The World Health Organization has elevated the risk assessment for the Ebola outbreak in the Democratic Republic of Congo to ‘very high’ at the national and regional levels, as the virus spreads to urban areas. In response, UK health officials have activated enhanced surveillance measures at ports of entry, including airports and seaports, to monitor for potential cases among travellers arriving from affected regions. This is a precautionary measure, but it underscores the gravity of the situation.
The outbreak, first declared in August 2018 in North Kivu province, has now infected more than 2,000 people, with a case fatality rate hovering around 67%. The recent confirmation of cases in Goma, a city of nearly 2 million people on the Rwandan border, marks a dangerous escalation. Goma’s dense population and its role as a transport hub amplify the risk of cross-border transmission. The virus is now spreading in an active conflict zone, where armed groups and community mistrust hamper containment efforts.
From a virological standpoint, Ebola is a filovirus with a basic reproduction number (R0) of 1.5 to 2.0 in previous outbreaks. Without intervention, each infected person transmits the virus to at least one other, sustaining the chain. The current outbreak is the second largest in history, surpassed only by the 2014 2016 West Africa epidemic. The WHO has identified 27 health zones in North Kivu and Ituri provinces reporting cases, with new clusters emerging daily.
The UK’s surveillance activation involves screening passengers from affected areas for symptoms such as fever, headache, muscle pain, and unexplained bleeding. Health officials are also coordinating with international partners to track contacts of known cases. The risk to the UK public remains low, as Ebola is not airborne and spreads through direct contact with bodily fluids of infected individuals or contaminated materials. However, the incubation period of 2 to 21 days means that a traveller could arrive in the UK before symptoms appear.
The challenges in DR Congo are formidable. The region lacks robust healthcare infrastructure, with only a handful of treatment centres equipped with proper isolation facilities. Community resistance, fuelled by misinformation and political instability, has led to attacks on health workers and the burning of treatment centres. The introduction of experimental vaccines, including the rVSV ZEBOV GP vaccine, has been hampered by logistical hurdles and cold storage requirements. As of July, over 160,000 people have been vaccinated, but coverage is uneven.
Epidemiological modelling suggests that without a significant ramp up in response efforts, the outbreak could infect tens of thousands more. The WHO has appealed for $98 million to fund containment, but only half has been raised. The UK’s contribution includes funding for surveillance and diagnostic support, but more is needed. This is a race against time: every day of delay increases the probability of international spread.
For the UK, the activation of surveillance is a sensible, data driven response. It mirrors protocols used during the 2014 outbreak, which successfully identified and isolated a handful of cases. The NHS has designated high level isolation units in London and Liverpool ready to receive any confirmed cases. The public should remain calm but vigilant. If you have recently travelled from affected areas and develop symptoms, seek medical attention immediately and disclose your travel history.
But we must not lose sight of the primary crisis in DR Congo. Without massive international support, the outbreak will continue to burn through communities, claiming lives and destabilising the region. The UK’s surveillance is a shield, but the fire needs to be extinguished at its source.
