On Sunday 17th May the World Health Organisation declared:
"...the Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern (PHEIC), but does not meet the criteria of pandemic emergency, as defined in the IHR."
On Monday 18th May The Africa Centres for Disease Control and Prevention (Africa CDC) officially declared the ongoing Bundibugyo ebolavirus disease outbreak affecting the Democratic Republic of the Congo (DRC) and Uganda a Public Health Emergency of Continental Security (PHECS).
While the world was watching wealthy people on a cruise struggle with Hantavirus, in a far poorer corner of the world a massive deadly outbreak was occurring. This Ebola outbreak is different from previous outbreaks I've told you about, and while your chance of it ever reaching you is incredibly slim, it isn’t ever zero.
This is already a massive (3rd largest) Ebola outbreak. At the time of the initial announcement last Friday (15th May) there were around 250 suspected cases and 65 deaths - that was later amended to 80 deaths. By Monday we were told 390 cases and 100 deaths. This lunchtime there was a daily update from DRC to 653 cases and 144 people who have died (as well as 2 lab-confirmed cases, 10 suspected cases and 1 death in Uganda).
Last night WHO convened a meeting of the Emergency Committee on the Ebola outbreak in the DRC and Uganda, and gave a press conference this morning. WHOAFRO gave their first situation report shortly afterwards. By their figures at the time of writing on 18th May (Monday)...
528 suspected cases, 132 deaths (Case Fatality Rate 25%)
35 confirmed cases, 5 deaths (CFR 14.3%)
(12 of those suspected cases including 1 death, and 2 confirmed cases including 1 death are in Uganda)
668 contacts have been identified: "contact tracing remains challenging in some areas of DRC due to insecurity and movement restrictions".
At the moment this outbreak is confined to a small area of the world, focussed in North Eastern Democratic Republic of the Congo (DRC). It is an epidemic, not a pandemic.
People with symptoms and anyone who could be a possible contact have been asked not to travel. Affected populations have been asked not to organise or attend large gatherings. WHO don't recommend closing borders or barring individuals from entry, but they are asking the world to be cautious. Obviously that advice can change at any point.
The first known suspected case is a medical worker who began to show flu-like symptoms on 24th April. This is not likely to be patient zero.
Dr Ancia of WHO, who is in DRC:
"I don't think that we have the ‘patient zero’ for now. What we know for now is that on 5 May, there was…a person who died in Bunia. The body was brought back [to] Mongbwalu…and put in a coffin. And then the family decided that the coffin was not worth the person. And therefore…they changed the coffin. And then there was the funeral, and it's from where it started."
Detection of the initial cases was delayed because the Ebola tests showed negative results for the far more common Zaire strain of Ebola. They don't work for Bundibugyo. Blood samples had to be sent from a remote war-torn area to a lab hundreds of miles away.
The outbreak is Bundibugyo species Ebola, and is only the 3rd ever outbreak of this type of Ebola. It was first identified in 2007 in the Bundibugyo district of Western Uganda. Reports vary, but in that outbreak there were around 130-150 cases and 42-47 deaths (case fatality rate of around 30% or 1 in every 3). The 2nd outbreak was in 2012 in Congo, with around 57 cases and 29 deaths (case fatality rate of over 50%, or 1 in every 2).
Most Ebola outbreaks are Zaire Ebola, which has therapeutic medicines and a vaccine. There are currently no specific treatments and no vaccine for Bundibugyo Ebola. There are potential antivirals that can be tried, and mRNA vaccines that can be adapted. Ervebo, a vaccine against the Zaire Ebola virus, is under consideration, but it will take a while for it to be available. There's nothing right now.
All you can really do is keep patients comfortable (IV fluids, pain relief, oxygen). Giving fluids as soon as possible increases the chances of survival.
This outbreak flew under the radar, and it has been able to spread for some considerable time before it was reported. We aren't counting all cases or all deaths even now. Analysts at Imperial College London estimate that by Sunday 17th May there were already 400-800 cases, and they couldn't rule out 1,000.
