WHO: Rare Bundibugyo Ebola outbreak in DRC and Uganda kills 506, cases exceed 1,500

The proliferation of a rare strain of Ebola known as the Bundibugyo virus in Central and East Africa now constitutes the third-largest Ebola outbreak on record. Having likely circulated undetected since around February, the disease continues to spread in the Democratic Republic of Congo (DRC), with additional cases in Uganda and France, more than a month after the World Health Organization (WHO) declared it a public health emergency of international concern.

There have been more than a thousand confirmed cases and hundreds of fatalities so far, with most cases concentrated in eastern DRC. While the global risk remains low, experts worry the outbreak could burgeon into a broader regional health crisis.

"We do not yet have a full picture of how widespread the outbreak is," Stephanie Psaki, who served as the inaugural U.S. coordinator for global health security at the National Security Council during the Biden administration, told CFR. It is "probably on track to be [the] first or second largest before it's contained," she said.

In addition to allocating $3.9 million from its Contingency Fund for Emergencies in May, the WHO and the Africa Centers for Disease Control and Prevention (Africa CDC) co-launched in early June a $518 million, six-month emergency response plan to contain the outbreak in the DRC and Uganda. However, declining humanitarian aid levels globally, the loss of the U.S. Agency for International Development (USAID), and the diminished international role of the U.S. CDC—which historically led international Ebola responses—have raised concerns about meeting that goal.

CFR unpacks what is driving the current Ebola outbreak, the scale of the crisis, and what it means for the state of global health infrastructure and preparedness.

What Is Ebola?

Ebola is a rare, severe illness that attacks the immune system, causing extreme fluid loss and often death. People can contract the disease through contact with infected wild animals such as fruit bats, or by handling and preparing contaminated foods. Unlike more common viruses such as COVID-19 or the flu, Ebola is not transmissible before an infected person begins to exhibit symptoms—which can start appearing between two to twenty-one days after exposure—though the risk of transmission increases as the disease progresses.

Where Has It Spread?

The current bout of Ebola originated in eastern DRC and is the country's seventeenth such outbreak since 1976. As of July 4, there have been 1,561 confirmed cases and 506 confirmed deaths in the DRC. In Uganda, 20 cases and 2 deaths have been reported as of June 29, according to the country's ministry of health. However, experts warn that the exact number of cases in both countries is likely higher. One case was confirmed in France in June in a traveler returning from the affected region after volunteering in the response effort.

To complicate matters, misinformation about the virus has been rife. There are several reports of Congolese communities raising concerns that the disease is a hoax, or was brought in by Western aid workers aiming to make a profit in the region.

"Public trust in authorities is exceedingly low, and foreigners are often presumed to have exploitative agendas," CFR expert Michelle Gavin told CFR. It is therefore not surprising that locals "are rarely willing to absorb public health messaging at face value, or that the environment is ripe for misinformation," she added.

Ebola is just one issue among a slew of others the Congolese communities are currently facing, including deaths from violent conflict, and other infectious diseases such as malaria and measles. The chronic, debilitating nature of these challenges makes Ebola feel like less of a priority among them, locals have told health experts.

What's Driving the Current Ebola Outbreak?

A U.S. CDC analysis estimates the virus was transferred from an animal to a human in February, but the health ministries in the DRC and Uganda did not declare an outbreak until mid-May. The WHO said it was first alerted on May 5 of suspected Ebola cases in the DRC, but initial tests were negative since they were not designed to detect the rare Bundibugyo strain.

"I find it unfathomable that something would have spread for three months without [health authorities] identifying it with the systems that we had in place," said Psaki. "That includes not just U.S. government staff, but the partners that were working around the world that were receiving support from the U.S. government and also multilateral institutions like [the] WHO." Because containing Ebola depends on early detection, isolation, and tracing, the delay has increased the risk of the outbreak expanding further.

The Bundibugyo virus is a separate strain from common Zaire species, rendering existing vaccines ineffective against it.

The outbreak is happening against a backdrop of severe, ongoing instability in the region.