Ebola is a deadly disease caused by the orthoebolavirus group of viruses. It is infamous for being extremely deadly, with a mortality rate as high as 80-90%. Luckily, it only spreads by direct contact with body fluid, not through the air. However, it is mainly a problem in sub-Saharan Africa where the lack of infrastructure and some cultural practices can cause it to spread fast. The virus lives in non-human hosts (so it cannot be eradicated), and occasionally spills over, mostly into rural villages in Africa.
Prior to the 2014-16 outbreak, Ebola outbreaks were measured in the hundreds and mostly were confined to small villages. The largest such outbreak was in 1976, which killed 280 people. Then in 2014 an Ebola outbreak spread to a larger town, resulting in the largest outbreak to date, with over 28,000 cases and over 11,000 deaths. Then in the 2018-2020 outbreak there were 3,481 cases (3,323 confirmed and 158 probable) and 2,299 deaths.
We are now in the middle of the 2026 outbreak, in the Democratic Republic of Congo (DRC), which has already caused 9,066 cases and 4,381 deaths. This is therefore the new second largest outbreak in history. However, you may have noticed that prior outbreaks spanned three years, and we are just in the first year of this outbreak. Further, this one is spreading much faster than previous outbreaks, passing 1,000 cases in 40 days, compared to 235 days for the 2018 outbreak.
Why have the last three Ebola outbreaks been 1-2 orders of magnitude larger than all previous outbreaks? It’s not due to the virus evolving or becoming more virulent. The current variant is Bundibugyo, which is not as deadly as other variants. Although – it is a variant for which we do not have a vaccine. We do have a vaccine for the Zaire variant – and there was a 2025 outbreak of this variant with only 64 cases and 45 deaths as a result.
The reasons Ebola outbreaks are generally much larger now is due to human factors. Populations density in vulnerable areas has increased, as has travel among towns and villages. Further, outbreaks often occur in active combat zones which causes displaced populations to move around and spread the disease.
Our ability to respond to large Ebola outbreaks has also eroded. Medical infrastructure is weakened in vulnerable areas due largely to political instability. This has also eroded trust in healthcare systems by the populace, which therefore do not follow best practices to limit spread.
After the 2014-16 outbreak, which shocked the medical world due to its unprecedented scale, there was lots of talk about building up our response infrastructure so that the world could collectively respond quickly and decisively to stop other outbreaks before they have a chance to spread widely. It was recognized that every Ebola outbreak is a roll of the dice – if the virus gets into a more populated area or a travel hub, the outbreak can increase by orders of magnitude. The great worry is that one of these outbreaks would become a regional epidemic, and might even become a pandemic. So it is in everyone’s best interest to rapidly stop these small outbreaks, while we also develop vaccines.
We have developed a vaccine for the Zaire variant, and work is in progress on others. But most variants, like the current outbreak, do not have vaccines, and so all we have are traditional containment methods to limit spread.
If someone told me in 2016 that in 2026 we would be less prepared for a massive Ebola outbreak, I would have found that hard to believe. Hadn’t we learned our lesson? Could it be simple stupidity, or had some calamity befallen human civilization limiting our ability to respond to such an outbreak? Further – between these two times, we suffered an actual pandemic, which claimed over 7 million lives and disrupted world economies. Where is the WHO and the CDC?
Well, here we are. The Trump administration has pulled out of the WHO and has “fed USAID into a woodchipper”. This has gutted the infrastructure we had in place to respond to outbreaks. This lack of infrastructure and networks makes it harder to detect new cases, which means our response to a new outbreak is delayed. The WHO has lost 20% of its workforce, which it uses to backup the fragile health infrastructure in much of sub-Saharan Africa.
The CDC has perhaps been even more affected, as I recently discussed. In the previous large outbreak the CDC sent 2,000 health workers to help contain the outbreak. This time they sent 100, and their primary goal is to prevent spread to the US, not to contain the outbreak itself.
The US has given over $182 million in assistance. However, you cannot simply throw money at this problem. The money is given to local governments – but the network of experts that we had in place is essentially gone, down the woodchipper with USAID.
The lack of a well-funded and coordinated response, through an established network of experts armed with early detection, is a main reason why this is that fastest spreading Ebola outbreak in history. This is a human and political failure of epic proportions. It will likely be two more years before we know the full extent of this outbreak, which may eventually take the top spot.
Further – many experts are concerned, and are warning, that we are less prepared for another pandemic than we were for COVID 19. The usual criticism of preventive measures is that humans tend to be too reactive and insufficiently proactive. It takes a disaster to wake us up and motivate us to take action. But now – even that is not working. Our society is collectively so dysfunctional that the net response to a pandemic is to trust institutions less and tear down existing infrastucture.
Of course, this is just the net response, not every individual. There seems to be many people who recognize the folly off what is happening. Those people need to get really politically active if we are going to get back to some measure of sanity before something truly disastrous happens.
You cannot appoint a bunch of cranks and pseudoscientists to key health positions, dismantle existing health infrastructure, wage all out war against experts and the very notion of expertise, and avoid serious consequences. Generational damage has already been done. What we need is some enlightened outrage and focused efforts to reverse these trends. Otherwise, the fastest growing Ebola outbreak in history may be the least of our worries.
Keep An Eye On This Ebola Outbreak