care and avoid health facilities could die not from Ebola itself but because the care that would have saved them was no longer accessible, trusted or safe.”

This reporting is part of an AP series on maternal mortality in sub-Saharan Africa, with financial support for global health and development coverage provided by the Gates Foundation. The AP retains full editorial control over all content.

A devastating Ebola outbreak in eastern Democratic Republic of Congo has reached a grim new threshold, with official fatalities surpassing 1,500 to make it the second-worst Ebola event recorded in modern history. Declared publicly this past May, public health experts warn that the actual death toll is far higher than the official count, and Congolese authorities confirmed last Thursday that the virus is spreading at a faster rate than any previous outbreak the country has faced.

Just across the border, however, Uganda’s experience of the same cross-border outbreak paints a dramatically different picture of successful containment. Two weeks ago, the East African nation discharged its final active Ebola patient from care, a moment the country’s health minister described as a “moment of joy.” In total, Uganda recorded just 20 confirmed cases and only two deaths from the virus – a outcome that was not a stroke of luck, according to senior global health officials.

“This is not by luck or chance. It is because people invested in preparedness,” explained Dr Kasonde Mwinga, the World Health Organization’s country representative for Uganda, in an interview with the BBC.

For half a century, DR Congo has borne the brunt of Ebola outbreaks, recording 17 separate events since the virus was first identified. Uganda, by comparison, has faced nine outbreaks since 2000, and government officials say decades of hard-won experience have given the country a playbook to stop transmission before it can spiral into a larger crisis.

A 2011 incident in Uganda’s central Luwero district illustrates this advantage. When a 12-year-old girl arrived at a local hospital with telltale Ebola symptoms, clinicians immediately moved to isolate her, donned full personal protective equipment for all interactions, and safely handled her remains after she died just three hours after admission. Those quick precautions stopped transmission in its tracks, before the virus could spread to other patients or healthcare workers, even before lab tests confirmed the diagnosis.

“We know Ebola. It has been here a few times, we know how to deal with it,” government spokesperson Alan Kasujja told BBC’s Newsday.

Uganda’s first confirmed case in the current cross-border event was a Congolese man who crossed the border to seek medical care. After DR Congo confirmed multiple imported cases originating from its territory, Ugandan health authorities immediately activated a pre-built specialist Ebola treatment center at Kampala’s Mulago Hospital, a facility that was already set up following a 2023 Ebola outbreak. The center already retained leftover medical supplies and maintained a standing emergency response team, meaning the facility was ready to accept patients within 24 hours of activation, according to Dr David Kaggwa, the center’s head.

“It was a matter of sorting and ordering a few more supplies, and then actually in one day we were ready to receive the patients. So, it is easy, it’s not that we’re starting from scratch,” Kaggwa said.

Fifteen of Uganda’s 20 confirmed cases were imported from DR Congo. After the two countries issued a joint public declaration of the outbreak on May 15, residents with Ebola symptoms – including fever, headache, and vomiting – began seeking care directly at the specialized treatment unit, rather than passing through crowded general hospitals, Kaggwa explained. This immediate routing cut off opportunities for community transmission by limiting contact between infected people and the general public.

To further block spread, Ugandan authorities also closed the shared border with DR Congo, accepting the unavoidable economic hit to cross-border traders who rely on daily movement between the two countries to make a living.

Beyond pre-existing preparation, Uganda also benefited from early awareness of the outbreak’s specific character. Before DR Congo confirmed its first cases, the virus spread undetected for weeks: local health officials were testing for common Ebola strains, but the current outbreak is caused by the rare Bundibugyo strain, delaying detection. By the time the outbreak was declared, the virus had already gained a foothold in Congolese communities, giving Uganda advance warning to activate its response before the virus reached its territory.

“Surveillance mechanisms were put in place then it was easy to identify all the patients quickly,” Kaggwa said.

In DR Congo, systemic challenges have hampered surveillance and contact tracing efforts that are critical to stopping Ebola. A field investigator working in Bunia, the city at the outbreak’s epicenter, told Reuters that poor planning, logistical backlogs, and reliance on under-trained staff have left response teams constantly playing catch-up.

“We discover the disease only after it has already spread. We’re just chasing it,” said Dr Moubarack Kano.

Chronic insecurity in eastern DR Congo has compounded these challenges. Ituri province, the current epicenter, has been under military rule for years as government forces battle dozens of active armed groups, while large swathes of territory further south are controlled by the M23 rebel militia. While M23 claims to have contained local transmission through early detection, mass displacement caused by ongoing conflict has left millions of people moving across the region, creating gaps in surveillance that the virus exploits. Cross-border trade and artisanal mining also drive constant population movement, giving the virus more opportunities to jump between communities and across borders.

In contrast, Uganda successfully completed full 21-day quarantine periods for more than 6,000 known contacts of confirmed Ebola cases, a step that Kaggwa says was critical to halting transmission, since most secondary cases emerge from known exposed contacts.

“I would say that our success is mainly due to our promptness and completeness of follow-up,” Kasujja concurred.

This successful containment is not the first time Uganda has earned international recognition for its proactive public health response. In the 1990s and 2000s, the country drew widespread praise for cutting national HIV prevalence from over 10% to 6% in a decade through a large-scale public education campaign centered on the “ABC” prevention framework: abstinence, being faithful, and condom use.

