Ebola outbreak in DR Congo becomes deadliest in country's history

Bunia, DR Congo – When three members of the hospital's medical team died within days of treating the same patient, Dr. Richard Lokudu suspected Ebola had already spread before authorities detected the outbreak.

The patient arrived at Mongbwalu General Hospital in Ituri province for surgery in early April, weeks before DR Congo officially declared an Ebola outbreak.

“Before the outbreak was announced, we found a patient admitted on April 2 and scheduled for surgery by our team on April 7,” Lokudu told Al Jazeera.

“Nearly a month later, we noted the deaths of the surgical assistant, the anesthesiologist, and a member of the post-operative care team.”

These deaths were among the first warning signs of an Ebola outbreak that later became the deadliest in DR Congo's history.

Three months after authorities declared the outbreak, more than 4,900 infections have been recorded and over 2,300 people have died, according to health agencies and international organizations.

The death toll has surpassed the previous record during the 2018–2020 Ebola outbreak caused by the Zaire strain, which killed 2,299 people.

The current outbreak is caused by the Bundibugyo virus (BVD), a rare form of Ebola first identified in Uganda in 2007. Unlike the Zaire strain, which has a vaccine and some treatments, no licensed vaccine or approved specific therapy exists for Bundibugyo.

Health workers are relying on early detection, supportive care, infection prevention measures, and community engagement to limit transmission.

The World Health Organization (WHO) says the outbreak was first identified in Ituri province and later spread to other areas. The agency has warned that armed conflict, population movement, and delayed case detection have complicated containment efforts.

For residents of affected communities, those numbers represent personal losses.

“Only God can save us from this disaster,” said Furaha Gisèle, 35, whose uncle died from Ebola in Rwampara, about 10 km from Bunia, the capital of Ituri province.

“Dealing with insecurity, poor governance, and poverty at the same time is difficult, and I fear we will also suffer through this deadly epidemic.”

Race against spread

Health officials say the disease was already transmitting before it was officially declared on May 15. By the time authorities identified the virus, it had spread within communities, allowing chains of infection to develop before response teams were fully deployed.

WHO says the outbreak was initially concentrated in the Mongbwalu health zone in Ituri before expanding to other provinces.

DR Congo has experienced Ebola outbreaks since 1976 and has accumulated extensive experience in responding to the disease. But in Ituri, health workers say experience alone cannot overcome the challenges they face: conflict, difficult terrain, delayed detection, and mistrust in some communities.

Congolese officials acknowledge that delayed case identification helped the virus spread. Professor Pierre Akilimali, head of DR Congo's Ebola response unit, said laboratory capacity has been expanded in Ituri since the outbreak began.

“At the start, we had no laboratories. Today, we have more than 12 laboratories in Ituri province,” he told Al Jazeera.

He said relying on laboratory facilities outside the province slowed case confirmation during the early phase of the outbreak.

Conflict and mistrust

In Ituri, Ebola response teams are operating in a province that has endured decades of armed conflict. Armed groups have fought for influence and control over mineral-rich areas, hampering movement and limiting access to some communities.

The Africa Centres for Disease Control and Prevention (Africa CDC) says it is supporting the response through surveillance, testing, infection prevention, patient care, and community engagement.

“Regarding Ituri, the situation is not favorable. We are in a war zone, and the province is under siege,” Dr. Justus Nsio, Africa CDC's field manager for Ebola response in DR Congo, told Al Jazeera.

“We are trying to use what we have to show solidarity with the communities.”

Dr. Thierno Balde, WHO's incident manager for the Bundibugyo virus disease in DR Congo, said movement between affected areas has helped the virus spread.

“The geographical spread of the outbreak is mainly linked to the uncontrolled movement of people, especially those who are sick, between already affected localities and neighboring areas,” he told Al Jazeera.

For health workers in Ituri, stopping Ebola is not only a medical challenge but also a race against conflict and access.

“When an incident occurs, especially gunfire, no one can hold their position,” said Dr. Charles Kashindi, head of Nyakunde Hospital, about 40 km southwest of Bunia.