Is history repeating itself — just four years after the COVID-19 pandemic — with the United States demanding an Ebola quarantine camp for Americans in Kenya? In May, the Kenya High Court ordered the US centre to temporarily close down , warning it will expose the public — in a country without a single confirmed Ebola case from the current outbreak — to unacceptable risks .
- Is history repeating itself — just four years after the COVID-19 pandemic — with the United States demanding an Ebola quarantine camp for Americans in Kenya?
- Ebola spreads through contact with bodily fluids . An outbreak first reported in the Democratic Republic of the Congo on 15 May, driven by a rare Ebola virus called Bundibugyo.
- In May, the Kenya High Court ordered the US centre to temporarily close down , warning it will expose the public — in a country without a single confirmed Ebola case from the current outbreak — to unacceptable risks .
- The US says the facility would allow Americans working in or travelling through outbreak areas in the DRC and Uganda to be moved quickly to a controlled setting, avoiding evacuation flights to America.
- To Tian Johnson, a Johannesburg-based activist and founder of the African Alliance , the deal is “bigger than quarantine itself”. “It is about why the same urgency is not directed towards strengthening African laboratories, surveillance systems, and the healthcare workforce,” he told Bhekisisa .
Is history repeating itself — just four years after the COVID-19 pandemic — with the United States (US) demanding an Ebola quarantine camp for Americans in Kenya, and Western countries, once again, rolling out travel bans for African countries?
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Ebola, while lethal, is not an immediate risk to South Africans, although there are nearly daily flights between the Democratic Republic of the Congo (DRC), the centre of the outbreak, and Johannesburg. Unlike COVID, it spreads only through contact with bodily fluids , not through the air.
In May, the Kenya High Court ordered the centre at Laikipia Air Base near the town of Nanyuki, about 190km north of Nairobi, to temporarily close down , warning it will expose the public — in a country without a single confirmed Ebola case from the current outbreak in the DRC — to unacceptable risks .
Caused by a rare Ebola virus strain called Bundibugyo, the DRC’s rise in cases started on 15 May , with 617 confirmed cases and 117 deaths by 9 June . There’s no vaccine for this type of Ebola and also no reliable treatments .
The outbreak has already crossed into Uganda, and experts now fear it could eclipse the deadliest Ebola outbreak on record , which killed more than 11 000 people across West Africa between 2014 and 2016.
The US says the facility would allow Americans working in or travelling through outbreak areas in the DRC and Uganda to be moved quickly to a controlled setting, avoiding evacuation flights to America.
Kenyan President William Ruto said last week that refusing the US “would look very unhuman”, given its long-time support of Kenyan healthcare.
To Tian Johnson, a Johannesburg-based health justice activist and founder of the African Alliance , the deal exposes something uglier than a simple quid pro quo.
“The issue is bigger than quarantine itself,” he told Bhekisisa . “It is about why the same urgency is not directed towards strengthening African laboratories, surveillance systems, and the healthcare workforce.
Johnson, and many others, say COVID mistakes are being repeated in the raging Ebola outbreak.
An open letter , calling for “an end to the cycle of panic and neglect” was released this week. It was signed by world health leaders, including South African scientists such as Helen Rees from Wits RHI and Shabir Madhi, the dean of the faculty of health sciences at Wits.
“At a time when humanity can sequence pathogens in hours, develop vaccines in months, and deploy artificial intelligence across entire economies, the world already has many of the tools it needs,” the letter reads.
“The question is whether leaders will choose to invest in and use them. We can no longer accept this cycle of panic and neglect.”
Countries, including the US and Canada, have banned travel from the affected region, despite the World Health Organisation warning it is hindering the response .
Here is what we know about Bundibugyo, why it caught the world off guard, and what South Africans need to understand to stay safe.
What is Bundibugyo Ebola?
Ebola is not a single virus but a group of related viruses known as ebolaviruses. Three of these — Zaire, Sudan and Bundibugyo ebolaviruses — have caused major outbreaks in humans. Zaire is the best-known type that caused the 2014-2016 epidemic in West Africa. It is lethal, relatively well-studied, and as of 2019 , vaccine-preventable.
