The Ebola outbreak in eastern Congo began months before officials publicly acknowledged it, making it the fastest-growing outbreak on record, the World Health Organization said Monday as health responders struggle to contain a surge in infections.
WHO regional director for Africa Dr. Mohamed Yakub Janabi told reporters that genetic sequencing pointed to February as the outbreak’s starting point. Several early infections, he said, were mistakenly diagnosed as illnesses such as malaria and typhoid.
“We are chasing the virus, the virus is ahead of us,” Janabi said.
Dr. Thierno Balde, the WHO incident manager overseeing the Ebola response, said the sequencing work was led by Dr. Steve Ahuka, chief of the virology department at Congo’s National Institute for Biomedical Research.
Government figures show that confirmed infections have risen to 4,200, with more than 1,900 deaths.
The WHO continues to rate the global risk of Ebola spread as low. Unlike respiratory viruses, Ebola is not transmitted through the air, which limits its ability to spread widely. The agency said cases identified beyond the affected area have been detected and contained quickly, without producing sustained transmission.
Declared on May 15, the outbreak differs from most previous Ebola emergencies because it is caused by the rare Bundibugyo virus, for which no approved vaccine or treatment exists. Initial tests targeted the more common Ebola virus, a misstep that contributed to delays in identifying the outbreak.
The response is taking place amid severe obstacles. Some health workers have gone on strike over unpaid wages, rebel groups have issued threats, and communities scarred by years of conflict have expressed anger. Misinformation claiming Ebola is not real has further complicated efforts. Response teams must navigate remote, unpaved roads, and officials have reported shortages of protective equipment. Meanwhile, large numbers of displaced people lack dependable access to water for handwashing.
The outbreak has killed more people at a faster pace than any previous Ebola outbreak, including the 2014-2016 crisis in West Africa, which remains the deadliest on record. That outbreak caused more than 11,000 deaths among at least 28,000 cases, but took roughly eight months to reach 1,000 fatalities.
Ebola is uncommon but highly contagious. People can contract it through bodily fluids, including vomit, blood and semen, as well as through contaminated items such as bedding and clothing. The disease is severe and frequently fatal.
WHO Director-General Tedros Adhanom Ghebreyesus said last week that the virus was spreading faster than response efforts. After meeting officials in the capital, Kinshasa, Tedros wrote on X that infections were doubling in some hot spots.
Health authorities estimate that between 60% and 70% of new infections are occurring among people who were not being monitored as known contacts. They have described the pace of transmission as “alarming.”
Access to medical care in the area has long been hindered by rebel violence in one of Congo’s most remote and vulnerable regions, near the borders with South Sudan, Uganda and Rwanda. Fear of infection is now keeping some pregnant women and other patients away from health centers, putting their lives at risk.
Several earlier Ebola outbreaks were also officially declared weeks or months after the virus first appeared. During the 2014-2016 West Africa outbreak, for example, authorities issued the declaration in March 2014, although investigators later determined that the first human case had occurred in December 2013.
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