The Ebola Outbreak Explained: What's Happening and What It Means

This article will be updated as the situation develops. Last updated: May 20, 2026.

On May 17, the WHO Director-General declared the Bundibugyo Ebola outbreak in the DRC and Uganda a Public Health Emergency of International Concern — the same designation used for COVID-19 in 2020. He did so without the normal emergency committee consultation process. This is the first time a Director-General has declared a PHEIC before convening an Emergency Committee.

Three days later, the situation has escalated further. As of May 20, the WHO reports almost 600 suspected cases, 51 confirmed, and 139 suspected deaths in Ituri Province of the DRC, with two laboratory-confirmed cases including one death in Kampala, Uganda. This is already the largest known outbreak of Bundibugyo virus disease ever recorded.

Understanding what is happening — and what it does and does not mean for people in the UK — requires understanding the specific virus involved, why this outbreak has been harder to contain than typical Ebola events, and what the PHEIC designation actually means.

TL;DR

• As of May 20, almost 600 suspected cases, 51 confirmed, and 139 suspected deaths have been reported. This is the largest Bundibugyo outbreak ever recorded.
• Cases are confirmed in Ituri Province and North Kivu in DRC — including in Bunia and Goma — with two confirmed cases in Uganda's capital Kampala.
• The outbreak is caused by Bundibugyo virus — a rare Ebola species for which there is no licensed vaccine or approved treatment.
• An American healthcare worker who contracted the virus in DRC is being treated at Berlin's Charité university hospital. Six other Americans have been moved out of DRC for observation.
• The US has imposed entry restrictions and enhanced travel screening for arrivals from DRC, Uganda, and South Sudan. The State Department has warned Americans against all travel to DRC, Uganda, and South Sudan.
• The LSHTM notes that the PHEIC reflects the operational complexity of the outbreak and the need for coordinated international support, rather than indicating a high global risk to the general public.
• The WHO assesses the risk as high at the national and regional levels, and low at the global level.
• The risk to people in the UK is currently low. Bundibugyo Ebola does not spread through casual contact or air.

What Bundibugyo Virus Is

Ebola is not a single virus. It is a family — the ebolaviruses — of which several species cause disease in humans. The Zaire strain is the one most people know — responsible for the catastrophic 2014 to 2016 West Africa epidemic that killed over 11,000 people, and the strain against which approved vaccines and treatments have been developed.

Bundibugyo is different and considerably rarer. The case fatality rates in the past two Bundibugyo outbreaks have ranged from 30% to 50%. Unlike Ebola-Zaire strains, there is no licensed vaccine or specific therapeutic against Bundibugyo virus.

This is only the third known Bundibugyo outbreak. The first was in Uganda in 2007 to 2008 with 149 cases and 37 deaths. The second was in the DRC in 2012 with 57 cases and 29 deaths. The current outbreak has already surpassed both combined.

The absence of approved medical countermeasures is the central clinical challenge. The vaccines and treatments developed for Zaire — used effectively in the 2018 to 2020 DRC outbreak — do not apply here. Medical workers are attempting to develop monoclonal antibody therapies, but these remain experimental and no timeline has been given for availability.

Why This Outbreak Spread Further Than Expected

Several factors have made containment of this outbreak harder than usual — and understanding them explains both why the PHEIC was declared so quickly and why the case count has risen so rapidly.

Three weeks of undetected spread. The first known suspected case — a health worker — developed symptoms on April 24. The outbreak was only confirmed on May 15. Standard Ebola field diagnostics check for the Zaire strain, not Bundibugyo. Initial samples returned false negatives. By the time the correct strain was identified, the virus had been spreading undetected through communities for three weeks with no contact tracing, no isolation protocols, and no response infrastructure activated.

The operating environment. The outbreak is occurring in areas affected by insecurity, population displacement, mining-related population movement, and frequent cross-border travel, all of which increase the risk of further transmission. Several listed contacts became symptomatic and died before they could be isolated. Health facilities in parts of the province are overwhelmed or non-functional due to active conflict.

