The Democratic Republic of the Congo's Ebola outbreak has killed nearly 4,000 people and infected more than 8,200, with violence and mass displacement in the country's east making it increasingly difficult for health workers to track infections and contain the virus.
The health ministry reported 8,224 confirmed cases and 3,982 deaths as of Sept. 29, putting the crude case-fatality rate at about 48%. More than 2,200 patients have recovered, while hundreds remained hospitalized or in isolation.
The outbreak, declared May 15, is caused by the rare Bundibugyo virus, a species of Ebola for which there is currently no approved vaccine or specific treatment.
It has spread across 63 health zones in seven provinces, with Ituri remaining the epicenter and cases also reported in North Kivu, South Kivu, Haut-Uele, Bas-Uele, Tshopo and Sud Ubangi.
The scale of the outbreak has made it the deadliest Ebola epidemic in Congo's history, surpassing the 2018-2020 outbreak caused by the Zaire species.
It is also the second-largest Ebola outbreak recorded globally, behind the 2014-2016 West Africa epidemic, which infected more than 28,000 people and killed over 11,000.
The World Health Organization (WHO) has warned that the virus is continuing to reach new health zones, stretching an already heavily pressured response.
WHO has classified the risk inside Congo as very high and the risk to neighboring countries as high, particularly as infections have appeared in areas near international borders.
Bundibugyo virus is a zoonotic disease believed to have a natural reservoir in fruit bats. It can initially spread to humans through contact with infected animals and then pass between people through blood, secretions and other bodily fluids.
Health facilities with weak infection-control measures and burial practices involving close contact with the dead can accelerate transmission.
Symptoms usually appear within two to 21 days and can include fever, fatigue, muscle pain, headache and sore throat before progressing to gastrointestinal problems and, in severe cases, organ failure and bleeding.
Without an approved vaccine or specific therapy for Bundibugyo virus, the response depends heavily on early diagnosis, isolation, contact tracing, safe burials and supportive treatment.
Health authorities have expanded laboratory capacity and treatment facilities, but insecurity and difficult terrain continue to limit access to affected communities.
The latest setback came at Kigonze, a displacement camp near Bunia in Ituri province that had housed about 19,000 people.
Security forces entered the camp searching for weapons and people suspected of links to armed groups, according to Congolese and health officials.
Clashes followed, prompting thousands of residents to flee over several days and leaving the camp largely abandoned.
The exodus has created a major problem for Ebola surveillance. Two health officials familiar with the situation told Reuters that about 1,000 people identified as Ebola contacts were living at the camp. Only about one-fifth had been traced after residents fled, according to one of the officials.
An Ebola transit center at Kigonze, where suspected patients could be isolated, tested and treated, was also burned down.
Julien Harneis, the U.N.'s senior Ebola coordinator in Congo, said the developments had made an already enormous challenge even harder, with surveillance, contact tracing and access to health care disrupted.
The camp had already experienced a deadly wave of illness. Reuters reported in June that more than 30 people had died there in just over a month, with many deaths linked to Ebola.
The U.N. refugee agency has recorded 88 confirmed Ebola cases and 56 deaths across displacement sites in Congo, including Kigonze, while warning that the actual toll is likely higher. The International Organization for Migration said fatality rates among Ebola patients in other displacement sites had exceeded 80%, compared with roughly 50% across the wider outbreak.
The crisis is unfolding in Ituri, North Kivu and South Kivu, regions that have endured decades of armed conflict and are home to more than 5 million displaced people. Crowded settlements, limited sanitation and frequent population movement create additional challenges for disease control.
Transmission has not followed a uniform pattern. WHO has reported declining cases in parts of Ituri, while North Kivu has experienced increases. New infections in border areas have also raised concerns that the outbreak could spread beyond Congo.
The response has expanded through cooperation between Congo's Health Ministry, WHO, Africa CDC and international partners. Teams are working to strengthen surveillance, laboratory testing, treatment, community engagement and cross-border coordination.
