On August 28, 2026, the World Health Organization (WHO) issued a warning regarding the ongoing Ebola outbreak caused by Bundibugyo virus (BV) in the Democratic Republic of the Congo (DRC). Although transmission remains concentrated in the DRC, cases have been reported in Uganda.

The outbreak has continued to expand rapidly in the DRC. As of August 26, 2026, 5794 confirmed cases and 2786 deaths had been reported, corresponding to a case fatality rate of 48.1%. The outbreak spread to 60 health zones across six provinces.

By September 7, 2026, the number of confirmed cases in the DRC had increased to 6757, including 3267 deaths, with a crude case fatality rate of 48.3%. The outbreak expanded to 61 health zones. The latest WHO update, published on September 10, reported that the additional affected health zone was Kayna in North Kivu.

The CDC reported that the outbreak is spreading substantially faster than previous Ebola outbreaks. The outbreak surpassed 1000 confirmed cases within 40 days of response activation compared with approximately 235 days during the 2018 Ebola outbreak in the DRC.

Several factors contribute to the current situation.

• The outbreak is caused by BV, for which no vaccine has been licensed for routine prevention, and no specific treatment has been approved. The Ervebo vaccine, which is licensed for Ebola virus disease caused by the Zaire virus, has not been approved for BV disease. The WHO recommends that Ervebo be used against BV disease only within a research protocol because its efficacy in humans remains unknown. Clinical trials for candidate treatments are also underway.
• Transmission occurs through direct contact with the blood or other bodily fluids of infected individuals and through contact with contaminated materials. Funeral practices involving contact with the bodies of deceased individuals can facilitate disease transmission. Population movement along trade routes and routes leading to mining areas can also complicate outbreak control.
• The situation is further complicated by food insecurity, population displacement caused by ongoing conflict in the northeastern part of the country, where many cases are concentrated, limited access to water and healthcare, and inadequate health infrastructure. Ongoing insecurity also limits access to affected communities and impedes surveillance, case investigations, and contact tracing.
• The WHO has estimated that $50 million in immediate funding is required.
• Public mistrust of healthcare workers and international organizations also makes it more difficult to control the outbreak, reflecting a lack of confidence in the country’s government. More than 260 attacks against healthcare workers have been reported over the past 6 months. Healthcare workers have also been infected with Ebola, and 43 had died from the disease as of August 21, 2026.

However, there were some signs of improvement.

• Although contact tracing remains challenging, the follow-up of identified contacts has improved from approximately 40%-80%; however, this is still below the 95% target.
• Virologic analyses have not identified any mutations known to increase the virus’s transmissibility or virulence.
• Testing capacity is approximately 3000 tests/d, supported by 21 operational laboratories. Laboratory testing is essential because Ebola virus disease can cause symptoms similar to those of other illnesses such as malaria, making it difficult to distinguish between them based on clinical symptoms alone.
• The number of hospital beds is increasing and is expected to reach approximately 1700 by mid-September.
• Uganda’s experience shows that the disease can be contained. WHO declared an outbreak after 20 cases were reported.

Currently, the risk for the virus spreading to other countries is very low, particularly in Europe. France reported one case involving a healthcare worker who had returned from the DRC. Doctors should remain vigilant when evaluating returning patients who have recently traveled from the DRC.

Any traveler returning within a 21-day period after returning from an active Ebola circulation zone with compatible symptoms is treated as a suspected case in France. Symptoms include

• Fever ≥ 38 °C
• Severe headache, weakness, muscle or joint pain, vomiting, diarrhea, abdominal pain, or unexplained bleeding
• When a person dies under unexplained or suspicious circumstances

Individuals returning from an area where the virus is circulating and who have no symptoms are not considered suspected cases that require evaluation.

According to Santé publique France’s case definition and management guidance for Ebola virus disease, any patient suspected of having Ebola virus disease must immediately undergo a clinical and epidemiologic evaluation involving the clinicians responsible for the patient’s care, a referent infectious diseases specialist for the epidemic and biological risk pathway, and the National Reference Center for Viral Hemorrhagic Fevers.

This story was translated from Univadis France, part of the Medscape Professional Network.