The World Health Organization declared on May 17 that the Ebola epidemic in Congo and Uganda constitutes a Public Health Emergency of International Concern (PHEIC) — the highest level of alarm, which the WHO has issued only eight times since the introduction of the International Health Regulations in 2005 prior to this case. In the Congolese province of Ituri, the toll has risen to 131 dead and 513 suspected cases, and the Bundibugyo strain has no approved vaccine or specific treatment. Three weeks lost to faulty laboratory diagnostics in the city of Bunia were enough for the virus to spread beyond the province through funerals and healthcare facilities — confirmed cases have been reported in Uganda's Kampala and in the city of Goma in North Kivu, which is under the control of the M23 movement. Charité in Berlin is set to admit American missionary Peter Stafford, and French Prime Minister Sébastien Lecornu has activated initial measures on the overseas territory of Mayotte.
Patient zero in the city of Bunia and three lost weeks
On April 24, the first patient — a healthcare worker — arrived at the hospital in the city of Bunia with symptoms resembling severe malaria. He died three days later.
Wikipedia ↗ Congolese Health Minister Samuel-Roger Kamba told Al Jazeera that initial tests in the city of Bunia identified the Zaire ebolavirus — a strain for which the approved vaccine Ervebo exists. Samples were therefore sent to the reference laboratory in Kinshasa, which only on May 14 announced the actual pathogen behind the outbreak — the rarer Bundibugyo strain.
Al Jazeera ↗ Three weeks passed between the first symptoms and the official diagnosis — enough time for traditional Congolese funerals, involving ritual contact with the body of the deceased, and healthcare facilities with minimal equipment, to spread the virus to nine territories of Ituri province.
Bundibugyo — a strain without a vaccine
Bundibugyo was first identified in 2007 in the district of the same name in western Uganda and has since claimed around 15,000 victims in Africa, according to Le Figaro.
Le Figaro ↗ The fatality rate ranges between 25 and 50 percent — Kamba admitted it "can reach up to 50 percent."
Al Jazeera ↗ The Ervebo vaccine, approved by the US FDA in December 2019 for the Zaire ebolavirus strain and on which the rapid response in Congo in 2018 and 2020 depended, does not work against Bundibugyo. Experimental candidate vaccines have so far only undergone testing on macaques, and none has reached large-scale clinical trials.
WHO ↗ Doctors in the city of Bunia are therefore working with symptomatic treatment, isolation of contacts, and personal protective equipment — without the biotechnological safety net that the Congolese healthcare system had during previous outbreaks.
WHO raises the highest alarm
Director-General of the World Health Organization Tedros Adhanom Ghebreyesus announced on May 17 that the situation meets the criteria for a global health emergency — "extraordinary circumstances" with "documented international spread."
WHO ↗ This is a status that the WHO has granted only eight times since the introduction of the International Health Regulations in 2005 — most recently for mpox in 2022 and 2024, before that for COVID-19 in 2020 and for Ebola in Congo in 2019. The toll is rising rapidly — Congolese Minister Kamba announced 80 deaths on Saturday, the French portal info.gouv.fr recorded 131 victims and 513 suspected cases as of May 19, and the American agency AP reports 134 suspected deaths and more than 500 cases.
info.gouv.fr ↗ The discrepancies stem from the additional counting of deaths in villages without access to the healthcare network — the actual number is likely even higher.
Charité and the American doctor
The Berlin university clinic Charité announced that it will admit American doctor Peter Stafford to the isolation ward at its Wedding campus. Stafford, who lives in the Democratic Republic of Congo with his wife and four children, served as a missionary at the Nyankunde hospital near the city of Bunia. Stafford tested positive over the weekend, and American health authorities requested his evacuation. Germany was chosen due to its proximity to central Africa and Charité's decade of experience with highly contagious diseases.
Tagesspiegel ↗ Along with Stafford, the United States evacuated six other Americans who had come into contact with the doctor. German Health Minister Nina Warken told Tagesspiegel that "she currently sees no need to act" in Germany — Charité is fulfilling the role of a European reference facility for the American evacuation here, not a response to local risk.
CIDRAP ↗
Mayotte, American restrictions, and Goma under M23
French Prime Minister Sébastien Lecornu stated that the government is "very attentive" and activated initial security measures on the overseas territory of Mayotte in the Indian Ocean. Modeling by the INSERM institute and the national agency Santé publique France estimates the risk of the virus being transmitted to mainland France as "very low" — there is no direct flight connection between Ituri and France.
info.gouv.fr ↗ The Mayotte hospital is prepared to hospitalize a potential patient. The United States has introduced a stricter regime — banning entry for 30 days to foreigners who visited the Democratic Republic of Congo, Uganda, or South Sudan in the preceding three weeks, and issuing the highest-level travel warning for Congo.
CIDRAP ↗ The situation directly in Congo is complicated — one of the confirmed cases appeared in the city of Goma, which has been under the control of the rebel M23 movement, backed by Rwanda, since January 2025.
Wikipedia ↗ Humanitarian access, contact isolation, and sample transport are considerably more difficult in a zone that was until recently a battleground than in Ituri, which is under Kinshasa's control.
Why 70 percent are dying when 80 percent should survive
The Berlin daily Tagesspiegel published an analysis under the headline "Disinterest in Ebola has deadly consequences: 80 percent could survive, instead 70 percent are dying."
Tagesspiegel ↗ The gap between the achievable and the actual mortality rate illustrates the epidemic's main problem — the Bundibugyo strain has been known since 2007, and candidate vaccines exist, but according to Tagesspiegel, market demand has never covered manufacturers' costs for clinical trials. For a virus that has claimed around 15,000 victims over nineteen years exclusively in African countries, pharmaceutical investment decided otherwise. The global health emergency status that the WHO granted on May 17 should rewrite this calculation — countries on the IHR Emergency Committee gain tools for rapid financing, accelerated clinical trials, and coordinated distribution of candidate vaccines. The question is whether that financing will arrive before additional cases are exported outside the region.
What hotinfo is following
- Charité and Stafford: exactly when the evacuation will take place and what the isolation protocol will be in the Wedding unit
- IHR Emergency Committee: the first meeting after the PHEIC, recommendations on travel restrictions and financing for clinical trials
- Mayotte: specific steps by the prefecture — flight checks, isolation beds, PPE supplies
- Goma and M23: whether the rebel movement will allow humanitarian teams access to suspected cases
- Vaccines: the PHEIC should unlock rapid financing from CEPI and Gavi for candidate Bundibugyo vaccines — we are watching for the first announcements
- Kampala and Fort Portal: additional confirmed cases outside Ituri will be a signal that the three-week delay has triggered a secondary wave of infections
