Ebola: how does it spread and can the outbreak be contained?

Summary

Science Weekly (The Guardian)

Episode Title: Ebola: how does it spread and can the outbreak be contained?
Date: May 18, 2026
Host: Ian Sample
Guest: Dr. Daniela Mano, Clinical Epidemiologist, London School of Hygiene and Tropical Medicine

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Overview

This episode of Science Weekly explores the worrying new Ebola outbreak in the Democratic Republic of Congo (DRC) and Uganda. Host Ian Sample is joined by Dr. Daniela Mano, a clinical epidemiologist who has worked on Ebola vaccine trials, to break down the facts about Ebola’s transmission, why this outbreak is particularly concerning, what is different about the current Bundibugyo strain, and whether existing containment strategies can succeed in halting its spread.

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Key Discussion Points and Insights

1. The Current Outbreak: Scale and Location

• Outbreak Details

  • The outbreak began several weeks ago in the Ituri region, eastern DRC—now spreading into Uganda ([02:13]).
  • So far, around 400 suspected cases and over 100 deaths reported; actual numbers may be higher ([02:13], [03:16]).
  • Recognized as a Public Health Emergency of International Concern by WHO ([02:02]).

• Why the Outbreak Is Worrying

  • The Ebola strain involved, Bundibugyo, is both rare and currently has no available vaccine or established treatments ([02:13], [07:28]).

2. Ebola: The Disease Explained

• Symptoms

  • Begins with fever, tiredness, body ache; can progress to diarrhea, vomiting, bleeding, multi-organ failure, and death ([03:59]).

• Transmission

  • Not airborne (unlike COVID-19)—spreads via direct contact with infected bodily fluids (vomit, diarrhoea, breast milk, tears, contaminated materials), typically via care of sick relatives or during traditional burial rituals that involve contact with the dead ([04:27]).
  • Quote:

    “It doesn't spread through air like COVID-19 so it's less transmissible...transmission can occur when family members look after sick relatives or...burial practices that require touching the dead body.”
    — Dr. Daniela Mano ([04:27])

3. Why Are These Regions Vulnerable?

• Ecological and Social Factors

  • Reservoir believed to be bats, with spillover into humans via hunting, butchering wild animals, and eating bushmeat.
  • Growing human encroachment into wildlife habitats and dense regional populations increase risk ([05:28]).

• Healthcare System Challenges

  • Weaknesses in local health systems allow outbreaks to grow unchecked, particularly if initial cases are missed or misdiagnosed ([06:29]):

    “Sometimes it infects healthcare workers in a setting where infection prevention and controls are not followed properly...where the healthcare system is quite weak.”
    — Dr. Daniela Mano ([06:29])

4. The Bundibugyo Strain: A Rare Threat

• About Bundibugyo

  • Rare Ebola strain; first appearance was in Uganda, 2007.

  • Only two previous outbreaks—has been overlooked in vaccine and drug development ([07:28]).

  • Current stockpiled Ebola vaccines and therapeutics are not effective against this virus ([07:28]):

    “Those vaccines and drugs do not work against Bundibugyo because the virus is different...that’s why we do not have currently a vaccine or drug that can be used during the current outbreak.”
    — Dr. Daniela Mano ([07:28])

5. Patient Care in the Absence of Treatments

• Supportive Care Only

  • Focus on early identification, intensive care (fluids, pain management, managing complications).

  • These interventions can still significantly reduce mortality if cases are caught early ([08:26]).

    “If a case is identified early, it’s much easier to manage… those treatments actually reduce mortality of infected cases substantially.”
    — Dr. Daniela Mano ([08:26])

6. Containment and Response Strategies

• Traditional Public Health Measures

  • Early case identification and isolated treatment; prompt contact tracing; safe burial practices; infection prevention in hospitals; strong community engagement ([09:10]).

    “Contact tracing and isolation, safe burials, infection prevention and control measures in healthcare settings, and also community engagement...they work when applied properly.”
    — Dr. Daniela Mano ([09:10])

7. Coordination, Urgency, and Obstacles

• International and Regional Response

  • Declaring a public health emergency unlocks international funding, technical support, and cross-border coordination ([12:35]).

  • Speed is essential: containment is only possible if implemented rapidly, before true scale is realized ([13:12]):

    “Health workers need to get in early, as early as they can...to get all of this containment procedure in place as soon as they can.”
    — Ian Sample ([13:12])

• Major Challenges

  • Coordinating response across borders (DRC, Uganda, Rwanda) ([13:57]).

  • Outbreak region is mired in insecurity and conflict, making disease control unsafe and difficult ([13:57]).

  • Mistrust of authorities hampers cooperation; community beliefs (attributing disease to black magic, etc.) can impede reporting and contact tracing ([13:57]).

