标签： Africa

A devastating chapter of the ongoing Ebola outbreak in the Democratic Republic of Congo (DRC) has claimed the lives of three Red Cross volunteers, who likely contracted the virus while handling deceased bodies before public health officials identified the growing epidemic, the International Federation of Red Cross and Red Crescent Societies (IFRC) has confirmed.

The three volunteers – Alikana Udumusi Augustin, Sezabo Katanabo and Ajiko Chandiru Viviane – were working on a non-Ebola related community project in the conflict-affected eastern province of Ituri when they were exposed to the virus on March 27, weeks before the outbreak was formally detected. They passed away between May 5 and May 16 in Mongbwalu, the town now recognized as the epicenter of the epidemic, and are counted among the earliest recorded fatalities of this outbreak.

As of the latest updates, the outbreak has been linked to more than 170 suspected deaths and over 750 suspected cases across eastern DRC. Paying tribute to the fallen workers, the IFRC honored them for serving their local communities “with courage and humanity” in a public statement.

On May 24, the World Health Organization (WHO) upgraded the public health risk assessment of the DRC outbreak from “high” to “very high”, acknowledging the rapid spread of the virus. WHO Director-General Dr Tedros Adhanom Ghebreyesus noted that while the regional risk across the African continent remains categorized as “high”, the global risk level is still classified as “low”.

A particularly challenging aspect of this outbreak is the Ebola strain involved: the rare Bundibugyo variant, which has no licensed, proven effective vaccine and carries a mortality rate of roughly one third of all confirmed infections. Health authorities have repeatedly emphasized that Ebola spreads easily through contact with bodily fluids of infected people, and remains highly contagious in deceased bodies even after death, making safe body management a high-risk task.

The outbreak has already spread beyond DRC’s borders. Neighboring Uganda confirmed three new confirmed cases on May 24, bringing the country’s total to five confirmed infections. The Africa Centres for Disease Control (Africa CDC) issued an urgent alert the same day, warning that 10 additional African countries – Angola, Burundi, the Central African Republic, the Republic of Congo, Ethiopia, Kenya, Rwanda, South Sudan, Tanzania and Zambia – face significant risk of imported cases and local spread.

Response efforts have been complicated by both community distrust and ongoing armed conflict in eastern DRC. On May 23, Médecins Sans Frontières (MSF) reported that an Ebola treatment tent it had set up in Mongbwalu was burned by local community members. The organization noted that the rapidly evolving outbreak has left many residents with deep uncertainty and fear, adding that the incident underscores the urgent need for sustained community engagement and trust-building to enable effective response.

The unrest follows another incident a day earlier, when an angry crowd in a separate district of Ituri set fire to part of a local hospital after authorities blocked the family and friends of a young man suspected of dying from Ebola from taking his body for a traditional burial. Beyond Ituri, confirmed cases have also been detected in North Kivu and South Kivu, where large swathes of territory are controlled by the M23 rebel group. Ongoing armed conflict in these areas has severely restricted access for public health response teams, creating additional barriers to containing the spread of the virus.

BUNIA, Democratic Republic of Congo — A growing wave of community distrust around the ongoing Bundibugyo Ebola outbreak in eastern Congo has boiled over into a second arson attack on a public health facility in less than a week, triggering a dangerous escape of infected patients and deepening concerns over virus containment efforts. Local hospital director Dr. Richard Lokudi, head of Mongbwalu General Reference Hospital, confirmed to the Associated Press that unidentified assailants targeted an MSF (Doctors Without Borders) isolation tent late Friday. The tent had been purpose-built to house both confirmed and suspected cases of the rare Bundibugyo strain of Ebola, which is currently driving the outbreak centered on the Mongbwalu area.

In the wake of the attack, 18 patients being monitored for possible Ebola infection fled the facility into the surrounding community, a development that public health officials warn drastically elevates transmission risks. “We strongly condemn this act, as it caused panic among the staff of the Mongbwalu Referral Hospital and also resulted in the escape of 18 suspected cases into the community,” Lokudi said. The attack marks the second targeting of Ebola response infrastructure in the region this week: just two days prior, a separate treatment center in nearby Rwampara was burned to the ground by community members after authorities blocked family members from recovering the body of a local man who had died from the virus.

This tension stems from a critical point of conflict between public health guidelines and local cultural practices: Ebola corpses are extremely contagious, and traditional funeral gatherings and body preparation are among the most common pathways for large-scale secondary spread. To curb transmission, authorities manage burials of confirmed and suspected Ebola victims whenever possible, a policy that frequently sparks pushback from grieving family and community members.

