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In 1976, a mysterious and deadly disease appeared almost simultaneously in Sudan and Zaire.
It killed at an alarming rate, baffled doctors, and was eventually named after a river few people had ever heard of: Ebola.
Since then, one of the most feared outbreaks in modern history has occurred and major advances have been made in medicine, vaccines, and global public health.
Learn more about the deadly Ebola virus and the efforts to combat it in this episode of Everything Everywhere Daily.
The word Ebola itself causes fear in some people, and for good reason. Ebola is one of the deadliest diseases on Earth. Not only is the death rate incredibly high, but the way victims die is horrific and painful.
Technically, Ebola is not a single virus. A group of closely related viruses within a genus. Ebola virus. When most people say “Ebola,” what they mean is the Zaire Ebola virus, the deadliest and historically most important member of this group.
Although Ebola is rarer than influenza or measles, it has a reputation for being different from almost all other viruses. If it invades a human population, it can kill a very high percentage of those it infects.
The Ebola virus is classified as a filovirus, which means “thread” in Latin. When viewed under an electron microscope, they often appear as long filament-like strands. Their natural habitat is not known with complete certainty, but fruit bats are considered a prime suspect, with outbreaks often starting after some level of contact between wildlife and humans.
Once infected, Ebola does not spread like measles or influenza. It is not primarily an airborne respiratory virus. It is spread through direct contact with the blood or body fluids of a sick or deceased person or through contaminated objects such as needles, bedding, or medical equipment.
This is one reason why Ebola can devastate families, health care workers and funeral teams. At the same time, in typical public settings, it is much less contagious than other airborne viruses.
The incubation period is usually 2 to 21 days. The CDC describes early illness as “dry” symptoms, including fever, aches, pains and fatigue. As the disease progresses, it may develop “wet” symptoms such as vomiting, diarrhea, and unexplained bleeding.
Bleeding is what made the old term “Ebola hemorrhagic fever” popular, but it is not always the main symptom. The real risk is often a combination of large fluid loss, shock, organ dysfunction, immune system overreaction, and blood clotting problems.
Severe cases may include abdominal pain, rash, red eyes, confusion, kidney and liver damage, internal bleeding, and bleeding from the gums, nose, or injection site.
Ebola is fatal, but the exact fatality rate varies depending on the type, outbreak, and quality of treatment. WHO estimates the average Ebola disease case fatality rate to be about 50%, with historical rates ranging from about 25% to 90%.
Ebola is one of the world’s deadliest diseases, but it’s not. that The most fatal disease. On average, the fatality rate is higher than that of smallpox, but lower than that of rabies, which has a 100% fatality rate. However, rabies can be prevented if treated in time after exposure.
Compared to other viruses, Ebola is in a unique position. On a case-by-case basis, it is much deadlier than seasonal influenza, measles or most coronavirus infections, but it is much less efficient at spreading through the air. Measles is one of the most contagious human viruses and is spread through breathing, coughing and sneezing, while Ebola typically requires contact with infectious body fluids.
In terms of fatality rate, Ebola is closer to Marburg virus, another filovirus. The WHO estimates the average fatality rate for the virus is around 50%, with past outbreaks ranging from 24 to 88%.
We don’t know when the Ebola virus first appeared. It has probably been around for hundreds, if not thousands, of years and is primarily transmitted by animals. If it did spread to humans, it would likely have occurred in isolated communities or individuals and would have been quickly swept away due to the high mortality rate.
The Ebola virus was first discovered in 1976 following a simultaneous outbreak of hemorrhagic fever in two neighboring regions, southern Sudan and northern Zaire. The virus was first isolated from a woman named Myriam Louise Ecran, a 42-year-old Belgian nun working at the Yambuku Mission Hospital who died while caring for people suffering from an unknown illness.
When it came time to name the virus, the international team of scientists faced a careful choice. When the committee considered naming it “Yambuku virus,” researchers Karl Johnson and Joel Breman noted that naming the Lassa virus after the Nigerian village where it was discovered brought stigma to that community.
Johnson instead suggested naming the new virus after a nearby river. There was a brief push to name the virus after the Congo River, the deepest river in the world, but another virus with a similar name already existed, the Crimean-Congo hemorrhagic fever virus. So the scientists looked at the map on the wall and discovered that there was a river nearby called Ebola.
There is irony in the name. The Belgian name for the river, “l’Ebola,” is actually a corruption of the indigenous Ngbandi name “Legbala,” meaning “white water” or “pure water.”
Co-discoverer Dr. Peter Piot later admitted in his memoirs that the map they used was inaccurate and that the Ebola River was not actually the closest river to the Yambuku, but it already had a name at the time.
There are five subtypes of the Ebola virus: Zaire, Sudan, Bundibugyo, Tai Forest, and Reston, each named after the location where it was first identified. The first three subtypes are associated with large outbreaks in Africa. The Reston subtype is found in the western Pacific and is not known to cause disease in humans, although it is very dangerous to non-human primates.
