In the Democratic Republic of the Congo, an Ebola outbreak that was declared in mid-May has grown into the largest the country has ever faced, and the second-largest recorded anywhere. Health officials find themselves still counting new cases each week, as the virus moves into new districts and into corners where armed conflict and fear make the work of care nearly impossible. Across the border, neighbors have managed to contain the few cases that arrived, but the wider story turns on whether a fractured landscape can be steadied long enough for science and care to reach the people who need th
WHO Warns DR Congo Ebola Outbreak Still Intensifying Amid Conflict, Attacks on Health Workers
The Nov 5 armed attack in Cantine-Aloya, North Kivu, killed 66 civilians including three health workers and displaced people, disrupting monitoring of over 1,000 contacts.
"We can't let our guard drop anywhere."
Mark
Cases fell in Ituri, so why is the WHO still so worried?
Mimi
Because North Kivu rose 31 percent over the same period, and the totals went up anyway: 1,472 cases in the latest 21 days against 1,388 before.
Luke
Worth noting that's a modest rise overall, and the WHO's own phrase is no sign of decline. That's not the same as accelerating nationally.
Mark
What does the violence do to the response itself?
Mimi
After the Nov 5 attack in Cantine-Aloya, more than 1,000 contacts lost monitoring and three confirmed patients can't be found. Response work in Mabalako is suspended.
Luke
Those are the WHO's figures. We don't know yet how many of those contacts have since been traced.
Mark
Mahagi seems to matter too.
Mimi
It went about 90 days without a case, then had new infections. That's why Smallwood says no area can be written off.
Mark
And Kenya and Nigeria?
Luke
Contained so far, per the WHO and Kenyan authorities. Nigeria's contacts hadn't finished monitoring as of the report, so that's not fully closed.
Mimi
And the vaccines are still trial candidates; results aren't expected until early 2027.
The Pulse
- Roughly 400 to 500 new Ebola cases are being reported every week, and transmission is described as high and sustained with no sign of decline.
- Eighty-one verified attacks on healthcare have shattered the response, and a November 5 raid in Beni killed 66 civilians, three of them health workers.
- Displacement after the Cantine-Aloya attack has left over 1,000 contacts hard to monitor, with three confirmed patients unaccounted for.
- Responders are racing to contain hotspots in North Kivu and Mahagi, while calling urgently for a halt to hostilities so care can reach communities.
- Vaccine trials are underway with Ervebo, and experimental Bundibugyo candidates await approval, though meaningful results are not expected until early 2027.
In the Democratic Republic of the Congo, an Ebola outbreak that was declared in mid-May has grown into the largest the country has ever faced, and the second-largest recorded anywhere. Health officials find themselves still counting new cases each week, as the virus moves into new districts and into corners where armed conflict and fear make the work of care nearly impossible. Across the border, neighbors have managed to contain the few cases that arrived, but the wider story turns on whether a fractured landscape can be steadied long enough for science and care to reach the people who need them most.
On Thursday, officials from the World Health Organization repeated an assessment they have been making for months: the Ebola outbreak in the Democratic Republic of the Congo is still not under control. Around 400 to 500 new cases are being reported each week. Marie Roseline Belizaire, the WHO's regional emergency director for Africa, described the picture as deeply concerning.
The outbreak was declared on May 15 and has since become the largest Ebola epidemic in the country's history. As of November 10, health authorities had counted 11,114 confirmed cases and 5,433 deaths across sixty-seven health zones in eight provinces. The geography is shifting. Infections fell in Ituri, where the outbreak began, but cases rose 31 percent in neighboring North Kivu, and Mahagi reported new infections after nearly three months without any.
The greatest obstacle is violence. The WHO has verified 81 attacks on healthcare workers and facilities since the outbreak began. On November 5, an armed attack in Cantine-Aloya killed 66 civilians, three of them health workers, and left health facilities looted and burned. The displacement that followed has made it hard to track more than 1,000 contacts, and three confirmed patients cannot be found. Further attacks in Mabalako have extended the suspension of response work there. Belizaire has called for an urgent halt to hostilities.
Beyond the border, Kenya and Nigeria have each reported imported cases, but both appear to have contained them without local spread. The WHO is strengthening surveillance in neighboring countries, especially the Central African Republic and South Sudan, as long as transmission continues in Congo.