    “Outbreak control teams could have a difficult job… sometimes the reason why the outbreak occur is not attributed to a virus or an infection, but other reasons like black magic...so the communication efforts can tackle the misjudgment.”
    — Dr. Daniela Mano ([13:57])

    “Ebola is a difficult disease to handle because it affects close contacts. It’s difficult for someone to actually report the disease in a family member...they will come and take it away from you. Sometimes people reasonably do not want to do that.”
    — Dr. Daniela Mano ([13:57])

8. Timeline for Containment

• When Will We Know if It's Working?

  • Reliable containment data will take weeks to manifest.

  • Expect an initial rise in cases as the response uncovers the true outbreak's size.

  • Decrease in new cases will signal potential containment ([15:32]):

    “Once we have an idea of the size of this outbreak and numbers starts to slow down and decrease, maybe we will have reached the tip of the outbreak and cases will slowly go down. It’s difficult to say when this is going to happen.”
    — Dr. Daniela Mano ([15:32])

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Notable Quotes

• “This outbreak is worrying because we do not know the exact size of the outbreak at the moment, so it can spread uncontrolled.”
  — Dr. Daniela Mano ([13:32])

• “Communication is done in a sensitive way with the communities that are affected.”
  — Dr. Daniela Mano ([14:59])

• “Let’s hope...we see signs of that [containment] soon.”
  — Ian Sample ([16:05])

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Timestamps of Important Segments

• Outbreak overview & numbers: [02:02]–[03:53]
• What is Ebola and how does it spread? [03:53]–[05:17]
• Why DRC and Uganda are vulnerable: [05:17]–[06:16]
• Bundibugyo strain details: [07:19]–[08:12]
• Patient care without vaccine or specific therapies: [08:12]–[09:03]
• Containment strategies: [09:10]–[09:42], [12:25]–[13:12]
• Challenges & community engagement: [13:50]–[15:22]
• Containment timeline: [15:22]–[16:05]

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Conclusion

This episode delivers a concise, thorough exploration of the complex new Ebola outbreak, underlining the unique dangers posed by the Bundibugyo strain and the crucial importance of classical outbreak control—swift identification, community engagement, and international coordination—in the absence of vaccines or highly effective treatments. Dr. Mano stresses the need for swift, sensitive communications and the unique sociopolitical obstacles facing health workers. While the outlook is uncertain and the next few weeks will be decisive, hope remains that a coordinated public health response can contain the outbreak.

Transcript

[Ian Sample]

This is the Guardian.

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[Ian Sample]

An outbreak of Ebola has emerged in the Democratic Republic of Congo and Uganda.

An outbreak of Ebola in the Democratic Republic of Congo has been declared as a public health emergency of international concern by the World Health Organization.

So far, there have been around 400 suspected cases and more than 100 people. People have died. Ebola is often fatal. It has a death rate of around 50%. And this outbreak has experts particularly worried because the strain involved is rare and there's currently no vaccine for it. So today, what do we know about the Ebola outbreak and can it be contained? I'm the Guardian Science editor, Ian Sample, and this is Science Weekly. Doctor Daniela Mano. You're a clinical epidemiologist at the London School of Hygiene and Tropical Medicine, and you've worked on Ebola vaccine trials. Tell us a bit about what we know so far in terms of when did this outbreak begin, how many people have been affected, and obviously, where is it happening?

This outbreak likely started weeks ago, and the number of suspected cases and deaths are already quite high. But the true size of this outbreak is still not fully known. So this outbreak is in a region of eastern DRC Called Ituri. It's a region that is highly populated and has movement of populations within DRC and also cross borders with Uganda and also neighboring Rwanda is a region where there is insecurity and conflicts. So it's a place where outbreak response can have issues.

And what exactly is Ebola? And you know, if you're infected with the virus, what happens?

Ebola is a severe viral infection that is caused by a group of viruses of the genus Orthoebola virus. And it consists in symptoms such as fever, tiredness, body ache and then can progress into diarrhea vom and severe manifestation like bleeding complications and eventually the case could have multi organ failure and die.

And how does it spread?

Through direct contact with body fluids from an infected or dead person. And these body fluids can be vomit, diarrhea, but also breast milk, tears or contaminated materials. It doesn't spread through air like COVID 19 so it's less transmissible than One of the situation where transmission can occur is when family members look after relative sick relatives or when they engage in traditional burial practices that requires touching the dead body and washing the dead body.

The outbreak we're talking about emerged in DRC and has now spread to Uganda. What are some of the factors that make these countries susceptible to Ebola outbreaks?

Ebola viruses are present in wildlife. The reservoir is considered to be a species of bats. And then occasionally there is a spillover event to humans that can start an outbreak. There are traditional practices that have been considered at risk. So for example, hunting or butchering wild animals or consumption of wild meat. But in general, with landscape changes in those countries and human activities encroaching more and more in wild environments, the contacts between human and animals are increasing. So I would say it's a combination of ecological, environmental and social factors.