As community tensions mount, regional authorities have implemented strict new public health measures to slow the outbreak. On Friday, officials in northeastern Congo announced a ban on funeral wakes and all public gatherings of more than 50 people. The World Health Organization has also upgraded its risk assessment for the outbreak, raising the domestic risk level from “high” to “very high” while noting that the risk of global spread remains low at this stage.

As of Friday, WHO Director-General Tedros Adhanom Ghebreyesus reported that 82 confirmed cases and seven confirmed deaths have been recorded, but he warned that the actual size of the outbreak is far larger than official confirmed counts. Currently, surveillance systems are tracking 750 additional suspected cases and 175 suspected deaths, numbers expected to rise as public health workers expand monitoring across the region.

A unique factor complicating the response to this outbreak is the lack of an approved vaccine for the Bundibugyo strain. The virus spread undetected for weeks across Ituri province after the first recorded death, when initial testing incorrectly targeted the more common Zaire Ebola strain and returned negative results, delaying the activation of a full response. Most recently, the revelation that three International Federation of Red Cross and Red Crescent Societies volunteers died from the virus in Mongbwalu after contracting it during a non-Ebola body management mission on March 27 has pushed back the estimated timeline of the outbreak. Previously, the first confirmed death was dated to late April in Bunia, Ituri’s capital.

Top African public health leaders have emphasized that repairing community trust is a core component of any effective response. “A response to the outbreak must include building trust with communities,” said Dr. Jean Kaseya, director-general of the Africa Centers for Disease Control and Prevention. On Saturday, a burial for Ebola victims in Bunia proceeded only under heavy armed security, a stark indicator of the ongoing friction between response teams and local communities. The Red Cross has confirmed that three of its volunteers have died from the virus linked to this outbreak, marking a major loss for the humanitarian effort working to contain the spread.

On the morning of May 1, as South Africa paused to observe the Labor Day public holiday, leading South African infectious disease specialist Lucille Blumberg logged into her work email and encountered an urgent alert that would launch a rapid, cross-continental disease investigation. The message came from a public health colleague based in the United Kingdom, who was monitoring disease activity across remote South Atlantic British overseas territories. It detailed a worrying situation: a passenger from a Dutch cruise ship sailing thousands of miles across the Atlantic had been medically evacuated and admitted to a Johannesburg hospital for suspected pneumonia, with multiple other passengers and crew on the vessel already showing symptoms of illness.

The passenger had been evacuated from the ship off Ascension Island, one of the British territories the UK-based colleague monitors, and Blumberg was asked to lead the follow-up investigation into the mysterious illness. Within hours, Blumberg and a team of specialists from South Africa’s National Institute for Communicable Diseases were mobilized, putting aside holiday plans to race against the clock to identify the cause of the growing outbreak on board the MV Hondius cruise liner.

“Even though it was a public holiday, we moved, we moved really fast,” Blumberg recalled in an interview with the Associated Press. “It was busy. There were many conversations. There were online discussions, and there was laboratory testing happening at the time.” In what would become a defining display of global public health collaboration, the team achieved a breakthrough in less than 24 hours, confirming the evacuated patient was infected with hantavirus, a rare pathogen carried and spread by rodents.

### A Methodical Process of Elimination
When the elderly British patient first arrived at the private Johannesburg hospital, he was in critical condition, and clinicians had no clear answer for what was causing his severe respiratory illness. By the time he was evacuated from the ship, two elderly Dutch passengers who had fallen ill on the cruise had already died, but the full scope of the outbreak had not yet come into focus. Health authorities on Ascension Island had only reported a cluster of pneumonia-like illnesses to the World Health Organization (WHO) without identifying a root cause.

Initially, Blumberg and her team prioritized the most likely causes of a respiratory outbreak on a cruise ship. Their first working theories were Legionella, a common bacterium linked to cruise ship and hotel pneumonia outbreaks that causes Legionnaires’ disease, and avian influenza, since the ship’s itinerary included stops at South Atlantic islands where bird flu is well documented. “Legionella is well described in outbreaks in hotels and on cruise ships, and influenza certainly is. These people had visited islands where avian influenza is well documented,” Blumberg explained.

Initial tests for both pathogens came back negative. The team ran a full panel of tests for dozens of other common respiratory illnesses, and all of those also returned negative results. It was only when the team shifted their focus to the ship’s full itinerary and the profile of passengers that a new lead emerged: the MV Hondius had sailed from Argentina, and most passengers on board were avid bird watchers who had spent time exploring remote areas of South America that are home to large rodent populations.