The 1976 outbreak in Zaire was the first and set the template for subsequent outbreaks. The virus spread quickly through Yambuku Mission Hospital, where unsterilized needles were reused, infecting staff and causing several deaths before closing the facility.
Many infected people fled to their hometowns out of fear and sought treatment from traditional healers, which helped spread the disease further. The first outbreak infected 318 people and killed 280.
In 1995, an outbreak began among charcoal producers in forests near the city of Kikwit, Democratic Republic of Congo. It resulted in 315 patients and 250 deaths. The virus spread through families and hospitals, but eventually stopped when medical staff began using masks, gloves, and gowns.
In 2000, there were 425 Ebola cases in Uganda and 224 deaths. The outbreak began in Gulu and spread to other regions. The variant involved was the Sudan virus, and although the average age of those infected was 27, nearly 15% of cases were children under 5 years old.
The largest outbreak in history occurred between 2013 and 2016. The outbreak in West Africa is the largest since the virus was first discovered in 1976, with more cases and deaths than all previous outbreaks combined. It started in Guinea and quickly spread to Sierra Leone and Liberia.
By July 2014, it had reached the capitals of three countries, and in August 2014, WHO declared it a public health emergency of international concern.
The disease eventually spread to seven additional countries, including the United States, Spain, and the United Kingdom. In total, there have been 28,652 cases worldwide and 11,325 deaths have been reported in 10 countries.
The second major Congolese outbreak between 2018 and 2020 was also severe. The outbreak in an active conflict zone has resulted in more than 3,000 cases, making it the largest outbreak in the country’s history.
As recently as September 2025, the Ministry of Public Health of the Democratic Republic of Congo declared an Ebola outbreak in the remote Kasai province, with 53 confirmed cases and 45 deaths by December 2025. It was the 16th Ebola outbreak in the Democratic Republic of Congo since 1976.
The 2026 Ebola outbreak is a rapidly spreading outbreak caused by the Bundibugyo variant, centered in eastern Congo and now including Uganda. As of recording this episode, the World Health Organization (WHO) has reported more than 800 suspected cases and more than 100 suspected deaths in the Democratic Republic of Congo.
So how worried should you be about the Ebola virus?
The short answer is ‘not really’. People in the particularly affected areas of the Democratic Republic of Congo and Uganda should be very concerned on a public health level, but the general public in countries far from the outbreak areas should not panic on a personal level. For most people outside of endemic areas, the risk is very low.
It may sound very strange to say, but Ebola is so deadly that it is very unlikely that it will spread like the Black Death. It kills infected people too quickly to spread quickly. Likewise, because it must be spread through bodily fluids, it is relatively easy to protect against it using modern medical precautions.
One of the concerns expressed is the fear that Ebola will become an airborne virus.
In a very broad sense, it is theoretically possible for viruses to mutate, but it is extremely unlikely that Ebola can spread naturally through the air like measles, chicken pox or influenza.
A lot needs to change for Ebola to actually become airborne. It replicates well in the upper respiratory tract, is shed in large quantities from the nose, throat, and lungs, survives in small suspended droplets, and, even after being inhaled, still infects others.
That’s no small adjustment. This requires major changes to the biology of the virus – the types of cells and organs it prefers to infect. At that point it will no longer be Ebola.
There is actually some good news on the Ebola front.
The 2013-2016 epidemic was the largest Ebola outbreak to date and prompted numerous partners in the public and private sectors to combine their efforts and resources to develop a vaccine as quickly as possible.
The lead candidate was originally developed by experts at the Public Health Agency of Canada and later licensed to Merck. It uses a genetically engineered version of vesicular stomatitis virus, an animal virus that primarily affects cattle, to carry an Ebola virus gene insert that trains the immune system to recognize Ebola.
The vaccine underwent preclinical testing and then clinical trials 1, 2, and 3. A major clinical trial in Guinea in 2015 used a “ring vaccination” strategy to vaccinate immediate contacts of confirmed cases and contacts of those contacts, and the results were surprising. Among those who were immediately vaccinated, there were no cases of Ebola for several weeks after vaccination.
In November 2019, the European Commission granted conditional marketing authorization for the vaccine, currently sold under the brand name Ervebo. WHO pre-screening took place within 48 hours, making it the fastest vaccine pre-screening process in WHO history. It was later approved in the United States in December 2019.
Ervebo was tested on approximately 16,000 individuals in several clinical studies in Africa, Europe, and the United States before being approved. However, its limitations are noteworthy. It specifically protects against the most dangerous Zaire Ebola virus strain, but does not protect against other strains.
Ebola is bad. There is no doubt. I wouldn’t wish that on my worst enemy. Public health agencies should certainly be concerned about this.
However, unless you live in Central or West Africa, this is not a concern for most people.
The good news is that if vaccine development continues, Ebola will probably never have to worry anyone again in the future.
