According to the latest figures released by the DRC's public health institute, confirmed cases have reached 4,053, including 1,850 deaths, representing a case fatality rate of approximately 44 percent. The outbreak, which has now spread across 53 health zones in five provinces—Ituri, North Kivu, South Kivu, Haut-Uele and Tshopo—is the fastest-spreading on record, with cases doubling every 20 days.
A Delayed Detection and an Untreatable Strain
The outbreak, caused by the rare Bundibugyo ebolavirus, was officially declared on 15 May 2026, but experts now believe infections had been circulating months earlier. A report published in the journal Science in July concluded that the outbreak likely began in January, with researchers identifying more than 500 suspected cases between mid-January and mid-May that went undetected.
Health officials say early samples were tested with tools designed to detect Ebola Zaire—the strain responsible for most previous outbreaks—rather than Bundibugyo, leading to negative results and significant delays in identifying the virus.
There is currently no licensed vaccine or approved specific treatment for the Bundibugyo strain. The absence of medical countermeasures, combined with the outbreak's spread through conflict-affected areas, has allowed the virus to outrun containment efforts.
Mutation Fears and Accelerating Transmission
Health officials are investigating whether the virus may be mutating, with changes that could complicate efforts to contain the outbreak. Africa CDC Director-General Jean Kaseya said at a press briefing on Thursday that the organisation was working with the DRC's biomedical research institute to determine whether mutations in the virus have altered its transmissibility or severity.
"If there are mutations, it could still affect the approach and the strategy," Kaseya said, urging member states to increase surveillance and preparedness and calling on the international community to mobilise more resources to support the response.
The WHO has warned that transmission is accelerating, with a record 567 new cases and 296 deaths reported in the past week alone. The outbreak is now the second-largest in history, surpassing the 2018-2020 epidemic in terms of cases.
Critical Constraints Hampering the Response
The response has been hampered by multiple challenges. More than 80 percent of new cases in Ituri, the epicentre, lack identified links to known contacts, making it extremely difficult to track and contain the virus. More than 60 percent of deaths are occurring within communities rather than at Ebola treatment centres, meaning people are dying without ever reaching care.
Persistent funding shortages, insecurity, unsafe burial practices, and infections and deaths among healthcare workers have further complicated the response. In early July, some healthcare workers in Ituri province went on strike due to delayed pay and unsafe working conditions. "They said, 'We've been promised so many times. Our colleagues have died. We're not going to work anymore,'" UN senior Ebola coordinator Julien Harneis told reporters.
Vaccine and Treatment Strategies Broadened
Despite the absence of a licensed vaccine for the specific strain, officials have decided to expand the use of Ervebo, a vaccine developed against the Zaire ebolavirus species, among populations in Ituri and North Kivu while formal studies continue. Field observations suggest that people previously vaccinated against Zaire ebolavirus who later contracted Bundibugyo virus disease either developed milder symptoms or survived, with no deaths observed in that group.
Two candidate vaccines specifically designed to target the Bundibugyo virus are also in development. A vaccine developed by the University of Oxford and the Serum Institute of India entered Phase 1 clinical trials in Britain on July 24, while a second candidate developed by Moderna is expected to begin Phase 1 testing in Canada this week.
Village-Level Response and School Reopening
Following a high-level crisis meeting in Kinshasa chaired by President Felix Tshisekedi, the Africa CDC announced a new village-centred community response approach. "We have now decided to bring the outbreak response at village level, not at provincial, health zone or district levels, but at the village level," Kaseya said.
Priority actions include implementing free healthcare, stabilising the essential health workforce, developing an integrated health and humanitarian plan, and accelerating the digital transformation of the response. Crucially, officials have committed to safeguarding the planned reopening of schools next month while putting measures in place to prevent any potential spread of the virus.
At least 19 internally displaced people have been infected, and five have died in camps in Ituri province, according to the UN refugee agency. Kaseya said the main weakness in the response was not a lack of funding, but a gap in sufficiently mobilising affected communities. "Community ownership must be at the heart of the response," said WHO Director-General Tedros Adhanom Ghebreyesus after visiting Kinshasa.
With reporting from Reuters, Africa CDC, WHO, UN OCHA, The East African and The Standard.
