Ebola Outbreak Escalates to Multinational Crisis, WHO Declares International Emergency

The Ebola outbreak first reported in the Democratic Republic of the Congo on Friday has seemingly escalated quickly into a large, uncontrolled multinational outbreak.

As of May 17, there were 10 confirmed cases, 336 suspected cases, and 88 deaths in the DRC, as well as two confirmed cases and one death in neighboring Uganda, according to the latest data from the US Centers for Disease Control and Prevention, which has offices in the region. The numbers already put the outbreak within the top 10 Ebola outbreaks recorded by size, though still far from the worst—the 2014–2016 West African outbreak had over 28,000 cases and 11,000 deaths.

International emergency

On Sunday, the World Health Organization declared the outbreak a public health emergency of international concern (PHEIC), though it noted that it does not meet the criteria for a pandemic emergency. In making the PHEIC determination, WHO Director-General Tedros Adhanom Ghebreyesus cited several factors in addition to the immediate large size, including clusters of suspected cases and deaths in multiple DRC health zones, four deaths among healthcare workers, and a lack of apparent links between geographically distant cases and clusters. The features collectively suggest that the outbreak is larger than what is currently being detected and is spreading regionally.

“Moreover, the ongoing insecurity, humanitarian crisis, high population mobility, the urban or semi-urban nature of the current hotspot, and the large network of informal healthcare facilities further compound the risk of spread,” the WHO said.

The final extraordinary aspect of the outbreak is that it is caused by the uncommon Bundibugyo strain of Ebola virus, which has no clinically validated treatments or vaccines. This is only the third Ebola outbreak caused by Bundibugyo, which has had fatality rates of 25–50 percent.

There are four virus strains known to cause Ebola disease in humans, and three have caused large outbreaks (Zaire, Sudan, and Bundibugyo). The most common strain is Zaire, for which treatments and vaccines have been developed. The viruses spill over from animals, including non-human primates and bats, and cause severe hemorrhagic fever, marked by diarrhea, vomiting, and bleeding. Person-to-person spread occurs via contact with bodily fluids and symptoms can develop between two and 21 days—though most often eight to 10 days—after an exposure.

CDC response and infected American

On Monday morning, the CDC announced on its website that it is implementing new travel restrictions, including screening and monitoring Americans arriving from DRC, Uganda, and South Sudan, while also barring the entry of non-US passport holders who have traveled in those countries in the past 21 days.

Additionally, in a CDC press briefing on Monday afternoon, Captain Satish Pillai, incident manager for CDC’s Ebola response, said that one American in the DRC has been infected after being exposed as part of their work there. The person developed symptoms over the weekend and tested positive late Sunday. The CDC is now working to transfer that person, along with six other Americans, to Germany, where they will receive care. Pillai did not answer questions about the person’s identity or their work.

Serge, a Christian missionary organization, announced that the infected person is Dr. Peter Stafford, who has been working in the Nyankunde Hospital in Bunia, DRC, since 2023. The other six people the CDC is working to relocate are his wife, Dr. Rebekah Stafford, the couple’s four children, and a third doctor with the organization, Dr. Patrick LaRochelle. All three doctors had exposures, the organization said, but Rebekah Stafford and LaRochelle are currently asymptomatic.

Pillai noted that the CDC considers the risk to the American public to be low.