WHO says DR Congo Ebola outbreak may be up to four times larger as health workers threaten strike

The World Health Organization says the Ebola outbreak in the Democratic Republic of the Congo may be far larger than the official figures suggest, as health workers in the epicentre threaten to stop work over unpaid salaries. The agency said modelling indicates the true scale of the outbreak is likely at least two to four times the number of cases that have been detected. The warning comes as the country continues to report a fast-moving health emergency first identified in mid-May.

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According to the latest figures cited by the agency, at least 1,963 cases have been confirmed and at least 719 people have died. WHO emergencies director Chikwe Ihekweazu said most deaths have occurred in family settings rather than in medical centres, suggesting many patients are not reaching treatment in time. He said the outbreak is likely undercounted and that the real number of infections could be much higher than the official tally.

The pressure on the response is increasing in Rwampara, one of the hardest-hit areas in Ituri province, which is the epicentre of the outbreak. At the Ebola treatment centre there, health workers burned a tyre in protest and temporarily blocked access routes on Monday, according to reports from the scene. Doctors said they had not been paid for two months and warned that after a 48-hour ultimatum they would begin a total strike if salaries and bonuses were not paid.

The situation matters because Ebola control depends on rapid case detection, isolation, contact tracing and safe burials, all of which become harder when infections are missed or when staff are unable or unwilling to continue working. As of July 12, 727 patients were being treated in Ebola treatment centres across the affected areas. The National Institute of Public Health has also said healthcare workers account for a significant number of cases, including 112 transmissions and 35 deaths by Sunday.

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The outbreak in eastern DR Congo is being described by experts as the fastest-growing Ebola outbreak ever recorded on the continent. Ituri province has been especially affected, with at least 384 confirmed cases and 89 deaths reported there. The concentration of cases among health workers adds to concern about infection control inside treatment facilities and the wider risk of transmission into households and communities.

What remains unclear is how many infections have not yet been identified and whether the response can close that gap before the outbreak expands further. The WHO has not issued a revised total, but its modelling suggests the epidemic may be substantially larger than the official count. The next developments to watch are whether salaries are paid, whether the threatened strike goes ahead, and whether surveillance and treatment efforts can keep pace with transmission.

The World Health Organization says the Ebola outbreak in the Democratic Republic of Congo may be far larger than the official figures suggest. The agency said on Tuesday that modelling indicates the scale of the outbreak is at least two to four times the number of cases that have been found. The warning comes as the country continues to report a fast-moving health emergency first detected in mid-May.

According to the latest official figures cited by the agency, the outbreak has infected more than 1,960 people and killed over 700. WHO emergencies director Chikwe Ihekweazu said the outbreak is outpacing the health response. He said the modelling points to substantial undercounting, with the true number of cases potentially much higher than the tally currently recorded by authorities.

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The figures underline the pressure on health workers trying to contain a disease that can spread quickly and place severe strain on local response systems. Ebola outbreaks often require rapid case detection, isolation, contact tracing and safe burials, all of which become harder when infections are not fully captured. The WHO assessment suggests the response may be struggling to keep pace with transmission.

The latest warning is significant because it points to a wider gap between reported cases and the likely real scale of the outbreak. That matters for planning, including the allocation of medical staff, protective equipment and treatment capacity. It also affects how officials and aid agencies judge the risk of further spread in affected areas.

The Democratic Republic of Congo has faced repeated Ebola outbreaks over the years, making the country one of the most closely watched settings for the disease. In this case, the outbreak was detected in mid-May and has since continued to grow. The WHO statement adds to concern that the official count may not reflect the full extent of transmission on the ground.

What remains unclear is how many infections have not yet been identified and whether the response can close that gap quickly enough. The WHO has not given a revised total, but its estimate suggests the outbreak could be substantially larger than the official toll. The key issue now is whether surveillance and treatment efforts can catch up before the situation worsens further.

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