Community buy-in has also been a core pillar of Uganda’s success, Kasujja added. Even after the country was declared Ebola-free, the public continues to follow recommended prevention precautions, he said.

This level of community cooperation is seen in the experience of one of Uganda’s early cases: a nurse who contracted Ebola while working in a Kampala intensive care unit, shortly before the outbreak was officially declared. She had treated a patient who later died of Ebola without anyone knowing the cause of death, and when she developed symptoms two weeks later and learned two of her colleagues had already tested positive, she voluntarily entered isolation immediately. Even when her 11-month-old breastfeeding infant was separated from her for a 21-day quarantine, she continued to fully comply with all public health guidelines.

Uganda broke standard World Health Organization protocol by declaring itself Ebola-free just two weeks after discharging its last patient, instead of the recommended 42-day waiting period. The health ministry justified the early announcement by noting all cases were imported from DR Congo, and no unexplained community transmission ever occurred within Uganda’s borders.

Even with this success, Ugandan officials are under no illusion that the threat has passed. The country shares a long, porous border with Ituri province, the heart of the Congolese outbreak, meaning the virus can easily re-enter Uganda at any time.

In response, Uganda has deployed dozens of healthcare workers across the border to support DR Congo’s response, with Health Minister Chris Baryomunsi writing on social media platform X that the country is standing with its “brothers and sisters” to tackle the shared threat.

“We are going to where the problem is. Uganda cannot win against Ebola if the Democratic Republic of Congo fails,” Kasujja explained.

Uganda has also ramped up screening at border crossings and continues to run public education campaigns on Ebola prevention and response protocols. “We’re always very prepared,” Kaggwa said.

The World Health Organization has confirmed that the ongoing Ebola outbreak in the Democratic Republic of the Congo (DRC) has become the largest in the nation’s recorded history, with case numbers continuing to climb at an alarming rate months after the outbreak was first declared.

As of July 30 this year, national and global health authorities have documented 3,605 confirmed Ebola infections, with 1,587 people dying from the virus – putting the current fatality rate at 44 percent. This outbreak, which was officially announced on May 15, 2026, is driven by the Bundibugyo strain of Ebola, and has already exceeded the size of the previous largest DRC outbreak recorded between 2018 and 2020, which registered just under 3,500 total cases. That earlier outbreak, caused by a different strain, recorded roughly 2,300 fatalities.

Unlike more widely studied Ebola strains, there are currently no formally approved vaccines or targeted treatments available for the Bundibugyo variant, a gap that has made controlling the outbreak far more challenging. However, research teams in the United Kingdom and Singapore are actively advancing candidate vaccine development, with the WHO naming a candidate being developed in Singapore as the most promising for rapid deployment. Clinical trials for a second potential vaccine have already launched in the UK.

In a public statement posted to the social platform X, the WHO warned that the outbreak is intensifying, with sustained community transmission driving consistent increases in both new cases and deaths. In the seven days leading up to July 30, the outbreak hit a new grim milestone: 567 new confirmed cases and 296 deaths, the highest weekly caseload recorded since the outbreak began. WHO officials noted that these numbers highlight the exceptional speed at which the virus is spreading through vulnerable populations.

Multiple overlapping challenges are severely hampering international and local response efforts, health officials say. The outbreak is centered in DRC’s northeastern Ituri Province, which shares borders with South Sudan and Uganda. It has since spread to neighboring North and South Kivu provinces, large swathes of which are controlled by the M23 armed group, a militia supported by Rwanda. Chronic insecurity, mass population displacement from conflict zones, unregulated cross-border movement, and limited access to affected communities have all combined to slow emergency response work and raise the risk of the virus spreading further afield.

To date, the outbreak has crossed international borders: 20 confirmed cases have been recorded in Uganda, one case has been reported in France, and two Congolese patients have been transferred to Germany for treatment. Over the past half-century, Ebola – which spreads through direct contact with infected bodily fluids – has killed more than 15,000 people across the African continent, with most major outbreaks concentrated in Central Africa.

BUNIA, Democratic Republic of Congo — The world’s most rapidly expanding Ebola outbreak on record has crossed a devastating milestone, with new official data released Thursday confirming more than 1,500 fatalities in eastern Congo. The sharp death toll increase — a 50 percent jump logged over roughly one week — underscores that the spread of the virus continues to outpace international and local response measures.

Updated statistics from the Congolese government show that as of Tuesday, the ongoing outbreak has recorded a total of 3,442 confirmed and probable cases, with the death count climbing to 1,521. First declared on May 15, this outbreak differs sharply from most prior Ebola events in a key, dangerous way: it is caused by the Bundibugyo strain, for which no specific, fully approved vaccines or antiviral treatments currently exist.

The speed and mortality of this outbreak have already outstripped every previous Ebola event in recorded history, including the devastating 2014-2016 West African epidemic that long held the title of the world’s worst Ebola outbreak. That crisis, which ultimately killed more than 11,000 people across at least 28,000 recorded cases, took roughly eight months to reach 1,000 deaths. This outbreak has reached 1,500 deaths in a far shorter timeframe.

Ebola is an uncommon but highly contagious viral illness, transmitted through direct contact with infected bodily fluids including blood, vomit, and semen. The disease it causes progresses rapidly, with severe symptoms that lead to death in a large majority of cases without prompt, specialized care.