Bundibugyo, by contrast, has caused only two known outbreaks: one in Uganda in 2007 with 131 confirmed cases , the other in the DRC in 2012 with 38 known cases . The current outbreak is already bigger, with more than 617 confirmed cases and 117 deaths (by 9 June) . While the fatality rate is lower than Zaire, which can kill close to 90% of those infected without treatment , Bundibugyo still killed up to half of those infected in previous outbreaks.
There is no approved vaccine or specific treatment for Bundibugyo ebolavirus. What patients receive is supportive care: managing fever, maintaining hydration, treating secondary infections, transfusions for severe bleeding when needed .
The main tools for halting the spread are contact tracing and infection control — both tricky in the outbreak zone. Contact tracers must track down everyone who has had close contact with a confirmed case and monitor them for symptoms. Healthcare workers wear protective equipment, such as gowns, masks and gloves, to protect themselves while they care for sick patients, to prevent the virus from spreading.
But both contact tracing and infection control are tricky in the outbreak zone, where there is high community distrust of healthcare workers and where burial practices involve mourners touching the body, greatly increasing the risk of virus spreading. This is because Ebola remains active in bodily fluids, such as blood, vomit and saliva, even after death.
How did this outbreak start?
The first confirmed case was a healthcare worker who fell ill on 25 April and died at a medical centre in Bunia in eastern DRC. But she is not thought to have been the first case. Ebola outbreaks usually start with a virus passing from an animal , such as a bat or a primate, to a human, a so-called spillover event, from a person hunting or eating bushmeat carrying the disease. Once that transmission has happened, the virus then starts transmitting between people.
In this outbreak, pinpointing the origin has been made harder by the fact that the virus spread for weeks, maybe months, before it was discovered. But scientists can learn a lot about how a virus has spread by studying the genetic fingerprint of viruses isolated from sick patients.
Tulio de Oliveira, director of the Centre for Epidemic Response and Innovation at Stellenbosch University, says that so far, all the viral samples studied from the current outbreak are nearly identical, and slightly different to earlier Bundibugyo strains, suggesting a single new spillover event (transmission from an animal to a human) caused the outbreak . “It is a new emergence of the virus, most probably in the region where the outbreak started,” he says.
Why wasn’t it caught sooner?
Diagnostic tests used for more common Ebola types do not work well for Bundibugyo , which require specialised laboratory equipment to pinpoint. Cases also flew under the radar because the early symptoms of Ebola mimic other diseases in the region.
“Nobody thought, ‘Oh, this is Ebola,'” Jean Nachega, director of the Biomedical Research Institute at Stellenbosch University and one of the scientists advising the African response to the crisis, told Bhekisisa . “They thought, ‘This is just another malaria,’ or ‘This is just another cholera or typhoid fever,'” he says.
Add to this that the outbreak is occurring in an active conflict zone where a lot of people are on the move, and where healthcare facilities and disease surveillance, such as laboratory testing networks and community health worker programmes have been undermined by cuts in global health funding , and you have a recipe for disaster. US funding had previously supported Ebola prevention and detection in the region. When Donald Trump’s administration rolled out aid cuts in early 2025, that safety net was greatly reduced .
What’s the risk to South Africans?
There have been no confirmed cases in South Africa so far, and the risk to the general public is low, says the National Institute for Communicable Diseases (NICD). With Ebola, transmission requires direct contact with the bodily fluids of someone who is visibly, severely ill — for instance, someone who is vomiting or has diarrhoea.
“This is not COVID-19,” Nachega explains. “If you’re not a healthcare worker, you did not travel to the epicentre, and you are here in South Africa, the risk is very, very low. “
That said, it’s possible that a traveller returning from the outbreak region could develop Ebola symptoms in South Africa. If that happens, there are guidelines designed to limit the spread and protect the public . Doctors will first rule out other causes, with malaria the most common culprit, Jantjie Taljaard, an infectious disease specialist at Tygerberg Hospital in Cape Town, told Bhekisisa . Clinics and hospitals should ideally keep these patients separate from others. For patients worried that they may have Ebola, Taljaard says Tygerberg uses a separate entrance and rooms that were used to isolate patients during the COVID-19 pandemic.
