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The World Health Organisation has declared the Ebola outbreak in the Democratic Republic of Congo and Uganda a public health emergency of international concern, warning of a potentially far larger epidemic than currently detected. WHO Director-General Tedros Adhanom Ghebreyesus issued the declaration on Sunday following more than 300 suspected cases and at least 87 deaths.

A laboratory-confirmed case has been reported in Congo's capital Kinshasa, some 1,000km (620 miles) from the epicentre in Ituri province, while two confirmed cases, including one death, have reached Uganda's capital Kampala.

Tedros said: "There are significant uncertainties to the true number of infected persons and geographic spread associated with this event at the present time.

"In addition, there is limited understanding of the epidemiological links with known or suspected cases."

The outbreak is caused by the rare Bundibugyo strain of Ebola, for which no approved vaccines or therapeutics exist. This is only the third time the variant has been identified. The highly contagious disease spreads through bodily fluids such as blood, vomit and semen, causing severe and often fatal illness.

Although the WHO stressed the situation does not yet meet the criteria for a pandemic emergency like Covid-19 and advised against border closures, it highlighted alarming signs of wider transmission. These include high positivity rates among samples tested, clusters of deaths, and community spread, particularly in the mining area of Mongwalu.

The Africa Centres for Disease Control and Prevention (Africa CDC) revealed the outbreak began in April but was only formally confirmed on Friday. By the time it was first flagged via social media on May 5, around 50 people had already died. The earliest known suspected victim, a 59-year-old man, developed symptoms on April 24 and died three days later.

As of Saturday, Congo had recorded 336 suspected cases and 87 deaths, with the vast majority of cases in the country. At least four healthcare workers have died showing Ebola symptoms.

Dr Jean Kaseya, Africa CDC Director-General, warned that a high number of active cases remain in the community, "significantly complicating containment and contact tracing efforts."

Violent conflict with Islamic State-backed militants in Ituri, along with population movements linked to mining and cross-border travel, have further hindered response operations.

The emergency declaration is designed to accelerate international aid and donor support, though experts have noted mixed success in previous declarations, including the 2024 mpox outbreak.

Residents in Bunia, Ituri's capital, spoke of growing fear and near-daily burials.

One local told journalists: "Every day, people are dying ... and this has been going on for about a week. In a single day, we bury two, three or even more people."

Health authorities are now racing to scale up screening and contact tracing, but significant logistical and security challenges remain in the vast, conflict-affected region.