The outbreak began in a mining area of significant population movement, and it is a conflict zone - WHO:
"The province of Ituri is highly insecure. Conflict has intensified since late 2025, and fighting has escalated significantly over the past two months, resulting in civilian deaths. Over 100,000 people have been newly displaced."
- One case has been reported in the capital Kinshasa - over 1,000 miles away from the epicentre.
- Uganda has informed WHO of two confirmed cases in the capital Kampala, including one death, among two individuals who travelled from DRC.
- Cases have been reported in large urban areas, including Kinshasa, Kampala and Goma.
- 4 healthcare workers have been reported to have died, indicating healthcare-associated transmission.
Ebola is a haemorrhagic disease. Symptoms begin as flu-like, with fever, generalised body aches and pains, weakness, diarrhoea and vomiting. In some cases, the patient then begins to bleed internally and externally. They can deteriorate and die rapidly, within a week or two after symptoms begin. Very often death is due to shock from loss of fluids.
The incubation period for Ebola is 2 days to 3 weeks or more, usually around 4 to 10 days.
Transmission is via all body fluids, including blood, semen, vomit, faeces, breast milk, saliva, tears, sweat etc, and from contaminated surfaces. Live Ebola virus has been found in survivors' sperm for over a year. The bodies of deceased patients remain highly contagious.
DRC, with help from WHO and other agencies are strengthening surveillance, contact tracing and laboratory testing capabilities. WHO are only able to release $500m, because they have less money than they did previously, because the US pulled out.
- The DRC INRB (Institut National de Recherche Biomedicale) has deployed a diagnostics team.
- Over 17 tons of emergency supplies have been shipped to DRC, incl. personal protective equipment, medical supplies, tents, stretchers and medicines. WHO have delivered nearly 7 tonnes to the affected area of Bunia.
- A team of 38 experts (20 from Ministry of Health and 18 from WHO) have been deployed from Kinshasa to Bunia.
- WHO, together with Alliance for International Medical Action, Doctors Without Borders, UNmigration and IFRC (Red Cross/Red Crescent) is supporting the setup of treatment facilities, lab teams and mobile laboratories in affected areas.
- Risk communications and community engagement are also being scaled up.
An American Doctor who was working with a medical missionary in DRC has become ill and tested postive. The patient and 6 other high risk American contacts (possibly his family and/or colleagues) have been/are being evacuated to Germany, where they have specialised treatment centres for viral haemorrhagic fevers, including units for isolation (patients) and quarantine (contacts). The patient is at Charité hospital in Berlin. A second exposed aid worker, another doctor, is now being sent to Czech Republic. Some experts are questioning why they've not gone home to the US, which has "world-class clinicians and an entire network of specialised biocontainment units built for exactly these situations after 2014" (Krutika Kuppalli). Others suggest shorter flight time is a very important consideration. It's a mystery, and when the US CDC are saying they'll send on-the-ground workers, you wonder who is going to volunteer if they won't even be repatriated should they accidentally find themselves at risk.
The US Government have also said they'll fund "up to 50 treatment clinics, and associated frontline costs being established in Ebola-affected regions of the DRC and Uganda".
It's not entirely clear what these clinics will look like or who will staff them, but they'll no doubt be very welcome, and we're told "will provide emergency Ebola screening, triage, and isolation capacity".
Several countries have issued travel advisories and warnings. The US has also issued travel warnings for DRC, South Sudan and Uganda, and barred any non-US citizens from entry if they have travelled to the region in the last 21 days.
(Viruses don't understand passports. If you want a ban, quarantine or health checks, do it for everyone.)
US Secretary of State Marco Rubio yesterday said the World Health Organization (WHO) was “a little late” in identifying the deadly Ebola outbreak.
Well, it isn't up to WHO to identify an outbreak, it's up to the country involved - which then reports it to WHO - and we've already discussed how hard that was in that particular area and with this virus.
And, as Dr Krutika Kuppalli MD FIDSA says:
"Many of us in global health warned this would happen.
The current Ebola outbreak in DRC is not occurring in a vacuum. Cuts to global health programs, surveillance, laboratory capacity, and outbreak response infrastructure have consequences."
