Nurse Killed in Attack on Ebola Responders as Congo's Outbreak Becomes Deadliest in Its History

A nurse was killed and a second health worker was severely injured on Saturday when attackers struck a team responding to an Ebola alert in Bafwasende, a town in the eastern Democratic Republic of Congo's Tshopo province, the World Health Organization said. The assault is the latest in a string of attacks on medical responders that officials say is hampering the fight against the deadliest Ebola outbreak in the country's history.

WHO Director-General Tedros Adhanom Ghebreyesus wrote on social media on Sunday that everyone working to protect communities from the disease must be able to do so "in dignity and safety." WHO's regional director for Africa, Dr. Mohamed Yakub Janabi, said "health is NOT a target" and warned that misinformation and fear must never be allowed to fuel violence against responders. Local authorities in Tshopo had not commented publicly on the attack or named any suspects as of Monday, according to Al Jazeera and an Associated Press dispatch from the region.

An outbreak now the deadliest in Congo's history

The outbreak, caused by the Bundibugyo strain of the Ebola virus, was declared in the Democratic Republic of Congo on 15 May and designated a Public Health Emergency of International Concern two days later. According to WHO's latest Disease Outbreak News bulletin, published 23 October with data current to 20 October, the epidemic has produced 9,704 confirmed cases and 4,687 deaths, a crude case-fatality ratio of 48.3 percent, across 66 health zones in eight provinces. Congo's health ministry has since put the toll at more than 9,800 cases and over 4,700 deaths. Both figures confirm it as the worst Ebola epidemic the country has recorded, surpassing the 2018-2020 eastern Congo outbreak.

Ituri province remains the epicenter, with 7,040 cases and 3,271 deaths. Nord-Kivu follows with 2,146 cases and 1,199 deaths and the highest provincial fatality rate, at 55.9 percent. Haut-Uélé and Tshopo, where Saturday's attack occurred, have recorded 421 and 76 cases respectively. Nord-Ubangi, which borders the Central African Republic, became the eighth affected province this month, an expansion that UN News reported complicates containment because armed violence there has already displaced thousands of people.

Spreading beyond Congo's borders

The virus has now reached five countries. Uganda recorded 20 cases and two deaths before declaring its own outbreak over at the end of August. Kenya has confirmed nine cases and one death; the fatal case was a Kenyan national who had worked in the DRC and returned home via Entebbe. Nigeria reported its first imported case on 20 October, in the capital, Abuja, in a patient who had traveled from Uganda; more than 40 close contacts have been identified there. A case was also recorded earlier in France. WHO's risk assessment rates the threat to the DRC itself as very high, to neighboring countries as high, and to the broader African region and the rest of the world as low, though the agency says that assessment is currently being revised.

Contact tracing, a central tool for containing any Ebola outbreak, is falling short of targets. WHO's bulletin says only 79.7 percent of an identified 30,130 contacts have been traced and monitored, well below the 95 percent threshold the agency considers adequate, with the worst performance in Nord-Kivu province. More than six in ten deaths are occurring in communities rather than in treatment centers, a pattern that signals continuing hidden transmission.

Violence compounding an already difficult response

Saturday's attack fits a pattern that has dogged the response for months. Last month, a Congolese politician was beaten to death in Nord-Kivu after he publicly defended the government's handling of the outbreak, including social-distancing and handwashing measures, on a local radio program. In May, residents set fire to two tents at health centers in separate incidents within a single week, and response teams working in several health zones have reported being held captive or threatened by local communities. WHO has previously said attacks on health workers are hampering what it has called the fastest-spreading Ebola outbreak on record.

Officials and aid workers attribute much of the resistance to deep public distrust of the Congolese government, compounded by chronic corruption and the legacy of earlier, mishandled outbreaks. Some residents dismiss Ebola as a hoax, complicating efforts by health teams to carry out safe burials, contact tracing and community education in remote and insecure areas that already face shortages of medical supplies and trained staff.

In August, a Red Cross convoy was attacked in Ituri province, with two volunteers hurt in a separate incident in Haut-Uélé and three more injured in Beni, in Nord-Kivu, according to Red Cross societies cited at the time. The movement said attacks of this kind were making an already difficult response harder, since burial teams and community mobilizers, not only clinicians, have repeatedly been targeted alongside treatment-center staff.

• 9,704 confirmed Ebola cases and 4,687 deaths in the DRC as of 20 October, per WHO; the Congolese health ministry has since reported over 9,800 cases and 4,700 deaths.
• Five countries have now confirmed cases linked to this outbreak: the DRC, Uganda, Kenya, Nigeria and France.
• Only 79.7 percent of known contacts have been traced, short of the 95 percent target WHO considers necessary to control spread.
• No vaccine or specific treatment is approved for the Bundibugyo strain, though a trial began this week in Bunia.

A health system under strain from two epidemics at once

The violence and the outbreak's scale are unfolding alongside a separate cholera emergency in the same country. A WHO update relayed by UN News this month said more than 125,000 suspected cholera cases and 3,644 suspected deaths have been recorded in the DRC since January 2025, with a renewed spike recorded in late September concentrated in Nord-Kivu, Sud-Kivu and Haut-Katanga provinces — the same insecure eastern region where Ebola has also hit hardest. Health authorities say insecurity linked to armed groups operating in Nord-Kivu and Ituri, including ongoing conflict involving the M23 rebel movement, continues to restrict medical teams' access to some of the worst-affected areas for both diseases.

The burden of both epidemics falls heaviest on rural communities with the least capacity to absorb it: households are losing working-age members to the two diseases at once, while clinics that would ordinarily treat cholera patients are stretched thin by Ebola isolation and treatment protocols. Health workers themselves make up a disproportionate share of the casualties, both from infection and now from violence, a dynamic that aid officials warn could drive further attrition from an already undersized workforce just as case numbers continue to climb in Nord-Kivu and the newly affected Nord-Ubangi province.

"Misinformation and fear must never fuel violence," Dr. Mohamed Yakub Janabi, WHO's regional director for Africa, said in response to the killing of the nurse in Bafwasende.

What happens next

WHO has said it is not recommending any restriction on travel or trade with the DRC or the other affected countries, instead urging states to strengthen cross-border surveillance and point-of-entry screening and to intensify contact tracing in provinces falling short of targets. A Phase 2/3 trial of vaccine candidates, including a study of whether the existing Ervebo vaccine — developed for the related Zaire strain of Ebola — offers any cross-protection against Bundibugyo, began enrolling patients in Bunia on 23 October; researchers say preliminary results are not yet available. No vaccine or specific antiviral treatment is currently approved against the Bundibugyo strain, leaving supportive care as the primary treatment option.

Congolese authorities had not announced any arrests or identified a motive for Saturday's attack as of Monday. WHO said it would continue working with the health ministry and local leaders to try to secure safer access for response teams, while officials in Tshopo province had yet to publicly address the killing.