Ebola outbreak: five big questions
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- DRC Ebola outbreak has recorded almost 5,000 cases and more than 2,000 deaths since being declared on May 15, making it the deadliest in the country's history and on course to surpass the 2014–2016 west Africa outbreak that killed more than 11,000 people.
- Africa CDC estimates the response is tracing just 12% of contacts in Ituri and North Kivu provinces — well below the 95% target — because armed conflict has displaced tens of thousands and undermined surveillance.
- 850 people who tested positive for the Bundibugyo virus are unaccounted for as of August 15, representing high onward transmission risk because their whereabouts are unknown; the Bundibugyo strain has no licensed vaccine or treatment.
- WHO's Tedros said only $264m of the $518m needed for the direct health response has been disbursed, while some frontline nurses and burial teams have gone on strike over unpaid wages — arguing they "see no point in risking our lives" without compensation.
- Case-fatality rate stood at 47% as of August 15 and has been climbing, with health workers blaming late presentation driven by deep community mistrust — in some areas, infected patients have fled treatment centres.
- Two Bundibugyo-specific vaccines are now in safety trials, and new evidence suggests the existing Ervebo vaccine (designed for the Zaire strain) may offer enough cross-protection to cut death rates; testing labs are also now operational in Ituri rather than Kinshasa.
- WHO officials are pivoting to a door-to-door, village-by-village case-finding approach aiming to reverse the outbreak's spread within three months; Uganda, by contrast, contained an imported cluster of 20 cases and 2 deaths using rapid contact tracing that has so far eluded the DRC.
Why it matters: With only 12% of contacts being traced, 850 positive patients missing, and roughly half of the $518m response budget yet to be disbursed, the DRC outbreak has the operational conditions to surpass the 2014–2016 west Africa epidemic — and the first 100 days of any successful vaccine rollout will test whether international pandemic-preparedness promises convert into actual deployed doses.
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