The Ebola outbreak in the Democratic Republic of the Congo (DRC) has become the second-largest on record, according to the World Health Organisation (WHO).

The country has recorded 4,449 confirmed cases and 2,061 deaths across five provinces and 53 health zones.

In a video posted on X on Wednesday, WHO Director-General Tedros Ghebreyesus said the outbreak was spreading faster than any previous Ebola outbreak at the same stage and was on track to surpass the 2014–2016 West African outbreak.

The West African outbreak, which affected Guinea, Liberia and Sierra Leone, remains the world’s largest Ebola outbreak, with more than 28,000 cases and 11,000 deaths recorded.

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Transmission concerns

Mr Ghebreyesus said a high proportion of cases were being detected in communities rather than treatment centres and outside known contact lists, suggesting that some chains of transmission remain unidentified.

“Most transmission happens when people have late-stage disease and are not in treatment, or when their body is handled after they have died,” he said.

He said early clinical care and safe and dignified burials were critical to interrupting transmission, adding that both depended on the trust and involvement of affected communities.

The outbreak was declared by the DRC government on 15 May, although health officials said investigations suggest the virus may have been circulating for two to three months before it was detected.

According to a BBC report, WHO Regional Director for Africa Mohamed Janabi, said the virus may have started spreading in February and was initially misdiagnosed as malaria or typhoid.

The outbreak is caused by the rare Bundibugyo species of Ebola virus, which has previously caused only two known outbreaks, in 2007 and 2012.

Unlike the Zaire species responsible for several previous Ebola outbreaks, there is currently no licensed vaccine specifically approved for Bundibugyo virus disease.

WHO has recommended that Ervebo, a vaccine primarily used against Zaire ebolavirus, be evaluated against the Bundibugyo species through a randomised clinical trial.

Response scaled up

Mr Ghebreyesus said WHO and its partners were scaling up the response, with authorities aiming to trace at least 95 per cent of contacts to help interrupt transmission.

Treatment capacity is also expected to be tripled, with a target of 3,000 beds within 12 weeks.

More than 21,000 community health workers have been trained, while treatment centres, safe burial teams, laboratories and community engagement operations are active across the affected provinces.

A total of 886 patients have recovered from the disease, according to the WHO.

The WHO said it hoped to bring transmission under control within three months, but warned that this would not necessarily mean the end of the outbreak.

Treatment challenges

According to the BBC, Mr Janabi said health workers were reaching only about 30 per cent of cases because of insecurity in the affected area.

The UK’s Medicines and Healthcare products Regulatory Agency has authorised the first human trials of a vaccine candidate for the Bundibugyo strain.

The WHO is also sponsoring a clinical trial in the DRC to assess whether two existing antiviral therapies can improve survival among Ebola patients.