DR Congo's deadliest Ebola outbreak as conflict hampers containment
Force in Play
The Bundibugyo strain has no approved vaccine. It has killed 5,372 people in DR Congo, where the fatality rate has topped 50%, and reached Kenya, Uganda and Nigeria; a Nigerian patient was evacuated to Switzerland for treatment.
Congo's Ebola outbreak has killed 5,372 people among 10,414 confirmed cases, a 51.6% fatality rate, the National Institute of Public Health said in a report released October 31. Across Africa the toll is now 5,376, after Kenya and Uganda each recorded two deaths, the Africa CDC said on November 2.
The Bundibugyo strain has reached Kenya, which has reported nine cases, and Nigeria, which has one imported case and no deaths; Uganda was declared Ebola-free in August. From late on November 3, the United States requires passengers on international flights to attest they have not been in Congo in the previous 21 days. No vaccine is approved for Bundibugyo, though a trial of Ervebo began in Bunia on October 23, and Jürgen May of the Bernhard Nocht Institute for Tropical Medicine has said broad use is unlikely before mid-2027.
Why it matters
More than 5,300 people have died, and responders still cannot trace most new infections to known contacts.
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Key Indicators
10,414
Confirmed cases
Congo's National Institute of Public Health report released October 31; up from 10,351 in the October 29 bulletin.
5,372
Ebola deaths in Congo
Includes 314 earlier deaths added in Ituri after a records review; reported October 31.
5,376
Deaths across Africa
Africa CDC total as of November 2: 5,372 in Congo, two in Kenya and two in Uganda.
51.6%
Case fatality rate
Deaths as a share of confirmed cases after the October 31 revision, up from 48.6%.
8
Provinces affected
Bas-Uele, Haut-Uele, Ituri, North Kivu, South Kivu, South Ubangi, Tshopo and Nord-Ubangi.
80%
New cases outside contact lists
Africa CDC estimate, reported November 2; the agency says 95% must come from known contacts for control.
9
Kenya confirmed cases
Including two deaths, both counted in the Africa CDC regional toll; 98 contacts remained under watch on October 26.
1
Nigeria confirmed cases
Patient evacuated to Switzerland on October 26; two suspected cases in Adamawa tested negative, and Nigeria has reported no deaths.
29 events
Latest: November 3rd, 2026 · 1 week ago
Showing 8 of 29
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November 2026
US Ebola air-travel attestation takes effect
LatestResponse
From 11:59pm US Eastern time, passengers boarding international flights to the United States must attest they have not been in Congo during the previous 21 days.
Africa CDC puts outbreak death toll at 5,376
Measurement
The agency counted 5,372 deaths in Congo, two in Kenya and two in Uganda, with 10,444 infections across Congo, Uganda and Kenya.
US tightens travel rules for people who have been in Congo
Response
The US Centers for Disease Control and Prevention said that from late November 3, anyone boarding an international flight to the US must attest they have not been in the Democratic Republic of Congo during the previous 21 days.
The National Institute of Public Health said 10,414 confirmed infections and 5,372 deaths, a 51.6% fatality rate, after a review of records in 97% of affected health zones in Ituri added 314 earlier deaths.
Nigeria says two suspected Ebola cases test negative
Measurement
Nigeria's health authorities said two suspected cases in Adamawa state tested negative after two rounds of testing, leaving the country with one confirmed infection.
Congo's Ebola deaths pass 5,000
Milestone
The national bulletin recorded 10,351 confirmed cases and 5,026 deaths through October 29, a 48.6% fatality rate. Ituri remained the centre with 7,346 cases and 3,436 deaths.
Last patient leaves an Ebola treatment centre in DRC
Development
Al Jazeera footage showed health workers celebrating after the last patient left an Ebola treatment centre in DR Congo. The report did not name the centre or say the outbreak was over.
Congo's Ebola outbreak passes 10,000 cases
Milestone
Government data put confirmed cases at 10,060 and deaths at 4,887 through October 25, making it the fastest-growing and deadliest Ebola outbreak in the country's history and the second-deadliest on record.
Nigeria's Ebola patient evacuated to Switzerland
Development
The Abuja patient was flown to Geneva University Hospital for treatment, and her husband, a close contact, was isolated at Zurich University Hospital.
ECDC deploys three experts to Nigeria
Response
The EU agency sent three experts to Abuja to advise the EU delegation and support Nigerian authorities on surveillance, contact tracing and infection control.
Uganda tightens border measures
Response
Uganda said 60 contacts linked to the Kenyan case had finished 21-day monitoring and announced new measures at points of entry plus movement restrictions along the Congo border.
Nurse killed while responding to suspected case in Tshopo
Incident
WHO said assailants killed a nurse and seriously injured a colleague in Bafwasende, Tshopo province, as the two responded to a suspected Ebola case.
Kenya reports second Ebola death
Milestone
Kenya's third confirmed case, a woman who developed symptoms on October 13, died. The country's nine cases now include two deaths.
