Marie Bakikula, a caregiver at a UNICEF-supported crèche in Mongbwalu in the Democratic Republic of Congo, works in an emergency crèche for Ebola orphans.
Marie Ruwet/AFP/via Getty Images
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Marie Ruwet/AFP/via Getty Images
The fastest-spreading Ebola outbreak in history has reached another grim milestone. More than 10,000 people have been infected since the outbreak was first reported in May, according to the latest figures from the government of the Democratic Republic of Congo.
“This is a step that we are all surprised to take so quickly,” said Katie Thomas-Canfield, acting director of Ebola response for the International Rescue Committee. “10,000 people affected by Ebola in such a short period of time is truly astounding,” she says, noting that at this point in the West African epidemic from 2014 to 2016, only about 4,000 people had been infected. But that earlier outbreak still has the highest number of cases – more than 28,000 cases.
The current outbreak is also the largest ever observed in terms of geographic scope, stretching from Nigeria to Kenya. It comes second in terms of the number of deaths, with almost 5,000 deaths, compared to more than 11,000 previously.
About a third of the people who died in this outbreak were children. Children under 5 years old, whose immune systems are developing, are particularly affected: around three out of four infected people have died.
“Behind every number is a life interrupted, a family grieving, a health worker under pressure and a community seeking solace,” Mohamed Janabi, the World Health Organization’s regional director for Africa, said at a news conference last week. “We need to reach people sooner, bring safe care closer, and build trust before fear becomes a barrier to survival.”
A woman mourns the loss of a loved one suspected of having died of Ebola.
Jospin Mwisha/AFP/via Getty Images
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Jospin Mwisha/AFP/via Getty Images
Here’s a look at some of the key questions surrounding the 2026 outbreak.
Why did the epidemic worsen so quickly?
Part of the answer lies in uncertainty about when the virus began circulating.
While the epidemic was officially declared in May, more recent data suggests the virus likely began spreading in February or March.
“It takes a long time for things to go undetected in communities, and that means we started at a disadvantage,” says Thomas-Canfield. A confluence of factors contributed to this delay.
First, there is the fact that a rarer species of Ebola is causing the epidemic: Bundibugyo. Existing tests have not been calibrated for this speciescausing delays. Additionally, this region of northeastern DRC is isolated and plagued by conflict. And U.S. foreign aid cuts could have slowed disease surveillance efforts, says Nahid Bhadelia, an infectious disease doctor at Boston University.
Workers build an Ebola treatment center in Beni territory, North Kivu province, Democratic Republic of Congo.
Xinhua News Agency/via Getty Images
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Xinhua News Agency/via Getty Images
At the time, “it was clear that this would be a difficult path and would require international cooperation,” says Bhadelia. International cooperation and support has been slower to come than in previous Ebola outbreaks.
In 2014, for example, health professionals from around the world traveled to West Africa to strengthen the response. Bhadelia was one of them.
“I think we’re seeing a lot fewer Americans or other health care workers coming to the DRC because of the U.S. policy where Americans can’t be allowed to return even if they’re sick,” says Bhadelia. This is different from the policy of the previous major epidemic. “This means that much of the burden is borne by health workers in the DRC and the region.”
Despite pledges of funding from around the world, including more than $880 million from the United States, some health workers on the ground say the money is slow to materialize. “The scale of funding available for this response is actually only a fraction of what it was in our previous response,” says Thomas-Canfield. “I think the degree of international solidarity has been much less.”
A Kenyan health ministry official checks the temperature of a traveler at the Kenya-Uganda border as health authorities step up Ebola screening measures. On October 12, Kenya reported its first-ever Ebola death: a Kenyan who lived in the Democratic Republic of Congo died after returning to the country.
Light emoji/AFP/via Getty Images
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Light emoji/AFP/via Getty Images
Are we making progress?
The response on the ground has improved in recent months. There are now around twenty diagnostic laboratories and more than 50 treatment centers.
“We are approaching almost 2,000 treatment beds for Ebola, so there has been a lot of progress,” says Douglas Noble, UNICEF’s global incident manager for Ebola. Still, about two-thirds of deaths occur in the community and not in treatment centers – a sign that people are not showing symptoms. That figure has been stubbornly consistent for months and needs to improve for the outbreak to be under control, Noble says.
Part of the reason people don’t seek care may be because Bundibugyo infections may seem mild at first. “Things like fever, headaches, body aches, these are all symptoms of the most common and largely treatable endemic diseases in the region,” says Thomas-Canfield. Those infected with Ebola may not decide to seek treatment until it is too late, he says.
An even bigger barrier, many health workers on the ground say, is community distrust.
A October survey of the International Rescue Committee found that 85% of people surveyed in North Kivu – a current hotspot – say that distrust of community stakeholders prevents them from seeking care.
“We’re constantly fighting different types of rumors, different types of misinformation,” says Thomas-Canfield of the International Rescue Committee. Many community members wonder if Ebola is real or think responders are just trying to make money. Others wonder why teams are coming for Ebola and not for other diseases hitting the region, like malaria or typhoid.
Community health workers are working hard to rebuild that trust. “I think in areas where we’ve been able to establish a longer-term presence, we’re better able to respond,” says Thomas-Canfield. But the virus is spreading quickly to new health zones. It’s difficult to build trust from scratch, she says. This is particularly true in conflict zones, where fighting makes work difficult and armed groups actively sow disinformation.
When trust is low, people do not seek care or contact health authorities to try to detect new cases and isolate their contacts. About 80% of new cases still come from people who weren’t on health authorities’ radar. Until that rate drops, the outbreak will remain out of control, says Bhadelia, an infectious diseases doctor.
She cites the cases of Nigeria and Kenya this month as proof. “The sporadic cases we are seeing in neighboring countries are a sign of growth in the DRC,” she says. Even though the number of daily cases appears to be plateauing, she says there are likely many areas where the virus is spreading undetected. “It’s so out of control.”
Is there any hope that an Ebola vaccine or better treatments could bring the numbers down?
No vaccines or treatments are authorized for the Bundibugyo species of Ebola. Several are in the worksbut all far from being used in this answer.
There is a vaccine against Ebola. It’s called Ervebo, but it targets a different species of disease. It hasn’t been widely rolled out, but health care workers began receiving the vaccine in late August and researchers have just launched a clinical trial, named Tumaini after the Swahili word for hope, aimed at testing Ervebo’s effectiveness against Bundibugyo. If it proves effective, “it would be incredible, it could make a difference,” says Bhadelia. But she warns that vaccines and new treatments are not a silver bullet.
A person who died of Ebola is buried in a cemetery in Mongbwalu, in Ituri province, eastern Democratic Republic of Congo.
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