Ebola
A rare but severe viral illness spread through direct contact with the blood or body fluids of a sick or deceased person. Early intensive supportive care can improve survival.
What causes Ebola?
Ebola disease is caused by viruses in the genus Orthoebolavirus. Zaire, Sudan, Bundibugyo, and Taï Forest viruses can cause human illness. Infection can begin after contact with infected wildlife and then spread through direct contact with a symptomatic or deceased person’s body fluids or contaminated objects. People are not contagious before symptoms begin.
Symptoms and what to notice
Sudden fever, severe fatigue, muscle pain, headache, and sore throat can be followed by vomiting, diarrhea, abdominal pain, rash, confusion, and impaired kidney or liver function. Internal or external bleeding can occur but is less common and often appears later.
How long can it last?
Symptoms can begin 2 to 21 days after exposure, commonly around 8 to 10 days. Acute illness often unfolds over one to two weeks. Recovery may take much longer, and some survivors experience persistent joint, eye, neurological, fatigue, or mental-health problems.
How serious is Ebola?
Ebola is often fatal. WHO reports an average case-fatality rate near 50%, with past outbreaks ranging from about 25% to 90%. Severe fluid loss, shock, abnormal clotting, and multi-organ failure can occur. Early isolation, testing, rehydration, and intensive supportive care are critical.
Treatment and management
Optimized supportive care includes oral or intravenous fluids, electrolyte correction, oxygen and blood-pressure support, symptom control, nutrition, and treatment of coinfections. Inmazeb and Ebanga are approved for Zaire ebolavirus disease only. No approved specific treatment exists for Bundibugyo or Sudan virus disease; candidate treatments are being studied.
Vaccine: who and when?
Product: ERVEBO (Ebola Zaire Vaccine, Live), a single-dose intramuscular vaccine licensed in the United States for people age 12 months and older against Zaire ebolavirus only. U.S. pre-exposure use focuses on eligible adults with occupational risk and the vaccine is not routinely recommended for ordinary travelers. It does not have a licensed indication against Bundibugyo or Sudan virus. During the 2026 Bundibugyo outbreak, DRC received ERVEBO for a Phase 3 trial and for frontline and health workers under emergency recommendations; protection against Bundibugyo remains unknown. Zabdeno plus Mvabea is an EU-authorized two-dose regimen for Zaire ebolavirus and is not approved in the United States.
Cost note: ERVEBO is not routinely sold through U.S. pharmacies or travel clinics. It is maintained in the U.S. Strategic National Stockpile and access is coordinated through CDC, employers, public-health programs, and designated institutions for eligible people, so no standard retail price applies.
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Patient cost varies by insurance, provider, location, and eligibility. Coverage and public-health access differ, so listed prices are examples rather than guaranteed patient prices. This page is for general education and does not replace individualized medical advice, diagnosis, vaccination assessment, or treatment.
Ebola: History, Symptoms, Transmission, Treatment, Prevention, and Vaccine Information
Ebola disease is a severe, often fatal illness caused by a group of viruses that circulate in parts of sub-Saharan Africa. It first came to world attention in 1976, when two separate outbreaks appeared within months of each other in what are now the Democratic Republic of the Congo (DRC) and South Sudan. Since then, outbreaks have recurred every few years, occasionally growing into major regional emergencies.
Ebola typically begins abruptly. Early symptoms include:
- Fever
- Severe fatigue and weakness
- Muscle pain
- Headache
- Sore throat
As the illness progresses, patients can develop:
- Vomiting
- Diarrhea
- Abdominal pain
- Rash
- Impaired kidney and liver function
- Internal or external bleeding in some patients
The disease is spread through direct contact with blood or body fluids from a person who is sick with or has died from Ebola. Family members and health workers who provide care, and mourners who touch the body of someone who has died, are at greatest risk. Ebola is not an airborne disease in the everyday sense, and it is not contagious before symptoms begin.
Ebola disease is caused by several different viruses. Zaire ebolavirus has caused the largest outbreaks and is the target of the only licensed vaccines and treatments. Bundibugyo virus and Sudan virus cause similar illness, but no vaccine or specific treatment is currently licensed for either.
That distinction matters right now. In May 2026, an outbreak of Bundibugyo virus disease was recognized in Ituri Province in eastern DRC. It has since become the second-largest Ebola outbreak ever recorded, exceeded only by the West African epidemic of 2014 to 2016. WHO declared it a public health emergency of international concern on 17 May 2026. At the time of writing, more than 7,700 confirmed cases and more than 3,700 deaths had been reported, and the outbreak was still active.
Important: This article is intended for general education. Ebola is rare outside outbreak areas, and the risk to the general public in most countries remains low. If you have recently been in an affected area, or cared for someone with suspected Ebola, and you develop a fever or other symptoms, contact local health authorities by phone right away rather than walking into a clinic, so that proper precautions can be arranged.
What Is Ebola?
Ebola disease (sometimes called Ebola virus disease, or formerly Ebola hemorrhagic fever) is caused by viruses in the genus Orthoebolavirus, part of the family Filoviridae. Filoviruses are named for their long, thread-like shape (from the Latin filum, meaning thread).
Key features of these viruses include:
- They are enveloped RNA viruses with a single-stranded, negative-sense genome
- Their particles are long and filamentous, often several hundred nanometers to more than a micrometer in length
- They infect immune cells first, then spread to many organs
- They are grouped among the most dangerous human pathogens and must be studied in the highest-containment (BSL-4) laboratories
The same family also includes Marburg virus and Ravn virus, which cause Marburg virus disease, an illness clinically very similar to Ebola.
