JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – November 11, 2026 – Ebola
“The Ebola epidemic currently raging in the Democratic Republic of Congo could last at least another year, a leading UK epidemiologist has warned.:
Experts have struggled to contain the current outbreak since the first cases of the rare Bundibugyo strain of the disease were reported in May.
There have so far been almost 11,000 cases including 5,000 deaths, making it the second largest outbreak in history, after the devastating West Africa epidemic of 2014-16. Cases have also been reported in Nigeria and Kenya, although transmission has not been widespread.
The outbreak is taking place across a vast area of DRC – North Kivu and Ituri – where conflict and widespread mistrust of authorities, including health workers, have hampered the response.
Neil Ferguson, professor of epidemiology at Imperial College, London, told a press briefing that at the current rate of disease spread that the epidemic could still be ongoing at the end of next year.
“Controlling Ebola outbreaks takes a long time so it is highly likely we’ll still be seeing transmission in a year’s time,” he said.
“We’re ticking over at about 70 confirmed cases a day at the moment and that’s almost certainly quite a significant underestimate of the true number of infections,” said Prof Ferguson, who rose to prominence at the beginning of the Covid pandemic when he advised government on the likely trajectory of the outbreak.
Experts believe that only about half of cases are being recorded, and around two thirds of deaths are taking place among people who have never been to a health clinic, indicating widespread undetected transmission.
Prof Ferguson said the shape of the current outbreak – a period of low case numbers followed by a large spike – is similar to previous outbreaks.
He added: “Trajectories of Ebola epidemics are quite difficult to predict. If we look back to the last North Kivu outbreak in 2018-2020 there was a period of flat case numbers then a sudden increase. And it took the best part of two years to bring that outbreak, which was considerably smaller than the current one, under control.”” (1)
“Seventy-one confirmed Ebola cases have been identified since the start of the outbreak through surveillance points supported by the International Organization for Migration (IOM) in the Democratic Republic of the Congo (DRC), as continued transmission, displacement and a USD 59.8 million regional funding shortfall threaten efforts to contain the outbreak. Nearly half of this funding gap is concentrated in the DRC, raising concerns about the ability to sustain critical oversight and preparedness efforts across the region.”
“The 71 initial alerts were identified at points of entry and control since the outbreak began, according to IOM’s latest report. Surveillance at displacement sites identified three nfirmed Ebola cases between 26 October and 1 November 2026, highlighting the importance of extending surveillance beyond formal border crossings. According to WHO, 10,467 confirmed cases and 5,103 deaths had been reported across 67 health zones in eight provinces as of 31 October.
The outbreak continues to affect communities in eastern DRC, with imported cases also reported in Kenya and Nigeria raising concerns about transmission along cross-border routes.
Insecurity and continued displacement are complicating efforts to reach affected communities and maintain oversight. IOM supports 67 displacement sites in the DRC, including 50 in health zones affected by the outbreak, while working with national authorities to strengthen early detection, health screening and referral systems.
To identify potential gaps in monitoring, IOM is mapping population movements along key travel routes and informal border crossings. In DRC’s Tshopo Province, assessments identified 19 strategic river locations where additional surveillance points may be needed.
Similar efforts are underway in neighbouring countries. In Uganda’s Kasese District, population mobility mapping identified 17 priority points of entry, including 13 informal crossings, helping authorities determine where to strengthen screening and surveillance. In Kenya, where nine confirmed cases had been reported as of 26 October, IOM is supporting preparedness at 22 points of entry. In South Sudan, IOM continued monitoring population movements at 12 border locations with DRC and Uganda.” (2)
“In the Democratic Republic of Congo, the largest number of new reports of Ebola cases is coming from North Kivu province, Health Minister Roger Kamba said at a government meeting on November 6. The Rio Times reports.”
“North Kivu is a province bordering Rwanda and Uganda where armed groups operate. Police in the city of Beni said that on the night of November 7, armed individuals tried to set fire to an Ebola treatment center run by Médecins Sans Frontières. According to police, bottles of gasoline were found at the site.” (3)
“IOM maps the places where people gather, such as markets, bus stations and places of worship. It also maps what it calls “the mobility corridor”, meaning where people are travelling to and from, including areas hit by the outbreak.
Those findings show responders where to send staff and resources.
Since the outbreak began, teams have carried out 55 million screenings in the DRC and 11 neighbouring countries.
Dr. Mbala said most people transporting the bodies of Ebola victims also use informal routes. So far, 258 bodies have been intercepted.
“It is quite important that we look into the points of control and to be able to expand our scope in terms of response to make sure that we cover all the informal routes, not only concentrating on the formal ones,” he said.
IOM also supports surveillance at 57 displacement sites in the DRC, 50 of them in health zones affected by the outbreak. It is helping affected and at-risk countries improve early detection and screening.
The agency needs $110 million for its regional operations through March 2027 but is nearly $60 million short.” (4)
“Kenya began a countdown on Wednesday to declare the end of its Ebola outbreak.
