JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – September 20, 2026 – EBOLA
Ebola viruses were first discovered in northern Congo (then Zaire) in 1976; since then, they have caused 16 outbreaks in that country and dozens more in the region. Ebola remains highly lethal, but over the past five decades, medical professionals and governments have learned how to diagnose the disease, detect its spread, and, when caught early, stop it. Yet the outbreak that has killed over 3,500 people across Congo since early this year is already the deadliest the country has experienced and the fastest spreading in history. Despite recent signs of progress, it is nowhere near being contained.
The difficulty containing this year’s Ebola outbreak does not bode well for the world’s ability to respond effectively to future biological threats. Naturally occurring viruses are emerging more frequently. There were 12 recorded outbreaks of Ebola and Marburg, another deadly disease from the same viral family, during the four years of the Biden administration, compared with five during the previous four years; the current Trump administration could well face even more, having already contended with five outbreaks in less than two years. And the risk of an accidental or deliberate release of a deadly virus is growing. A rising number of labs are handling high-risk pathogens, in part because of a research boom following the COVID-19 pandemic, and it is becoming easier and easier to engineer new viruses using artificial intelligence. Earlier this month, the American AI company Anthropic disclosed five cases in which scientists used its AI software Claude for research that could support biological weapons development, including on variants of bird flu that could evade human immunity. The report confirmed fears that AI models could help bad actors access biological weapons.
The global health system, meanwhile, has been weakened by the Trump administration’s cuts to disease surveillance and outbreak preparedness programs, both within the United States and abroad. But the system was shaky long before U.S. President Donald Trump arrived on the scene. Global threat monitoring processes have significant gaps, inconsistent funding models delay vaccine development, and most countries underinvest in regular, comprehensive health services. Washington and other donors often step up when a crisis emerges, but scrambling to put together an emergency response is far from the best way to handle a biological threat. That approach is struggling to contain Ebola today. When a new, lesser-known pathogen begins to spread, the world needs to be much better prepared.” (1)
“Bundibugyo belongs to the filovirus family, the same group of viruses that includes the much better-known Ebola virus. Despite its potential severity, Bundibugyo has been linked to only two previously recognized outbreaks, one in Uganda in 2007 and another in the Democratic Republic of Congo (DRC) in 2012.
The current outbreak, however, has already surpassed those earlier events in both its trajectory and scale. According to the WHO, 695 confirmed cases and 138 confirmed deaths had been reported in the DRC and Uganda as of June 11.
Sullivan, a professor of biology and virology, immunology & microbiology at Boston University, explains that bringing an outbreak under control depends on several measures working quickly together. These include rapid diagnosis, isolating infected patients, tracing people who may have been exposed, strengthening infection control, and providing supportive medical care.
Those steps become much harder when laboratory resources are limited. In settings where testing capacity is scarce, delays in confirming infections can give the virus more time to spread.
Bundibugyo can cause a severe form of hemorrhagic fever. Infection can trigger widespread inflammation, damage and failure of the cells lining blood vessels, uncontrolled bleeding, and failure of multiple organs.
The virus spreads through direct contact with infected bodily fluids. That creates particular risks for family members, caregivers, and health workers, especially when patients are being treated in hospitals without adequate infection control. The 2026 outbreak was formally recognized after the death of a nurse.
Another major challenge is that Bundibugyo can initially resemble several far more common illnesses. Symptoms overlap with malaria, typhoid fever, and other diseases, meaning laboratory testing is necessary to confirm an infection.”
“Sullivan says preparedness also needs to involve much more than creating diagnostic tests, vaccines and drugs. Health systems must be capable of coordinating quickly when outbreaks spread across borders.
“Preparedness planning should extend beyond diagnostics, vaccines, and therapeutics to include operational readiness for multinational outbreak response,” she said.” (2)
“West African laboratory scientists called on governments Friday to strengthen capacity to detect disease outbreaks to avoid another major outbreak, saying health systems across the region are becoming weaker.
The scientists issued their warning in Togo’s capital, Lome, where they have gathered this week to discuss the region’s level of preparation for disease outbreaks and dependence on vaccines from Western countries.
They said governments in the region have to cooperate to strengthen disease detection and invest in diagnostic capacities, citing lessons from Ebola and COVID-19 outbreaks that the region has grappled with in the past decade.
Between 2014 and 2016, an Ebola outbreak killed at least 11,000 people across West Africa, overwhelmingly in Guinea, Liberia and Sierra Leone.
“We need to anticipate these outbreaks,” said Kossi Kabo, the head of the Association of Medical Biologists of Togo and a co-chair of the congress. “We shouldn’t wait for an epidemic to emerge somewhere before responding. By then, it would be too late.”
Africa as a whole remains at risk for outbreaks. The rare Bundibugyo virus has killed over 3,600 people among nearly 7,500 cases in Congo since mid-May, when Congolese authorities announced a fresh deadly Ebola outbreak. The Africa Centers for Disease Control and Prevention said the tolls are likely three times the official figures and the outbreak is already history’s fastest-spreading Ebola outbreak. The virus spread without detection for several weeks. Also, Hantavirus was detected on a cruise ship that docked in the Atlantic off Cape Verde in May.
Scientists are worried that in the absence of a major outbreak threatening the region, maintenance of the health systems has waned, leaving them unprepared for potential future epidemics.” (3)
“Despite “encouraging signs” in the fight against the Ebola outbreak in the Democratic Republic of Congo (DRC), efforts to wipe out the virus in the east of the country are “far from over”, according to the World Health Organisation (WHO).
In an online news conference, WHO chief Tedros Adhanom Ghebreyesus told journalists cases were surging in North Kivu province as officials raced to control the spread of “many outbreaks in many places”.
