Ebola Bundibugyo Virus Outbreak in the DRC and Uganda: What Pharmacists Need to Know

A rapidly evolving outbreak of Ebola disease caused by the Bundibugyo virus (BDBV) has prompted international alarm. On May 15, 2026, the Ministry of Health of the Democratic Republic of the Congo (DRC) officially confirmed the nation's seventeenth recorded Ebola outbreak, originating in Ituri Province in northeastern DRC. The outbreak was first flagged in early May when a hospital in the Bunia Health Zone identified a cluster of severe illnesses—including deaths—among health care workers. Initial laboratory samples tested negative for the more familiar Zaire Ebola strain, delaying confirmation until the Institut National de Recherche Biomedicale identified Bundibugyo virus in 8 of 13 blood samples on May 15.^1-3

Scale and Spread

As of May 24, 2026, there are over 904 suspected cases and 101 confirmed cases in DRC, with 119 suspected deaths and 10 confirmed deaths. Cases have now been confirmed across multiple provinces—initially in Ituri, then spreading to Nord-Kivu and Sud-Kivu. The outbreak has also crossed borders, with 5 cases linked to the DRC outbreak having been confirmed in Uganda's capital of Kampala. In prior Bundibugyo outbreaks, case fatality rates have ranged from 30% to 50%.^1,2

Global Health Emergency Declaration

On May 17, 2026, the WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC)—the most serious designation the WHO can issue short of a pandemic emergency. The declaration cited the operational complexity of the outbreak, conflict-affected geography, population displacement, and significant uncertainty in epidemiological data. Africa CDC followed with a Public Health Emergency of Continental Security declaration on May 18, 2026.²

A Critical Therapeutic Gap

Of particular relevance to pharmacists, there is currently no FDA-approved vaccine or licensed therapeutic for Bundibugyo virus disease. The FDA-approved Ebola vaccine (rVSV-ZEBOV/Ervebo) targets the Zaire strain and is not considered effective against BDBV. Response efforts currently rely entirely on supportive clinical care, isolation, and contact tracing.^1,3

US Response and Risk to Americans

The CDC issued a Level 3 Travel Health Notice for DRC and a Level 1 Notice for Uganda on May 15, 2026. On May 18, the CDC and Department of Homeland Security implemented enhanced travel screening; 21-day entry restrictions on non-United States citizens traveling from DRC, Uganda, and South Sudan; and activated the CDC Emergency Operations Center. As of the latest update, no cases have been confirmed in the US, and the overall risk to the American public remains low.^1,3

Pharmacist Perspective and Insights

Pharmacy Times spoke with Kelly T. McKee, Jr, MD, MPH, chief medical officer of GeoVax; and Spencer Durham, PharmD, FCCP, BCPS, BCIDP, associate clinical professor of pharmacy practice and director of professional affairs at Auburn University Harrison College of Pharmacy, on the pharmacist’s role in Ebola preparedness.

Expert: Kelly T. McKee, Jr, MD, MPH

Pharmacy Times: How should pharmacists and health systems in nonendemic regions evaluate their readiness to manage a potential imported Ebola case?

Kelly T. McKee, Jr, MD, MPH: Health systems should evaluate readiness around core principles: identify, isolate, and inform. Ebola preparedness is not only an emergency-department issue; it requires coordination across pharmacy, infection prevention, laboratory, occupational health, emergency management, and public health reporting channels. CDC and health care readiness guidance emphasize awareness, early recognition through screening and testing for Ebola and other potential causes of illness, immediate isolation, personal protective equipment (PPE) readiness, and rapid notification of public health authorities.

For pharmacists, readiness includes confirming protocols for investigational or available medical countermeasures, understanding vaccine and therapeutic access pathways, supporting PPE and disinfectant supply chains, and ensuring staff know how to handle medication delivery, waste, and exposure-risk workflows without unnecessary direct contact.

Pharmacy Times: What are the primary logistical barriers to rapid, equitable vaccine deployment that the pharmacy community should prioritize?

McKee: The first barrier is strain specificity. Today, the only FDA-approved Ebola vaccine is for Zaire ebolavirus, while the current WHO-declared PHEIC involves Bundibugyo virus, for which no widely approved vaccine exists.

Second, vaccine deployment depends on stockpile access, cold-chain logistics, trained vaccinators, regulatory permissions, and clear prioritization of frontline health workers, contacts, and at-risk communities. WHO notes that the global Ebola vaccine stockpile was established for outbreak response, but availability, matching strain coverage, and deployment speed remain critical constraints.

