Ebola: Largest ever outbreak of rare strain 'likely even greater' – and the 'first line of defence' has collapsed

The number of Ebola infections in the Democratic Republic of Congo (DRC) is likely far higher than official figures, Oxfam has warned, due to lack of clean water and sanitation.

The humanitarian organisation said there has been a near-total collapse in hygiene infrastructure and a critical fall in contact tracing since the rare Bundibugyo strain began to spread.

Only one in five health centres in the province of Ituru, one of the epicentres of the virus, has access to enough clean water, Oxfam's field data shows.

In Mongbwalo, a town of nearly 140,000 people in the province, only 20% of people have access to clean water and only 25% to functional sanitation and hygiene facilities.

'First line of defence' has collapsed

Manel Rebordosa, Oxfam's field response coordinator in Ituri, said the findings highlighted the crisis unfolding due to contaminated water, lack of handwashing infrastructure and the challenge of disposing of infectious waste.

"Water – the absolute first line of defence in any public health emergency – is simply not available," he said.

"Miners working in the surrounding areas have no toilets and handwashing stations. Then they return home to communities already battling the virus.

"Clean water costs $2 (£1.50) for 20 litres. For most families here, that is far beyond what they can afford."

Cases hit record high

The warning came as the US Centers for Disease Control and Prevention (CDC) confirmed the outbreak was the largest of the Bundibugyo strain on record.

There were 781 confirmed cases and 181 deaths in the country, according to the DRC Ministry of Health as of 13 June.

The Bundibugyo strain has no licensed vaccine, meaning that clean water and sanitation are critical components of the fight against the virus.

Contact tracing has also fallen to 43% coverage, which is far below the 79% recorded one month into the 2018-2020 outbreak in the same region.

US funding cuts fuelling spread

Mr Rebordosa spoke of shortfalls in funding resulting from the US withdrawing its support of disease surveillance.

"One month into the 2018 outbreak, healthcare workers achieved contact tracing rates where nearly eight in 10 known contacts were successfully monitored," he said.

"Today, following the withdrawal of the US funding for disease surveillance and severe funding shortfalls, contact tracing is reaching fewer than half of the contacts.

"That gap is not just a statistic; it is a painful reality that allows the virus to spread undetected through communities."

'Rumours spread faster than the virus'

With more than 70 health facilities being destroyed by conflict and only 0.2 doctors per 1,000 people, the DRC's health authorities are struggling to identify new infections quickly enough.

In North Kivu province, deaths are being reported in communities before they are ever identified as Ebola cases, Oxfam said.

In addition, many families are caring for sick relatives at home and exposing others to the virus.

Aid funding for the DRC has been cut from $2.58bn (£1.92bn) in 2024 to $1.4bn (£1.04bn) in 2026, a reduction of 46%.

As a result, aid agencies have scaled back, forcing organisations to reduce outreach services.

Mr Rebordosa said: "When trusted community outreach teams disappear, rumours spread faster than the virus.

"People now fear healthcare facilities, which they see as death traps.

"Families are turning to traditional remedies, which risks delaying treatment and allowing the virus to spread further. Every day without funding, the virus takes more lives."

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Tibakanya Mireille, a mother of five in Ituri, said one of her children had started to show symptoms.

"I brought my child to the hospital when I noticed she had a fever, and she is now being tested. We are very worried," she said.

"Here, two houses have been quarantined, and one family lost several relatives after caring for a sick relative, which caused others to be sick.

"The disease has already killed several people in our community of Shari, in Bunia."

Oxfam has scaled up its operations in the DRC, launching an initial $11.6m (£8.64m) six-month intervention to provide clean water and hygiene kits to 200,000 people in Ituri province.

The charity said the response fell short of what was required to contain the spread.

(c) Sky News 2026: Ebola: Largest ever outbreak of rare strain 'likely even greater' – and the 'first