Ebola Outbreak Resurfaces in Eastern DRC Amid Conflict and Limited Vaccine Coverage

Ebola has returned to eastern Democratic Republic of Congo (DRC), where ongoing conflict, public mistrust and the absence of an approved vaccine for the current strain are complicating efforts to contain the outbreak.

The virus, transmitted through direct contact with infected bodily fluids, causes a severe haemorrhagic fever and has claimed more than 15,000 lives across Africa over the past five decades.

Health authorities formally declared the DRC’s 17th Ebola outbreak on May 15, although evidence suggests the virus had been circulating unnoticed for weeks. The World Health Organization (WHO) was first alerted on May 5 after four health workers died in quick succession in Mongbwalu, a mining town in Ituri province.

Residents in northeastern Ituri reported unexplained deaths as early as March, with rumours spreading of a “mystical illness” before medical confirmation was possible. Early diagnosis efforts were complicated by the disease’s similarity to malaria, typhoid and yellow fever, leading to initial misclassification of cases.

Laboratory testing in Bunia, the provincial capital, also delayed confirmation because local facilities were equipped to detect only the Zaire strain of Ebola, not the Bundibugyo strain identified in this outbreak.

By the time the outbreak was officially declared, 246 suspected cases, including 80 deaths, had already been recorded in the region. On the same day, Uganda reported a related fatal case involving a Congolese traveller, raising concerns of cross-border transmission. Uganda has since confirmed cases and introduced border restrictions with the DRC.

As of the latest updates, health authorities have reported 19 confirmed infections and two deaths in the current wave, though Africa CDC has warned that more than 200 deaths may be linked to the outbreak across affected areas, with limited testing capacity raising concerns that the true toll may be higher.

The Bundibugyo strain has no approved vaccine or specific treatment, unlike the Zaire strain targeted by vaccines developed between 2018 and 2019. Health workers are therefore relying on isolation, contact tracing and basic infection control measures in an environment where insecurity severely restricts access to affected communities.

The outbreak is centred in Ituri, a region marked by armed violence involving militia groups and displacement crises. Attacks by armed factions, including those linked to Islamic State affiliates and local militias, have forced thousands into crowded camps where infectious diseases spread more easily.

Medical infrastructure remains weak, with hospitals lacking isolation facilities and essential protective equipment. Aid workers have reported patients arriving at treatment centres via motorbike taxis without protective measures, increasing the risk of further transmission.

Authorities have suspended flights to Bunia to control movement, but this has also slowed the delivery of medical supplies and emergency response teams. Humanitarian organisations, including Doctors Without Borders, have raised concerns about delayed coordination and gaps in the response effort.

Despite these challenges, officials in Kinshasa maintain that the situation is under control. However, public distrust of health workers remains widespread, with some communities preferring traditional healers and resisting medical intervention. In some cases, families have attempted to retrieve bodies of deceased relatives from treatment centres, further complicating containment efforts.

WHO Director-General Tedros Adhanom Ghebreyesus has expressed cautious optimism, stating that coordinated international support could still bring the outbreak under control, although experts warn that insecurity and weak health systems continue to pose significant risks to containment efforts.