In its latest update, published Thursday, WHO said hidden chains of transmission are being fuelled by patients who reach advanced stages of the disease without ever receiving care. 

Deaths are still occurring outside health facilities and known transmission chains, while several treatment centres are now overwhelmed.

“Transmission is occurring faster than case detection and isolation, while contact tracing capacities are increasingly strained,” WHO said.

Spilling outward

The outbreak remains heavily concentrated in Ituri province, which accounts for roughly 90 per cent of cases and 80 per cent of deaths. The Bunia–Rwampara–Mongbwalu–Nizi corridor remains the main axis of spread, but transmission is also continuing in neighbouring North Kivu, and cases are rising in Haut-Uélé. 

In all, 53 of 140 health zones across five affected provinces have now reported cases.

Congolese authorities reported 4,449 confirmed cases and 2,061 deaths as of Tuesday – a fatality rate of 46 per cent. 

Only 886 patients have recovered. Those numbers put the outbreak on track to potentially become the deadliest Ebola epidemic ever recorded, surpassing the 2014 to 2016 West Africa outbreak, which killed more than 11,000 people among over 28,000 cases.

Contact tracing up, but patchy

One indicator is improving: the contact-tracing rate has passed 85 per cent nationally for the first time. 

But the average masks sharp regional gaps – in Haut-Uélé, the rate is only around 58 per cent, which WHO attributed partly to incomplete reporting.

Gaps also persist in alert reporting and in following up confirmed cases, meaning patients can slip through surveillance and sustain chains of transmission that authorities never detect. 

Insecurity and community mistrust are compounding the problem, with some incidents delaying safe burial teams.

WHO said community trust is now central to the response, and urged greater reliance on local leaders and trusted community networks to find cases and contacts, encourage early care-seeking, and ensure safe burials.

Overwhelmed, under strain

Even when patients are found, capacity to treat them is running short. Several treatment and transit centres in Ituri are now “saturated”, WHO said. North Kivu lacks sufficient options to refer patients to specialized facilities, and none of the six affected health zones in Haut-Uélé yet has a treatment centre meeting required standards.

Response teams themselves are under pressure. WHO said delays in paying some response personnel had been reported in several affected zones, warning this “could affect staff motivation and the continuity of response activities, including community engagement and operations at entry and checkpoints.”

The challenge is now twofold: finding the transmission chains still evading surveillance, while urgently expanding capacity to treat those who are found. Until case detection and isolation outpace transmission, better tracing alone will not be enough to turn the epidemic around.

“The poor infection control practices at Dr Tam’s practice means all former patients may be at low risk of a blood borne virus infection, which can have serious and long-lasting health impacts,” Dr Leena Gupta, the public health clinical director of the Sydney Local Health District, said in the ministry statement.

Available for over a year

Most of us have Epstein-Barr Virus (EBV) hiding in our bodies.

You may know it as the cause of glandular fever or “kissing disease”.

But more research is suggesting that it can turn our immune systems against us to cause autoimmune disease, such as multiple sclerosis or lupus.

So, what is the virus doing in our bodies – and can we do anything about it?

James is joined by Dr Claire Shannon-Lowe, a virologist at the University of Birmingham, and Dr Patrick Kearns from the University of Edinburgh, a neurologist and epidemiologist.

And we delve into the world of echolocation.

Bats hunt at night by making pulses of sounds and listening to the echoes so they can build a picture of the world around them in total darkness – and it’s a technique some people with visual impairment use to explore the world.

A team at the University of East Anglia has been testing how well humans can pick up these skills, so James pays a visit to have a go…

Presenter: James Gallagher
Producers: Gerry Holt, Tom Bonnett & Thomas Hunt
Production coordinator: Stuart Laws
Content editor: Ilan Goodman

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So far, eight possible cases have been reported in the South Ethiopia Region and laboratory testing is ongoing to determine the exact cause.

Health workers are among those who have been infected, WHO Director-General Tedros Adhanom Ghebreyesus said in a tweet.

What is viral haemorrhagic fever?

Viral haemorrhagic fevers are a group of epidemic-prone diseases that are caused by several distinct families of viruses and include Marburg and Ebola virus diseases, Crimean Congo haemorrhagic fever and Lassa fever.

They can be relatively mild to severely life-threatening and are characterized by sudden onset of muscle and joint pain, fever, bleeding and shock from loss of blood. 

Bleeding, or haemorrhaging, from orifices and internal organs is a prominent symptom in severe cases. 

Transmission can occur in several ways, depending on the disease, including through contact with symptomatic patients, slaughtering practices and direct contact with rodents or their droppings in the case of Lassa fever.

Medical professionals, supplies and funds

“WHO has deployed experts to the affected towns, along with medicines and other materials to support care for people in need, and personal protective equipment for health workers,” Tedros said.

The 11 technical officers will assist in several areas including disease surveillance, investigation and testing, as well as infection prevention and control.

The agency is providing other essential supplies, including a rapidly deployable isolation tent to boost clinical care and management capacity.

