Ebola Outbreak in Congo Declared a Public Health Emergency of International Concern

An Ebola outbreak in eastern Democratic Republic of Congo is spiraling, with health workers struggling to contain the virus as it spreads across a vast and conflict-torn region. According to the latest government figures, there are more than 1,000 suspected Ebola cases and up to 246 people suspected to have died from the disease so far. That's not a small number — and it's likely an undercount.

Here's the backstory: The first known case was a nurse who showed symptoms on April 24 in the city of Bunia, in Ituri province. The nurse was buried in the gold-mining town of Mongbwalu, in Ituri, which had already seen a wave of unexplained deaths throughout April — including four health workers who died in a single week. The outbreak was quietly spreading long before anyone sounded the alarm.

So why didn't anyone catch it sooner? Delays in identifying the outbreak were caused in part by the rarer species of virus circulating. Congo has had 17 official Ebola outbreaks since 1976, with the majority caused by the Zaire species — for which there is a vaccine. But this outbreak is caused by a much less-studied species named Bundibugyo. In other words, doctors were testing for the Ebola they knew, and this one slipped past them.

That distinction matters a lot. The current outbreak is of particular concern due to the high fatality rate of the Bundibugyo strain, its spread into neighboring Uganda, and the absence of an approved vaccine or targeted treatments. A WHO special adviser said a vaccine to address Bundibugyo would not be available for at least six to nine months.

The WHO officially declared this a "public health emergency of international concern" — the highest alarm level short of a full pandemic — on May 17. WHO Director-General Tedros Adhanom Ghebreyesus described the outbreak as a "catastrophic collision of disease and conflict" and said the disease is outpacing the response.

The outbreak has already crossed borders. Both Rwanda and Uganda have closed their borders with Congo. Uganda has its own, much smaller Ebola outbreak, with seven confirmed cases announced by its health ministry. Canada has announced a 90-day entry ban for residents from Congo, Uganda, and South Sudan. The United States has banned non-citizens who have traveled to those countries from entering, and the White House said it is establishing a facility in Kenya for Americans who may have been exposed but are not showing symptoms.

On the ground, the situation is grimmer than just the case numbers suggest. Ituri province itself is deeply poor and ravaged by decades of brutal militia warfare. Three times in one recent week, healthcare facilities were attacked. On one Sunday, angry young men stormed a hospital treating Ebola patients, forcing staff to evacuate. On a Saturday, residents set fire to a tent for suspected and confirmed cases run by Doctors Without Borders, and more than a dozen people suspected to have the virus fled.

Hospital director Dr. Richard Lokudi said he and his staff have faced serious resistance from the local community, with many people who don't believe Ebola is real — making contact tracing particularly difficult.

And then there's the money problem. U.S. aid cuts are complicating the response, according to Congo's Health Minister, who has called for increased funding to battle the disease. International donors have pledged $500 million to the Ebola response, according to the Africa Centers for Disease Control and Prevention — but experts say the clock is ticking.