Ebola epidemic scale ‘much larger’ than known cases, WHO head says – National

The head of the World Health Organization said on Wednesday that the risk of global spread of the Ebola outbreak in the Democratic Republic of Congo and Uganda is high at the national and regional levels but low at the global level.

WHO Director-General Tedros Adhanom Ghebreyesus said 51 cases have been confirmed in Congo’s northern provinces of Ituri and North Kivu, “although we know the scale of the epidemic is much larger.”

During a media briefing on Wednesday, Ghebreyesus said Uganda has told the UN health agency of two confirmed cases in the country’s capital, Kampala.

“Beyond the confirmed cases, there are almost 600 suspected cases and 139 suspected deaths,” he said. “We expect those numbers to keep increasing.”

Ghebreyesus said he declared a public health emergency of international concern (PHEIC) over the epidemic of Ebola disease in the Democratic Republic of the Congo (DRC) and Uganda on Sunday.

“This is the first time a Director-General has declared a PHEIC before convening an Emergency Committee. I took this step in accordance with Article 12 of the International Health Regulations (IHR), after consulting the Ministers of Health of DRC and Uganda, and in view of the need for urgent action,” he said on Wednesday.

He said he determined that the situation was “not a pandemic emergency, which is the new and highest classification under the amended International Health Regulations.”

After declaring the public health emergency of international concern, Ghebreyesus convened an emergency committee under the IHR, which met on Tuesday.

The committee agreed that the situation is a public health emergency of international concern, “but is not a pandemic emergency.”

“WHO assesses the risk of the epidemic as high at the national and regional levels, and low at the global level,” Ghebreyesus added.

On Wednesday, the WHO director-general said there are several factors that “warrant serious concern about the potential for further spread and further deaths.”

“First, beyond the confirmed Ebola cases, there are almost 600 suspected cases and 139 suspected deaths. We expect those numbers to keep increasing, given the amount of time the virus was circulating before the outbreak was detected,” he said.

The epidemic has also expanded, with cases reported in several urban areas, according to Ghebreyesus.

“Deaths have been reported among health workers, indicating healthcare-associated transmission,” he said, adding that there is “significant population movement in the area.”

“The province of Ituri is highly insecure. Conflict has intensified since late 2025, and fighting has escalated significantly over the past two months, with over 100,000 people newly displaced,” Ghebreyesus continued. “The area is also a mining zone, with high levels of population movement that increase the risk of further spread.”

Ghebreyesus said the epidemic is caused by Bundibugyo virus, a species of Ebola virus for which there are no approved vaccines or therapeutics.

“In light of all these risks, I decided it was urgent to act immediately to prevent more deaths and mobilize an effective and international response,” he added.

The WHO thanked the government of the DRC, the National Institute for Biomedical Research, the National Institute of Public Health and local health authorities in the affected areas for their leadership and co-operation.

Ghebreyesus also thanked the government of Uganda for postponing the annual Martyrs’ Day celebrations, which can attract up to two million people, because of the risk posed by the epidemic.

“WHO has a team on the ground supporting national authorities to respond. We have deployed people, supplies, equipment and funds,” he said.

In order to continue to support the response, Ghebreyesus said he approved an additional US$3.4 million from the Contingency Fund for Emergencies, bringing the total to $3.9 million.

“In the absence of vaccines and therapeutics, there are many other measures countries can take to stop the spread of the virus and save lives, which the Emergency Committee has outlined in its temporary recommendations,” he said.

While the most common form of Ebola, the Zaire strain, does have an approved vaccine, Bundibugyo currently does not have approved vaccines or therapeutics.

Vasee Moorthy, the WHO’s senior science and strategy advisor, said Wednesday that one vaccine candidate was six to nine months away from being available for clinical trials.

Another is being developed by the University of Oxford and India’s Serum Institute and was having doses “manufactured as we speak,” he added.

But Moorthy said there was no data from animal testing to support the vaccine.

“It is possible that doses could be available for clinical trial in two to three months but there is a lot of uncertainty about whether that is a promising candidate,” he said.

“It will depend on the animal data on whether that’s considered a promising candidate research vaccine for Bundibugyo, so that’s what I would say about the pipeline now.”

The WHO’s Dr. Anaïs Legand said the priority right now is to help set up optimized treatment centres to ensure that every suspected case can be detected early and cared for while they are preparing for the upcoming trial.

A U.S. national who tested positive for the virus in Congo arrived in Berlin on Wednesday for treatment in a special isolation ward.

“An American national who was working in DRC has also been confirmed positive, and been transferred to Germany,” Ghebreyesus said on Wednesday.

A “comprehensive examination” was taking place to determine how to proceed with treatment, German Health Ministry spokesperson Martin Elsässer told The Associated Press. He said he wouldn’t comment on the patient’s condition. The German authorities and the U.S. CDC have not identified the patient.

