Africa CDC Director-General Jean Kaseya stated that more than 1,100 suspected Ebola cases are now under investigation in the Democratic Republic of the Congo and Uganda, with 263 confirmed cases and 43 confirmed deaths [8]. The figure represents a significant increase from earlier tallies and coincides with suspected cases surfacing — and testing negative — in Italy and Brazil, extending the outbreak's surveillance footprint to three continents even as health authorities assess the risk of global spread as very low [5][7].
The outbreak, caused by the Bundibugyo strain of Ebola virus, was declared on May 15 in DRC's Ituri province. WHO has classified it as a public health emergency of international concern [25]. Within the DRC alone, 906 suspected cases and 223 suspected deaths have been recorded, alongside 282 confirmed cases and 42 confirmed deaths; Uganda has reported nine confirmed cases and one death [6][10]. Africa CDC separately tallied 263 confirmed cases and 43 confirmed deaths across both countries [8].
**Containment optimism versus alarm over response capacity**
WHO Director-General Tedros Adhanom Ghebreyesus, visiting the epicenter in Bunia, announced that five patients had been discharged after recovering from the Bundibugyo strain: "Cuatro personas serán dadas de alta hoy y hubo una que fue dada de alta anteayer" (Four people will be discharged today and one was discharged the day before) [4]. He told communities that "We can stop this Ebola and anyone who has it can also recover. But the rule … is this thing is everybody's business and every citizen should be involved" [6]. Tedros cited DRC's record of ending 16 previous Ebola outbreaks as grounds for confidence [10].
Médecins Sans Frontières offered a different assessment. Alan Gonzalez, MSF's Deputy Director of Operations, stated: "Never before has an Ebola outbreak recorded so many cases so soon after its declaration" [10]. He added: "The reality today is that nobody knows the true scale and severity of this outbreak. New suspected cases are being reported daily, yet hundreds of samples remain untested" [6]. MSF called for an immediate expansion of diagnostic testing, faster deployment of aid workers, and sustained access for medical supplies [10][16].
**Suspected cases outside Africa**
Brazil isolated two patients — a 37-year-old man from the DRC in São Paulo and a Belgian traveler from Uganda in Rio de Janeiro — after they presented with Ebola-like symptoms [3][5]. The São Paulo patient was diagnosed with severe meningitis; the Rio patient tested positive for malaria [1][5]. Brazil's health ministry confirmed the Rio patient's Ebola tests returned negative, and the São Paulo state government stated that "the technical assessment indicates that the risk of the disease being introduced into Brazil and South America remains very low" [5]. A patient isolated in Sardinia, Italy, after returning from the DRC also tested negative, as did two individuals tested at a Milan hospital after returning from Uganda [7]. Italy's Ministry of Health maintained that the risk in the country remains very low [7][19]. Kenya's Principal Secretary for Public Health, Mary Muthoni Muriuki, confirmed that all 16 suspected cases in Kenya tested negative [2].
**Armed conflict and the response**
Armed groups including ADF and Codeco attacked Ebola treatment centers in Ituri province between May 21 and 25, setting tents on fire [9]. Illegal checkpoints established by armed groups have also restricted humanitarian access along key routes [9]. The UN Protection Cluster attributed the attacks to manipulated groups [9]. WHO warned that armed clashes cause mass displacement, close humanitarian corridors, and limit health workers' ability to reach affected populations [15]. Tedros called on all parties to declare a ceasefire: "No cause, no conflict, no grievance is worth condemning innocent people to death from a preventable disease" [6].
**African ownership and the funding gap**
Kaseya argued that the outbreak is "a serious test" for African institutions and criticized the continent's dependence on outside financial support: "Africa's response to Ebola must be defined by Africa itself" [6][8]. He called for the momentum of a $319-million regional response plan adopted by the health ministers of DRC, Uganda, and South Sudan to expand continent-wide [8].
The question of external funding carries its own tensions. The United States announced $80 million in additional aid, raising its total commitment to over $112 million [6][10]. U.S. media reported that Trump administration cuts to USAID and foreign aid had reduced DRC health infrastructure before the outbreak began, creating a funding gap that hindered frontline preparedness [13][14].
**No vaccine for the Bundibugyo strain**
A WHO expert consultation confirmed that no licensed vaccines or therapeutics exist for the Bundibugyo virus [12]. The most promising vaccine candidate has been tested only in animals, and clinical studies may take six to nine months to begin [17]. German pharmaceutical reporting noted that all Bundibugyo vaccine candidates remain in preclinical stages, with none having entered even phase I safety trials in humans [18]. Treatment of current patients has relied on symptomatic care. A physician at the Bunia treatment center, Davin Ambitapio, stated: "De verdad tenemos esperanza. El virus aquí no es tan complicado como los que hemos enfrentado en el pasado" (We truly have hope. The virus here is not as complicated as those we have faced in the past) [4]. A recovered nurse in Bunia described being contaminated while handling patients without protection: "Ebola est une très mauvaise maladie, j'ai souffert" (Ebola is a very bad disease, I suffered) [11].
**Travel bans and border measures**
Tedros asked countries that have imposed travel bans or border closures to reconsider, arguing that such measures discourage affected nations from reporting cases transparently [10]. Uganda and Rwanda have closed their borders with the DRC [10][20][22], and the Trump administration banned entry of non-U.S. passport holders who had recently visited Congo, Uganda, or South Sudan [10]. Turkey, India, Vietnam, and Russia have enhanced screening at airports and entry points [21][23][24][26]. India's Ministry of Health stated that no Bundibugyo cases have been reported in the country but that surveillance has been strengthened as a precaution [26].
The outbreak's trajectory depends on whether diagnostic capacity, humanitarian access, and community trust can be expanded faster than the virus spreads. WHO's expert consultation on vaccines and therapeutics is expected to guide the next phase of medical countermeasure development, with clinical trials potentially beginning no earlier than late 2026 [12][17].