The WHO declares the Ebola outbreak in the Congo a public health emergency of international concern

BarcelonaThe Ebola virus has once again positioned itself at the center of international health alert after the World Health Organization (WHO) declared the new outbreak in the east of the Democratic Republic of the Congo as a "public health emergency of international concern". According to available data, at least 336 probable cases and 88 suspected deaths have been registered in an illness that mainly affects border areas with Uganda – where two cases have been confirmed – although it has also been detected in the Congolese capital, Kinshasa, far from the initial focus. The geographical spread particularly concerns health authorities, as it indicates a potentially wider transmission than initially detected.

The outbreak is concentrated mainly in mining areas of Ituri and in areas near North Kivu, regions with high population mobility due to commercial activities, artisanal mining, and forced displacement due to insecurity. The combination of factors facilitates the spread of the virus in a territory with rather fragile health surveillance systems. Initial symptoms include fever, muscle pain, fatigue, headache, and sore throat, followed by vomiting, diarrhea, a rash, and bleeding.

African health authorities warn that the initial case has not yet been identified and that the first infections could date back to late April, which would imply several weeks of undetected circulation. This uncertainty greatly complicates the epidemiological response, as it prevents the precise reconstruction of transmission chains. Another worrying element is the detection of cases in healthcare personnel, which points to possible failures in infection control measures within medical centers. This type of intrahospital transmission has been a key factor in previous outbreaks, as it can rapidly amplify the number of infections.

The type of virus identified in this new outbreak is the Bundibugyo strain, a particularly problematic variant because it does not yet have an approved vaccine or specific treatment. This forces authorities to rely exclusively on classic public health measures: isolation of cases, contact tracing, and strict control of infections in hospitals.

The WHO considers the risk to be high for the East Africa region, especially due to the intensity of cross-border movements between Congo, Uganda, and neighboring countries such as South Sudan. However, the organization does not consider the outbreak to yet meet the criteria to be declared a global pandemic, despite its potential severity. Experts emphasize that the context is particularly vulnerable: displaced populations, limited health infrastructure, and hard-to-access areas create a scenario in which early detection and epidemic control become very complicated.

Zoonotic origin

Ebola is a zoonotic pathogen that circulates naturally in bat populations and was already present in West African forest environments long before the major human outbreaks. The turning point occurred in 2013 in a remote area of southern Guinea. According to epidemiological research, the outbreak would have begun when two children came into contact with bats in a hollow tree and, subsequently, these animals were consumed as food within the community.

This contact allowed the virus to jump to humans. From that moment on, it spread uncontrollably through Guinea, Sierra Leone, and Liberia, causing nearly 30,000 infections and around 11,000 deaths between 2013 and 2016. It was the largest Ebola outbreak ever recorded. The initial lack of diagnosis was decisive: months passed before the virus was correctly identified, and when it was confirmed, it had already spread beyond the initial focus, including large urban centers. Another outbreak in 2020 caused at least 2,200 deaths.

One of the most disturbing legacies of that epidemic is the realization that Ebola can persist in some survivors for very long periods, especially in immunologically protected tissues such as the testicles. In some cases, relapses have been documented years later linked to sexual transmission from survivors.

This phenomenon has opened a complex field of research into the virus's latency and its persistence mechanisms. Even today, scientists are trying to determine how long it can remain infectious in certain bodily fluids.

The comparison between the current outbreak in eastern Congo and the West African outbreak is inevitable. In both cases, the common factors are late detection, population mobility, and insufficient health structures to contain the initial spread. WHO experts warn that surveillance systems in some areas have been weakened in recent years by a lack of resources, which may have contributed to the current late detection. The challenge, according to epidemiologists, remains the same: detect earlier, act faster, and prevent small invisible outbreaks from becoming regional crises.