Congo’s Ebola Outbreak Likely Went Undetected for Weeks Before Official Declaration

The Democratic Republic of Congo officially declared an Ebola outbreak caused by the Bundibugyo variant on May 15, though initial infections likely began considerably earlier.

The precise origins of the outbreak remain under discussion, but there is broad agreement that Congolese authorities failed to mount an optimal initial response, with multiple international organizations criticizing significant delays.

While the Democratic Republic of Congo has considerable experience managing Ebola outbreaks and has previously been commended for its containment expertise, this episode raised serious concerns.

Early warnings came from WHO, Africa CDC

A joint timeline published by the World Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (Africa CDC) provides a foundation for tracing the outbreak’s origins.

Congo’s Ebola crisis: Fear, mistrust and a growing outbreak

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According to WHO and Africa CDC data, the earliest confirmed case was a health worker from Mongbwalu in northeastern Ituri Province who developed Ebola-like symptoms around April 24 or 25.

The individual subsequently died at a medical facility in Bunia, the provincial capital, and to date 80 percent of all reported cases have been concentrated in Ituri.

The WHO was not notified of an unexplained, high-mortality illness in the Mongbwalu Health Zone until May 5, at which point the agency issued its first alert.

Congo’s delayed response questioned as Ebola spread

Ten days afterward, on May 15, the Congolese government formally declared the Ebola outbreak.

Laboratory tests by the National Institute for Biomedical Research in Kinshasa confirmed the presence of the rare Bundibugyo strain.

Three days later, the Africa CDC publicly questioned the pace of Congo’s response.

Approximately three weeks elapsed between the onset of symptoms in the suspected index case and laboratory confirmation, despite the fatality being a healthcare worker.

“This significant delay highlights a critically low initial index of clinical suspicion among local healthcare providers, which facilitated wider geographic spread prior to the initiation of containment efforts,” concluded the Africa CDC.

According to DW reporting, residents of Mongbwalu had already reported suspicious deaths as early as the end of April.

“Several deaths were reported following high fevers, with victims often exhibiting traces of blood around various body orifices,” said Dieudonne Lossa Dekhana, provincial coordinator for civil society in Ituri.

Red Cross reported ‘widespread’ public fear ‘since March 30’

Other indications suggested that Ebola was already circulating well before the first confirmed case emerged.

A May 16 report by the Red Cross of the Democratic Republic of the Congo stated that “since March 30, 2026, there has been widespread fear among the population of the Mongbwalu Health Zone following a series of deaths.”

The symptoms described matched those of Ebola: high fever, chest pain, severe exhaustion, persistent cough, nosebleeds, vomiting, loss of consciousness, coma, and death.

The Red Cross report identified the trigger as the body of a Mongbwalu resident “who died and was placed in a coffin purchased in Bunia, which was then replaced by another in Mongbwalu.”

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US researchers: February outbreak is plausible

The funeral, which brought numerous people into direct contact with the body and the contaminated coffin, is believed to have triggered the subsequent rise in infections and deaths in Mongbwalu and Bunia.

While the available data do not allow definitive confirmation that these deaths were caused by the Bundibugyo virus, they demonstrate that an unusual health phenomenon had already been observed more than six weeks before the official declaration on May 15.

Furthermore, investigations launched since May 15 have bolstered the thesis that Ebola may have been circulating even earlier.

A study published in the Morbidity and Mortality Weekly Report on June 11 by researchers from the US Centers for Disease Control and Prevention (CDC) reconstructed the early course of the epidemic.

The researchers concluded that an initial animal-to-human spillover between mid- and late February is “plausible,” whereas a late-April spillover would be difficult to reconcile with the epidemic’s scale by that time.

WHO: Genome sequencing suggests February outbreak

On August 10, WHO Regional Director for Africa Mohamed Janabi said genome sequencing analyses suggested the outbreak likely began “as early as February 2026.”

He noted that several early infections were mistakenly attributed to more common regional diseases, particularly malaria and typhus.

In an August interview with DW, Janabi highlighted a significant gap in case reporting, stating, “The Ebola situation is catastrophic… In three months, we only had access to one-third of the patients.”

Could ‘pig Ebola’ shed some light on the matter?

Jules Villa, a researcher in the anthropology and ecology of disease emergence at the Pasteur Institute in Paris, points to a phenomenon observed during previous Ebola epidemics.

Villa’s study does not cover the 2026 outbreak but reviews local reports gathered during earlier Ebola outbreaks in northeastern Congo.

Villa found that livestock farmers, veterinarians, and residents reported unusually high animal mortality even before at least two human Ebola outbreaks.

In 2017, witnesses described what they termed “pig Ebola”—a high mortality among pigs ultimately attributed to swine fever.

According to Villa, monitoring livestock mortality in the general population could provide early warning signs long before a laboratory confirms an outbreak.

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