If Ebola is suspected, samples are sent to the NICD in Johannesburg for testing while the patient is isolated, either at home if possible or in a healthcare clinic. A confirmed Ebola case would then kick infection control protocols into action, and close contacts would be traced and asked to isolate for 21 days.
The NICD confirmed there were no suspected Ebola cases in the country as of 8 May. The Institute did test one case — though it barely met the case definition — which Jacqueline Weyer, head of its Centre for Emerging Zoonotic and Parasitic Diseases, said had an upside: “This case actually allowed us to test out our systems in real time, so was beneficial from that point of view.”
Why hasn’t South Africa banned flights from the region?
Some countries, including the United States and Canada , have restricted travellers from affected areas. Although there are near-daily flights between Kinshasa, the capital of the DRC, to Johannesburg, South Africa has not implemented travel restrictions, and the WHO isn’t recommending it.
Scientists who studied travel bans introduced during the COVID-19 pandemic have found that while they in some cases delayed the spread somewhat, they did not stop it . Moreover, such bans have severe economic effects and often unfairly target developing countries .
“Travel bans are generally not recommended because they disrupt the economy, but they also disrupt response efforts and encourage informal or illegal travel routes, which may be even more concerning,” says Nachega.
What works instead, is exit screening at airports and borders, checking travellers who arrive in a country for signs of illness, immediate isolation, and thorough contact tracing. “Those are really, really effective ways to stop Ebola,” says Nachega.
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Why is there no vaccine?
Almost all Ebola research has focused on the Zaire strain. This is because it has caused the most outbreaks, had the highest death toll, and the 2014-2016 epidemic finally generated the political and financial will to develop a vaccine. There were discussions about developing vaccine candidates for all known ebolaviruses — advancing them through early clinical trials, building stockpiles so any outbreak could be met with a fast response. But it did not happen, and now scientists are playing catch-up.
Last week, the Coalition for Epidemic Preparedness Innovations announced it was fast-tracking three vaccine candidates that it hopes to test in the current outbreak. Scientists are also drawing up plans to test treatments for Bundibugyo , including remdesivir that was widely used to treat COVID-19, and obeldesivir , an antiviral that scientists hope can prevent those exposed to Ebola from developing the disease.
The vaccine candidates could be ready for testing within a few months to a year. “We’re moving as quickly as possible, but this really highlights the importance of proactive outbreak preparedness and prioritised investment in vaccines and therapeutics for serious emerging threats before they strike again,” says Samantha Bowen, director of portfolio management for emerging infectious disease at IAVI, a global alliance that developed one of the vaccines being fast-tracked.
How long will the outbreak last?
The African Centres for Disease Control and Prevention (Africa CDC) launched a six-month response plan on 5 June with the World Health Organisation. The plan, which takes us to November, aims to coordinate actions between governments, partners and communities. “The only way to beat this outbreak is through close partnership,” WHO director general Tedros Adhanom Ghebreyesus told the launch. The plan will cost more than $500-million (about R8.3-billion) to operationalise — much of which has yet to be secured.
One big challenge is to improve contact-tracing in the areas where Ebola cases have been reported. Last week, Ghebreyesus said only 45% of contacts had been traced . To get ahead of the virus, that rate needed to rise above 90%, he said. There’s also a shortage of protective equipment such as goggles, masks, overalls, face shields and the like needed to protect healthcare workers in the DRC, Africa CDC said .
Formally, the outbreak will be over after 42 consecutive days with no confirmed or probable cases. Nobody knows how long this will take. At the launch of the response plan, one Africa CDC official described it as “a marathon, not a sprint”. But the body’s director Jean Kaseya said that the outbreak can be contained “very quickly” with the right support and actions. ” This outbreak is serious,” he said. But it’s not hopeless if we act.”
This story was produced by the Bhekisisa Centre for Health Journalism . Sign up for the newsletter .