The final patient who had tested positive for the virus was discharged from the hospital on Wednesday. And the Kenyan cabinet secretary for health, Aden Duale, said at a news conference that the last 11 people being monitored for Ebola symptoms had also been discharged after completing a 21-day quarantine period.
“For the first time since this outbreak began, Kenya has no patient under treatment and no contact in quarantine,” he said.
The milestone is further evidence that countries have succeeded in containing the small number of cases, most coming in from the Democratic Republic of Congo, where the outbreak continues to spread.
Since Kenya announced its first-ever Ebola case on Oct. 6, two people have died and nine have tested positive in the country. The initial case was a Kenyan man who returned from Congo and infected others before the virus was diagnosed and he was put in isolation. He died days later.
The Kenyan authorities say that all of those who subsequently became ill were in quarantine before they developed symptoms and became infectious. As a result, there have been no instances of what experts call community transmission, when a person passes on the virus outside a medical setting.
Kenya’s outbreak will be officially declared over on Dec. 23, or 42 days from when the last case was recorded, if there are no further positive Ebola tests, the health secretary said. In all, 135 people have been monitored for signs of the virus.” (5)
Ebola: Why is there still no vaccine?
“1976: A hitherto unknown disease breaks out near the Ebola river in the country then known as Zaire, now the Democratic Republic of Congo (DRC). This was the first scientifically documented Ebola epidemic.
Now, 50 years on, the DRC once again finds itself at the center of a major Ebola outbreak. This time the pathogen is the less common Bundibugyo type of the genus orthoebolavirus. The virus was identified in 2007 during an outbreak in Bundibugyo, Uganda. Another outbreak occurred in the DRC in 2012.” .
“Herein lies the paradox. From a scientific point of view, Ebola is a good vaccine candidate, yet there is still no licensed form of prevention against the Bundibugyo variant that is currently circulating.
Mayer explained that vaccines cannot be developed as a precautionary measure against every potential pathogen. Lack of funding or the prioritization of other pathogens often have a role to play. Many researchers had assumed that a fresh outbreak of the Sudan Ebola virus was more likely, and vaccine development for this strain is more advanced.
Another part of the problem is that Ebola is not one single virus. The known, highly dangerous orthoebolaviruses include Ebola virus (EBOV), previously called the Zaire Ebola virus (ZEBOV), the Sudan virus (SUDV), and the Bundibugyo virus (BDBV). The existing vaccine, Ervebo, was developed and licensed for use against the Zaire variant. But there is still no approved protection against the others.
This is why the existing Ebola vaccine has been of only limited use to people in the areas of the current outbreak.
Another factor may also be relevant: The Bundibugyo virus appears to be less aggressive than the Zaire variant. At first, that sounds like good news, but it may make it harder to contain, as people remain mobile for longer after being infected, and can pass on the virus without realizing.” (6)
“If you’re flying into the U.S. from another country, the Centers for Disease Control and Prevention wants to make sure a certain central African nation was not on your itinerary.
Starting Nov. 3, the CDC requires anyone traveling on an international flight to the U.S. to sign a statement “that they have not been present in the DRC (Democratic Republic of the Congo) in the 21 days prior to boarding the flight to the United States.”
According to the CDC, travelers are required to sign a statement, or attestation, that “applies to all people traveling on any aircraft, including crew on passenger- and cargo-carrying aircraft involved in operation of aircraft or the positioning of crew not operating the aircraft.”” (7)
Can two new vaccines help turn the tide against Bundibugyo Ebola?, https://www.gavi.org/vaccineswork/can-two-new-vaccines-help-turn-tide-against-ebola-caused-bundibugyo-virus
1.Ebola could be raging in DRC for another year, expert warns, by Anne Gulland, https://www.telegraph.co.uk/global-health/science-and-disease/ebola-drc-year/
2.71 Ebola Cases Detected on DRC Routes as Funding Gap Risks Outbreak Remaining Out of Control, IOM Warns, https://www.iom.int/news/71-ebola-cases-detected-drc-routes-funding-gap-risks-outbreak-remaining-out-control-iom-warns
3.DR Congo government says Ebola hotspot has shifted to North Kivu — The Rio Times, https://ua.news/en/dovkolo-svitu/uriad-dr-kongo-zaiaviv-pro-zmishchennia-oseredku-eboli-do-pivnichnogo-kivu-the-rio-times
4.Ebola: IOM Urges DR Congo to Expand Surveillance Beyond Formal Routes, https://www.miragenews.com/ebola-iom-urges-dr-congo-to-expand-surveillance-1775131/
5.Kenya Contains Ebola Outbreak as Last Patient Leaves Hospital, By Matthew Mpoke Bigg, https://www.nytimes.com/2026/11/11/world/africa/kenya-ebola-countdown.html?smid=nytcore-ios-share
6.Ebola: Why is there still no vaccine?, By: Hannah Fuchs , https://globalnation.inquirer.net/346654/ebola-why-is-there-still-no-vaccine
7.CDC institutes new travel rule for ‘deadly’ virus in central African nation, By Katherine Rodriguez, https://www.nj.com/news/2026/11/cdc-institutes-new-travel-rule-for-deadly-virus-in-central-african-nation.html
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai