Ebola Virus Disease (EVD) is a rare but severe and often fatal illness caused by infection with an ebolavirus. This viral hemorrhagic fever causes unpredictable outbreaks in parts of Africa, representing a persistent public health challenge. The current global situation reflects heightened vigilance following the recent conclusion of a significant outbreak. This analysis provides an overview of the disease, the immediate post-outbreak status, and the measures employed to manage and prevent future occurrences.
Understanding Ebola Virus Disease (EVD)
EVD is caused by viruses belonging to the Ebolavirus genus, specifically within the Filoviridae family. The Zaire ebolavirus is responsible for the majority of human outbreaks. The virus is initially transmitted to people from wild animals, such as fruit bats or nonhuman primates, through contact with their blood, secretions, organs, or other bodily fluids. Human-to-human transmission then occurs through direct contact with the bodily fluids of a person who is sick with or has died from EVD.
The incubation period, from infection to the appearance of symptoms, ranges from 2 to 21 days, commonly starting around 8 to 10 days after exposure. Initial symptoms often resemble the flu, including sudden onset of fever, fatigue, muscle pain, and severe headaches. As the disease progresses, patients typically develop vomiting, diarrhea, a rash, and impaired kidney and liver function. This progression can involve internal and external bleeding, contributing to a high case fatality rate, which ranges from 50% to over 90% depending on the outbreak and access to care.
Global Status of Active Outbreaks
The global status of Ebola Virus Disease is characterized by the end of the most recent outbreak in the Democratic Republic of the Congo (DRC), followed by a mandatory surveillance phase. The outbreak in Kasai Province, DRC, caused by the Zaire ebolavirus strain, was officially declared over on December 1, 2025, by the Ministry of Health. This declaration occurred after a 42-day period—twice the maximum incubation time—passed without any new confirmed cases.
This particular outbreak began on September 4, 2025, and resulted in a total of 64 cases, comprising 53 confirmed and 11 probable cases, with 45 fatalities. The case fatality ratio was calculated at approximately 70.3%, highlighting the severe nature of the infection in this region. The primary epicenter of the outbreak was the Bulape Health Zone, which, along with Dikolo, accounted for the vast majority of cases and deaths.
Genomic sequencing indicated the virus responsible for the Kasai event was likely the result of a new spillover from an animal reservoir, rather than a recurrence linked to a previous outbreak survivor. Following the official end, the DRC transitioned into a 90-day phase of enhanced surveillance. This period involves intensive monitoring and a survivor care program to provide post-recovery support to those who overcame the illness.
Another recent event was the outbreak of Sudan ebolavirus disease (SVD) in Uganda, declared over in April 2025. SVD is a separate ebolavirus species for which there is currently no approved vaccine. That outbreak involved 14 cases and four deaths, demonstrating that other ebolaviruses continue to pose a threat, even though the Zaire strain causes the most frequent outbreaks. The successful containment of both the DRC and Uganda events reflects improved response capabilities.
Current Tools for Response and Treatment
The modern response to EVD is different from past outbreaks due to the availability of preventative and therapeutic medical tools. The primary preventative measure is the recombinant vesicular stomatitis virus-Zaire ebolavirus vaccine, known as rVSV-ZEBOV, which has received regulatory approval. This vaccine targets the Zaire ebolavirus glycoprotein, prompting an immune response in the recipient.
During an outbreak, the vaccine is deployed using a “ring vaccination” strategy. Contacts of confirmed cases and their contacts, as well as frontline workers, are prioritized for inoculation. This approach creates a protective ring around the infected individual, effectively limiting the spread of the virus. For those who do become infected, two highly effective monoclonal antibody treatments are now available.
These treatments, including the single monoclonal antibody ansuvimab and the combination product atoltivimab/maftivimab/odesivimab, work by binding to the Zaire ebolavirus glycoprotein. This action neutralizes the virus and prevents it from entering host cells. The use of these targeted therapies has significantly reduced the death rate for the Zaire strain when administered early. Supportive care remains fundamental, focusing on managing symptoms and maintaining fluid and electrolyte balance to counteract the severe effects of vomiting and diarrhea.
Surveillance and Prevention Efforts
Sustained public health infrastructure is necessary to prevent future outbreaks and quickly contain new clusters of infection. A core component is rigorous contact tracing, which involves identifying, listing, and following up with every person who has been in contact with a confirmed EVD patient. Contact tracing helps interrupt the chain of transmission by ensuring exposed individuals are monitored for symptoms during the 21-day maximum incubation period.
Safe and dignified burial (SDB) practices are another cornerstone of prevention, as the bodies of individuals who have died from EVD remain highly infectious. SDB teams ensure that burial rituals are conducted safely, minimizing the risk of exposure while still respecting cultural and religious traditions. This step reduces the potential for transmission during funeral ceremonies, which have historically been a major source of virus spread.
Community engagement and risk communication are equally important, involving local leaders and communities to build trust and acceptance of public health measures. International organizations like the World Health Organization (WHO) support these efforts by providing technical guidance, financial resources, and coordinating the deployment of response teams to high-risk regions. Enhanced screening at borders and checkpoints also serves as a proactive measure to detect and isolate potential cases before the virus spreads geographically.