Tedros said the number of weekly cases had doubled over the past two weeks from 100 to more than 200 cases in North Kivu.
“The area is so vast that it’s hard to speak of a single epidemic,” Tedros added.
Tedros said that transmission was declining in the worst-affected areas of Ituri province, the epicentre of the outbreak, while South Kivu has not reported any new cases since May.
“But make no mistake, the epidemic continues to grow and continues to kill”, Tedros warned.
Battling the outbreak has been complicated by the emergence of a rare strain of Ebola known as the Bundibugyo virus, which has no known cure.” (4)
“The race to contain the Ebola disease outbreak in Democratic Republic of Congo (DRC) is far from over, warns Médecins Sans Frontières (MSF). While some indicators, such as declining patient admissions and slower transmission, may suggest the outbreak is easing, MSF teams are observing a worrying trend: cases are emerging and spreading into new, underprepared areas while basic response measures are still not in place in the original hotspots, making containment efforts increasingly challenging.
“Assuming the outbreak is under control because some Ebola treatment centres are admitting fewer patients would be a mistake,” says Anthony Kergosien, MSF emergency coordinator in DRC. “In Ituri [province], the original epicentre, the spread is indeed slowing down for now. But nationally, the number of new cases has not fallen.”
“The outbreak is not shrinking, it is moving: South Ubangi has become the seventh affected province, while North Kivu now accounts for nearly half of all newly confirmed cases, with test positivity rising sharply in recent days,” says Kergosien. “While undetected chains of transmission are already taking hold in the main operational hubs, the spread of the outbreak into new areas with even weaker preparedness and response capacities poses a serious risk.”” (5)
“Congo on Saturday began vaccinating healthcare staff against Ebola in Bunia, the epicenter of the fastest-growing outbreak of the disease in history as they are “particularly exposed and deeply involved in the response,” the provincial governor said.
Health workers and other front-line workers in the Ebola response are being prioritized to receive the Ervebo vaccine that was effective in past Ebola outbreaks caused by a different, more common type of virus. Clinical trials are ongoing to find a licensed vaccine for the current outbreak, caused by the Bundibugyo virus, which has no licensed vaccine or treatment.” (6)
“The Democratic Republic of the Congo (DRC) has turned to mobile operators who are set to help the country fight its current Ebola outbreak caused by the Bundibugyo virus disease (BVD).
According to the World Health Organization (WHO), since it was detected in May 2026, the BVD outbreak has rapidly evolved into a large and geographically expanding epidemic affecting six out of the 26 provinces in the Central African country.
The current use of anonymized mobile operator metadata to map out population movements is being coordinated by Vodacom and the Flowminder Foundation, a Swedish nonprofit organization.
Already, the Flowminder Foundation has flagged Kisangani city in Tshopo province and Kinshasa – the capital and most populous city – as relatively high risk, through the use of anonymized mobile operator data – including call, SMS and Internet detail records.
According to the WHO, delayed detection of cases continues to increase the risk of further spread within households, communities, and healthcare settings.
The use of anonymized mobile operator data is not new to the country as it was successfully used before to support the government’s response to the COVID-19 pandemic.
Furthermore, this type of data has been used to estimate population displacement following the eruption of Mount Nyiragongo in 2021 and strengthen routine immunization planning for the Expanded Program on Immunization (EPI).
However, this is the first time it is being used to curb the Ebola Bundibugyo outbreak and is expected to produce timely, evidence-based insights to prevent further regional spread and ensure an effective public health response.” (7)
“I have just returned from Bunia, the epicentre of the Democratic Republic of the Congo’s 17th Ebola outbreak – and what is now the fastest-growing outbreak on record.
What I saw there was a bleak picture of what this outbreak does to women and girls.
Women are on the front line – in health centres, in homes and in their communities. And they are paying the price, sometimes with their lives.
Women and girls caring for the sick – young and old – as health workers in health centres, and as carers at home. Women and girls washing and burying the dead. Women and girls collecting water and food.
When it comes to Ebola, care is a chain of transmission. Because Ebola transmission mirrors the distribution of these care responsibilities, women and girls account for most cases.” (8)
1.Ebola Is Only the Beginning, by Stephanie Psaki, https://www.foreignaffairs.com/democratic-republic-congo/ebola-only-beginning
2.A deadly ebola relative is surging after years in the shadows, by Boston University, https://www.sciencedaily.com/releases/2026/09/260919031042.htm
3.Scientists warn of weakening health systems and urge stronger outbreak detection, By ERICK KAGLAN, https://abcnews.com/Health/wireStory/west-african-scientists-warn-weakening-health-systems-urge-136574739
4.Ebola fight in DRC ‘far from over,’ warns WHO chief, https://www.heraldonline.co.zw/ebola-fight-in-drc-far-from-over-warns-who-chief/
5.Assuming the Ebola disease outbreak in DRC is under control would be a mistake, https://www.msf.org/assuming-ebola-disease-outbreak-drc-under-control-would-be-mistake
6.Congo begins Ebola vaccinations for health workers in the epicenter of the outbreak, By CONSTANT SAME BAGALWA, https://apnews.com/article/ebola-vaccine-congo-bundibugyo-ervebo-3f28becb36c401084cb3b19183edb940
7.DRC using anonymized mobile operator data to curb Ebola virus, by Daniel Itai,https://www.connectingafrica.com/innovation-hub/drc-using-anonymized-mobile-operator-data-to-curb-ebola-virus
8.Women’s care work fuels an unaccounted death toll in the fastest-growing Ebola outbreak on record, https://www.unwomen.org/en/news-stories/press-briefing/2026/09/womens-care-work-fuels-an-unaccounted-death-toll-in-the-fastest-growing-ebola-outbreak-on-record
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai