标签： Africa

An ongoing Ebola outbreak originating in the Democratic Republic of the Congo (DRC) has spread faster and wider than initial assessments projected, international health officials have warned, with cases already detected in neighboring Uganda and multiple provinces across the unstable Central African nation. As of Tuesday, official counts put suspected cases in the DRC at more than 513, with 131 recorded fatalities in the country and one additional death in Uganda. But new analysis from the London-based MRC Centre for Global Infectious Disease Analysis suggests official numbers are likely far lower than the actual caseload, with researchers warning that substantial under-detection could mean the total number of infections has already surpassed 1,000. The true size of the outbreak remains uncertain, the study added, noting that current confirmed figures understate the outbreak’s real scale.

The World Health Organization (WHO) representative to the DRC, Dr. Anne Ancia, told the BBC that expanded on-the-ground investigations have confirmed the virus has reached multiple new regions, including the conflict-affected province of South Kivu and Goma, eastern DRC’s largest population center home to roughly 850,000 residents that is currently controlled by Rwandan-backed armed groups. The outbreak’s epicenter remains DRC’s Ituri province, a chronically insecure region marked by widespread forced population displacement that has severely complicated response efforts. “The more we are investigating this outbreak, the more we realise that it has already disseminated at least a little bit across border and also in other provinces,” Ancia explained. Chronic instability across multiple affected provinces pushes residents to move frequently, raising the risk of further transmission, she added.

The Red Cross echoed the WHO’s warning, noting that all the conditions that allow Ebola to escalate rapidly—delayed case identification, low community awareness, and strained health systems—are already present in the current outbreak. DRC President Félix Tshisekedi called for calm and urged citizens to maintain vigilance following an emergency crisis meeting on the outbreak Monday evening. WHO Director-General Tedros Adhanom Ghebreyesus, who declared the outbreak a Public Health Emergency of International Concern (PHEIC) last week, said he is deeply alarmed by both the size and acceleration of the epidemic.

Health investigators believe the outbreak had been circulating for several weeks before it was first officially detected on April 24. Complicating response efforts further, there is no approved vaccine for the specific viral strain driving the current outbreak: the rare Bundibugyo strain, which has only caused two recorded outbreaks previously, with roughly a third of infected patients dying from the disease. The WHO is currently evaluating whether existing antiviral treatments developed for other Ebola strains may offer some protection against Bundibugyo.

Neighboring and regional countries have already implemented emergency precautions to slow cross-border spread. Rwanda has closed its entire border with the DRC, while Uganda has advised citizens to avoid traditional greetings including hugs and handshakes, and multiple other African nations have tightened entry screenings and prepped health facilities to handle potential cases.

International fallout from the outbreak has already spread beyond Africa: an American citizen, identified as missionary doctor Peter Stafford, developed Ebola symptoms over the weekend and is being evacuated to Germany for treatment. The U.S. Centers for Disease Control and Prevention (CDC) confirmed it is also coordinating the evacuation of at least six other American citizens who had potential exposure to the virus.

WHO and partner humanitarian organizations are currently working alongside DRC government officials and local community leaders to contain transmission, urging residents to follow public health safety guidelines and seek immediate care at the nearest health facility if they develop any Ebola symptoms.

Ebola is a viral infectious disease that begins with flu-like symptoms including fever, headache, and fatigue. As the infection progresses, patients often develop vomiting and diarrhea, which can progress to organ failure; some patients also experience internal and external bleeding. The virus spreads through direct contact with infected bodily fluids such as blood or vomit. The 2014-2016 West African Ebola epidemic, caused by the Zaire strain for which an approved vaccine now exists, remains the largest outbreak of the virus since its discovery in 1976, with more than 28,600 confirmed infections and 11,325 recorded deaths across multiple countries including Guinea, Sierra Leone, the United States, the United Kingdom, and Italy.

KINSHASA, Democratic Republic of Congo — A fast-escalating rare Ebola outbreak in eastern Democratic Republic of Congo has already claimed at least 131 lives and sparked over 500 suspected infections, Congolese health officials confirmed Tuesday, as the top leader of the World Health Organization (WHO) issued urgent warnings over the outbreak’s alarming scale and accelerating spread.

Health experts and humanitarian aid workers report the virus circulated undetected for several weeks after the first fatality, and delays in identifying and responding to the crisis have severely complicated efforts to contain transmission. Congolese Health Minister Samuel Roger Kamba told reporters the country has recorded 513 suspected cases and 131 deaths to date, noting that all fatalities are still under investigation to confirm linkage to the current outbreak. These figures represent a dramatic jump from just one day prior, when authorities reported 300 suspected cases, underscoring how much remains unknown about the full scope of the crisis.

WHO Director-General Tedros Adhanom Ghebreyesus stated he is “deeply concerned about the scale and speed of the epidemic”, and announced the U.N. health agency would convene its emergency committee later the same day to assess the outbreak and coordinate a global response. Tedros outlined key factors driving fears of further spread: transmission in densely populated urban centers, deaths of frontline healthcare workers, high volumes of population movement through the affected region, and critical shortages of targeted vaccines and treatment options.

The outbreak, formally confirmed on May 14, is caused by the Bundibugyo variant, a rare strain of Ebola for which no fully approved vaccines or specific therapeutics currently exist. Just three days after confirmation, on May 17, the WHO declared the event a Public Health Emergency of International Concern (PHEIC), the highest level of global health alert.

Confirmed cases have already been documented across five locations: Bunia, the rebel-held North Kivu provincial capital of Goma, Mongbwalu, Butembo, and Nyakunde. The outbreak has also crossed an international border, with one confirmed case and one death recorded in Uganda in an individual who traveled from the affected Congolese region.

In Ituri province’s capital of Bunia, one American physician has tested positive for the virus, according to Dr. Jean-Jacques Muyembe, medical director of the DRC’s National Institute of Bio-Medical Research. Dr. Peter Stafford, who was treating patients at a local hospital when he developed symptoms, works for the international medical organization SERVE. Three other SERVE staff members, including Stafford’s wife, were working at the same facility but have not reported any symptoms to date.

The chain of delayed detection stretches back to April 24, when the first recorded Ebola fatality occurred in Bunia. The victim’s body was subsequently transported for burial to the Mongbwalu health zone, a heavily populated gold mining region, a movement that health minister Kamba says directly fueled the outbreak’s rapid escalation.

When a second person fell ill on April 26, samples were shipped to the national capital Kinshasa for testing. Congolese officials report that samples were initially screened only for Zaire ebolavirus, the more common circulating strain, and returned a false negative result. Local authorities therefore ruled out Ebola and took no immediate containment action. It was not until May 5, when WHO was alerted to an unexplained cluster of 50 deaths in Mongbwalu—including four local health workers—that officials ordered expanded testing, leading to the formal confirmation of the outbreak on May 14.

Matthew M. Kavanagh, director of the Georgetown University Center for Global Health Policy and Politics, says the false negative result left global and local responders playing catch-up with a deadly pathogen. He criticized the former Trump administration’s decision to withdraw U.S. membership from the WHO and slash global health foreign aid funding, cuts that he says weakened the very early warning surveillance systems designed to detect these outbreaks before they grow out of control.

The U.S. State Department rejected criticism on Monday, noting that Washington had moved quickly to deploy support and already committed $13 million in emergency assistance to the outbreak response.

Esther Sterk, a representative for the humanitarian medical organization Medecins Sans Frontieres (Doctors Without Borders), told the Associated Press that the situation remains deeply worrying and is evolving much faster than initial projections. She added that delayed detection is not an uncommon challenge for Ebola outbreaks, as the disease shares early symptoms with many other common tropical illnesses.

Ebola is a highly contagious viral pathogen spread through direct contact with infected bodily fluids, including blood, vomit, and semen. While infections are rare, the disease causes severe illness that is frequently fatal. During the 2014-2016 West African Ebola epidemic that killed more than 11,000 people, many transmissions occurred during traditional funeral practices that involve close contact with deceased victims’ bodies.

Dr. Craig Spencer, an associate professor at Brown University School of Public Health who survived an Ebola infection he contracted while working in Guinea in 2014, notes that Ebola disproportionately harms those who care for the sick, a dynamic he describes as the “disease of compassion.” Common symptoms of infection include fever, headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain, and unexplained bleeding or bruising.

Rising caseloads and severe symptoms have fueled growing panic among residents in Bunia’s neighborhoods. Noëla Lumo, a Bunia resident who previously lived through an Ebola outbreak in Beni, says she understands the threat firsthand and has already begun production of homemade protective cloth masks to distribute to her community.

