WHO raises DRC Ebola outbreak to highest risk level as cases surge to 82

On Friday, the World Health Organization moved the Ebola outbreak in the Democratic Republic of Congo into its highest risk category. The decision came as confirmed cases climbed to 82, with seven deaths already recorded. But those numbers tell only part of the story. Nearly 750 suspected cases and 177 suspected deaths suggest the virus has been spreading quietly for weeks, moving through communities faster than health workers can track it.

The outbreak is caused by the Bundibugyo strain of Ebola, a less common variant that has appeared only twice before—in Uganda in 2007 and in the DRC itself in 2012. What makes this outbreak particularly difficult is that no approved vaccines or treatments exist for Bundibugyo. The virus spreads through direct contact with bodily fluids and can cause severe bleeding and organ failure. In its early stages, symptoms resemble malaria or typhoid, which means transmission can go undetected for days or weeks while the virus moves from person to person.

WHO Director-General Tedros Adhanom Ghebreyesus described the situation as "especially challenging." Health workers are struggling to keep pace with the spread in areas marked by insecurity and limited infrastructure. "We know the epidemic in DRC is much larger" than confirmed cases suggest, he told journalists at WHO headquarters in Geneva. The virus has been circulating silently, and case numbers will continue to rise until response operations are fully in place. Anne Ancia, the WHO's representative in the DRC, put it plainly: "We are sprinting behind," she said, with the spread "not yet under control."

The only proven way to stop transmission is to find everyone who has had contact with an infected person and isolate them for 21 days. This is painstaking work in the best circumstances and nearly impossible in areas where security is fragile. Meanwhile, the WHO is moving quickly to test existing tools that might help. Two monoclonal antibodies—Regeneron 3479 and Mapp Biopharmaceutical's MBP134—have been prioritized for emergency clinical trials. Researchers are also evaluating an oral antiviral called obeldesivir as a post-exposure preventive for high-risk contacts, which WHO chief scientist Sylvie Briand said looks "promising."

The vaccine situation is more complicated. Ervebo, which protects against the Zaire strain of Ebola, offers "very little evidence of cross-protection" for Bundibugyo. A Bundibugyo-specific vaccine has been in development, but even if prioritized immediately, it could take six to nine months to produce. In the meantime, the outbreak continues to spread.

Neighboring countries are taking precautions. Uganda has confirmed two cases in people who traveled from the DRC, along with one death, but intense contact tracing appears to have prevented wider spread. Rwanda announced Friday that foreign nationals who had traveled through the DRC would be denied entry, though Rwandan citizens and foreign residents would be allowed in under mandatory quarantine. A US national working in the DRC tested positive and was transferred to Germany for treatment, while another American deemed a high-risk contact was moved to the Czech Republic. In the Netherlands, a patient with suspected Ebola was admitted to Radboud University Hospital and placed in isolation pending test results.

The WHO upgraded its risk assessment for the DRC from high to very high, while keeping the regional risk at high and the global risk at low. The upgrade reflects what Abdi Rahman Mahamud, the WHO's emergency alert and response director, described as the virus's potential to spread rapidly. "That changed the whole dynamic," he said. For now, the outbreak remains contained to the DRC, but the race to develop treatments and trace contacts will determine whether it stays that way.