The pharmacy community can help by preparing vaccine-handling infrastructure supporting cold-chain integrity, educating staff on eligibility and risk prioritization, and ensuring equitable access plans do not wait until cases appear locally.

Pharmacy Times: Despite post-COVID planning, what remains the biggest gap preventing us from shifting to a proactive, rather than reactive, containment model?

Mckee: The biggest gap is that preparedness remains too pathogen-specific and too episodic. COVID improved awareness, but it did not fully solve the need for flexible vaccine platforms, rapid diagnostics, standing manufacturing capacity, pre-positioned countermeasure stockpiles, and response protocols for less common but high-consequence viruses.

The Bundibugyo outbreak highlights this clearly: Recognition, initial testing, and response were delayed, with infrastructure optimized around more familiar Ebola strains. The result was that this less common Bundigugyo strain spread unabated for weeks to months before it was fully characterized. WHO has now declared the DRC/Uganda Bundibugyo outbreak a PHEIC, underscoring the need for earlier detection and faster strain-matched countermeasure development.

Pharmacy Times: As frontline providers, how can pharmacists best counter misinformation and maintain public trust during an Ebola outbreak?

Mckee: Pharmacists are among the most accessible healthcare professionals, which makes them essential trusted messengers. The most important approach is to be well informed and to communicate clearly, consistently, and without exaggeration: Ebola is serious, but transmission requires direct contact with bodily fluids of a symptomatic infected person or contaminated materials; it is not spread like influenza or COVID through casual airborne exposure.

Pharmacists should reinforce official public health guidance, explain what is known and not yet known, correct false claims early, and help patients understand why isolation, contact tracing, PPE, and targeted vaccination are protective rather than punitive. Trust is built when health care professionals acknowledge uncertainty while explaining the concrete steps being taken to reduce risk.

Expert: Spencer Durham, PharmD, FCCP, BCPS, BCIDP

Pharmacy Times: With the WHO declaring a PHEIC, how should the public interpret this designation—is it a signal of immediate global danger, or primarily a mechanism to mobilize resources for the affected region?

Spencer Durham, PharmD, FCCP, BCPS, BCIDP: This declaration should be viewed less as a warning of imminent global catastrophe and more as a call for rapid international coordination and resource mobilization to contain a serious outbreak before it becomes harder to control. Ebola is not spread through airborne transmission like some respiratory viruses or something like measles; rather, it is spread through direct contact with infected body fluids or contaminated materials. So, a global outbreak in the vein of something like COVID-19 is unlikely at this time.

Pharmacy Times: With no approved vaccines or specific treatments for the Bundibugyo strain, how should pharmacists advise patients seeking therapeutic options?

Durham: Unfortunately, because there are no specific therapeutic options available against this strain, treatment remains supportive care only (eg, aggressive fluid replacement, hemodynamic support, electrolyte correction). As such, pharmacists should counsel patients that management remains centered on early recognition, isolation, supportive care, and public health containment measures, rather than drug therapy. Pharmacists should also counsel patients that prevention of exposure remains the most effective strategy, including avoidance of direct contact with infected individuals, bodily fluids, contaminated materials, or potentially infected animals.

Pharmacy Times: What are the most critical infection control measures community pharmacies and other health care providers should implement now to prevent potential health care-associated transmission?

Durham: The most important infection control measures are rapid identification of potentially exposed patients, strict adherence to standard and contact precautions, appropriate use of PPE, and immediate coordination with public health authorities. Preventing health care-associated transmission depends far more on early recognition and protocol adherence than on widespread community restrictions.

REFERENCES

1. Centers for Disease Control and Prevention. Ebola Disease: Current Situation. Updated May 25, 2026.Accessed May 26, 2026. https://www.cdc.gov/ebola/situation-summary/index.html.

2. World Health Organization. Epidemic of Ebola disease in the Democratic Republic of the Congo and Uganda determined a public health emergency of international concern. Published May 17, 2026. Accessed May 26, 2026. https://www.who.int/news/item/17-05-2026-epidemic-of-ebola-disease-in-the-democratic-republic-of-the-congo-and-uganda-determined-a-public-health-emergency-of-international-concern.

3. Centers for Disease Control and Prevention. Health Alert Network Advisory: Ebola Disease Outbreak in the Democratic Republic of the Congo and Uganda. Published May 16, 2026. Accessed May 26, 2026. https://www.cdc.gov/han/php/notices/han00530.html.