The Six Orthoebolavirus Species
Six species are currently recognized. Four are known to cause disease in humans.
| Virus (species) | Abbreviation | Disease name | Human disease | Notes |
|---|---|---|---|---|
| Zaire ebolavirus (Orthoebolavirus zairense) | EBOV | Ebola virus disease (EVD) | Yes | Most outbreaks and deaths; licensed vaccine and antibody treatments exist |
| Sudan ebolavirus (Orthoebolavirus sudanense) | SUDV | Sudan virus disease (SVD) | Yes | Outbreaks in South Sudan and Uganda; no licensed vaccine or treatment |
| Bundibugyo ebolavirus (Orthoebolavirus bundibugyoense) | BDBV | Bundibugyo virus disease (BVD) | Yes | Cause of the 2026 DRC outbreak; no licensed vaccine or treatment |
| Taï Forest ebolavirus (Orthoebolavirus taiense) | TAFV | Taï Forest virus disease | Yes (one known case) | Identified in Côte d’Ivoire in 1994 |
| Reston ebolavirus (Orthoebolavirus restonense) | RESTV | None known | Infects people without known illness | Found in monkeys and pigs in the Philippines |
| Bombali ebolavirus (Orthoebolavirus bombaliense) | BOMV | None known | Not known to cause disease | Detected in bats in Sierra Leone |
Ebola Quick Facts
| Feature | Information |
|---|---|
| Disease | Ebola disease |
| Causes | Viruses of the genus Orthoebolavirus |
| Virus family | Filoviridae |
| Genetic material | Single-stranded RNA |
| Suspected natural reservoir | Bats |
| Primary transmission | Direct contact with blood or body fluids of a sick or deceased person |
| Airborne spread | Not through ordinary respiratory spread |
| Contagious before symptoms | No |
| Typical incubation period | 8 to 10 days |
| Possible incubation range | 2 to 21 days |
| Monitoring period after exposure | 21 days |
| Main early symptoms | Fever, fatigue, muscle pain, headache, sore throat |
| Average case fatality | About 50% (range roughly 25% to 90%) |
| Specific antiviral treatment | Antibody drugs approved for Zaire ebolavirus only |
| Licensed vaccine | Ervebo (Zaire ebolavirus only) |
| Vaccine for Bundibugyo virus | None licensed; trials under way |
| Main prevention | Early isolation, infection control, safe burials, contact tracing, and vaccination where available |
The History of Ebola
The history of Ebola is a story of recurring outbreaks in Central and East Africa, a single enormous epidemic in West Africa, and steady progress in vaccines and treatments that are now being tested against a different virus species.
1976: Two Outbreaks, Two Viruses
In June 1976, an outbreak began in Nzara, in what is now South Sudan. It was caused by what would later be named Sudan virus. It infected several hundred people and killed just over half of them.
In August and September 1976, a second outbreak began near Yambuku, in what was then Zaire (now the DRC). It centered on a mission hospital, where reused needles and syringes helped the virus spread, and it caused approximately 318 cases and 280 deaths, a fatality rate of about 88%.
Blood samples from Yambuku were sent to laboratories in Belgium and elsewhere, where scientists, including Belgian virologist Peter Piot, identified a new, thread-shaped virus. The virus was named after the Ebola River, which flows near the outbreak area, rather than after the village itself.
Where Did the Name Ebola Come From?
The name refers to the Ebola River in northern DRC. Investigators chose it deliberately to avoid stigmatizing the village of Yambuku. Modern naming practices for diseases, including WHO’s guidelines, similarly discourage naming illnesses after specific places, but “Ebola” remained in use because of its historical familiarity.
The disease itself is now described by the virus that causes it: Ebola virus disease (Zaire ebolavirus), Sudan virus disease, or Bundibugyo virus disease.
1977 to 1994: Sporadic Cases and New Viruses
Over the next two decades, Ebola appeared only occasionally.
- 1977: A single case was identified in Tandala, DRC.
- 1979: A second outbreak occurred in Nzara, South Sudan.
- 1989: Reston virus was discovered in laboratory monkeys imported to the United States from the Philippines. It infected some workers but did not cause recognized illness in people.
- 1994: A researcher in Côte d’Ivoire became infected with a previously unknown species, Taï Forest virus, after examining a dead chimpanzee.
1995: Kikwit, DRC
In 1995, a large outbreak in Kikwit, DRC, caused about 315 cases and roughly 250 deaths. It showed how quickly Ebola can spread in hospitals and among families, and it strengthened international response networks, including the use of protective equipment and isolation wards.
2000 to 2001: The Gulu Outbreak in Uganda
Uganda’s outbreak of Sudan virus in and around Gulu in 2000 and 2001 caused about 425 cases and 224 deaths. It remains the largest Sudan virus outbreak on record and is often cited as an example of how community engagement and rapid isolation can eventually control an outbreak.
2007 to 2008: Bundibugyo Virus Is Discovered
In late 2007, an outbreak in the Bundibugyo District of western Uganda revealed a fifth species of Ebola virus. It caused roughly 130 to 150 cases and about 40 deaths, with a fatality rate lower than typical Zaire outbreaks. The species was named Bundibugyo virus after the district.
A second, smaller Bundibugyo outbreak occurred in Isiro, DRC, in 2012. Before 2026, only these two Bundibugyo outbreaks had ever been recorded, so scientists had very limited clinical experience with the virus.
2014 to 2016: The West African Epidemic
The largest Ebola epidemic in history began in December 2013 in the village of Meliandou, Guinea, and was not recognized as Ebola until March 2014. It spread to Liberia and Sierra Leone, reaching capital cities and densely populated areas for the first time.
The epidemic:
- Caused approximately 28,600 cases and 11,300 deaths
- Sent imported or locally acquired cases to Nigeria, Senegal, Mali, the United Kingdom, Italy, Spain, and the United States
- Led WHO to declare a public health emergency of international concern on 8 August 2014
- Overwhelmed health systems, killing hundreds of health workers
- Ended in 2016 after sustained international response
The epidemic exposed serious weaknesses in global outbreak preparedness and directly led to accelerated vaccine and treatment development.
2018 to 2020: Eastern DRC
In August 2018, a Zaire ebolavirus outbreak began in North Kivu and Ituri, the same conflict-affected region now facing the 2026 outbreak. It caused about 3,470 cases and 2,287 deaths and was declared over in June 2020.
It was the first large outbreak in which a vaccine (Ervebo) and effective antibody treatments were used. Violence against health workers and community mistrust, however, repeatedly interrupted the response. The outbreak was declared a public health emergency of international concern in July 2019.
2019 to 2020: Vaccines and Treatments Are Approved
A major turning point came during and after the 2018 to 2020 outbreak.
- 2019: The PALM trial showed that two monoclonal antibody treatments, later marketed as Ebanga and Inmazeb, substantially improved survival compared with older experimental treatments for Zaire ebolavirus.
- December 2019: The U.S. FDA approved Ervebo, the first Ebola vaccine.
