Bundibugyo Ebola Outbreak in DRC and Uganda: Over 1,000 Confirmed Cases, Widespread Response Challenges

A major outbreak of Ebola virus disease caused by the Bundibugyo virus is ongoing in the Democratic Republic of the Congo (DRC) and Uganda. Declared a Public Health Emergency of International Concern by the World Health Organization (WHO) on May 17, 2025, the outbreak has resulted in thousands of suspected and confirmed cases and hundreds of deaths. The response is complicated by the virus's rarity, which has no approved vaccine or treatment, as well as ongoing conflict, population displacement, and community mistrust.

Outbreak Overview and Scale

As of late June 2026, the DRC Ministry of Health reported 1,003 confirmed cases and 254 deaths, with over 100 recoveries. Additional reports from the DRC's public health institute later placed the total at 2,536 confirmed cases and 1,033 deaths, making it one of the country's largest Ebola outbreaks. Uganda has reported approximately 20 confirmed cases and two deaths, primarily linked to cross-border travel from the DRC. The WHO reported the number of suspected cases has fluctuated, reaching over 1,000 at times before being revised down after testing cleared backlogs.

The outbreak is concentrated in the northeastern provinces of Ituri, North Kivu, and South Kivu, with Ituri province accounting for over 90% of confirmed cases. Cases have also spread to Haut-Uele province and to the capital, Kinshasa, via travel.

The first known suspected case was a health worker who developed symptoms on April 24 in Bunia, Ituri province, with the outbreak officially declared on May 15. A delay in detection occurred because initial tests were for the more common Zaire Ebola strain and returned negative. Samples later sent to Kinshasa confirmed the Bundibugyo species.

Virus Characteristics

The outbreak is caused by the Bundibugyo virus, a species of Orthoebolavirus. This is a rarer strain compared to the Zaire strain which has caused most previous outbreaks in the DRC. Bundibugyo has a reported case fatality rate of 25–50% based on previous outbreaks in 2007 and 2012.

No licensed vaccine or specific treatment exists for the Bundibugyo strain. Unlike the Zaire strain, there is no readily available vaccine or therapeutic. The WHO is evaluating experimental candidate treatments, including MBP134 (Mapp Biopharmaceutical), the antiviral remdesivir, and the oral antiviral obeldesivir for post-exposure prophylaxis. Clinical trials for these treatments are being initiated. Vaccine development is underway by organizations including IAVI, the University of Oxford, and Moderna, with potential availability estimated to be months away. The WHO and other agencies have advised against border closures and travel bans, stating they can complicate the response and discourage transparency.

Response and Challenges

The response is being led by health authorities in the DRC and Uganda, supported by the WHO, Africa CDC, and other international partners. Key response measures include:

• Surveillance and contact tracing: Identifying cases, tracing contacts, and monitoring them for 21 days.
• Laboratory testing: Establishing rapid diagnostic capacity for the Bundibugyo virus.
• Case management and treatment: Setting up Ebola treatment centers (ETCs) and providing supportive care.
• Safe and dignified burials: Implementing protocols to prevent transmission from deceased individuals.
• Community engagement: Countering misinformation and building trust with affected populations.

Multiple challenges are hindering containment efforts:

• Security and Conflict: The epicenter in eastern DRC is a region of long-standing armed conflict involving groups such as the M23 and the Allied Democratic Forces (ADF). This insecurity complicates access for health teams, disrupts contact tracing, and has led to population displacement.

• Community Mistrust and Misinformation: Rumor, fear, and distrust of health authorities have led to resistance to public health measures. There have been multiple attacks on Ebola treatment centers, including arson, by residents angered over strict burial protocols that conflict with local customs.

• Displacement and Mobility: Over 2 million people are internally displaced in the affected provinces. Overcrowded displacement camps with poor sanitation create high-risk environments for transmission. Population movement, including by artisanal gold miners, makes contact tracing difficult.

• Delayed Detection: Initial testing failures allowed the virus to spread undetected for weeks, giving the outbreak a significant head start before the response could fully mobilize.

• Healthcare Strain: The health system in the affected areas is weak and under-resourced. At least 75 health workers have contracted the virus and 17 have died. Shortages of personal protective equipment (PPE), testing supplies, and other essential materials have been reported.

• Funding Gaps: International funding has been pledged but was reported to be slow in disbursement. The Africa CDC and WHO launched a $518 million emergency response plan.

International and National Measures

• US Response: The US CDC activated a Level 1 emergency response. The US government imposed travel restrictions, barring entry to non-citizens who have been in DRC, Uganda, or South Sudan within the past 21 days. US citizens and legal permanent residents returning from these countries are funneled through designated airports for enhanced screening. The US also committed funding and is providing experimental treatments for clinical trials.

• Regional Measures: Uganda closed its border with the DRC, a move the WHO advised against. Rwanda also closed its land border. Neighboring countries have heightened surveillance and screening at points of entry.

• DRC Government Measures: Authorities banned funeral wakes and gatherings of more than 50 people in the worst-affected areas. The government later expanded a ban on mass gatherings to four provinces, including Kinshasa, to limit spread.

Global Risk Assessment

The WHO assesses the risk as very high at the national level in the DRC, high at the regional level for neighboring countries, and low at the global level.

A historical study found only 28 confirmed Ebola cases outside Africa in the past 50 years, with most occurring during the 2014-2016 West Africa outbreak. The first case of the current outbreak outside Africa was reported in France, in a doctor returning from the DRC who has since been isolated and treated. Cases of suspected Ebola in countries like Brazil and Italy tested negative for the virus.