More than 1,000 people have died in the space of two months in the latest outbreak of Ebola, the fastest in history. Dr Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, confirmed that 1,031 deaths have been reported in the Democratic Republic of Congo. The outbreak, declared on May 15, has been hampered by conflict, community resistance, and an uneven response across provinces.
"These people are dying. They are dying because we don't have vaccines, we don't have medicine, we don't have funding," Dr Kaseya said. The latest data from Congo's Ministry of Health showed 2,437 cases recorded as of Monday, with at least 737 patients in isolation or hospital.
Fastest Ebola outbreak on record
The outbreak is caused by the Bundibugyo virus, which has no approved vaccination or treatment. According to the US Centers for Disease Control and Prevention, more than 100 fatalities were reported in the first week of July. This outbreak, the 17th in the DRC, has killed more people at a faster rate than any on record, including the 2013-2016 epidemic that killed more than 11,000. The current outbreak reached 1,000 deaths in just two months, compared to eight months for the previous worst outbreak.
The World Health Organization has warned the true scale could be two to four times larger than official figures, as some communities in Ituri province remain difficult to reach due to rebel fighting and attacks on healthcare workers.
Transmission and tracking challenges
Ebola is rare but highly contagious, spreading through contact with bodily fluids of infected people or contaminated surfaces. Officials warned that 80% of new cases have emerged outside known chains of transmission, indicating the outbreak is spreading faster than officials can track. Researchers at the US CDC used computer modeling to estimate that in a worst-case scenario, it could approach the scale of the 2014-2016 West Africa epidemic, which killed more than 11,000.
Trish Newport, emergency program manager for Doctors Without Borders working in Congo, said: "There's never been an Ebola outbreak that started with so many cases because it was so late to be identified." She added: "It's like the outbreak is running the response." Epidemiologist Dr Jean Nachega at the University of Pittsburgh, who is advising African health authorities, said he does not expect the worst-case scenario but warned challenges remain "huge."
Disorganised response and community resistance
One humanitarian worker involved in the response, speaking on condition of anonymity, described poor coordination, delays in transferring patients, and waits of more than four days for test results. He said: "At times, it's unclear who is doing what and where." Delays have led some patients to leave health facilities before diagnosis, increasing transmission risk. Dr Kaseya called for intensified efforts at a health summit in Ghana on Tuesday, saying: "If we do not stop this outbreak today, it could become one of the worst Ebola outbreaks the world has ever documented."
Less than 9% of contacts of confirmed patients are being monitored, far below the level needed to contain the outbreak, according to Africa CDC. More than 60% of deaths are occurring in the community before patients can receive care. Pierre Akilimali, Ebola response incident manager at the National Public Health Institute of the DRC, said the high number of community deaths suggests many infections are not being detected or isolated in time.
Response teams face pushback and violence in Ituri province, the worst-hit area, and four other provinces. Robert Ndjalonga, head of civil protection in Ituri, said some communities have refused burial teams, preferring traditional burials that increase transmission risk. He said: "The biggest challenge remains resistance from, or outright refusal by, some communities to accept response teams. On several occasions, burial teams have had to be escorted by security forces to ensure that safe and dignified burials could be carried out without incident."
Dr Adelard Lufongola, operations manager for the Ebola response, said: "Members of the various response teams have been held captive in some health zones. Teams responsible for safe and dignified burials have been threatened and continued to be threatened in some cemeteries and within several communities." Shortages of burial supplies have also delayed responses.
Since the outbreak was declared in mid-May, at least 12 attacks have been recorded aimed at health facilities and teams, largely fuelled by scepticism and rumours. Some healthcare workers have gone on strike, claiming they haven't been paid since the outbreak started. Many attacks have been carried out by angry mobs storming treatment centres or targeting response teams, according to Pierre Akilimali. Locals in Ituri, which accounts for about 90% of all cases, say health and aid workers have been leaving remote communities for Bunia.
On Thursday, UN spokesman Stéphane Dujarric told reporters that humanitarian actors are "deeply concerned by escalating violence" hindering the Ebola response, and that access to treatment centres remains limited. He said: "The worsening security situation has forced several humanitarian partners involved in the Ebola response to temporarily relocate staff to Bunia which is relatively safer."
Ebola cases outside Africa
Several Ebola cases have been investigated outside Africa, with three confirmed among doctors or humanitarian workers. One suspected case in the UK involves a UK resident in isolation at a London hospital after returning from DR Congo. The patient is not displaying symptoms and remains well, the UK Health Security Agency said, with isolation as a precaution. The person was evacuated on a chartered flight.
A doctor tested positive after flying to France on June 23 from the DRC, the country's first Ebola case. The doctor was "almost asymptomatic" apart from headaches. Five other passengers were identified as possible contacts and put in isolation. The Alliance for International Medical Action confirmed the patient was one of its doctors. France's health minister confirmed on July 4 that the doctor had recovered and left hospital.
Two US nationals also tested positive. The first was a doctor, Peter Stafford, who tested positive while working with medical missionary group Serge. He was exposed while treating patients at Nyankunde Hospital in Bunia, where he had worked since 2023. He was treated in a special isolation ward at Charité hospital in Berlin after being evacuated. Two other doctors from the group, including Dr Stafford's wife Dr Rebekah Stafford, were also exposed but did not have symptoms and were following quarantine protocols. Serge said the Staffords and their four young children were in a location for risk monitoring and specialised care.
The second American patient arrived in Germany for treatment last week, landing in Frankfurt before being transferred to the city's university hospital. WHO director general Tedros Adhanom Ghebreyesus said the man was a "humanitarian worker" who had been in Bunia and was provided with "clinical care and close monitoring." An official from Samaritan's Purse said the patient, in his 60s, was a full-time employee working as a warehouse manager in the DRC. The German health ministry said he represented "no danger for the general population or for other patients" and that US authorities had requested assistance due to Germany's expertise and shorter flight time from the DRC.
Previous UK Ebola case
One of the most prominent UK cases was Scottish nurse Pauline Cafferkey, who contracted Ebola while working in Sierra Leone in 2014 during the lethal outbreak. She was part of a 30-strong NHS team. She spent several weeks in London's Royal Free Hospital in January 2015 after becoming the first person diagnosed with Ebola in the UK. She had 16 years of nursing experience and said: "I have experience in the past. I've done aid work, I've worked in Africa, so I didn't really think about it actually, I just did it."
She returned to the UK on December 28, 2014, and was screened at Heathrow without concerns. After arriving in Glasgow, she raised the alarm feeling unwell and was taken to the Brownlee Unit for Infectious Diseases in Glasgow before being flown to the Royal Free Hospital. Initially stable, her condition deteriorated but later stabilised, and she was discharged in January 2015. However, the virus was later found still present, and she was readmitted in October 2015 and again in February 2016 due to complications.