- 2020: The FDA approved Inmazeb (October) and Ebanga (December), the first approved treatments for Zaire ebolavirus.
2022 to 2025: More Outbreaks, Including Sudan Virus
Ebola outbreaks continued.
- 2022: Uganda experienced a Sudan virus outbreak of about 164 cases and 77 deaths, for which no licensed vaccine existed.
- January to April 2025: Uganda reported another Sudan virus outbreak, which was controlled within a few months.
- September to December 2025: DRC’s 16th Ebola outbreak, a Zaire ebolavirus outbreak in Kasai Province, was declared over in December 2025.
2026: The Bundibugyo Outbreak in DRC
Only about five months after the previous DRC outbreak ended, health authorities were alerted on 5 May 2026 to a cluster of unexplained deaths in the Mongbwalu Health Zone of Ituri Province, including deaths among health workers.
Early tests failed to identify the cause because they were designed to detect Zaire ebolavirus. Laboratory testing capable of detecting Bundibugyo virus later confirmed the outbreak, which the DRC government declared on 15 May 2026 as its 17th Ebola outbreak. Investigators believe the first human infections occurred several months earlier, possibly in January or February 2026.
The details of this ongoing outbreak are covered later in this article.
Ebola Timeline at a Glance
| Year | Event |
|---|---|
| 1976 | Ebola recognized in Yambuku (DRC) and Nzara (South Sudan) |
| 1989 | Reston virus found in imported monkeys in the U.S. |
| 1994 | Taï Forest virus identified in Côte d’Ivoire |
| 1995 | Kikwit outbreak, DRC |
| 2000 to 2001 | Gulu outbreak, Uganda (Sudan virus) |
| 2007 | Bundibugyo virus discovered in Uganda |
| 2014 to 2016 | West African epidemic, about 28,600 cases |
| 2018 to 2020 | North Kivu and Ituri outbreak, DRC |
| 2019 | Ervebo approved in the U.S. |
| 2020 | Inmazeb and Ebanga approved in the U.S. |
| 2022 | Sudan virus outbreak, Uganda |
| 2025 | Sudan virus outbreak in Uganda; Kasai outbreak in DRC |
| 2026 | Bundibugyo virus outbreak in eastern DRC; PHEIC declared |
Where Does Ebola Come From?
Scientists believe Ebola viruses originate in animals, and bats are the leading suspected natural reservoir. Bats have been found carrying evidence of Ebola-related viruses, and antibodies have been detected in fruit bats in several African countries. However, a bat has not been confirmed as the source for every species, and the exact reservoir of Bundibugyo virus has not been established.
Other animals can become infected after contact with bats or their droppings, including:
- Great apes such as chimpanzees and gorillas
- Forest antelope
- Monkeys
- Porcupines
Ebola outbreaks among great apes have also killed large numbers of these animals in parts of Central Africa.
How Does Ebola First Spread to People?
Outbreaks are believed to begin with spillover, when a person is infected through contact with an infected animal. Recognized routes include:
- Handling or butchering infected animals, including bushmeat
- Contact with blood, body fluids, or carcasses of infected wildlife
- Entering caves or mines where bats roost
Spillover events are thought to be rare. Once one person is infected, the outbreak continues through human-to-human transmission.
How Does Ebola Spread Between People?
Ebola spreads through direct contact with the body fluids of a person who is sick with or has died from Ebola. The virus enters through:
- Broken skin, including small cuts
- Mucous membranes such as the eyes, nose, and mouth
Body fluids that can carry the virus include:
- Blood
- Vomit
- Feces
- Urine
- Saliva
- Sweat
- Breast milk
- Semen and vaginal fluids
It can also spread through objects contaminated with these fluids, such as needles, syringes, bedding, and clothing.
Who Is Most at Risk of Exposure?
The highest-risk groups are:
- Family members and caregivers who look after sick relatives at home
- Health workers without adequate protective equipment or infection control
- Mourners who wash, touch, or kiss the body of someone who has died
- Burial workers handling bodies without protection
- Laboratory workers handling infectious samples
This is why health worker infections have been a major concern in the 2026 outbreak. More than 150 health workers had been infected by August, and dozens have died, according to WHO and United Nations reports.
Why Are Funerals So Important in Ebola Outbreaks?
The bodies of people who have died from Ebola remain highly infectious, and the amount of virus in body fluids is often very high at the time of death.
Traditional funeral practices in many communities include washing and dressing the body, touching or embracing the deceased, and traveling long distances for burial. These practices are deeply meaningful, but during an Ebola outbreak they can cause many infections.
Safe and dignified burial programs try to protect families while respecting customs. They involve trained teams, protective equipment, and, where possible, allowing relatives to take part in safe ways. Community trust is essential. In the 2026 outbreak, attacks on burial teams and treatment centers, fueled partly by fear and misinformation, have interrupted response activities in some areas.
Is Ebola Airborne?
No, not in the way that measles or COVID-19 is.
Ebola does not normally spread through:
- Breathing the same air at a distance
- Casual contact such as passing someone in a market
- Water or food in the usual sense
- Mosquitoes or other insects
Infection requires direct contact with infected body fluids. In healthcare settings, procedures that generate droplets or aerosols can increase risk, which is why health workers use full protective equipment.
Can You Catch Ebola From Someone Without Symptoms?
No. People are not contagious before they develop symptoms. Infectiousness increases as the illness progresses and is highest in the late stage of illness and after death.
This is a major difference from many respiratory viruses. It also makes Ebola controllable when cases are identified quickly, isolated, and their contacts monitored for 21 days.
Can Ebola Spread Through Sex?
Yes, in survivors. Ebola virus can persist in semen for many months after recovery, and sexual transmission from male survivors has been documented in past outbreaks, sometimes long after the person had recovered. Health authorities therefore recommend:
- Semen testing for male survivors where possible
- Abstinence or consistent condom use until semen tests are negative
- Support and counseling for survivors
The virus has also been found in breast milk and other fluids of survivors, so breastfeeding advice for survivors is individualized.
Can Survivors Spread Ebola Through Casual Contact?
No. Survivors who have cleared the virus from their blood are not a risk in everyday social settings. The main concern is limited to specific body sites where the virus may persist, and to sexual contact and certain body fluids.
How Does Ebola Infect the Body?
