What we should know about Ebola

In this week’s WhyAfrica health column RES Health shares some important information about Ebola.

An Ebola outbreak (Bundibugyo strain) is currently active in the eastern DRC, centred mostly in the Ituri province (Bunia, Mongbwalu and Rwampara), with cases in North and South Kivu and Uganda. The WHO declared a global health emergency on 17 May 2026. If you are travelling to eastern DRC or northern Uganda, take note of the fictional case below.

A Fever that Looked like Everything Else

A fictional case – a real pattern

A patient presents to a doctor after recently returning from a trip to the Democratic Republic of Congo (DRC). He reports fever, aches and pains and a rash. He also mentions he had a few episodes of diarrhoea. This is malaria right ? Maybe typhoid or dengue? Nothing quite fits. Oh, and then he mentions he attended a funeral of one of the local workers… Everything changed.

Why it hides in plain sight

This scenario is fictional. But it is exactly how Ebola walks in the door and exactly why it gets missed. Early Ebola has no signature of its own. The first few days look like the everyday fevers of African travel: the fever and chills of malaria, the bone-deep ache of dengue, the stomach upset of typhoid or simple food poisoning, the rash of tick-bite fever. No single test clears all of these at the first visit. This is why the detail that matters most is not a symptom at all. It is knowing exactly where you were and what you did.

What Ebola does

Symptoms appear two to 21 days after exposure, usually around day five to nine. It begins as a flu-like illness (fever, headache, muscle pain and deep fatigue). Within days it can turn into heavy vomiting and watery diarrhoea, a rash, and in some cases bruising or bleeding. During past outbreaks about half of those people infected died. However, if it is caught early with fluids and intensive supportive care far more infected people survive. One reassuring fact is that a person is not contagious until symptoms appear, this means a well and healthy traveller is no risk to anyone.

How Ebola spreads

It is not airborne. Ebola passes only through direct contact with infected bodily fluids like blood, vomit, diarrhoea. Outbreaks usually start when someone touches, butchers or eats infected wild animals: fruit bats and primates sold as bushmeat are the natural source. From there it spreads person to person. High risk groups include people who care for sick patients with Ebola and traditional burials that involve touching the body of people who died from Ebola.

What to do

Check the outbreak map on one of the following websites before you travel: nicd.ac.za, cdc.gov and who.int. Watch yourself for 21 days after you return. Any fever in that window needs a same-day assessment. Tell your doctor exactly where you went. That means the province and community, not just the country. Lead with your travel history. Before you describe a single symptom. It is the most important thing you can say.

No vaccine. No specific treatment

The Bundibugyo strain of Ebola has no licensed vaccine and no approved antiviral. The existing Ebola vaccine and drugs were built for a different strain and are not expected to work here. What saves lives is early recognition and rapid transfer to specialist care.

The patient scenario above is entirely fictional, created for educational illustration only. This article is for general information and is not a substitute for medical advice. Any suspected Ebola case requires immediate isolation and notification of public health authorities. NICD 24-hour Bundibugyo/VHF hotline (South Africa): 0800 212 552. RES Healthcare — healthcare@res.co.za

Image: Healthcare workers treating Ebola patients are at high risk of infection. Image credit: RES Healthcare.

What we should know about Ebola