And I was going to ask about that, Daniela, actually is why is it that these spillover events can then turn into these much larger outbreaks? I mean, does that say something about the healthcare system, about awareness of these diseases?

So traditionally Ebola outbreaks happened in remote areas and possibly died out without involving a large number of cases. But now the regions that are at risk of Ebola outbreaks are more and more densely populated and are connected. And so a case can easily travel to a major city. One important factor of Ebola outbreaks is also that sometimes it infects healthcare workers in a setting where infection prevention and controls are not followed properly. Maybe because the outbreak happens in an area where the healthcare system is quite weak and there's no suspicion that infection could Be Ebola.

Daniela, it's now been confirmed that the Bundibugio virus is behind this particular outbreak. What do we know about this particular strain?

So Bundibugio is a rare virus. It appeared the first time in Uganda in 2007. It has caused only two previous outbreaks, and so it's not been prioritized for vaccine development and therapeutics. There are other vaccines, especially against Ebola virus disease, formerly known as Zaire Ebola virus. And we have also several therapeutics that can be used against Ebola virus. But those vaccines and drugs do not work against pudimogio because the virus is different. And that's why we do not have currently a vaccine or a drug that can be used during the current outbreak.

I know there are some experimental vaccines for Bundubuggio in development, but as you say, these probably won't be available during this outbreak, nor will any specific treatments. So how are patients cared for?

There are other treatments that can be used and they are extremely beneficial. I think the first important thing is that if a case is identified early, it's much easier to manage. The treatment that can be given are intensive care treatment like fluid resuscitation, pain management, management of complications, and those treatments actually reduce mortality of infected cases substantially.

It sounds like that is largely supporting the patient to basically get through the infection themselves. Is that right?

Yes, it is right.

And what sort of traditional containment measures will the authorities be relying on?

They will rely on early identification of cases and generic treatment and then contact tracing and isolation, safe burials, infection prevention and control measures in healthcare settings, and also community engagement. These more traditional outbreak response methods have been extremely important in the response to previous outbreaks, and they work when applied properly,

Coming up with no treatment or vaccine, how will authorities try and get this outbreak under control?

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[Ian Sample]

So look, what will the response to the outbreak look like now? I mean, what will the health authorities from drc, from Uganda and internationally, what will they be doing now?

The fact that the WHO has now declared a public health emergency of international concern is extremely important. This is recognizing that the outbreak has the potential to spread regionally. And so it's extremely important that there is a coordinated response effort across different countries including drc, Uganda, Rwanda. And this will allow to mobilise international coordination, release of funding and also technical support and cross border preparedness to avoid further spread.

And presumably it is one of those situations where time is of the essence, that these health workers need to get in early, as early as they can to start doing that case isolation, identification, the contact tracing and getting all of this containment procedure in place as soon as they can.

Yes, absolutely. This outbreak is worrying because we do not know the exact size of the outbreak at the moment so it can spread uncontrolled. So it's extremely important that control measures are applied rapidly.

As this emergency response kicks in, then what are going to be the challenges you think that will lie ahead for containing this?

Challenges would be coordination within the country and also among neighbouring countries. But also the area where the outbreak is happening is a difficult area where there is insecurity, conflict, and so outbreak control teams could have a difficult job. And the population sometimes do not have a huge trust in the authorities. And also maybe Ebola is not fully understood. And sometimes the reason why the outbreak occur is not attributed to a virus or an infection, but other reasons like black magic or, you know, beliefs in the. In the community, that needs to be understood so the communication efforts can tackle the misjudgment. And Ebola is a difficult disease to handle because it affects close contacts. And I think in general, it's difficult for someone to actually report the disease in a family member. Like, it can be your son, it can be your husband, it can be parents. And you need to report that case to the authorities and they will come and take it away from you. And sometimes people reasonably do not want to do that. So it's important that communication is done in a sensitive way with the communities that are affected.

Just finally, Daniela, how long do you think it will be before we can have a sense of whether this is being contained, whether these measures are working?

Yes, I think it would be important to have an accurate number of cases recorded. And I think in the next weeks, probably we will have an increase of these numbers because the transmission has been going on for some weeks already. But once we have an idea of the size of this outbreak and numbers starts to slow down and decrease, maybe we will have reached the tip of the outbreak and cases will slowly go down. It's difficult to say when this is going to happen.

Well, let's hope that all does happen soon and we see signs of that. Daniela, thank you very much.

Thank you.

Thanks again to Dr. Daniela Mano. You can follow our coverage of the ebola [e-mail] this episode was produced by Madeline Finley. The sound design was by Joel Cox and executive producer was Ellie Burey. We'll be back on Thursday. See you then.

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