### Global Collaboration Drives Rapid Diagnosis
The new clue led the South African team to test for a less common but well-documented pathogen in southern South America: hantavirus, specifically the Andes strain that is endemic to parts of Chile and Argentina. Their work was greatly accelerated by close collaboration with hantavirus specialists based in South America and the United States, with the WHO coordinating cross-border communication between experts. “You can get onto a Zoom online and ask your questions and get advice. This is not something every day. So that was quite extraordinary,” Blumberg noted of the international cooperation.

By Saturday morning, just two days after the initial alert, Blumberg contacted the director of South Africa’s only laboratory equipped to test for hantavirus. Within hours, the lab director had mobilized her team on the weekend to process the samples. “I said, we want to do hanta, and she said, ‘yeah, I’m coming,’” Blumberg recalled. That same afternoon, initial tests on the evacuated patient’s blood samples came back positive for hantavirus. The team ran a second round of confirmatory testing to rule out error, and the positive result was upheld.

### Confirmation Paves the Way for Targeted Outbreak Response
The positive diagnosis, which also confirmed the pathogen was the Andes hantavirus strain, allowed the WHO to immediately alert the cruise ship leadership and formally declare a hantavirus outbreak on board. Unlike most hantavirus strains, which cannot spread easily between humans, the Andes variant can pass from person to person, making rapid identification critical to implementing appropriate safety measures. After the diagnosis, Blumberg’s team also moved quickly to test tissue samples from a deceased Dutch passenger, one of the two who had died earlier in the outbreak. The woman had disembarked at St. Helena to accompany her husband’s remains before traveling to South Africa where she later died, and her posthumous test also returned positive for hantavirus.

“It was a bit of a wow moment,” Blumberg said. “And at least once you know what you’re dealing with, it’s much easier to respond.” As of the latest update from South Africa’s health ministry, the British patient who was the first confirmed case is now recovering in hospital and showing steady improvement. Meanwhile, the MV Hondius has completed its journey to its home port of Rotterdam in the Netherlands, where the vessel was thoroughly disinfected and all remaining crew have disembarked for monitoring.

With 25 years of experience responding to disease outbreaks around the world, Blumberg framed the rapid identification of the cruise ship hantavirus as a case study in effective public health practice. “I’ve been doing outbreaks for 25 years. That’s what we do. We do them every day,” she said. “I think the important thing was to respond immediately to a question that clearly was urgent and then to take it from there.”

More than a decade after West Africa suffered the deadliest Ebola epidemic in recorded history, a new outbreak in the eastern Democratic Republic of the Congo has stirred traumatic memories for survivors of the earlier crisis, while forcing global health experts to confront gaps in preparedness for rare, untreatable strains of the virus.

Patrick Faley, a Liberian Ebola survivor who lost his four-year-old son to the disease during the 2013–2016 West African outbreak that killed over 11,000 people across Guinea, Liberia and Sierra Leone, says images of medics scrambling to contain the DR Congo outbreak have brought back haunting recollections of loss and chaos. “I saw the burial team taking eight of them,” Faley recalled. “I made new friends although they ended up dying. I was the only person that was left there.”

Faley was recruited as a community health volunteer by Liberia’s Ministry of Health at the height of the West African epidemic, tasked with traveling between rural villages to educate locals on how Ebola spreads through direct contact with bodily fluids, discourage unsafe traditional practices like handshakes and ritual washing of deceased bodies, and dispel dangerous misinformation about the virus. His own infection came after he set aside safety guidance to comfort grieving community members at a colleague’s Ebola funeral: “You have to shake hands; you have to hug people. Forgetting to know that we have a crisis, an emergency crisis in our country.”

Three days after the funeral, Faley fell ill, transforming from a frontline outreach worker to a patient in an overcrowded Monrovia treatment ward, where he watched dozens of patients die waiting for care. He survived the infection, but his wife and young son later contracted the virus. While his wife recovered, four-year-old Momo did not survive.

Today, the lessons learned from Faley’s experience and the broader West African outbreak are shaping the public health response to the new DR Congo outbreak, where the World Health Organization (WHO) has confirmed over 170 deaths so far. One key change adopted from past outbreaks is an immediate ban on traditional funerals for suspected Ebola cases to cut transmission chains — but the policy has already sparked community unrest. Last Thursday, a crowd angry over authorities’ refusal to release a body for burial set fire to part of a hospital near the outbreak epicenter in Bunia.

