Ebola spreads in Congo as aid and security strain rise

Aid workers and health staff in eastern Congo say the Ebola outbreak is accelerating, with growing suspected deaths and cases, no available vaccine for the Bundibugyo strain, and mounting challenges from conflict and weak health capacity.

For the third day, nobody in eastern Congo could point to “patient zero.” Instead, healthcare workers in Bunia—where the first known death occurred last month—spoke about one reality they can’t ignore: the Ebola outbreak is moving faster than the system around it can cope.

Hama Amado. a field coordinator in Bunia for the Alima aid group. said Thursday the situation was “worrying because this is gaining momentum.” He added that “this is spreading in many areas” and that “everyone must mobilize.” He said they are “still far from saying that the situation is under control.”.

The outbreak is linked to the Bundibugyo strain, for which there is no available vaccine or medicine. It spread undetected for weeks after the first known death as authorities tested for a more common Ebola virus.

By Thursday, authorities had announced 139 suspected deaths and nearly 600 suspected cases. But healthcare workers and aid groups say the outbreak is much larger than what has been officially reported. The World Health Organization has said the threat of a global spread is low. yet it has also said health officials have not yet found “patient zero.”.

A confirmed case was reported Thursday by the M23 rebel group, which controls parts of eastern Congo. In a statement. M23 said it had a confirmed case near the major city of Bukavu. about 500 kilometers (310 miles) south of the outbreak’s epicenter in Ituri Province. The person died, according to M23. The announcement was the first confirmation of a case in South Kivu.

As the disease expands beyond its initial region. confirmed cases were also reported in North Kivu province and two in Uganda. In Ituri. the first known death’s location. the pressure is visible in the way care is delivered—often in crowded spaces. with scarce supplies. and while families watch helplessly.

“While almost 20 tons of aid has been airlifted to Bunia,” healthcare workers have still been forced into painful compromises. Doctors tending to suspected Ebola patients in general wards have used out-of-date facemasks because of a lack of isolation space.

At a treatment center in Rwampara near Bunia, healthcare workers in protective gear handled the bodies of suspected Ebola victims. Families who washed loved ones’ bodies themselves watched as workers disinfected the corpses and placed them into coffins for burial. Some relatives burst into tears. Survivors and families described a sudden, terrifying deterioration—symptoms initially mistaken for illnesses such as malaria.

Botwine Swanze, who lost her son, said: “He told me his heart was hurting. Then he started crying because of the pain. Then he started bleeding and vomiting a lot.”

Ebola is highly contagious and spreads through contact with bodily fluids such as vomit, blood, feces, or semen. Symptoms include fever, vomiting, diarrhea, muscle pain, and at times internal and external bleeding.

The strain on daily life is unfolding alongside the strain on healthcare. Schools and churches remain open in Bunia, and some residents have started wearing facemasks, which have become harder to find. Justin Ndasi. a resident. described the layered crisis: “It’s truly sad and painful because we’ve already been through a security crisis. and now Ebola is here too.”.

At the Salama hospital in Bunia. a Doctors Without Borders team identified suspected cases over the weekend but found no available isolation ward. Trish Newport. an emergency program manager. said on social media. “Every health facility they called said, ‘We’re full of suspect cases. We don’t have any space.’ This gives you a vision of how crazy it is right now,” she said.

In Bambu General Hospital elsewhere in Ituri, suspected Ebola patients shared a ward with others. In Mongbwalu—where the body of the first known death was taken—the nearby border with Uganda remains open and gold mining continues. said Chérubin Kuku Ndilawa. a civil society leader. describing how difficult containment is in a region that never fully slows.

At Mongbwalu General Hospital, Dr. Didier Pay said they were treating around 30 Ebola patients. He said a student from the local medical technology institute died on Wednesday. Dr. Richard Lokudu. the hospital’s medical director. told the AP the patients are “scattered here and there in rather unusual conditions. ” and said that without help setting up new facilities. they could be “completely overwhelmed.”.

International health officials are warning that the outbreak may already be bigger than the current count. The World Health Organization has declared the outbreak a public health emergency of international concern. WHO director-general Tedros Adhanom Ghebreyesus said he is “deeply concerned about the scale and speed of the epidemic” and that it’s likely much larger than the official case count. WHO’s chief in Congo said the outbreak could last at least two months.

WHO viral hemorrhagic fevers expert Anaïs Legand said investigations are continuing into the source, but “given the scale, we are thinking that it has started probably a couple of months ago.”

A London-based analysis group, the MRC Centre for Global Infectious Disease Analysis, estimates that cases have been substantially undercounted and that the actual number could already exceed 1,000.

The danger isn’t only medical. Insecurity is now directly entangled with the response effort. Long a scene of attacks by armed groups, the region’s volatility complicates containment and care.

Local leaders said an attack by militants linked to the Islamic State group killed at least 17 people on Tuesday in Alima. a village in Ituri. Fighters with the Allied Democratic Forces (ADF). which has ties to IS. killed civilians with machetes and firearms. burned down houses and business. and took several people hostage. Civil society groups warned that other villages in the region face a threat of attack.

The number of ADF fighters in Congo is unclear, but they have a significant presence and regularly attack civilians. Another armed group active in the region is CODECO, described as a loose association of militia groups.

Ladd Serwat, a security analyst, said he would be “especially worried about an opportunistic attack on healthcare workers” if the outbreak spreads into rebel areas.

The wider shock is already reaching public events. India and the African Union said Thursday that the India-Africa Forum Summit. scheduled to be held next week in New Delhi. had been postponed due to the “evolving health situation in parts of Africa.” On Wednesday. Congo’s soccer team canceled a three-day World Cup preparation training camp and a planned farewell to fans in the capital Kinshasa because of the Ebola outbreak.

The outbreak’s economic and logistical stakes are now inseparable from the human ones—while aid has been airlifted. health workers still face isolation wards that don’t exist and security that can’t be relied on. And as officials continue to search for how the virus arrived. the most immediate question is whether the response can catch up to the momentum now spreading across more provinces and borders.

Ebola outbreak Congo Bunia Bundibugyo strain M23 rebel group Bukavu Ituri Province North Kivu South Kivu Uganda cases World Health Organization public health emergency of international concern Tedros Adhanom Ghebreyesus aid shortages internal displacement