After entering the body, Ebola virus first infects immune cells, especially macrophages and dendritic cells. Infected cells carry the virus through the lymph nodes and bloodstream to organs such as the liver, spleen, and adrenal glands.
The virus disrupts the immune response and triggers massive inflammation. Damage to blood vessels and organs leads to:
- Fluid loss and low blood pressure
- Abnormal blood clotting
- Liver and kidney injury
- Shock and multi-organ failure in severe cases
Death typically results from shock and organ failure rather than blood loss alone.
What Is the Incubation Period?
The period between exposure and symptoms is usually 8 to 10 days, with a possible range of 2 to 21 days. People who may have been exposed are monitored for 21 days, and travelers returning from outbreak areas are often asked to monitor their temperature and symptoms for that period.
What Are the First Symptoms of Ebola?
Ebola often begins suddenly, with symptoms that look like many other tropical illnesses. Early signs include:
- Fever
- Extreme tiredness and weakness
- Muscle and joint pain
- Headache
- Sore throat
- Loss of appetite
Because these early symptoms overlap with malaria, typhoid fever, influenza, and other infections, diagnosis in the early stage can be difficult.
What Symptoms Appear Later?
As the illness progresses, patients may develop:
- Persistent vomiting
- Watery diarrhea, sometimes severe
- Abdominal pain
- Dehydration
- Rash
- Red eyes
- Chest pain and cough
- Hiccups
- Confusion or altered consciousness
- Bleeding, including from the gums, nose, or in vomit or stool
- Signs of organ failure
Severe fluid loss from vomiting and diarrhea is one of the most dangerous features and one of the most treatable with aggressive rehydration.
Do All Ebola Patients Bleed?
No. Bleeding is often associated with Ebola in popular imagery, but many patients never experience visible bleeding. Historically, only a minority of patients in large outbreaks have had obvious hemorrhage, and it is more typical in the late stage.
This has been highlighted in the 2026 Bundibugyo outbreak. Public health officials have noted that some patients present without prominent bleeding, which can make it harder to recognize the disease from symptoms alone. As a result, people with mild or non-specific illness may stay at home instead of going to a health facility, which can allow transmission to continue. Laboratory testing is therefore essential.
What Are the Stages of Ebola Illness?
Clinicians often describe the illness in phases, although the timing varies from person to person.
| Phase | Typical timing after symptom onset | Common features |
|---|---|---|
| Early | Days 1 to 3 | Fever, fatigue, muscle pain, headache, sore throat |
| Gastrointestinal | Days 3 to 7 | Vomiting, diarrhea, abdominal pain, dehydration |
| Severe | Around days 5 to 10 | Shock, organ failure, bleeding, confusion |
| Recovery or death | Second week onward | Gradual improvement in survivors; death most often from shock and multi-organ failure |
How Long Does Ebola Last?
The acute illness usually lasts around one to two weeks. Patients who survive often begin to improve in the second week, though weakness and other symptoms may last for weeks or months. Hospital discharge generally requires repeated negative laboratory tests confirming the virus has cleared from the blood.
What Is Post-Ebola Syndrome?
Many survivors face long-term health problems, sometimes called post-Ebola syndrome. Reported problems include:
- Joint and muscle pain
- Extreme tiredness
- Headaches
- Vision problems, including uveitis, which can threaten sight
- Hearing problems
- Abdominal pain
- Memory or concentration difficulties
- Anxiety, depression, and post-traumatic stress
- Stigma and social rejection
Survivors need follow-up care, eye examinations, mental health support, and community reintegration programs.
Can Ebola Virus Persist in the Body After Recovery?
Yes, in certain “immune-privileged” sites where the immune system is less active. These include:
- Semen (for months, occasionally longer)
- The eyes
- The central nervous system
In rare cases, the virus persisting in these sites has caused relapse illness or new transmission chains long after an outbreak was declared over. This is why survivor monitoring programs continue after outbreaks end.
What Complications Can Ebola Cause?
Ebola is a multi-system illness. Serious complications can include:
Circulatory complications
- Shock from fluid loss and vascular leakage
- Abnormal blood clotting and bleeding
Kidney and liver complications
- Acute kidney injury
- Liver inflammation and dysfunction
- Electrolyte disturbances, such as dangerously low potassium
Neurological complications
- Confusion and seizures
- Meningoencephalitis (rare)
Other complications
- Secondary bacterial infections
- Malaria coinfection
- Miscarriage or stillbirth in pregnancy
- Eye inflammation in survivors
Who Is at Highest Risk of Severe Disease?
Risk of severe illness or death is higher among:
- Young children, especially under five years
- Older adults
- Pregnant women
- People who receive care late or are unable to reach care
- People with weakened immune systems or other serious illnesses
Data from the 2026 outbreak reported by WHO in September indicate that children make up roughly a quarter of confirmed cases but a larger share of deaths. Among children under five, more than 60% of confirmed cases have been fatal, compared with fewer than 30% among adults.
Ebola in Children
Children can develop the same symptoms as adults, but may deteriorate faster. Young children can become dehydrated very quickly from vomiting and diarrhea, and they can be difficult to diagnose early because their symptoms are less specific.
Prompt medical care, careful fluid replacement, and infection control in pediatric wards are particularly important. Children who are separated from infected parents also need protection and psychosocial support.
Ebola During Pregnancy
Ebola is especially dangerous in pregnancy. Pregnant women face higher risks of severe disease, and infection often causes pregnancy loss or stillbirth. Infants born to infected mothers have historically had very poor survival.
Pregnant women with suspected Ebola should receive urgent specialist care. Health workers assisting with childbirth are at very high risk of exposure and need appropriate protective equipment.
How Is Ebola Diagnosed?
Diagnosis requires laboratory testing, because Ebola symptoms cannot be reliably distinguished from other illnesses. The standard test is reverse transcription polymerase chain reaction (RT-PCR) performed on blood samples, which detects viral genetic material.
Important points about testing include:
- Blood samples taken very early, before or within about three days of symptom onset, may test negative even in an infected person, so repeat testing may be needed
- Testing must be done in a laboratory with appropriate biosafety precautions
- Samples are shipped under strict infectious-substances rules
- Antibody tests can support diagnosis later in the illness or in survivors
- Some rapid antigen tests exist for Zaire ebolavirus, but they may not detect other species
Why Was the 2026 Outbreak Detected Late?