Urban spread. The outbreak has moved beyond Ituri's remote communities. 51 confirmed cases have been identified in the northern provinces of Ituri and North Kivu, including in the cities of Bunia and Goma. Goma is a city of one million people, a major humanitarian hub, and an international transit point. Its involvement significantly changes the risk profile for further geographic spread.

Cross-border transmission. Two confirmed cases in Uganda's capital Kampala — involving individuals who travelled from DRC — have been confirmed. Uganda postponed its annual Martyrs' Day celebrations, which can attract up to two million people, because of the risk posed by the epidemic.

What a PHEIC Actually Means

The WHO's declaration of a Public Health Emergency of International Concern is frequently misread as an announcement of pandemic risk. It is more precisely understood as a formal trigger for coordinated international response.

The LSHTM notes that the PHEIC declaration reflects the operational complexity of the outbreak and the need for coordinated international support, rather than indicating a high global risk to the general public.

The WHO Director-General confirmed he determined the situation was not a pandemic emergency — the new and highest classification under the amended International Health Regulations. The Emergency Committee convened the day after the PHEIC declaration agreed the situation is a PHEIC but confirmed it is not a pandemic emergency.

A PHEIC activates several practical mechanisms: it requires WHO member states to heighten surveillance and preparedness, enables faster deployment of international response resources, and signals to the global health community that a situation warrants serious attention and resource allocation. It has been declared for outbreaks that never spread significantly beyond their origin — including H1N1 in 2009 and Zika in 2016.

The WHO assesses the risk of the epidemic as high at the national and regional levels, and low at the global level.

How Bundibugyo Spreads — and How It Does Not

Bundibugyo Ebola spreads through direct contact with the bodily fluids of a person who is symptomatic — blood, vomit, faeces, and other secretions — or through contact with contaminated materials such as used medical equipment or the bodies of those who have died from the disease.

It does not spread through casual contact, through the air, through water, or through food. It becomes contagious only once symptoms appear — meaning asymptomatic individuals are not transmitting the virus.

This transmission route is why Ebola outbreaks, while devastating in the communities they affect, do not produce the kind of exponential global spread that airborne pathogens can. Healthcare workers caring for patients without adequate protective equipment, family members providing care for sick relatives, and those involved in burial practices involving contact with the deceased are the highest-risk groups.

Symptoms — fever, generalised body pain, weakness, vomiting, and in some cases bleeding — can appear between 2 and 21 days after exposure.

The International Response

The response infrastructure now assembled around this outbreak is substantial.

WHO has health professionals on the ground supporting DRC's national authorities. Africa CDC is coordinating regional response across DRC, Uganda, and South Sudan. The US CDC has deployed staff to its DRC country office with more being deployed.

DRC's health minister has announced three Ebola treatment centres are being opened in the affected region. The WHO Director-General thanked DRC and Uganda for their cooperation and commitment to coordinated response.

An American healthcare worker who contracted the virus while caring for patients in DRC tested positive on May 17 and is being transported to Berlin's Charité university hospital for treatment. Six other Americans have been moved out of DRC for observation — none are being sent back to the US.

Medical researchers are working to accelerate development of a monoclonal antibody therapy specific to Bundibugyo. A candidate experimental vaccine has shown around 50% efficacy in animal models but has not been assessed in human patients. Neither is currently available for use in the outbreak.

The Risk to UK Travellers

The FCDO has updated its travel advice for DRC, Uganda, and South Sudan. Anyone with travel planned to any of these countries should check the FCDO travel advice page before departure. For broader context, see our guide to travel health in 2026.

For the vast majority of people in the UK with no connection to the affected region, the personal risk from this outbreak is very low. Ebola does not spread through casual contact. There are no confirmed cases outside DRC and Uganda.

