Kampala: An Ebola outbreak centered in the eastern Democratic Republic of the Congo and spreading into neighboring Uganda is raising alarm among global health authorities, who warn that the virus may already be circulating far beyond officially confirmed cases.
According to Anadolu Agency, Doctors Without Borders has warned that the outbreak is "out of control" after weeks of undetected transmission in the conflict-hit region. The Red Cross has also highlighted the challenges posed by fear, misinformation, weak health systems, and intense population movement, which could complicate efforts to contain the virus's spread across borders.
The World Health Organization (WHO) declared the outbreak a public health emergency of international concern, citing the risk of wider regional spread, rising infections in urban areas, and severe operational challenges in eastern Congo. This declaration represents the highest global health alert and aims to mobilize international coordination, funding, and preparedness efforts. Health authorities are particularly concerned about the Bundibugyo strain of Ebola, a less common variant for which there are currently no approved vaccines or treatments.
WHO Director-General Tedros Adhanom Ghebreyesus stated that the outbreak poses a high risk at national and regional levels, although the global risk remains low. As of May 18, WHO data indicates that Congo has reported 516 suspected cases and 131 suspected deaths in Ituri and North Kivu provinces, with 33 confirmed infections and four confirmed deaths. Uganda has also confirmed two imported cases in Kampala, including one death.
The outbreak was officially confirmed on May 15 after laboratory testing identified Bundibugyo virus disease in samples from eastern Congo. WHO noted that the first alerts emerged following reports of an unknown illness with high mortality in the Mongbwalu Health Zone, including the deaths of four health workers. Health officials and aid organizations fear the outbreak may be significantly larger than current figures suggest, as the virus likely circulated undetected for weeks before identification.
Surveillance is crucial for containing any outbreak, especially Ebola, according to Manuel Albela Miranda, an epidemiology adviser at Doctors Without Borders (MSF). More than 660 contacts are currently being monitored across both countries as health authorities race to contain the spread.
Ebola disease is caused by viruses belonging to the Orthoebolavirus genus, with three strains known to cause major outbreaks in humans: Ebola virus (Zaire), Sudan virus, and Bundibugyo virus. Eastern Congo has experienced multiple Ebola outbreaks over the past decade, including a massive epidemic from 2018 to 2020. While vaccines and treatments exist for some strains, there are currently no licensed vaccines or approved therapeutics for the Bundibugyo strain.
WHO is working with experts and Congolese authorities to accelerate vaccine research. One candidate vaccine, Ervebo, could become available in approximately two months, according to Anne Ancia, WHO representative in Congo. However, the single-dose vaccine is not specifically approved for the Bundibugyo variant.
The outbreak is unfolding in a region already destabilized by armed violence, mass displacement, and fragile health systems. According to WHO, Bunia, one of the affected cities, is a major transport and commercial hub with intense population movement across borders with Uganda and South Sudan, increasing transmission risks.
Ebola symptoms can appear suddenly between two and 21 days after infection, with early signs resembling illnesses such as malaria or typhoid fever, necessitating laboratory testing for confirmation. Human-to-human transmission occurs through direct contact with infected bodily fluids, and burial ceremonies have historically contributed to transmission.
Response efforts face challenges such as limited isolation capacity, shortages of protective equipment, and fragile healthcare systems. Testing remains difficult, as the Bundibugyo strain requires a different diagnostic process than other Ebola viruses. WHO advises against border closures and travel restrictions, warning that such measures can complicate outbreak tracking.
The coming weeks are critical for understanding the outbreak's scale, containing it, and accelerating efforts to develop effective vaccines and treatments for the Bundibugyo strain.