Tedros also released $300,000 from the WHO Contingency Fund for Emergencies to provide immediate support to the national authorities.    

“WHO’s offices in Ethiopia and South Sudan are collaborating closely to prevent potential cross-border transmission,” he said, and the agency “is ready to scale up support, as and when needed.” 

There has been a significant increase in the number of UK cases of a mosquito-borne virus that can cause sudden fever and joint pain and is normally only found in Africa and southern Asia.

The UK Health Security Agency (UKHSA) says more than 70 cases of the chikungunya virus were reported in the first six months of this year, more than double than in the same period last year – all of them linked to travel.

Chikungunya, while rarely fatal, can leave people experiencing joint pain for years.

The UKHSA is warning travellers to take precautions against mosquito bites.

In most cases, people recover fully within a couple of weeks, but for some, pain can persist for months or even years.

In very rare cases it can be fatal.

While the 73 infections seen in the UK in the first six months of this year is not a huge number, it is more than double the 27 cases over the same period last year.

An outbreak of the virus is under way in the Indian Ocean region, and almost all of the infections were linked to travel in India, Sri Lanka and Mauritius.

Chikungunya is spread by two types of mosquito, neither of which are present in the UK, so there is no risk on onward infection.

But Dr Philip Veal, Consultant in Public Health at UKHSA, says it is a warning to travellers to make sure they take precautions against mosquito bites.

“Chikungunya can be a nasty disease and we’re seeing a worrying increase in cases among travellers returning to the UK.

“It is essential to take precautions against mosquito bites when travelling.

“Simple steps, such as using insect repellent, covering up your skin and sleeping under insecticide-treated bed nets can greatly reduce the risk.

“Before you travel, check the Travel Health Pro Website for the latest advice on your destination.

“A chikungunya vaccine may also be considered for those travelling to higher-risk regions.”

The same report also says the first ever UK cases of Oropouche virus, normally only found in Central and South America and the Caribbean, have also been detected in travellers returning from Brazil.

This virus is predominantly spread by midge bites rather than mosquitos, with the main type of midge involved in transmission not found in Europe or the UK.

Symptoms include high fever, chills, headache, joint pain and muscle aches.

The UKHSA warns of a rise in Oropouche virus infections globally since 2024, and says pregnant travellers should take particular care following some concerns about the impact the virus can cause during pregnancy.

University Hospital Southampton

What are the symptoms of RSV?

West Nile virus has been detected in UK mosquitoes for the first time, UK health officials say.

The risk to the general public is “very low” and although the virus can make people seriously ill in rare cases, there is no evidence the virus is spreading in mosquitoes in the UK, the UK Health Security Agency (UKHSA) added.

The virus, spread via bird-biting mosquitoes, is found in many parts of the world, including mainland Europe.

Climate change and other factors have been pushing mosquitoes – and the diseases they carry – further north in recent years.

To date, there have been no human cases of West Nile virus acquired in the UK – although there have been seven cases of the disease linked to travel to other countries since 2000.

West Nile virus is endemic in several regions across the world, including parts of Africa, Asia, South America and Europe, and has expanded in recent years.

A research programme by the UKHSA and the Animal and Plant Health Agency (APHA) found fragments of the virus in mosquitoes collected at ponds near Retford, Nottinghamshire in 2023.

“While this is the first detection of West Nile Virus in mosquitoes in the UK so far, it is not unexpected as the virus is already widespread in Europe,” said Dr Meera Chand, a deputy director for travel health and infections at UKHSA.

Dr Arran Folly, the lead of the project which found the virus, said its detection is part of a “wider changing landscape, where, in the wake of climate change mosquito-borne diseases are expanding to new areas.”

While the Aedes vexans mosquito is native to Britain, he added that warming temperatures may bring non-native species to the UK and, with them, the potential of infectious disease.

The mosquito is often found in wet areas. Experts recommend getting rid of standing water sources – where they breed – and taking personal measures such as using mosquito repellent and bed nets.

Last year, protests were held in Seville, Spain, after the death of five people infected with the disease.

West Nile virus causes either very minor symptoms or none at all – but around 20% of cases can experience headaches, high fever and skin issues. In rare cases, it can kill.

Paediatrician Yasmin Baki, who works at UCLH in London, said they see 500 patients each winter with RSV.

“It’s potentially life-threatening, particularly for very young, vulnerable babies who may have other conditions, like cardiac conditions, or may be premature. Those babies tend to get very sick.”

She urged pregnant women to get vaccinated and said the vaccine could be a game-changer this winter.

“It could change what we see at the front door of A&E here, in terms of vulnerable young babies.”

NHS England says research from the thousands of pregnant women worldwide who have been vaccinated against RSV shows that the jab reduces the risk of severe lung infection by about 70% for their babies in the first six months of life.

A recent study in the Lancet suggested the vaccination programme could prevent 5,000 hospitalisations and 15,000 A&E attendances for infants, and 2,500 hospital admissions for older people this winter, which NHS England said could also reduce pressures for front-line staff.

The vaccine is called abrysvo and is made by Pfizer.