Ebola outbreak in DR Congo may be two to four times larger than reported, WHO says

The scale far exceeds official counts

According to the latest government SITREP published on 14 July with data to 12 July, the Democratic Republic of the Congo has recorded 1,963 Ebola cases and 719 deaths since the outbreak was declared on 15 May in Ituri province. The World Health Organization now projects the true burden is far heavier.

Based on our projections, the scale of the outbreak is at least two to four times the number of recorded cases.

Those projections would put total cases in the range of approximately 3,900 to 7,800 (a midpoint estimate using the 1,963 official figure). The WHO's emergency director stressed that the capacity to detect infections is improving daily, but the initial undercount reflects late recognition of early cases (experts now suspect the first deaths occurred in April, well before the formal declaration).

The outbreak is spreading across provinces and borders

What began in the mineral-rich, conflict-ridden northeast province of Ituri has now fanned out to four additional provinces (North Kivu, South Kivu, Tshopo and Haut-Uélé) and across the border into Uganda, where 20 cases have been recorded. More than 90% of infections are still detected in Ituri, which remains the epicentre.

This is now the third largest Ebola outbreak ever recorded, and it is the one with the fastest progression in a single month of all the Ebola outbreaks we have managed.

The outbreak is officially the 17th Ebola epidemic in Congolese territory. Its rapid pace has outpaced containment measures despite intensifying efforts.

Community deaths and contact-tracing gaps

Ihekweazu highlighted what he called the most alarming finding: many newly reported cases concern people who died in their communities without ever reaching a health facility.

The most alarming finding is that many of the new reported cases involve people who died in their communities, without ever having reached a health facility or received care.

This pattern undermines contact tracing because it is far harder to map transmission chains when patients die outside the formal health system. The current contact-tracing rate is approaching 80%, still below the 90% target needed to regain control. "We need to detect cases earlier. We need to strengthen and accelerate contact tracing. We need to ensure that health facilities are accessible, safe, and trusted by the communities they serve," Ihekweazu added.

Glimmers of progress

Despite the grim outlook, several operational indicators have improved. The number of available treatment beds has risen to 700, and laboratory facilities have expanded from a single unit to 14. Two treatments are being tested on site, and on Tuesday, a landmark clinical trial began recruiting patients in Bunia, Ituri, to evaluate a post-exposure prophylaxis. Up to 1,000 contacts of confirmed cases could be enrolled in the study, which is led by the Institut National de Recherche Biomédicale (INRB) in Kinshasa, the French agency ANRS MIE, and the NGO Alima.

WHO leadership to visit this week

WHO Director-General Tedros Gebreyesus is expected to travel to the DRC before the end of the week, with a stop planned in Ituri. The visit comes as the organization attempts to rally faster international support.