One reason is testing. Early samples in Ituri reportedly tested negative because the tests used in the region were designed to detect Zaire ebolavirus, not Bundibugyo virus. Only when testing that could detect other species was used did the outbreak become clear.
Africa CDC has since recommended molecular (RT-PCR) testing for Bundibugyo virus, noting that no rapid antigen test has been recommended for use in this outbreak. This is one of the lessons of 2026: an “Ebola-negative” result may mean only that the virus is not Zaire ebolavirus, and tests for the specific species are needed.
What Diseases Can Look Like Ebola?
Ebola resembles many illnesses that are common in the same regions:
- Malaria
- Typhoid fever
- Cholera and other severe diarrheal diseases
- Lassa fever
- Marburg virus disease
- Yellow fever and other viral hemorrhagic fevers
- Meningitis
- Severe bacterial infections and sepsis
- Influenza
Patients with fever after travel to or residence in an outbreak area should be tested for malaria as well, because it is common, treatable, and can coexist with Ebola.
Ebola vs. Marburg
Both viruses belong to the Filoviridae family and cause very similar illness.
| Feature | Ebola disease | Marburg virus disease |
|---|---|---|
| Virus genus | Orthoebolavirus | Orthomarburgvirus |
| Family | Filoviridae | Filoviridae |
| Suspected reservoir | Bats | Egyptian rousette fruit bats |
| Transmission | Direct contact with body fluids | Direct contact with body fluids |
| Typical incubation | 2 to 21 days | 2 to 21 days |
| Symptoms | Fever, weakness, vomiting, diarrhea, bleeding in some | Very similar |
| Licensed vaccine | Yes, for Zaire ebolavirus only | No |
| Approved specific treatment | Yes, for Zaire ebolavirus only | No |
Ebola vs. Malaria
| Feature | Ebola | Malaria |
|---|---|---|
| Cause | Virus | Plasmodium parasite |
| Spread | Contact with body fluids | Anopheles mosquito bite |
| Person-to-person spread | Yes, through body fluids | No (except rare blood transfusion or congenital cases) |
| Onset | Sudden fever, weakness | Fever, chills, sweats |
| Specific treatment | Supportive; antibodies for Zaire ebolavirus | Antimalarial drugs |
| Vaccine | Ervebo for Zaire ebolavirus | Available in some high-risk regions |
How Is Ebola Treated?
Treatment depends on the virus species and on how early the patient reaches care. For every species, the foundation of care is supportive treatment delivered in a properly equipped isolation unit.
Supportive care can include:
- Oral rehydration, and intravenous fluids when needed
- Correction of electrolyte abnormalities, especially potassium
- Oxygen and blood pressure support
- Treatment of fever, pain, nausea, and vomiting
- Treatment of coinfections such as malaria and bacterial infections
- Nutrition and psychological support
- Monitoring of kidney and liver function
Patients who receive early, high-quality supportive care have a far better chance of survival than those who arrive late or cannot reach care. This is one reason that fatality rates in well-resourced settings, such as the small number of patients evacuated to Europe and the United States, have been much lower than in outbreak zones.
Are There Approved Drugs for Ebola?
For Zaire ebolavirus only, two monoclonal antibody treatments are approved in the United States:
| Drug | Type | Approved | Notes |
|---|---|---|---|
| Inmazeb | Combination of three monoclonal antibodies | October 2020 | Given as a single intravenous infusion |
| Ebanga | Single monoclonal antibody (ansuvimab) | December 2020 | Given as a single intravenous infusion |
In the PALM trial during the 2018 to 2020 DRC outbreak, both antibody treatments reduced mortality substantially compared with older experimental products, with death rates of roughly one in three among treated patients, and much lower when treatment began early.
These drugs are approved for Zaire ebolavirus. They have not been shown to work against Bundibugyo virus, and they are not licensed for use in the current outbreak.
What Treatments Are Being Tested for Bundibugyo Virus?
In May 2026, a WHO-convened expert group recommended that several candidate treatments be evaluated in clinical trials. The candidates include:
- Remdesivir, an antiviral drug originally developed for other viruses
- MBP134, an antibody cocktail designed to work against multiple ebolavirus species
- Maftivimab, one of the antibodies contained in Inmazeb
Trials of remdesivir and MBP134 began enrolling patients in the DRC in July 2026 under a WHO-supported trial protocol. Results were not yet available at the time of writing, so none of these products can be described as proven for Bundibugyo virus disease.
Should Someone With Suspected Ebola Take Medicines at Home?
No. A person with suspected Ebola should not try to treat the illness at home, and should not share care with family members without proper protection. Medical guidance is needed for medicines as well. In viral hemorrhagic fevers, doctors often avoid aspirin and other NSAIDs such as ibuprofen because of bleeding risk, and prefer other pain and fever medicines under supervision.
Delaying care is dangerous. Early hospital care with fluids and monitoring saves lives and also protects families by limiting home transmission.
Do Antibiotics Treat Ebola?
No. Ebola is a viral infection and antibiotics do not kill the virus. Antibiotics may be used if a bacterial coinfection is suspected, which can happen in severe illness.
Is There an Ebola Vaccine?
Yes, for Zaire ebolavirus only. This is an essential point that is often misunderstood. Two vaccines have been used against Zaire ebolavirus, and neither is licensed for Bundibugyo virus or Sudan virus.
Ervebo (rVSV-ZEBOV)
Ervebo was developed by Merck, building on work by Canadian scientists, and was first licensed in 2019. It uses a weakened vesicular stomatitis virus that carries a gene for the Zaire ebolavirus surface protein.
Key facts:
- Doses: One dose
- Type: Live, attenuated recombinant vaccine
- U.S. licensure: People 12 months of age and older
- Protection: Zaire ebolavirus only
- Common reactions: Injection-site pain and swelling, fever, headache, muscle and joint pain, and fatigue
- Use: Ring vaccination of contacts during outbreaks, and vaccination of frontline workers
During the 2018 to 2020 outbreak in the DRC, hundreds of thousands of people were vaccinated, and the vaccine was shown to be highly protective against Zaire ebolavirus disease.
Zabdeno and Mvabea
The second regimen combines Zabdeno (Ad26.ZEBOV-GP) and Mvabea (MVA-BN-Filo), given as two doses about eight weeks apart. It has been approved by the European Medicines Agency and used in the DRC and other countries, but it is not approved in the United States. It is also designed for Zaire ebolavirus.