Bundibugyo vaccine trial opens in Bunia
Launch
The TUMAINI Phase 2/3 trial began in Bunia, Ituri province, testing vaccine candidates against the Bundibugyo strain, including an existing licensed Ebola vaccine.
WHO says transmission active in 50 of 66 health zones
Measurement
WHO's Africa office reports that 75.8% of affected health zones had a new confirmed case in the previous 21 days, with more than 9,600 cases and 4,646 deaths in Congo.
DRC cases reach 9,704 as deaths hit 4,646
Measurement
DRC's October 20 situation report records 9,704 confirmed cases. The health ministry reports 4,646 deaths as of October 19, a 48.2% fatality rate.
Kenya confirms ninth Ebola case
Measurement
Kenya's case count rises to nine, including one death. Most infections are among relatives, health workers and a patient attendant linked to the first imported case.
Nigeria confirms first Bundibugyo Ebola case
Milestone
A woman who traveled from Uganda to Abuja on October 3 tests positive. Nigeria's NCDC identifies 44 contacts, mostly health workers, and says the strain matches Congo's.
Ebola reaches eighth province, Nord-Ubangi
Spread
DRC health authorities report two cases, one fatal, in the Wapinda health zone of Nord-Ubangi, which borders the Central African Republic.
Suspected Ebola case in Kenya tests negative
Measurement
Preliminary laboratory results for a suspected Ebola case in Kenya's Wajir County came back negative, easing fears of a second Kenyan case, though monitoring continued.
Oxford Ebola vaccine trials begin in Uganda
Launch
Phase Ib clinical trials of a University of Oxford vaccine candidate begin in Uganda. Moderna's candidate received ethical approval for Phase Ib trials in the country.
Cases reach 8,728 as outbreak expands
Measurement
WHO reports 8,728 confirmed cases and 4,205 deaths as of October 6, up from 8,603 and 4,148 a week earlier. The outbreak expanded to the Alimbongo health zone in North Kivu; weekly cases rose 2.5%.
Kenya reports first imported Ebola case
Milestone
Kenya's Ministry of Health reported its first confirmed case of Bundibugyo virus disease, a Kenyan national who had lived in DRC and traveled through Uganda to Nairobi. The patient, confirmed and isolated in Nairobi, died on October 5. Authorities identified 66 contacts, including flight passengers; tracing continues in Uganda and DRC.
Case count rises to 8,603
Measurement
DRC reports 8,603 confirmed cases and 4,148 deaths as of Oct 4, with 59 new cases in the latest reporting period. North Kivu accounts for 55.9% of new cases.
Death toll surpasses 4,000
Milestone
DRC health ministry reports 4,018 deaths and 8,300 confirmed cases across seven provinces.
Health workers protest unpaid wages
Protest
Surveillance team members in Ituri demand months of unpaid wages, waving placards reading "No money, no data!"
September 2026
Transit center burned in Kigonze camp
Incident
Soldiers searching for weapons burn an Ebola transit center in Kigonze camp, forcing 19,000 residents to flee.
August 2026
Weekly deaths peak at 364
Measurement
Weekly Ebola deaths hit 364, the highest point of the outbreak so far, according to Africa CDC figures.
May 2026
DRC declares Ebola outbreak
Declaration
Government announces an Ebola outbreak with cases confirmed in eastern provinces near the Uganda and Rwanda borders.
Scenarios
1
Decline reverses as surveillance gaps are confirmed
Likely
Resolves by Jan 2, 2027
Discussed by: Wessam Mankoula (Africa CDC) and the Clarity analysis of contradictory trends
Mankoula and other officials warn the September drop may reflect underreporting, not control. Insecurity in Katwa, Beni, Butembo, Nizi and Nia-Nia blocks surveillance teams from reaching communities. If cases resume climbing in North Kivu and Tshopo, the outbreak could expand into new health zones.
2
Outbreak spreads beyond DRC borders
Possible
Resolves by Apr 2, 2027
Discussed by: WHO, which raised the alarm about rapid spread into new health zones
Fighting has already restricted humanitarian access to health zones in Ituri province, including Fataki, Drodro and Lita. If containment fails in the eastern provinces near the Uganda and Rwanda borders, the virus could cross into neighboring countries. The WHO has said the current outbreak is on track to approach the scale of West Africa's 2014-2016 epidemic, which killed 11,000.
3
Outbreak declared over within six months
Possible
Resolves by Apr 2, 2027
Discussed by: WHO and DRC health authorities pursuing containment; MSF published a plan for ending the outbreak
More than 21 days have passed without a new case in 18 health zones, and weekly case counts fell to their lowest level since mid-June. If security improves and vaccination and contact tracing expand, the outbreak could follow the standard trajectory toward declaration of the end. The WHO's criterion for declaring an Ebola outbreak over is 42 days without a new confirmed case.