The affected region of eastern DRC already faces overlapping crises that complicate the outbreak response. Mongbwalu is located in a remote part of Ituri province, more than 620 miles from Kinshasa, with poorly maintained road networks that slow the movement of medical supplies and response teams. Eastern DRC has been grappling with a years-long humanitarian crisis and ongoing violence from armed rebel groups, which have killed dozens of people and displaced thousands in Ituri alone over the past year. According to U.N. data, Ituri is home to more than 273,000 internally displaced people out of a total provincial population of just 1.9 million.

A U.N. official based in Bunia, speaking on condition of anonymity due to restrictions on speaking to media, confirmed that all U.N. staff in the region have been ordered to work remotely, avoid close physical contact with others, and stay away from crowded public spaces to reduce their risk of infection.

A deadly Ebola outbreak in the Democratic Republic of the Congo has claimed nearly 120 lives, and public health teams are facing unusual challenges because the outbreak is driven by Bundibugyo virus, one of the rarest Ebola species, with no licensed specific treatments or vaccines ready for deployment. Unlike the more common Zaire Ebola species, for which multiple vaccines and therapeutics have been developed and approved, Bundibugyo virus has no candidate interventions even advanced enough to enter human clinical trials, leaving frontline responders to rely on foundational, decades-old outbreak control measures. “There’s nothing even close to ready for clinical trials,” explained Dr. Celine Gounder, an infectious disease specialist and epidemiologist who treated patients during the devastating 2014–2016 West African Ebola epidemic. “And so that means responders, healthcare workers and other aid workers are really back to the basics.”

What makes this outbreak unusual is the specific pathogen at its center. Bundibugyo virus was first formally identified in 2007 by the U.S. Centers for Disease Control and Prevention’s Special Pathogens Branch, then led by Dr. Tom Ksiazek, now a virologist and veterinarian at the University of Texas Medical Branch. To date, this marks only the third recorded Bundibugyo outbreak, with all previous events occurring in the same Congo River basin region where the current outbreak is unfolding.

Like all known Ebola viruses, Bundibugyo spreads through direct close contact with the bodily fluids of infected people—living or deceased. These fluids include blood, sweat, feces, and vomit, meaning healthcare workers and family members caring for sick patients face the highest risk of infection. “So very often we see doctors and nurses among the first to be infected and to die,” noted Gounder, who serves as editor-at-large for public health at KFF Health News.

Based on limited data from the two prior small outbreaks, experts believe Bundibugyo virus may have a slightly lower mortality rate than the more widespread Zaire Ebola virus, the species responsible for most large Ebola outbreaks. Even so, the estimated 30% or higher mortality rate remains a major public health threat, though precise estimates are hard to calculate given the limited number of recorded infections. “I think a 30%-plus mortality rate is still quite scary, but it’s hard to say with a lot of precision because we don’t have a lot of experience,” Gounder said.

Without targeted treatments or vaccines, clinical care for infected patients is limited to supportive care, a strategy that has proven effective at reducing death rates in past outbreaks. In the two previous Bundibugyo events, early identification of initial cases allowed rapid response teams to implement core control measures: providing frontline staff with full personal protective equipment, identifying and isolating exposed contacts, and delivering aggressive supportive care including intravenous or oral fluid replacement to manage dehydration, a common complication of Ebola infection. Proper supportive care “reduces mortality significantly,” Ksiazek confirmed.

Today, public health teams are leaning on these same proven core strategies to contain the current outbreak. Response efforts focus on active case finding, prompt isolation of infected people, contact tracing to stop secondary transmission, and public education to help communities avoid exposure. As during the 2014–2016 West African epidemic, promoting safe burial practices is a top priority, since traditional funeral rites that involve close contact with deceased bodies have historically been a major driver of Ebola spread. Experts also emphasize that consistent access to high-quality personal protective equipment for healthcare workers remains non-negotiable for stopping transmission.

While the absence of a vaccine is certainly a setback, experts point out that basic public health tools have successfully stopped every previous Ebola outbreak in the DRC, which has now weathered 17 separate Ebola events in its history. “Of course, it’s problematic because vaccines are some of our best tools for combating infectious diseases,” said Lina Moses, an epidemiologist and disease ecologist at Tulane University. “But other public health tools — public education, contact tracing, quick testing — still work. It’s important to keep in mind that every single Ebola outbreak that has occurred in the (Democratic Republic of the Congo) — we’re on our 17th now — has been stopped.”

This reporting was contributed by Associated Press Southern Africa reporter Mogomotsi Magome from Johannesburg. The AP Health and Science Department receives funding support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation, with the AP retaining full editorial control over all content.