DRC are more familiar with Ebola than anywhere else. They usually handle it incredibly well. This outbreak is unusual, it is concerning experts at WHO, and containment and contact-tracing are going to be incredibly difficult. It could be a very long outbreak. Dr Angie Rasmussen PhD, who is one of the world's top Virologists:
"People are highly mobile and that means we don't know the scale of the outbreak. We have no idea how many people have been exposed, or if it has spread to countries besides Uganda. It will take months if not years to contain."
I repeat, right now unless you are in DRC, or possibly neighbouring countries, it is highly unlikely you are personally at risk now or will ever be personally at risk - but it would be brazen and foolhardy to ever think your future risk is zero, or to ignore the biggest ever uncontained outbreak of an Ebola virus we do not have any treatment for. It will be utterly devastating to the population of any areas it does reach. This will kill a huge number of people.
If you want to know more, best to follow official sources - WHO are giving daily updates. If you speak French, DRC Ministry of Health are also very good. Experts who are reporting include Dr Angela Rasmussen PhD (Virologist at the Vaccine and Infectious Disease Organisation, Canada, and over a decade studying Ebola), and Dr. Krutika Kuppalli MD (multiple deployments to Ebola outbreaks for WHO).
All fingers crossed for rapid slowdown of infections and losses of life, and that containment does not extend to years...
They look like numbers, but they are all people.
.
.
.
Sources
PHEIC IMAGE
https://x.com/i/status/2055901737286770717
WHO Sit rep Friday 15th May
https://www.afro.who.int/countries/democratic-republic-of-congo/news/democratic-republic-congo-confirms-new-ebola-outbreak-who-scales-upsupport
WHO sit rep and announcement of global health emergency Sunday
https://www.who.int/news/item/17-05-2026-epidemic-of-ebola-disease-in-the-democratic-republic-of-the-congo-and-uganda-determined-a-public-health-emergency-of-international-concern
Imported case in Uganda
https://x.com/i/status/2055317002781065418
Guardian Ebola report Sunday
https://www.theguardian.com/world/2026/may/17/who-ebola-outbreak-congo-uganda-global-health-emergency
Associated press Sunday
https://apnews.com/article/congo-ebola-uganda-who-africa-emergency-6f93a87ff28107bdda8990599bbcd52d
US Embassy travel advisory DRC
https://ug.usembassy.gov/health-alert-u-s-embassy-kampala-may-15-2026/
UK info Ebola
https://www.gov.uk/government/publications/ebola-overview-history-origins-and-transmission/ebola-overview-history-origins-and-transmission#uk-guidelines
The INRB (Institut National de Recherche Biomedicale) has deployed a team to Bunia, diagnostics can begin there 17th May
https://x.com/i/status/2056131882127946028
Nearly 7 tonnes of emergency medical supplies and equipment along with a team of 35 experts from WHO and MinSanteRDC arrived today in Bunia from Kinshasa to support frontline Ebola response in Ituri Province.
The supplies, including personal protective equipment, tents, beds and operational support items, will help scale up frontline response efforts, strengthen infection prevention and control measures, and protect communities at risk as operations intensify in affected areas.
WHO is working closely with national authorities and partners to reinforce response operations and end the outbreak as quickly as possible.