4
Outbreak spreads deeper into East Africa
Possible
Resolves by End of 2026
Discussed by: WHO, which confirmed the first imported case in Kenya
The Kenya case, which proved fatal, shows the virus can cross borders. The patient traveled through Uganda, and contact tracing is underway in both countries. WHO has warned that cases are likely to rise further, and insecurity continues to hamper the response in DRC's eastern provinces.
5
Kenya contains its first imported case without local spread
Deadline passed (Oct 26, 2026)
Discussed by: Kenyan health authorities and WHO, which is tracing contacts and flight passengers
The imported case, a Kenyan national who died on October 5, was isolated at a Nairobi hospital. Kenyan authorities identified 66 contacts, and WHO is tracing passengers from the patient's flight. Resolved no: Kenya's cluster reached nine cases and two deaths by 23 October. WHO assessed the risk to DRC's border-sharing neighbors as high.
6
Kenya sees household transmission after confirming second case
Possible
Resolves by Nov 25, 2026
Discussed by: Kenya Ministry of Health and WHO, which is tracing contacts from the first imported case
Kenya's second confirmed case, a relative of the man who died October 5, points to household spread after the initial import. Kenyan authorities had listed 66 contacts for the first patient, including flight passengers. If more relatives test positive, Kenya shifts from containing an imported case to suppressing local chains, a harder task without a Bundibugyo vaccine.
7
Nigeria contains its first Bundibugyo case without local spread
Possible
Resolves by Dec 2, 2026
Discussed by: Nigeria Centre for Disease Control and Prevention and WHO
Nigeria's first patient traveled from Uganda to Abuja on October 3 and was admitted to a private hospital on October 11. Officials identified 44 contacts, most of them health workers. If no linked case appears within 42 days, Nigeria can close the cluster. A secondary infection would confirm local transmission in West Africa.
8
Kenya's Ebola cluster widens beyond the first household
Possible
Resolves by Nov 30, 2026
Discussed by: Kenya Ministry of Health and WHO
Kenya has reported nine cases since October 6, including relatives of the first patient, three health workers and a patient attendant. Most were already in quarantine. If new cases appear outside known contacts, Kenya has wider community transmission.
9
Bundibugyo vaccine trial produces an efficacy signal
Uncertain
Resolves by Q2 2027
Discussed by: CEPI, which announced the first participant was vaccinated in the TUMAINI trial on October 23
The TUMAINI trial in Bunia is testing vaccine candidates against the Bundibugyo strain, which has no approved vaccine. A Phase 2/3 trial can take months to yield efficacy data, and enrolment in Ituri depends on security in an area where responders have been attacked. A positive readout would give responders a tool they have never had for this strain; a null result leaves containment to contact tracing and safe burials.
10
Official toll underestimates the outbreak
Likely
Resolves by Jan 31, 2027
Discussed by: Torsten Feldt and Jürgen May, in comments to dpa
Feldt, head of tropical medicine at Düsseldorf University Hospital, told dpa that official numbers show a broadly reliable trend but hide a significant undercount, with actual infections possibly two to three times higher. May, who leads the Bernhard Nocht Institute for Tropical Medicine, said the confirmed figures are probably the lower limit, citing delayed reporting and mild cases that are never tested.
11
No Bundibugyo vaccine before mid-2027
Likely
Resolves by Jul 1, 2027
Discussed by: Jürgen May, Bernhard Nocht Institute for Tropical Medicine
May told dpa that vaccine studies and production take months rather than weeks, making broad use of a Bundibugyo vaccine unlikely before mid-2027. The TUMAINI trial in Bunia began on October 23, and Ervebo, licensed for the Zaire strain, is being tested for cross-protection.
Historical Context
2 moments from history that rhyme with this story — and how they unfolded.
1 of 2
December 2013 - June 2016
West Africa Ebola epidemic (2014-2016)
The largest Ebola outbreak in history began in Guinea and spread to Sierra Leone and Liberia, killing more than 11,000 people. It was the Zaire strain, which later gained an approved vaccine. The virus reached major cities and overwhelmed underfunded health systems across three countries.
Then
Closed borders, overwhelmed health systems, and more than 11,000 deaths across three countries.
Now
Spurred development of Zaire-strain vaccines and treatments and led to reforms in global outbreak response.
Why this matters now
The current outbreak is on track to approach this scale if containment fails, but it involves a strain without approved tools.
2 of 2
August 2018 - June 2020
North Kivu Ebola outbreak (2018-2020)
Previously DRC's deadliest Ebola outbreak, also centered in the eastern provinces. Armed groups attacked health workers and treatment centers, and community mistrust slowed contact tracing. It was eventually contained using a vaccine for the Zaire strain.
Then
Containment took years and required military escorts for response teams in insecure zones.
Now
Established vaccination as the key tool, but showed how armed conflict can prolong an outbreak.
Why this matters now
The same security constraints recur in 2026, but no vaccine or therapeutic exists for the Bundibugyo strain driving this outbreak.
