EASTERN CONGO — World Health Organization Director-General Tedros Adhanom Ghebreyesus stated that Ebola is spreading faster than efforts to fight it in eastern Congo. "Ebola is spreading faster than efforts to fight it," he said in a post on X.

As of Tuesday, confirmed cases in the outbreak reached 4,381, including 2,011 deaths, according to government figures. The outbreak is caused by the rare Bundibugyo virus, which has no approved vaccines or treatments. Health authorities stated that between 60% and 70% of new cases are recorded outside of contacts being monitored.

Tedros noted that new cases are doubling in some hot spots. Mohamed Yakub Janabi, WHO Regional Director for Africa, described the dynamic as a race against an agile pathogen. "So we are chasing the virus, the virus is ahead of us," he said at a news conference. He added in a separate press conference that "The Bundibugyo virus continues to outpace us."

The World Health Organization stated that the Ebola outbreak in eastern Congo began in February, months before it was officially declared on May 15. Genetic sequencing indicated the outbreak's start date, with Thierno Balde, WHO incident manager for the Ebola response, stating that the work was conducted under the leadership of Steve Ahuka, head of the virology department at Congo's National Institute for Biomedical Research.

Delays in identification were compounded by early testing conducted for the more common type of Ebola. Some early cases were wrongly attributed to other diseases, including malaria and typhoid, allowing the virus to circulate undetected during the initial weeks of transmission.

The current outbreak is the 17th Ebola outbreak faced by the Democratic Republic of the Congo. The first Ebola virus was identified in 1976 near the Ebola River in what is now Congo. This event marks the second-largest outbreak in history, behind the 2014-2016 West Africa outbreak.

The 2014-2016 West Africa outbreak resulted in over 11,000 deaths out of at least 28,000 cases. That crisis was declared in March 2014, although the first human case occurred in December 2013. It took about eight months for that outbreak to reach 1,000 deaths, whereas it took around three weeks for the death toll in the current outbreak to double from 1,000.

The current outbreak has had a case fatality rate of 45.9%, compared to 39.6% in the 2014-2016 West Africa outbreak, according to government data. Ebola can be contracted from bodily fluids such as vomit, blood, or semen, and from contaminated surfaces and materials such as bedding and clothing.

The collateral damage to health services has been severe, particularly for maternal care. Maternal deaths in Ituri province nearly doubled after the outbreak began, rising from an average of 3.1 deaths per week to 5.8 per week. The percentage of women dying outside health facilities in Ituri province rose from 9.1% before the outbreak to 17.4% afterward.

The United Nations Population Fund estimates that about 37,800 pregnant women live in the Ebola response area in Ituri province. Pregnant women and others are avoiding health centers for fear of the virus. Between 60% and 70% of deaths are happening in communities far from care, according to the World Health Organization.

Half of the deaths observed among transported individuals are linked to the conditions of their care, according to the World Health Organization. Response efforts face additional hurdles from security and logistical challenges. Health workers in the region have gone on strike over lack of payment, and rebel groups have threatened health teams in the region.

Health teams have reported shortages of protective gear, while displaced people in the region struggle to find reliable water sources for washing hands. Misinformation asserting that Ebola is not real is present in communities, further hindering public health messaging.

Clinical trials for vaccines and treatments for the Bundibugyo virus have begun in Ituri province. The World Health Organization plans to add 400 beds dedicated to Ebola patients and another 100 for various health services to expand capacity.

In Aru, Ituri province, response teams identified 159 contacts, including 121 people considered suspected cases, after a case was detected. No new Ebola cases have been recorded in Aru for two weeks, suggesting localized containment is possible despite broader challenges.

The World Health Organization assesses the global risk of spread as low because Ebola does not travel through the air. Cases detected outside the affected region have been quickly identified and contained without leading to sustained transmission.

Why It Matters

The outbreak ranks as the second-largest in history, with a case fatality rate of 45.9% exceeding that of the 2014-2016 West Africa crisis. Death tolls are doubling in three weeks compared to eight months during the previous epidemic, while maternal deaths in Ituri province have nearly doubled due to avoided care. With no approved vaccines or treatments for the Bundibugyo virus, response teams face a pathogen spreading faster than containment efforts during security threats and logistical shortages.