Health officials in Brazil and Italy are monitoring patients with suspected Ebola symptoms after both countries flagged potential cases tied to the fast-moving outbreak in the Democratic Republic of Congo, an outbreak that Doctors Without Borders says has grown faster than any on record.
Two patients in Brazil are isolated in separate hospitals. One is a 37-year-old man in São Paulo who recently returned from the DRC. The other is under observation in Rio de Janeiro with symptoms including cough, chills, and diarrhea. In Italy, authorities in Cagliari on the island of Sardinia triggered Ebola protocols after a man showed symptoms upon returning from the Congo.
The suspected cases have emerged as the DRC outbreak has already produced more than 1,000 suspected infections and 250 deaths, the Daily Mail reported. The Bundibugyo strain driving this outbreak can kill up to 50 percent of those infected. No vaccine for it exists. And the international response, by all accounts, is already behind.
The São Paulo patient was placed into isolation at the Emilio Ribas Institute of Infectious Diseases after his return from the DRC. Doctors diagnosed him with a severe form of meningitis on Sunday, but officials have not ruled out Ebola and continue monitoring him.
The second Brazilian patient, isolated in Rio de Janeiro, tested positive for malaria and returned a negative Ebola test. He remains in isolation anyway. Officials say they have not cleared him because patients can carry the Ebola virus for up to 21 days before symptoms appear.
The government in São Paulo said the risk to Brazil and South America was "very low."
In Italy, the Sardinia regional health ministry confirmed that the suspected Italian case returned a negative Ebola test. The ministry said the risk of Ebola reaching Italy "remains very low." Still, the fact that protocols were triggered at all in Cagliari, a Mediterranean island far from central Africa, shows how quickly anxiety about this outbreak has traveled.
The epicenter remains the DRC's Ituri Province, centered on the eastern city of Bunia. That is where most cases and deaths have occurred. All flights to and from Bunia have been grounded.
Dr. Alan Gonzales, deputy director of Doctors Without Borders, described the situation in stark terms on Saturday:
"Two weeks after the declaration of the Ebola disease outbreak in Ituri Province, the situation is deeply alarming. Never before has an Ebola outbreak recorded so many cases so soon after its declaration."
Gonzales added that the organization is "witnessing a response that has not yet caught up to the rapid spread of the epidemic." His assessment of the data gap was blunt:
"The reality today is that nobody knows the true scale and severity of this outbreak. New suspected cases are being reported daily, yet hundreds of samples remain untested."
Hundreds of untested samples. More than a thousand suspected cases. And the international community still scrambling to stand up a response two weeks in. That timeline alone should concern anyone who remembers the 2014 West Africa Ebola crisis, which ultimately produced more than 28,000 cases and 11,000 deaths.
The response inside the DRC faces obstacles beyond the virus itself. Dr. Richard Lokodu, medical director of Mongbwalu General Referral Hospital, said the facility has come under attack from people seeking to bury the bodies of friends and family members who died from Ebola. Some factions in the region have confronted Red Cross volunteers.
On May 26, Doctors Without Borders team members were photographed helping each other into protective suits and face shields outside the Mongbwalu hospital. By May 29, the Alliance for International Medical Action was setting up a treatment center in Rwampara outside Bunia. Awareness campaigns were underway in Goma, in North Kivu province, and in the Kigonze displacement camp in Bunia.
The World Health Organization warned that the true reach of the outbreak may be far greater than the confirmed numbers suggest. WHO director-general Tedros Adhanom Ghebreyesus visited Bunia on May 31 to witness the discharge of four nurses who had recovered from Ebola, a small piece of good news. Ghebreyesus said that although no vaccine exists for the Bundibugyo strain, good medical care offers hope for treatment.
But Ghebreyesus also pushed back against countries that have imposed travel bans on patients from infected regions:
"These measures make the response harder, and they discourage transparency and trust that saves lives."
That argument deserves scrutiny. The WHO's instinct during every outbreak is to oppose travel restrictions. It made the same case during COVID-19. Countries that ignored that advice and moved early to restrict travel often fared better in the early weeks of that pandemic. The question is not whether travel bans are polite. The question is whether they work.
Scientists at the University of Oxford are racing to develop a vaccine for the Bundibugyo strain, but they warned it may take two to three months before their candidate can even be tested on humans. They said it is unlikely patients in Africa will receive the drug within the next six months.
DRC Health Minister Roger Kamba said the country aims to contain and end the outbreak within "four to six months" in the "best case scenario." Given the pace of spread and the scale of untested samples, that timeline looks optimistic.
The outbreak has already crossed into Uganda, where several infections and one death have been reported. Experts believe the virus may have spread to South Sudan as well.
British health officials activated a Returning Workers Scheme for healthcare workers coming back from Ebola outbreak regions. Dr. Derek Sloan, an infectious disease expert at the University of St. Andrews and spokesman for UK-Med and Healthy World, Secure Britain, tied the outbreak to broader preparedness concerns:
"This outbreak, along with the recent Hantavirus cases on a cruise ship and meningitis infections in the UK shows how important it is that we stay vigilant and use effective public health tools to protect our populations."
Sloan went further, arguing that "infectious disease outbreaks such as these in our interconnected world cannot be dismissed as someone else's problem." He called for preserving funding for global health and international aid.
That framing, more money, more international coordination, more deference to global health bureaucracies, is the default reflex of the public health establishment every time a crisis flares. It is worth asking whether the institutions that failed to contain this outbreak in its first two weeks have earned that trust.
The immediate risk to the Western Hemisphere may be low. Both the São Paulo and Sardinia cases returned negative Ebola tests. The Rio patient tested positive for malaria, not Ebola, though monitoring continues. Governments are calling the threat "very low."
But "very low" is what officials always say at the start. The 2014 outbreak started small too. So did COVID-19. The pattern is familiar: a deadly pathogen emerges in a region with weak health infrastructure, international organizations issue warnings while urging against decisive border measures, and the rest of the world watches the case count climb.
More than 1,000 suspected cases. Two hundred and fifty dead. Hundreds of samples sitting untested. Hospitals under physical attack. No vaccine for months. And the WHO's top priority is lecturing countries about travel bans.
When the people in charge of the response cannot even count the cases, telling everyone else to keep their borders open is not leadership. It is habit.