Who Should Receive an Ebola Vaccine?
In the United States, CDC’s advisory committee recommends Ervebo for adults with potential occupational exposure to Zaire ebolavirus, including:
- Responders to outbreaks of Zaire ebolavirus disease
- Health care personnel at designated Ebola treatment centers
- Laboratory and support staff at facilities that handle Ebola virus
- Others who may be exposed through their work
It is not recommended for the general public or as a routine vaccine for travelers, because the risk of infection for most travelers is extremely low.
Why Doesn’t Ervebo Simply Solve the 2026 Outbreak?
Because the 2026 outbreak is caused by Bundibugyo virus, not Zaire ebolavirus. Vaccines are highly specific. Immune protection against one Ebola species does not automatically protect against another.
Laboratory studies in monkeys suggested Ervebo might provide partial cross-protection against Bundibugyo virus. In August 2026, WHO and Africa CDC welcomed an allocation of 70,000 Ervebo doses to the DRC: 20,000 doses for a Phase 3 clinical trial and 50,000 doses for frontline and health workers under WHO emergency recommendations. WHO emphasizes that protection against Bundibugyo virus in humans remains unknown. People offered the vaccine must receive clear information about its potential benefits, risks, and limitations and provide informed consent.
Which Bundibugyo Vaccines Are in Development?
The Coalition for Epidemic Preparedness Innovations (CEPI) announced funding in June 2026 to accelerate three candidates:
- A candidate from the University of Oxford, based on the ChAdOx1 platform, which entered a first-in-human Phase 1 trial in the United Kingdom in July 2026
- An mRNA candidate from Moderna
- A candidate from IAVI
None is licensed, and it will take time to show that they are safe and effective. These products are in early testing.
Vaccine Quick Reference
| Question | Current information |
|---|---|
| Is there an Ebola vaccine? | Yes, for Zaire ebolavirus only |
| Licensed vaccines | Ervebo (U.S. and EU); Zabdeno with Mvabea (EU) |
| Is any vaccine licensed for Bundibugyo virus? | No |
| Is any vaccine licensed for Sudan virus? | No (candidates have been tested in outbreaks) |
| Ervebo doses | One |
| Routine vaccine for the public or travelers? | No |
| Main use | Frontline workers, responders, laboratory staff, and ring vaccination of contacts |
| 2026 outbreak | Ervebo under a research trial in DRC; specific candidates in early trials |
How Can Ebola Be Prevented?
Because there is no widely usable vaccine for the current species, prevention relies on classic public health measures. These have stopped every Ebola outbreak in history.
Find cases quickly
- Recognize and test suspected cases early
- Isolate confirmed and probable patients
- Notify health authorities right away
Trace and monitor contacts
- Identify everyone exposed to a patient
- Follow contacts daily for 21 days
- Isolate and test contacts who develop symptoms
Protect health workers
- Use appropriate personal protective equipment, including gowns, gloves, masks or respirators, eye protection, and boots
- Follow strict donning and doffing procedures
- Use safe injection practices and sterilized or single-use equipment
- Set up triage and isolation at the front door of health facilities
Provide safe and dignified burials
- Use trained burial teams
- Avoid touching or washing the body without protection
- Work with religious and community leaders to adapt rituals safely
Engage communities
- Explain risks honestly and clearly
- Address fears and rumors
- Involve local leaders, survivors, and community health workers
- Ensure that patients receive food, care, and respect
Community trust is often the deciding factor. Where trust is low, patients hide, contacts refuse follow-up, and outbreaks grow.
What Can Individuals Do to Reduce Their Risk?
For people living in or traveling to an outbreak area:
- Avoid contact with the blood or body fluids of anyone who is sick, and with the bodies of people who have died
- Do not touch or handle the bodies of people who may have died from Ebola, and follow safe-burial instructions
- Wash hands frequently with soap and water or an alcohol-based hand sanitizer
- Avoid bushmeat, and avoid contact with bats and with sick or dead wild animals
- Avoid contact with items such as clothing, bedding, needles, or medical equipment that may be contaminated
- Seek medical care early at a proper facility if you develop fever or other symptoms
- Follow local health authority instructions and report suspected cases
- Do not hide sick relatives, since early care improves survival and protects others
For health workers, protective equipment and infection control are essential at all times, even when the patient is not yet known to have Ebola.
Travel Advice
Travel advice changes with the outbreak. As of 23 September 2026, CDC’s travel notices for the 2026 Bundibugyo outbreak included:
- Level 4 (avoid all travel): Ituri and North Kivu provinces in the DRC
- Level 3 (reconsider nonessential travel): Haut-Uélé and Tshopo provinces in the DRC
- Level 2 (practice enhanced precautions): the rest of the DRC and Uganda
The United States has also placed temporary entry restrictions on travelers who have recently been in the DRC. Travelers, including U.S. citizens, who have been in the DRC within 21 days generally cannot board commercial flights to the United States, and those who have been in Uganda or South Sudan must enter through designated airports for enhanced screening. Other countries have introduced their own screening, monitoring, or quarantine rules.
Anyone planning travel to central or east Africa should check the latest advice from their national health authority and airlines before departure, and monitor their health for 21 days after leaving an affected area.
The 2026 Ebola Outbreak: What We Know
Where and When Did It Begin?
The outbreak is centered in Ituri Province, in northeastern DRC, an area with gold mining, heavy population movement, and long-running armed conflict. Health authorities were alerted on 5 May 2026 to deaths among residents and health workers in the Mongbwalu Health Zone. The Ministry of Health declared an Ebola outbreak on 15 May, and WHO declared a public health emergency of international concern on 17 May. Investigators believe the virus began spreading in January or February 2026, some months before it was recognized.
How Large Is the Outbreak?
According to figures reported by DRC health authorities on 22 September 2026 and summarized by ECDC:
| Measure | Figure (data up to 21 September 2026) |
|---|---|
| Confirmed cases in DRC | 7,773 |
| Deaths among confirmed cases | 3,759 |
| Recovered patients | 1,935 |
| Patients in isolation | 839 |
| Most affected province | Ituri: 5,966 cases and 2,737 deaths |
| Second most affected province | North Kivu: 1,438 cases and 872 deaths |
Confirmed cases have also been reported in Haut-Uélé, Tshopo, Bas-Uélé, South Kivu, and, per CDC, South Ubangi. Health officials have warned that the true number of infections is likely to be substantially higher than the confirmed count, because many people are not reaching testing or care.