https://x.com/i/status/2056016541427077570
DRC - Ebola outbreak: Approx. 246 suspected cases & 65 deaths reported, 4 deaths confirmed. More results pending, Ituri province - May 2026 - FluTrackers News and Information
https://flutrackers.com/forum/forum/africa/ebola-tracking-dem-republic-of-congo/1034822-drc-ebola-outbreak-approx-246-suspected-cases-65-deaths-reported-4-deaths-confirmed-more-results-pending-ituri-province-may-2026
WHO Tuesday morning address:
https://x.com/i/status/2056637786669633791
Video WHO Tuesday morning
https://x.com/i/status/2056636330365292843
In Ebola outbreak, a number of Americans in the Congo believed to have had exposure to suspected cases
At least one may have developed symptoms, sources say, but test results not yet available
One source said that there are not yet test results for any of the individuals, but the U.S. government is reportedly trying to arrange to transport them out of the DRC to somewhere they can be safely quarantined, and cared for, if they prove to have been infected. It’s not clear if that would be in the United States; there is some discussion of perhaps taking the individuals to an American military base in Germany, a source said
https://www.statnews.com/2026/05/17/ebola-outbreak-congo-americans-exposure-suspected-cases/
While I agree funding cuts have deeply impacted this response my understanding is that some of the challenge is that Bundibugyo can't be detected by Gene Xpert which is the test used - it only detects Zaire
So samples had to be sent to INRB
https://x.com/i/status/2056132753733677069
Trump admin has just BANNED foreigners from entering the US who have traveled to the Congo, South Sudan, or Uganda in the past 21 days, per STAT
This is an order from the CDC.
https://x.com/i/status/2056421939934118354
Potential treatments / vaccines
https://x.com/i/status/2056466505269920001
Potential mRNA vaccine study
https://www.pnas.org/doi/10.1073/pnas.2517814123
US press conf video - Travel ban and warnings
https://x.com/i/status/2056492134060957977
Medical missionary US patient
https://www.cbsnews.com/news/american-doctor-ebola-congo-missionary/
US Doctor with Ebola
https://www.bbc.co.uk/news/articles/cjwpy2qww5do
German Ebola centres and preparedness
https://www.ncbi.nlm.nih.gov/books/NBK401929/
Tuesday lunch update
https://x.com/i/status/2056703453611631084
UN update
https://www.unognewsroom.org/story/en/3126/ebola-update-who
UN update
https://news.un.org/en/story/2026/05/1167542
Angie Rasmussen video
https://substack.com/@rasmussenretorts/note/c-261077980?r=354hjt
Imperial college analysis of case numbers
https://www.imperial.ac.uk/medicine/departments/school-public-health/infectious-disease-epidemiology/mrc-global-infectious-disease-analysis/research-themes/preparedness-and-response-to-emerging-threats/report-ebola-18-05-2026/
Latest update Tuesday night 7.30pm UN
https://news.un.org/en/story/2026/05/1167542
[The International Health Regulations Emergency C
Committee on Ebola caused by Bundibugyo virus in DRC and Uganda will meet today, 19 May 2026 from 17h30 CEST (GMT+2) https://www.who.int/teams/ihr/ihr-emergency-committees ]
Africa CDC declares PHECS
https://reliefweb.int/report/democratic-republic-congo/africa-cdc-declares-ongoing-bundibugyo-ebola-outbreak-public-health-emergency-continental-security
Krutika Kuppalli quote
https://x.com/i/status/2056985448073826416
Will take a long time to stem outbreak
https://x.com/i/status/2056778348768948471
https://www.theatlantic.com/health/2026/05/ebola-outbreak/687216/
Devi Sridar use of vaccines
https://www.theguardian.com/commentisfree/2026/may/19/ebola-drc-needs-worlds-attention-rare-strain-congo-dangerous
An American aid worker with #Ebola was sent to Germany. Another exposed American worker is now being sent to the Czech Republic.
This is unacceptable. The U.S. has world-class clinicians and an entire network of specialized biocontainment units built for exactly these situations after 2014.
https://x.com/i/status/2057019103265620458
US CDC sending on-the-ground staff
https://x.com/i/status/2056843669739565086
US will fund up to 50 Ebola clinics
https://www.state.gov/releases/office-of-the-spokesperson/2026/05/united-states-to-fund-establishment-of-up-to-50-ebola-response-clinics/
WHOAFRO situation report
https://iris.who.int/server/api/core/bitstreams/bb1d4668-04e0-4563-b7c4-d1bdefbc9f05/content
Daily Ebola update:
- Cases: 653 (+102)
- Deaths: 144 (+12)
Wednesday afternoon figures
https://x.com/i/status/2057077648967233712
WEDNESDAY PM WHO update on what has been sent to Bunia
https://x.com/i/status/2057073582803415453
