Ebola outbreak in the DRC in 2026 : symptoms, history, and protective measures

1. What is Ebola virus disease?

Ebola virus disease can be caused by several viruses belonging to the Filoviridae family. The name “Ebola” was given in reference to a river in northern DRC (formerly Zaire), where the pathogen was first identified in 1976.

Six species of Ebola virus have been identified, three of which have caused outbreaks in humans:

• Zaire ebolavirus
• Sudan ebolavirus
• Bundibugyo ebolavirus

1.1. Reservoir and modes of transmission

Fruit bats are thought to be the primary reservoir of the virus, though no definitive evidence exists to date. The virus is capable of infecting a large number of animal species. In the weeks preceding a human outbreak, an epizootic is often observed among great primates, such as gorillas and chimpanzees, or among antelopes. Hunters who come into contact with sick animals — which are more easily caught — may contract the virus and transmit the disease.

Human-to-human spread then occurs through:

• direct contact with bodily fluids (blood, saliva, sweat, semen, faeces),
• indirect contact with contaminated objects, such as syringes.

The risk of airborne transmission remains very limited, except in specific circumstances (endotracheal intubation in intensive care, for example). An infected individual becomes contagious only upon the onset of the first symptoms, and contagiousness increases as the disease progresses. The incubation period is most commonly between 5 and 12 days. Deceased individuals also remain highly contagious for several days.

1.2. Symptoms and case fatality rate

The initial symptoms of the disease resemble those of influenza: high fever, muscle pain, and headache. These are followed by vomiting, diarrhoea, skin rashes, and in some cases internal and external haemorrhaging.

The mean case fatality rate is 50%.

2. History of Ebola outbreaks in Africa

The first known Ebola outbreak dates to 1976, the year the virus was identified. It struck a dispensary in a remote area of the tropical rainforest in what is now the DRC (then Zaire). Its extremely high infectivity and fatality rates had already prompted considerable alarm. It claimed the lives of 280 people, including healthcare workers, before dying out on its own, due to a lack of transmission vectors. Further outbreaks of limited scope subsequently occurred in this region of Central Africa.

The year 2013 marked a major turning point. For the first time, an Ebola outbreak struck West Africa. Cases were identified in Guinea, and owing to road and air travel, the epidemic spread to Sierra Leone, Liberia, and, to a lesser extent, Nigeria, Senegal, and Mali. The pathogen identified was Zaire ebolavirus, the most lethal species within this viral family. The outbreak was declared over in 2016, after more than 11,000 deaths had been officially recorded. The scale of this epidemic accelerated medical research, leading to the approval of two vaccines by the WHO.

These vaccines were deployed during the two subsequent outbreaks, both also caused by the Zaire strain:

• the 2018 outbreak in northwestern DRC: brought under control by 2020 through a large-scale ring vaccination campaign, i.e. the vaccination of close contacts;
• the autumn 2025 outbreak in Kasaï Province, southwestern DRC: rapidly contained through early case identification and a vaccination campaign.

3. 2026 Ebola outbreak : current situation and countries at risk

In mid-May 2026, health authorities in the DRC reported the emergence of cases in the north-east of the country, in Ituri Province, which borders Uganda and South Sudan. As new cases were being reported in Uganda and in Goma — a city in the DRC located over 500 km from Ituri — laboratory analyses identified the Bundibugyo virus. This strain, previously responsible for highly localised outbreaks in Uganda and the DRC, remains poorly understood and currently has no approved vaccine.

In response to this health crisis, the World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC) on 17 May. This constitutes its second-highest alert level, reflecting the seriousness of the situation and the elevated risk of local and regional spread. For its part, the Africa Centres for Disease Control and Prevention (Africa CDC), the autonomous body responsible for disease prevention and control in Africa, expanded to 11 the list of countries threatened by the outbreak, which is now present in three provinces of the DRC and in Uganda: South Sudan, Rwanda, Kenya, Tanzania, Ethiopia, Congo, Burundi, Angola, the Central African Republic, Zambia, and Somalia.

The WHO nonetheless considers the risk of a pandemic to be “low”, in particular because the virus is not respiratory and is transmitted through direct contact with bodily fluids.

3.1. Factors driving the current crisis

Several factors account for the concern expressed by WHO Director-General Dr Tedros Adhanom Ghebreyesus:

• the late diagnosis of the first cases, probably several weeks after their onset, which contributed to uncontrolled progression of the disease: the PCR sequencing tests initially used had been optimised for the Zaire virus and failed to detect the Bundibugyo virus;
• the underestimation of the true number of cases;
• the socio-economic ecosystem of the main outbreak epicentre, located at the junction of the DRC, South Sudan, and Uganda: this is a densely populated gold-mining region characterised by constant large-scale population movements;
• disinformation and the population’s distrust of institutions;
• the presence of armed groups, which hampers access to certain areas;
• the absence of protective protocols during funeral rites, in the course of which relatives are in direct contact with the deceased, who remains infectious.

4. Long-term sequelae

Ebola sequelae — referred to as post-Ebola syndrome (PES) — affect a large proportion of survivors, up to four in five according to some studies. The most common physical sequelae include arthralgia, chronic headaches, visual disturbances, persistent fatigue, and hearing impairment. Neurological involvement (memory impairment, concentration difficulties) has been observed, including in children. Studies have shown that symptoms persist over time. Survivors are also at elevated risk of post-traumatic stress disorder, anxiety, and depression, often compounded by social stigmatisation.

In January 2026, a preprint identified potential metabolic biomarkers of PES, paving the way for biological diagnosis. However, no specific approved treatment for PES currently exists.

5. How to protect against the Ebola virus?

The declaration of a PHEIC is accompanied by a series of recommendations: the establishment of health emergency management systems and operations centres, public awareness campaigns, contact tracing, and the coordination of responses at national and international levels.

Although Africa CDC has committed to making a vaccine against the Bundibugyo strain available by the end of 2026, its development and deployment could take many months, as no product is currently in clinical trials.

5.1. Treatment and collective measures

In the absence of a proven specific treatment, symptomatic management is provided (rehydration, transfusion, intensive care) to prevent patient deaths. Protecting the population is essential to prevent transmission:

• isolation of patients,
• contact tracing,
• community outreach in affected areas to promote compliance with barrier protocols and the adaptation of funeral rites to protect the family of the deceased.

5.2. Healthcare worker protection

The protection of healthcare workers relies on adherence to protective and decontamination protocols and the use of specific personal protective equipment (PPE):

• Type 3 biological protection suit, impermeable to pathogenic fluids,
• respiratory protective mask,
• goggles or a protective visor,
• gloves, boots, and waterproof overshoes.

Earlier case detection — made possible in particular by tests capable of immediately identifying the various strains of the virus — would have helped contain the spread of the epidemic.

This outbreak is a reminder that the Ebola virus remains a threat in Central and West Africa. In the absence of a specific treatment and a vaccine against the Bundibugyo strain, controlling this outbreak depends on strict adherence to protective protocols and international coordination for the management of patient care and the provision of PPE.