These numbers change rapidly. Readers should check the WHO, CDC, and DRC Ministry of Health for current data.
How Does It Compare With Previous Outbreaks?
- It is the second-largest Ebola outbreak in history, after West Africa in 2014 to 2016
- It is already the largest outbreak in the DRC’s history, surpassing the 2018 to 2020 outbreak
- It has been described as the fastest-growing on record. CDC notes that it passed 1,000 confirmed cases within 40 days of response activation, compared with roughly 235 days for the 2018 outbreak
- The crude case fatality rate among confirmed cases has been about 48%, within the historical range for Bundibugyo virus of roughly 25% to 50%
Why Is This Outbreak So Hard to Control?
Public health agencies cite several overlapping challenges:
- No licensed vaccine or treatment for Bundibugyo virus
- Delayed detection, because early tests looked for the wrong species
- Armed conflict and insecurity, which limit access, complicate contact tracing, and endanger health workers
- Population movement linked to mining, trade, and displacement
- Weak health infrastructure, shortages of protective equipment, and unpaid health workers who have gone on strike in some facilities
- Community mistrust and misinformation, including attacks on treatment centers and burial teams
- Health worker infections, which drain the response workforce
- Funding gaps, despite a joint WHO and Africa CDC plan seeking about US$518 million
Has Ebola Spread Beyond the DRC?
Uganda reported 20 confirmed cases and two deaths in May and June 2026, including cases in the capital Kampala. Uganda’s response, which included isolating thousands of contacts, was successful in stopping the spread, and WHO declared its outbreak over in late August after 42 days without a new confirmed case.
Outside Africa, a small number of imported cases have been reported: a doctor returning to France in June, and two U.S. citizens who worked with humanitarian organizations and were medically evacuated to Germany. All three were reported to have recovered.
How Is the Global Risk Assessed?
WHO’s assessment in August 2026 rated the risk as:
- Very high in the DRC
- High for countries that share a border with the DRC
- Low for the rest of the African region and globally
CDC states that the overall risk to the American public is low and the likelihood of Ebola spreading to the United States is very low. ECDC rates the risk of infection in the EU and European Economic Area as very low. Those assessments could change if the outbreak spreads, so official updates are worth following.
Why Is the Bundibugyo Species Different?
Bundibugyo virus was first identified in 2007. Before 2026, only two outbreaks, both small, had been recorded, so scientists had limited clinical and epidemiological experience with it. Historically, its fatality rate has been somewhat lower than Zaire ebolavirus in the outbreaks studied, but this outbreak shows it can still cause many deaths. Laboratory studies suggest it may replicate more slowly than Zaire ebolavirus, but the practical consequences of that are still being studied.
What matters most in practice is that the current tools built around Zaire ebolavirus, including the licensed vaccine, antibody treatments, and some tests, cannot be assumed to work against it.
What Is Being Done to Stop It?
Response activities include:
- Surveillance, testing, and contact tracing across affected provinces
- Isolation and treatment centers, including facilities run by the DRC government, WHO partners, and Médecins Sans Frontières
- Safe burial teams and community outreach
- Clinical trials of treatments and vaccines
- Support for neighboring countries, including preparedness, screening, and border measures
- International funding and technical assistance from WHO, Africa CDC, CDC, ECDC, and other partners
Ebola vs. Other Viral Hemorrhagic Fevers
| Feature | Ebola disease | Lassa fever | Dengue |
|---|---|---|---|
| Virus family | Filoviridae | Arenaviridae | Flaviviridae |
| Main reservoir or vector | Bats (suspected) | Mastomys rodents | Aedes mosquitoes |
| Human-to-human spread | Body fluids | Body fluids, contaminated surfaces | Not directly |
| Typical setting | Central and East Africa | West Africa | Tropical and subtropical regions worldwide |
| Licensed vaccine | Zaire ebolavirus only | No | Yes, for selected people |
| Specific treatment | Antibodies for Zaire ebolavirus | Ribavirin used in some settings | No |
When Should Someone Seek Medical Care?
Seek urgent medical advice by telephone first if you have:
- Fever, severe weakness, headache, vomiting, diarrhea, or unexplained bleeding, and
- Been in an area with an Ebola outbreak within the past 21 days, or
- Had contact with a person with suspected or confirmed Ebola, or with the body of someone who died from it
Tell the health professional:
- Where you traveled and when
- Whether you had contact with sick people, funerals, health facilities, or wild animals
- The date your symptoms began
- Any underlying medical conditions or pregnancy
Calling ahead allows health workers to arrange isolation and protective measures before you arrive.
Frequently Asked Questions About Ebola
What causes Ebola?
Ebola disease is caused by viruses of the genus Orthoebolavirus, family Filoviridae. Zaire ebolavirus, Sudan virus, Bundibugyo virus, and Taï Forest virus cause disease in people.
Where did the name Ebola come from?
It comes from the Ebola River in northern DRC, near the site of the 1976 outbreak in Yambuku.
When was Ebola discovered?
Ebola was identified in 1976, during simultaneous outbreaks in Yambuku, DRC, and Nzara, South Sudan.
How is Ebola transmitted?
Through direct contact with the blood or body fluids of a person who is sick with or has died from Ebola, through broken skin or mucous membranes, or through contaminated objects such as needles.
Is Ebola airborne?
No. It does not spread through the air like measles or COVID-19. Spread requires direct contact with infected body fluids.
Can you get Ebola from someone who has no symptoms?
No. People with Ebola are not contagious until they develop symptoms.
Can Ebola spread through mosquitoes?
No. Ebola is not spread by mosquitoes or other insects.
Can you get Ebola from food?
Infection can occur through handling or eating meat from infected wild animals, known as bushmeat. Ebola is not known to spread through ordinary cooked food or water.
Can Ebola spread through touching someone?
Casual touching of intact skin on a healthy person is not a risk. Touching the blood or body fluids of a sick person, or the body of someone who has died from Ebola, can transmit the virus.
How long is the incubation period?
Usually 8 to 10 days, with a range of 2 to 21 days.
What are the first symptoms of Ebola?
