A traveller who flew from Kampala to Kenya's capital died within two days of landing, the first confirmed imported case in the country, as the largest Ebola epidemic ever recorded in the Democratic Republic of Congo shows no sign of burning out
NAIROBI / GOMA / GENEVA
The call came in on a Monday. An adult man, desperately ill, had been isolated at Nairobi Hospital after flying in from Kampala. By Tuesday he was dead, and by Tuesday night laboratories in two separate facilities had confirmed what public health officials across East and Central Africa have dreaded for five months: Ebola had crossed another border, and this time it had boarded an international flight.
Kenya's Ministry of Health announced the country's first laboratory-confirmed imported case on 6 October. The World Health Organization, which had been told the day before, set out the grim details in a Disease Outbreak News bulletin published on 8 October. The man, an adult who had been living in the Democratic Republic of Congo, had been sick for roughly a month. He had been treated in several hospitals there, travelled overland to Kampala in Uganda, and flew to Nairobi on 3 October. A sample taken on 5 October came back positive for Bundibugyo virus. He received supportive care, but died the same day.
His burial was carried out in a safe and dignified manner, according to WHO, and contact tracing is under way, including among people who shared the international flight. Public health measures have also started in Uganda, the country he passed through on the way.
It is the sharpest reminder yet that the epidemic gripping eastern Congo is no longer only a Congolese emergency.
The numbers behind the panic
The scale of the outbreak is staggering. According to WHO figures current to 6 October, the DRC has recorded 8,728 confirmed cases and 4,205 confirmed deaths, a crude case fatality ratio of 48.2 per cent. A further 2,269 people have recovered. A separate update published on 9 October, using data to 7 October, put the toll even higher, at 8,787 confirmed cases and 4,242 deaths.
In just the 11 days since WHO's previous bulletin on 25 September, the country added 775 confirmed cases and 379 confirmed deaths. In the most recent 24-hour period reported by WHO, 62 new cases were confirmed, 33 of them in Ituri province and 30 in North Kivu, and the seven-day average stood at 72 new cases a day.
The disease has now touched 64 of the country's 167 health zones, spread across seven of its 26 provinces. Ituri, where the first alert was raised in May, remains the epicentre with 6,480 cumulative cases and 2,989 deaths. North Kivu has logged 1,755 cases and 1,013 deaths, giving it the highest provincial fatality rate in the country at 57.7 per cent. Haut-Uele has reported 364 cases and Tshopo 51. Bas-Uele, South Kivu and Sud-Ubangi have each reported affected zones, and the newest zone to join the list is Alimbongo in North Kivu, with four confirmed cases and two deaths.
WHO officials describe transmission as intense nationally but uneven. Some areas are slowing while others continue to grow. Over the last three completed epidemiological weeks, weekly cases crept up 2.5 per cent, from 475 to 487, while weekly deaths held steady at around 224. In other words, the epidemic is not exploding, but it is not shrinking either. It is grinding on.
How a mystery illness became the biggest Ebola outbreak in Congo's history
The story began on 5 May 2026, when WHO received an alert about an unknown illness with high mortality in the Mongbwalu health zone of Ituri province. Four health workers had died within four days. Rapid response teams were sent to Mongbwalu and neighbouring Rwampara. On 15 May, the national biomedical research institute in Kinshasa confirmed the cause: Bundibugyo virus disease, a rarer cousin of the Zaire Ebola virus that has caused most of the big outbreaks of the past decade.
The same day, the DRC declared its 17th Ebola outbreak. Uganda confirmed two imported cases within hours. By 16 and 17 May, the WHO Director-General had declared the event a Public Health Emergency of International Concern, the organisation's highest level of alarm.
Bundibugyo virus is a particularly cruel adversary. This is only the second documented Bundibugyo outbreak in the DRC, after 2012, and WHO now says this one is the largest Ebola outbreak ever recorded in the country, regardless of virus species. Historical fatality rates in earlier Bundibugyo outbreaks were about 30 per cent in Uganda in 2007 and about 50 per cent in the DRC in 2012. The current figure of just over 48 per cent sits at the deadlier end of that range.
And here is the problem that keeps outbreak experts awake at night: there is no approved vaccine and no approved specific treatment for Bundibugyo virus. The vaccines and antibody treatments developed for the Zaire species do not offer the same assurance here. A clinical trial of candidate treatments began enrolling patients on 2 July, and a WHO advisory group reviewed candidate vaccines on 31 July, but neither has yet delivered a proven tool.
Why the Kenya case matters
One man's death might seem small against thousands. It is not. WHO's analysis of the case contains a worrying detail. Ebola does not usually take a month to kill. The agency presumes the man was infected in a health facility or in the community while seeking care for another illness, then fell sick and spent weeks moving through the health system before reaching Nairobi.
