Initially, three provinces in eastern DRC were battling Ebola outbreaks: Ituri (bordering Uganda and South Sudan), neighboring North Kivu, and South Kivu. Uganda has reported 20 cases, including two deaths.

The Haut-Uélé province now becomes the fourth to report infections. Bordering Ituri, this region shares frontiers with South Sudan and the Central African Republic. Health officials confirm that an infected traveler carried the virus from Ituri to Haut-Uélé, with the patient later succumbing to the disease.

Listen again: “We will contain this outbreak, but it will take more time,” warns Dr. Jean-Jacques Muyembe.

Contact tracing efforts are underway as teams work to identify and isolate potential contacts. Transmission often occurs during traditional funeral rites, where the highly contagious nature of Ebola victims’ remains poses significant risks. Humanitarian workers, despite facing intense community resistance, are attempting to organize safe burials that adhere to strict sanitary protocols to prevent human contact with the deceased.

In DRC and across Africa, funeral ceremonies often span several days, with family members and loved ones traditionally touching the deceased’s body—a practice that significantly fuels transmission risks.

Armed group violence complicates response efforts

Over recent weeks, multiple health centers have reported incidents, including violent clashes sparked by grieving families demanding the return of their relatives’ bodies. The Haut-Uélé province shares troubling similarities with Ituri: remote borderlands rich in gold deposits. These dual factors create intense transit and trade networks that inadvertently facilitate viral spread.

Both regions also suffer from persistent armed group violence. For over a decade, Ituri has endured regular massacres carried out by community militias or the ADF, an Islamic State-affiliated armed group. Recent incursions by these fighters have extended into Haut-Uélé, compounding the security crisis. This volatile environment severely hampers health response efforts, which were already delayed by late virus detection. Epidemiological investigations suggest the earliest suspected deaths may date back to January.

Response teams have intensified containment measures in Ituri, but under-resourced health facilities—operating in one of the world’s poorest nations—lack essential supplies like protective gear and chlorine. Ebola treatment centers, established with support from WHO and multiple NGOs, are operating at over 138% capacity, according to the National Institute of Public Health. To date, 78 healthcare workers have been infected, with 18 fatalities.

Health experts and authorities agree that the outbreak has not yet peaked, with projections suggesting the crisis could persist for another six months to a year. Ebola, transmitted through bodily fluids, has claimed over 15,000 lives across Africa over the past five decades. The deadliest outbreak in DRC recorded nearly 2,300 deaths among 3,500 confirmed cases between 2018 and 2020.