Fever, extreme tiredness, muscle pain, headache, and sore throat.
Do all Ebola patients bleed?
No. Many patients never have visible bleeding. Bleeding is more common in later, severe stages.
How deadly is Ebola?
The average fatality rate is about 50%, ranging from about 25% to 90% depending on the species, the outbreak, and the quality of care. The 2026 Bundibugyo outbreak has had a crude fatality rate of around 48% among confirmed cases.
Who is most at risk of dying?
Young children, older adults, pregnant women, and people who receive care late are at highest risk.
Can you survive Ebola?
Yes. Many people recover, especially with early supportive care. Survivors may have long-term health problems and need follow-up care.
Can you get Ebola twice?
Survivors usually develop immunity that lasts for years, at least against the same species. Reinfection appears to be rare. Some cases of relapse from virus persisting in the body have been reported.
How long are survivors contagious?
Survivors are not contagious through casual contact once they have recovered. Virus can persist in semen for months, so safe sex practices are recommended until testing shows it has cleared.
How is Ebola diagnosed?
By RT-PCR testing of blood in a laboratory. Testing very early in illness may be negative and can need to be repeated. Tests must detect the specific species involved.
Is there a cure for Ebola?
There is no drug that cures Ebola in every patient, but supportive care saves many lives, and antibody drugs are approved for Zaire ebolavirus. No treatment is licensed for Bundibugyo virus.
Do antibiotics treat Ebola?
No. Antibiotics do not treat viral infections, though they may be used for coinfections.
Is there an Ebola vaccine?
Yes, Ervebo, for Zaire ebolavirus only. No vaccine is licensed for Bundibugyo virus.
Will the Ebola vaccine protect against the 2026 outbreak?
It is not known. Ervebo is being tested in a research trial in the DRC to find out whether it gives cross-protection against Bundibugyo virus.
Should travelers get an Ebola vaccine?
Ebola vaccination is not recommended for routine travelers. It is intended for responders and other people at occupational risk of Zaire ebolavirus.
Which vaccines are being developed for Bundibugyo virus?
Candidates from the University of Oxford, Moderna, and IAVI are being fast-tracked, with early-phase trials under way or planned.
What treatments are being tested in 2026?
Remdesivir and the antibody product MBP134 have been enrolling patients in a clinical trial in the DRC, and maftivimab was also recommended for evaluation.
Is the 2026 outbreak a global emergency?
WHO declared the outbreak a public health emergency of international concern on 17 May 2026, and its emergency committee confirmed in August that it remained one. WHO assesses the global risk to most countries as low.
Which countries have been affected?
The DRC is by far the most affected. Uganda reported 20 confirmed cases and later declared its outbreak over. A small number of imported cases were treated in Europe.
Has Ebola reached the United States?
As of 23 September 2026, CDC reported no Ebola cases associated with the 2026 outbreak diagnosed in the United States. Two U.S. citizens infected in the DRC were treated in Germany.
Has Ebola reached Asia?
In the sources reviewed for this article, confirmed cases outside Africa were limited to a few imported cases treated in Europe. Many countries in Asia, including India, issued advisories and strengthened screening of arriving travelers.
Should the general public in low-risk countries be worried?
Health agencies rate the risk to the general public in most countries as low or very low, because Ebola spreads only through direct contact with body fluids of symptomatic people. Staying informed through official sources is more useful than panic.
What should I do if I recently traveled to an affected area?
Monitor your health, including your temperature, for 21 days after leaving. If you develop fever or other symptoms, call your local health authority or doctor before going to a clinic, and tell them about your travel.
Can Ebola be eradicated?
Because Ebola viruses circulate in animals, eradication is unlikely. The goals are to detect outbreaks early, stop them quickly, and protect people through vaccines and treatments.
Why Ebola Remains an Important Global Health Threat
Ebola has been known to science for fifty years, yet it continues to surprise health systems.
The virus was first recognized in 1976 in two isolated outbreaks in Africa. For decades, it seemed to be a rare, geographically limited disease. Then the West African epidemic of 2014 to 2016 showed how quickly Ebola could spread through cities and across borders when it was not recognized in time, and how devastating it could be for health systems and communities.
That experience transformed the field. Scientists developed a licensed vaccine, and clinical trials showed that antibody treatments could substantially reduce deaths. In the outbreak in the DRC from 2018 to 2020, these tools helped save many lives, even in a conflict-affected region.
The 2026 outbreak is a reminder that those tools were built for one species. Bundibugyo virus is a different Ebola virus, and the vaccine and antibody drugs that work against Zaire ebolavirus cannot be assumed to work against it. The outbreak went undetected for weeks, in part because early tests looked for the wrong virus. It has since grown into one of the largest and fastest-moving outbreaks ever recorded, in a region already stretched by violence, displacement, and poverty.
At the same time, the response shows what modern outbreak science can do. Within weeks, WHO and partners organized clinical trials of treatments and vaccines. The first candidate vaccine entered human testing within about ten weeks of the outbreak being declared. Uganda’s success in stopping its outbreak shows that fast detection, isolation, and contact tracing still work.
The enduring lessons of Ebola are the same ones public health has learned again and again:
- Detect cases early and test for the right pathogen
- Isolate patients and trace contacts for 21 days
- Protect health workers with equipment, training, and pay
- Provide safe and dignified burials
- Earn and keep community trust
- Invest in vaccines and treatments for every species, not only the best-known one
- Support survivors long after the outbreak ends
Ebola is a serious disease, but it is not unstoppable. Where health systems, communities, and international partners work together, outbreaks can be brought under control.
Outbreak figures in this article reflect data reported by DRC health authorities, WHO, CDC, and ECDC through 22 September 2026 and change daily. Medical, vaccine, and treatment information is drawn from CDC, WHO, and ECDC guidance available as of 25 September 2026.
Official Sources
- CDC: Ebola Outbreak Current Situation
- CDC: About Ebola
- CDC: Signs and Symptoms
- CDC: How Ebola Spreads
- CDC: Clinical Guidance
- CDC: ERVEBO Vaccine Information
- FDA: ERVEBO Prescribing Information
- WHO: Ebola Disease Fact Sheet
- WHO: 2026 DRC Ebola Outbreak
- WHO and Africa CDC: ERVEBO Allocation for DRC
- ECDC: 2026 DRC Ebola Outbreak Updates