Dr. Patrick Otim, the WHO’s Africa area manager, emphasized that integrating past lessons into the current response is non-negotiable, and that community buy-in is as critical as medical infrastructure. “One of the biggest lessons from the West Africa outbreak and previous Ebola outbreaks in DRC is that speed matters,” Otim explained. “Early delays in detecting cases, isolating patients and engaging communities can allow transmission chains to expand very quickly.” He added that outbreaks cannot be controlled by medical intervention alone: “Community trust is essential. Safe and dignified burials, local leadership engagement and clear communication are just as important as laboratories and treatment centers.”

This outbreak marks the 17th Ebola event recorded in DR Congo since the virus was first identified in 1976, but it carries unique challenges: it is only the third global outbreak of the rare Bundibugyo Ebola strain, a variant that circulates far less often than the common Zaire strain. Unlike the 2013–2016 West African outbreak, which was eventually curbed with the first approved Ebola vaccine Ervebo, no approved vaccine or specific treatment exists for Bundibugyo.

Professor Thomas Geisbert, a leading Ebola researcher at the University of Texas Medical Branch and co-inventor of Ervebo, explained that the genetic makeup of Bundibugyo differs from Zaire by roughly 30%, rendering existing stockpiled vaccines ineffective. “Just because a vaccine works against one particular type of a virus doesn’t mean it’s going to work against another one,” he said. Ervebo remains the only Ebola vaccine currently available in the global emergency stockpile.

Developing new vaccines is an expensive, time-consuming process that has long been overlooked by profit-driven pharmaceutical companies, Geisbert noted. He and other researchers have already made progress on a Bundibugyo vaccine built on Ervebo’s existing framework, with preclinical trials in non-human primates showing 83% protection. However, the candidate has not yet moved to human testing. Geisbert estimates that moving a vaccine from laboratory development to full-scale deployment can cost more than $1 billion, a price tag that has so far discouraged private sector investment. Teams at the University of Oxford have also announced they are developing a candidate that could be ready for human trials within two to three months, and the WHO says a fully tested, deployable vaccine could take up to nine months to deliver.

Kenyan biochemistry professor Wallace Bulimo of the University of Nairobi said the current outbreak exposes a long-standing failure to prioritize research on less common Ebola strains, which were first identified as a distinct variant in 2007. “Why is it that we have not actually done a lot of work on this virus? And yet we knew it was there,” Bulimo said. “It was first discovered in 2007, so we should have actually never ignored it.”

Faley, who has experienced first-hand the fallout of mismanaged community outreach, warns response teams against openly telling locals that the current outbreak has no cure. Doing so, he argues, will discourage sick people from seeking treatment and fuel stigma, as communities believe seeking care is a death sentence. He also cautions against the common pitfalls of a sudden influx of international aid: large numbers of foreign responders can stoke fear and distrust in local communities, which played a role in slowing the West African response early on. Currently, tons of aid have been shipped to the outbreak epicenter in Ituri province, and multiple international medical and UN agencies are preparing to deploy support teams.

Unlike the early days of the West African outbreak, DR Congo has built up one of the world’s most experienced workforces for Ebola response over the past decade, having managed 16 prior outbreaks. Otim stressed that the Congolese government is leading the current response, and the country has built robust expertise in everything from case detection to outbreak coordination. The biggest challenges do not stem from a lack of experience, he said — instead, they come from the region’s difficult operating environment: long-standing insecurity from armed groups, widespread population displacement, crumbling infrastructure, and constant cross-population movement all make containment far more complex.

Experts warn the outbreak may already be larger than official counts show, as confirmation of the first case took three weeks: the initial patient, a nurse, developed symptoms on April 24, but the outbreak was not confirmed until mid-May. While the situation remains serious, there are small points of cautious optimism: the historical case fatality rate for Bundibugyo is roughly 30%, lower than many other Ebola strains. Still, Geisbert noted that Bundibugyo has a longer incubation period than other variants, which means infected people can unknowingly spread the virus in communities for longer before developing symptoms.

On a more encouraging note, the WHO plans to prioritize experimental use of the antiviral drug Obladesivir, which was developed during the COVID-19 pandemic, under strict clinical protocols. Researchers hope the drug may prevent infection in people who have been exposed to confirmed Ebola cases.

For his part, Faley says he stands ready to support affected communities in DR Congo, drawing on his own experience as a survivor to help people navigate the trauma of the outbreak. “Our arms are open as Liberians,” he said. “Our arms are open in order to help our colleagues who will be surviving, to give them a proper perspective, what it means to survive Ebola. I will always be here to advocate for survival.”