The Ebola Outbreak in East Africa: A Major Public Health Challenge in an Impoverished and Unstable Region
On 15 May 2026, an Ebola outbreak in Ituri Province, in the north-east of the Democratic Republic of Congo (DRC), was confirmed by the Africa Centres for Disease Control and Prevention (CDC). Two days later, the WHO declared a Public Health Emergency of International Concern (PHEIC) in the DRC and Uganda, with a potential public health risk to multiple nation-states. The outbreak cannot, as of yet, be considered a pandemic. The Africa CDC went on to declare a Public Health Emergency of Continental Security on 18 May. As of 26 May, the Ministry of Health in DRC had reported 121 confirmed cases, including 17 deaths, and 1,077 suspected cases, including 238 deaths, in Ituri, North Kivu, and South Kivu provinces.
The Ebola virus was first isolated in 1976 during an outbreak of haemorrhagic fever in southern Sudan and northern Zaire (now DRC). It was named for the Ebola River, which flows near the village of Yambuku where the first patient was identified. It is a zoonotic disease, transmitted by wild animals to humans. Fruit bats serve as a natural reservoir for the virus. The largest outbreak of Ebola until now has been in West Africa (Guinea, Liberia, and Sierra Leone) between 2013 and 2016.
Ebola is caused by infection with an orthoebolavirus, five species of which can affect humans. Human-to-human transmission results from direct contact, through broken skin or mucous membranes, with blood or bodily fluids (saliva, sweat, tears, semen, vomit, urine, breast milk) from symptomatic individuals or with contaminated inanimate objects (clothing, needles). Close family members and health care workers are most at risk of acquiring Ebola.
Ebola is a severe form of viral haemorrhagic fever. Initial symptoms of high fever, headache, muscle and joint pains, malaise, and fatigue develop within two to 21 days after exposure to the virus and progress to nausea and vomiting, diarrhoea, progressive weakness, and internal and external bleeding. Multiple organ failure and death are among the likely outcomes. The average case fatality rate is around 50%. The diagnosis is confirmed by laboratory testing, which entails the detection of viral material (RNA or antigen) or specific antibodies to the virus.
This is the seventeenth Ebola outbreak in the DRC, following closely on a previous outbreak between September and December 2025. The current outbreak has been attributed to the Bundibugyo species of virus (Orthoebolavirus bundibugyoense), which is named after a district in the Western Region of Uganda where it was first detected in 2007. Previous Bundibugyo outbreaks have been reported along the DRC-Uganda border in 2007, when 42 people died, and in the DRC in 2012- with 13 deaths. No licensed vaccine or approved specific treatment is currently available for this species of virus. Supportive care, to manage symptoms, is all that can be offered to infected individuals. Ervebo, a single-shot vaccine against the Zaire species (Orthoebolavirus zairense), was developed by Merck, successfully trialled in West Africa in 2015, and approved by the US Food and Drug Administration in 2019. Some reports suggest that this vaccine may be tried out in the current outbreak.
A matter for concern is the widespread mistrust in public health officials that is hampering attempts to contain the outbreak- in a region disadvantaged by poor transport links, inadequate healthcare facilities, and large numbers of displaced people, including refugees from South Sudan. Spread of the virus has been facilitated by the continuing movement of people along mining corridors and in the course of trade across porous borders. The gold-rich Ituri Province is a particularly unstable region, where ongoing conflict between rebel ethnic militias has led to the imposition of direct military rule from 2021 onward.
Some experts have shared their concern that the outbreak appears to be spreading faster than first predicted. Under ideal circumstances, easy access to laboratory testing, early case detection, isolation of infected patients, contact tracing, infection control measures (hand hygiene, eye protection, personal protective equipment), and safe burial practices would be expected to help restrict community spread. It has been reported, however, that as many as one of three people in the epicentre of the outbreak deny the very existence of the virus. Many attribute Ebola to witchcraft instead, and some others consider it to be a fictitious illness, concocted by Western powers and Big Pharma. Traditional mourning practices have been curtailed in an attempt to limit the spread of infection from people who have died from the illness, leading a group of young men to set fire to a hospital in the city of Bunia on 24 May as they attempted to reclaim the bodies of deceased relatives. Ebola treatment facilities and frontline workers have indeed been attacked on several different occasions.
Uganda has temporarily closed its 54-mile-long border with DRC on 27 May, “with immediate effect”, despite WHO guidance to the contrary. Only essential workers will hereafter be allowed to travel between the two nations. Various countries have introduced protocols to screen and monitor citizens returning from areas where cases of Ebola have been reported-ie, DRC, Uganda, and South Sudan. The US is even setting up a quarantine and treatment centre in Kenya for American citizens exposed to Ebola in the region, instead of bringing them back to the US for specialist treatment.
The Ebola outbreak is providing yet another wake-up call to the global community. Complacence, inertia, and a shortage of frontline resources is being compounded by political instability, a breakdown of law and order, ingrained mistrust of public health control measures, and insufficient global coordination of efforts. For those fortunate enough to be watching from a safe distance, subsequent events will inevitably speak for themselves.
Ashis Banerjee