The virus, Bundibugyo, still has no approved vaccine or specific treatment. Trials began in Bunia in October using Ervebo, whose effectiveness against this strain is uncertain. Two experimental vaccines have been recommended for future trials, pending national approvals. Initial results are not expected until early 2027, so the coming months will depend largely on whether responders can reach the communities where the virus is spreading.
On Thursday, officials from the World Health Organization sat before an online press briefing and gave the same assessment they have been giving for months: the Ebola outbreak in the Democratic Republic of the Congo is not coming under control. Marie Roseline Belizaire, the WHO's regional emergency director for Africa, said the overall picture remains concerning, with around 400 to 500 new cases still reported every week.
The outbreak was declared on May 15, nearly six months ago. It is now the largest Ebola epidemic in the DRC's history and the second-largest ever recorded anywhere. As of Nov 10, the country's health authorities had counted 11,114 confirmed cases and 5,433 deaths, a case fatality rate of 48.9 percent. Sixty-seven health zones across eight provinces have been affected.
The geography is shifting. A WHO regional situation report published Tuesday described transmission as high and sustained, with no sign of decline. In the 21 days ending Nov 7, the DRC reported 1,472 confirmed cases, up from 1,388 in the 21 days before. Ituri Province, where the outbreak began, saw infections fall, but in neighboring North Kivu cases rose 31 percent.
Catherine Smallwood, the WHO's incident manager for the Ebola response, said most new infections are now concentrated in a handful of areas where armed conflict, displacement and mistrust hamper the work. She also pointed to Mahagi, in Ituri, which went about 90 days without a case and then reported new infections. "We can't let our guard drop anywhere," she said.
Violence is among the gravest obstacles. Belizaire said the WHO has verified 81 attacks on healthcare since the outbreak began. On Nov 5, an armed attack in Cantine-Aloya, in North Kivu's Beni territory, killed 66 civilians, three of them health workers, and left three health facilities looted and burned. The displacement that followed disrupted the monitoring of more than 1,000 people who had been in contact with Ebola patients, and three confirmed patients cannot be accounted for. Smallwood said further attacks hit the Mabalako health zone on Wednesday night, causing new displacement and extending a suspension of response activities there. Belizaire called for an urgent halt to hostilities so health workers can reach communities safely and patients can seek care without fear.
Beyond Congo's borders, cases have appeared in Kenya and Nigeria, but both appear to have contained them. Kenya recorded nine confirmed cases, including two deaths; the eight secondary cases all traced to one imported case, and no community transmission was found. Authorities said Wednesday that all surviving patients have been discharged and the last monitored contacts released after 21 symptom-free days. Nigeria reported a single imported case, a 42-year-old woman diagnosed in Abuja in October and evacuated to Switzerland for treatment. No secondary infections were identified, and her remaining contacts were expected to finish monitoring by Nov 13. Belizaire cautioned that continued transmission in the DRC, together with population movement and insecurity, still threatens neighbors, and the WHO said it is strengthening cross-border surveillance and preparedness, notably in the Central African Republic and South Sudan.
On the research side, there is some movement. The virus behind this outbreak is Bundibugyo, for which no vaccine or specific treatment has been approved. On Nov 4, the WHO announced that two experimental vaccines designed for Bundibugyo were recommended for the Tumaini clinical trial: ChAdOx1, developed by the University of Oxford with the Serum Institute of India, and Moderna's mRNA-1469. Both are expected to join after national regulatory approvals.
The Phase 2/3 Tumaini trial began Oct 23 in Bunia, the capital of Ituri, using ring vaccination of contacts of confirmed patients. It started with Ervebo, an existing Ebola vaccine whose effectiveness against Bundibugyo is uncertain. Trials of experimental treatments are also underway. The WHO expects initial vaccine results in early 2027, which means the months ahead will depend on whether responders can reach the places where the virus is spreading.
Notable Quotes
We need an urgent halt in hostilities and violence. Health workers and humanitarian teams must be able to reach affected communities safely.— Marie Roseline Belizaire, WHO regional emergency director for Africa
We can't let our guard drop anywhere.— Catherine Smallwood, WHO incident manager for the Ebola response
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