That suggests chains of transmission that have not been spotted. It also highlights how a patient can pass through multiple hospitals, cross a land border, clear an airport and reach a capital city of millions before anyone confirms what he has.
The Kenya case is not the only export. On 1 October, the Netherlands reported the medical evacuation of a healthcare worker who tested positive while responding to the outbreak in the DRC. The patient is being treated in the Netherlands. WHO says that case will not be counted as a local case there, and it is a reminder of the risks the responders themselves run.
WHO's risk assessment, last updated on 14 August, rates the risk as very high in the DRC and high for countries sharing a land border with it. The risk for the wider African region and globally remains low. A detailed rapid risk assessment for Kenya is being prepared. Kenya does not share a border with the DRC, but the route this patient took, by road to Kampala and then by air, shows how quickly geography can be shortened.
The race that responders are losing
Perhaps the most troubling signal in WHO's latest bulletin is the state of contact tracing, the old-fashioned detective work that stops Ebola. The target is to follow up at least 85 per cent of the contacts of every confirmed case for 21 days. In the latest period, coverage was 80.4 per cent, with 23,741 of 29,535 contacts reached as of 4 October. WHO calls the shortfall a persistent inability to monitor exposed people throughout the full follow-up window.
The deaths tell the same story. Of the 372 deaths recorded since the previous bulletin, 264 happened in communities and only 108 in treatment centres. WHO says the high mortality and the number of deaths outside clinics point to delays in identifying illness and reaching appropriate care. Every death at home is a funeral waiting to become a transmission event, which is why safe burials have become a major strand of the response.
WHO describes a substantial scale-up of surveillance, laboratory testing, infection prevention and control, clinical care, community engagement, research and logistics, but warns that critical funding gaps remain. Temporary recommendations were issued to countries on 24 August, stressing coordinated control, cross-border collaboration and surveillance. In recent days, 23 patients were declared recovered after two negative tests, 15 in Ituri and eight in North Kivu, a small but real sign that people can survive.
The children caught in the crossfire
UNICEF issued a stark statement on 6 October. Nearly 2,000 children have lost one or both parents, or been separated from their parents or guardians, since the start of the outbreak, mostly in Ituri and North Kivu. As of 29 September, at least 2,076 children had tested positive and at least 1,162 had died.
Children make up more than one in four confirmed cases but nearly one in three deaths. Among children under five, seven in ten infected children have died, up from six in ten only a few weeks earlier. UNICEF said bluntly that children are disproportionately affected by the epidemic. Behind those numbers are orphaned toddlers, stigmatised survivors and schools that have emptied.
Expert perspective
WHO's own language is unusually frank. It calls transmission intense, notes that contact follow-up has fallen short of the target, and attributes the high death toll to delays in care. It also notes that the Kenyan patient most likely caught the virus while seeking care for something else, a pattern that points to infection prevention failures in health facilities. In previous Ebola epidemics, hospitals that were not equipped to isolate patients became amplifiers of spread, and control only turned once clinics were secured and communities trusted the response.
The agency still advises against travel or trade restrictions on affected countries. That position, long held by WHO, rests on evidence that border closures push travellers onto informal routes, make contact tracing harder and punish economies that are already fragile.
What this means for you
For the vast majority of readers, the immediate risk is very low. WHO rates the global risk as low, and Ebola does not spread through the air like flu or measles. It passes through direct contact with the blood or body fluids of a symptomatic person, or of someone who has died of the disease, and through contaminated materials. People are generally not infectious before they develop symptoms.
If you are planning travel to the DRC, Uganda or Kenya, check the latest guidance from your national health authority before you go, avoid contact with sick people and with funeral rites for anyone who died of an unexplained illness, and wash hands with soap or use alcohol-based rub frequently. If you have recently been in an affected area and develop fever, severe headache, muscle pain, vomiting, diarrhoea or unexplained bleeding, call ahead to a health facility before turning up, and tell staff about your travel. Do not self-medicate and wait.
Travellers returning from East and Central Africa may see extra screening questions at airports in the coming days. That is normal and nothing to panic about.
The bottom line
Five months after a cluster of dead health workers in Ituri raised the first alarm, the Bundibugyo outbreak has become something the region has never faced: more than 8,700 confirmed cases, more than 4,200 deaths, seven provinces, a patient dying in Nairobi, and a responder evacuated to Europe. There is no vaccine and no cure to deploy. What remains is the unglamorous, unforgiving work of finding every contact, treating every patient early, burying the dead safely and earning the trust of frightened communities, and WHO says that work is underfunded and behind target.
The Kenya case is a warning shot. Whether it stays a single tragedy or becomes the start of a new chain will depend on what happens in the next 21 days, the length of the Ebola incubation watch, in a hospital ward and an aeroplane cabin in East Africa. The world will be watching the contact lists.
