The Ebola outbreak in eastern Democratic Republic of Congo is at least two to four times larger than the 1,926 confirmed cases and 702 deaths officially recorded, the World Health Organization stated on Tuesday. WHO emergencies director Chikwe Ihekweazu told reporters in Geneva that modelling indicates the true scale far exceeds detected infections, with four out of five new cases having no known epidemiological link to existing patients. The outbreak, caused by the rare Bundibugyo strain for which no approved vaccine or treatment exists, has now spread to five provinces, including the major city of Kisangani, and across the border into Uganda.

At the epicentre in Ituri province, dozens of health workers at the Rwampara treatment centre burned tyres and blocked access on Monday, issuing a 48-hour ultimatum for the payment of salaries and bonuses owed since the outbreak was declared on 15 May. Doctor Pascal Bahoya told AFP that staff continue to treat patients under oath but in extremely difficult conditions. The Congolese health minister acknowledged delays and promised to resolve the organisational issue, yet the strike threatens to disrupt contact tracing, safe burials, and patient isolation at a moment when the epidemic is accelerating faster than any previous Ebola outbreak managed by the WHO.

Viewed from Washington, the Trump administration moved to place US citizens in DR Congo on a “do-not-board” list, requiring them to spend 21 days in a third country before flying home, after a second American humanitarian worker contracted the virus and was transferred to Frankfurt University Hospital for care. The WHO has received only 40 percent of the $115 million it requested for the response, and Ihekweazu warned that the country cannot bear the burden alone. A clinical trial of two potential treatments—Gilead’s remdesivir and Mapp Biopharmaceutical’s experimental antibody MBP134—has begun enrolling patients at a single treatment centre in Ituri, though the WHO estimates it may take months and up to 1,000 participants to determine if either drug works.

In Kinshasa, health authorities are now tracing contacts in the newly affected provinces of Haut-Uele and Tshopo, where all initial cases appear imported from Ituri. The region’s chronic conflict, displacement, and deep community mistrust continue to hamper surveillance, with many victims dying in their communities without ever reaching a health facility. The immediate milestone to watch is the expiry of the health workers’ strike ultimatum, which could either force a government payment or trigger a full-scale withdrawal of minimum services at the outbreak’s centre.