Tumaini trial begins as Bundibugyo Ebola death toll hits 4,887

MSF and experts raise concerns over Ervebo vaccine access

Medical experts and organizations are raising concerns regarding the use of the Ervebo vaccine, which is not specifically licensed for the Bundibugyo strain. Although the DRC Ministry of Health is using Ervebo within research protocols, its effectiveness against this virus remains unproven.

The Strategic Advisory Group of Experts (SAGE) reaffirmed its recommendation that Ervebo should only be used for Bundibugyo virus disease within the context of research protocols. Ervebo is currently licensed for the Zaire species of Ebola, but clinical evidence to support its programmatic use against the Bundibugyo virus is insufficient.

MSF Access expressed concern that manufacturing challenges could constrain access to the vaccine. MSF called on the manufacturer, Merck Sharp & Dohme, to allocate all available Ervebo supplies to affected communities without delay.

SAGE highlights urgency of evidence for Bundibugyo vaccine

The WHO Immunization Director issued a message in October 2026 relaying the group's deep concern over the outbreak.

SAGE reported that the Bundibugyo virus disease has been difficult to control and noted the high number of young children who have died. The advisory group reiterated the urgency of obtaining evidence through the TUMAINI randomized controlled trial to guide future vaccine policies.

Surveillance gaps hinder containment of Ebola transmission

This follows an earlier report from the Africa CDC on 6 October stating that more than 70 percent of new cases were identified outside of known transmission chains.

WHO’s regional office for Africa recorded 1,466 confirmed cases in the 21 days leading to 19 October, which represents a 10.4 percent increase over the previous three weeks. Responders were tracking 81.6 percent of 19,853 contacts as of 25 October, which remains below the 95 percent threshold required for effective containment.

Ebola virus spreads across eight provinces in DRC

North Kivu reported 2,309 cases and 1,293 deaths, while Haut‑Uélé reported 436 cases and Tshopo reported 83 cases.

In the 21 days to 19 October, cases in North Kivu grew by 22.6 percent, while cases in Ituri grew by 3.7 percent. The outbreak has also spread to Kenya and Nigeria.

Insecurity and health system failures complicate response

Containment efforts are failing because of insecurity in the eastern provinces. The World Health Organization (WHO) reported that the latest seven-day average indicated a renewed intensification of transmission.

He cited insecurity, the humanitarian situation, and the high mobility of people in the mining sector as primary factors.

Attacks on health personnel have further crippled the response. A nurse was killed by members of the population in the Bafwasende health zone in Tshopo.

Infection control standards remain poor, with assessments in North Kivu showing scores between 36.3% and 49.4% against an 80% standard. Of the 46 deaths reported on 25 October, 40 occurred in the community. WHO's 23 October update reported that 307 of 482 deaths since the previous update occurred in communities.

Historical data shows high fatality rates for Bundibugyo

The 17th Ebola outbreak in the Democratic Republic of Congo was declared after cases moved from initial suspicion to laboratory confirmation of the Bundibugyo virus between 24 April and 15 May.

Historical data from the WHO shows that the Bundibugyo strain has high fatality rates, with 30% in Uganda in 2007 and 50% in the DRC in 2012. Children are particularly vulnerable, accounting for 37.6% of deaths despite representing 27.4% of confirmed cases as of 30 September, according to UNICEF.

MSF reported that most children admitted over the summer were already hospitalised for other illnesses and were highly likely to have contracted Ebola inside healthcare facilities. During the 2018-2020 response, a vaccine was licensed and two treatments were found highly effective, but none of these tools are approved for use against the Bundibugyo strain.