Separately, Christian aid organization Serge said one of its doctors — which it identified as American medical missionary Dr. Peter Stafford — had been evacuated from Congo and is “receiving specialized medical treatment” after he developed Ebola symptoms.

Serge announced Wednesday that all the organization’s workers with “potential exposure have been safely evacuated from the Democratic Republic of Congo.”

“We received confirmation that Dr. Peter Stafford safely arrived at Charite University Hospital in Germany, where he will receive the highest level of clinical care and treatment,” said Dr. Scott Myhre, Serge area director for East and Central Africa.

“The complex, coordinated efforts of many government agencies and international health authorities resulted in Peter Stafford’s safe transport and the protection of those involved in his transfer. Serge leadership extends their deepest gratitude to all involved in Peter’s care and is praying for all involved in the fight to end this ebolavirus outbreak for the good of the people of the DRC.”

Stafford, a 39-year-old board-certified general surgeon with a specialization in burn care, tested positive for Bundibugyo Ebola virus after serving patients in Bunia before the outbreak was identified.

Stafford’s 38-year-old wife, Dr. Rebekah Stafford, and their four young children, along with Dr. Patrick LaRochelle, 46, have also departed DRC and are en route to other locations where they can be monitored in close proximity to expert care if needed, Serge said.

U.S. Secretary of State Marco Rubio told reporters on Tuesday that the Trump administration would “lean into” Ebola response efforts with a priority on funding 50 emergency clinics in affected areas. The U.S. has contributed $13 million to the effort and Rubio said more would come.

Rubio also said the WHO was “a little late” in identifying the Ebola outbreak.

When asked about Rubio’s comments on Wednesday, WHO’s Legand said that as soon as the organization was aware of the outbreak, it began to investigate “as quickly as possible.”

“Investigations are ongoing to determine when and where this outbreak started. Given the scale, we are thinking that it had started probably a couple of months ago,” she added.

Legand said the priority is to “cut the transmission chain by implementing contact tracing, isolating and caring for all suspected and confirmed cases.”

“This is very important, maybe, on what the secretary said, it could be from lack of understanding how the IHR works and the responsibilities of WHO and other entities,” the WHO director-general added.

Ghebreyesus said the WHO does not replace the countries’ work, but does support them.

“That’s why there could be some lack of understanding. But then, of course, there is a delay in detection and there are many factors here,” Ghebreyesus said, before listing the factors as security due to conflict in the DRC and Uganda as well as displacement.

“Health facilities cannot work optimally when there is conflict and when the health workers are also fleeing as part of the community which is displaced,” he added.

Ghebreyesus said it’s very difficult to “follow a simplistic approach and say blame this or that.”

“It’s very important to understand the complexity and before we conclude, bring all the factors into some kind of understanding of the complexity. It’s not that simple,” he said. “From our side, we don’t replace countries. This is the countries’ responsibility, each and every country. But we support them.”

Ebola disease is a severe, often fatal illness that affects humans and other primates, according to the WHO.

The virus is transmitted to people from wild animals, such as fruit bats, porcupines and non-human primates, including gorillas, monkeys and chimpanzees, and then spreads in the human population through direct contact with blood, organs or other bodily fluids of infected people and with surfaces and materials, such as clothing and bedding, contaminated with the fluids.

Bundibugyo has caused two other outbreaks in the same region of the Congo River basin, said Dr. Tom Ksiazek, a University of Texas Medical Branch virologist and veterinarian. He directed the U.S. Centers for Disease Control and Prevention’s Special Pathogens Branch.

The Bundibugyo virus was first detected in Uganda’s Bundibugyo district during a 2007-08 outbreak that infected 149 people and killed 37. The second time was in 2012, in an outbreak in Isiro, Congo, where 57 cases and 29 deaths were reported.

The virus is spread the same way as other Ebola viruses: through close contact with sick or deceased patients’ bodily fluids, such as sweat, blood, feces or vomit. Health-care workers and family members caring for sick patients face the highest risk, experts said.

From the few outbreaks health experts have seen, Bundibugyo might be slightly less deadly than what is often called the Zaire virus, the most common species.

On Tuesday, the WHO’s Dr. Anne Ancia said Bundibugyo virus is one with “no licensed vaccines or treatment.”

“I don’t think that we have the ‘patient zero’ for now. What we know is that on [the] fifth of May, there was a person who died in Bunia. The body was brought back in Mongbwalu. That body was put in a coffin and then the family decided that the coffin was not worth the person, and therefore what they did, they changed the coffin,” Ancia said.

“Then there was the funeral and it’s from where it started. That’s what we know for sure. Now we have diagnosed it and we really need to go fast to really try to stop the spread of disease further.”

— with files from The Associated Press