If you have recently returned from DRC, Uganda, or South Sudan:

Monitor for symptoms — fever, severe headache, muscle pain, weakness, vomiting, diarrhoea, unexplained bleeding — for 21 days from the date of last potential exposure. If any symptoms develop, call 999 or go to A&E immediately and disclose your travel history. Do not wait for symptoms to worsen.

Frequently Asked Questions

How many Ebola cases are there as of today?

As of May 20, 2026, the WHO reports almost 600 suspected cases, 51 confirmed, and 139 suspected deaths in Ituri Province of the DRC, with two laboratory-confirmed cases including one death in Kampala, Uganda. This is the largest known outbreak of Bundibugyo virus disease ever recorded.

Why is there no vaccine for this Ebola strain?

The approved vaccines and treatments for Ebola — including the rVSV-ZEBOV vaccine — were developed specifically for the Zaire strain, which causes the majority of DRC outbreaks. Bundibugyo is a different species of Ebola. It has only caused two previous outbreaks — in 2007 and 2012 — and the research investment required to develop a specific vaccine or treatment was not prioritised during the periods between those outbreaks. Medical researchers are now working to accelerate development of a Bundibugyo-specific monoclonal antibody therapy and vaccine candidate.

Is this going to become a pandemic?

The WHO Director-General has confirmed the situation does not meet the criteria for a pandemic emergency under the International Health Regulations. The WHO assesses the risk as high at the national and regional levels, and low at the global level. Bundibugyo Ebola does not spread through air or casual contact — its transmission route makes exponential global spread structurally unlikely. The PHEIC designation reflects the need for coordinated international response, not a forecast of pandemic spread.

Why did the outbreak go undetected for so long?

Standard Ebola field diagnostics check for the Zaire strain. Initial samples returned false negatives because the tests were not designed to detect Bundibugyo. Samples had to be sent to the national laboratory in Kinshasa for confirmatory testing — a process that takes days in ideal conditions and longer given the security situation in Ituri. The result was approximately three weeks of undetected community transmission before the outbreak was confirmed.

What should I do if I have recently returned from DRC or Uganda?

Monitor for symptoms — fever, headache, muscle pain, weakness, vomiting, diarrhoea, unexplained bleeding — for 21 days from last potential exposure. If any symptoms develop, seek emergency medical care immediately and disclose your travel history. Do not wait to see if symptoms worsen.

Is the UK at risk?

The risk to people in the UK is currently low. Bundibugyo Ebola spreads through direct contact with the bodily fluids of a symptomatic person — not through air or casual contact. There are no confirmed cases outside DRC and Uganda. The FCDO has updated travel advice for the affected countries — check before any planned travel to the region.

The Bottom Line

The Bundibugyo Ebola outbreak in the DRC is already the largest of its kind ever recorded — and it is still growing. The speed of escalation has surprised infectious disease specialists. The three-week diagnostic delay, the absence of approved medical countermeasures, active conflict in the worst-affected areas, and the virus's presence in Goma — a major transit city — have combined to produce an outbreak that is harder to contain than a typical Ebola event.

The LSHTM is clear that the PHEIC reflects operational complexity rather than high global risk to the general public. That framing is accurate and worth holding onto against the noise that surrounds any Ebola outbreak. This is not COVID. The transmission route does not support the kind of spread that a respiratory pathogen can achieve. The international response infrastructure is now fully mobilised.

For people in the UK, the practical actions are straightforward: check FCDO travel advice before travelling to the affected region, know the symptoms, and seek emergency care immediately disclosing travel history if symptoms develop within 21 days of return.

We will continue to update this article as the situation develops. If developing public-health news leaves you feeling anxious, our Reset Companion is a calm, evidence-led space to talk it through.

Related reading: What Is the Bundibugyo Ebola Outbreak — and Should You Be Concerned? · Travel Health in 2026: Vaccines, Risks and What the Hondius Outbreak Changes · Andes Virus: Why the MV Hondius Outbreak Has Changed Everything

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