Review Article
The global Ebola threat: A review of India’s healthcare
preparedness in response to the rising African health crisis
R. Rajendran
Former Joint Director and Consultant, National Centre for Disease Control, Ministry of Health
and Family Welfare, Government of India, Thiruvananthapuram, Kerala, India
Corresponding author: R. Rajendran, Email: rajendran061@gmail.com
Journal of Experimental Biology and Zoological Studies. 2(2): p 142-53, Jul-Dec 2026.
Received: 19/06/2026; Revised: 26/06/2026; Accepted: 27/06/2026; Published: 05/07/26
_____________________________________________________________________________________
Abstract
Ebola virus disease, formerly known as Ebola haemorrhagic fever, is a zoonotic viral infection
affecting humans and non-human primates. The incubation period spans from two days to three
weeks post-infection. Historically, Ebola outbreaks exhibit a case fatality rate ranging from 25%
to 90%, with a mean mortality rate of approximately 50%. A new Ebola outbreak emerged during
the last week of April 2026. However, early infections are theorized to have begun as early as
February 2026 in the town of Mongbwalu. Since then, imported cases from Ituri have been
reported in both North Kivu Province and Uganda’s capital, Kampala. On May 21, 2026, a case in
South Kivu was epidemiologically linked to Tshopo Province. The ongoing Ebola outbreak is
caused by the Bundibugyo virus. This specific virus has caused only two recorded outbreaks in the
past: the first in the Bundibugyo district of Uganda during 2007–2008, from which the virus
derives its name, and the second in Isiro, Democratic Republic of the Congo (DRC), in 2012. As
of June 26, 2026, a total of 1,138 confirmed Ebola cases and 293 deaths have been reported across
the DRC and Uganda with a case fatality rate of 25.7%.
Keywords: Bundibugyo virus disease, Ebola outbreaks, healthcare preparedness Orthoebolavirus.
______________________________________________________________________________
Introduction
Ebola disease (EBOD), formerly known as Ebola haemorrhagic fever, is a severe and often fatal
illness affecting humans and other primates. Ebola disease is caused by viruses belonging to the
genus Orthoebolavirus within the Filoviridae family. Six species of Orthoebolavirus have been
identified to date, three of which are known to cause major outbreaks in humans: Ebola virus or
Zaire ebolavirus (EBOV), Sudan virus (SUDV), and Bundibugyo virus (BDBV). The fourth
species is the Tai Forest Virus (TAFV), which has only one recorded human case in history. In
1994, a scientist in the Ivory Coast contracted the virus after performing an autopsy on an infected
chimpanzee; fortunately, the patient eventually made a full recovery. Among the four viruses,
EBOV is the most lethal and is most frequently associated with outbreaks.[1] Although harmless to
humans, the fifth and sixth viruses (Reston virus and Bombali virus) have been shown to cause
disease in other primates. All six viruses are closely related to the Marburg virus.
The ongoing Ebola outbreak in the Democratic Republic of the Congo (DRC) marks the 17th
epidemic since the virus was first discovered in the region in 1976. Historically, most outbreaks
have been caused by the highly virulent Zaire ebolavirus, the most lethal ebolavirus species, with
a remarkably high human case fatality rate. While the current epidemic is caused by the
Bundibugyo virus, a species known to be relatively less virulent, it still poses a severe health threat.
The lower comparative virulence of the Bundibugyo virus must not lead to complacency. Public
health authorities should maintain maximum vigilance and execute full-scale preparedness,
prevention, and control protocols to contain this deadly disease effectively.
Around three million individuals of Indian ancestry live on the African continent, forming part of
a 30-million-strong global Indian diaspora.[2] Beyond this civilian population, nearly 4,500 Indian
soldiers are currently deployed across Africa under various United Nations peacekeeping missions.
Furthermore, over 80,000 Indians reside across the DRC and Uganda. Because Indians frequently
relocate to African nations to pursue lucrative business opportunities, secure employment, and
engage in bilateral trade, migration between India and Africa remains highly active. Keralites, in
particular, regularly travel to and from many of the countries, in search of higher education,
superior career opportunities, and a better living.
The high volume of travel has become a point of critical concern. The DRC and Uganda are
currently the epicentres of an ongoing Ebola outbreak, which the World Health Organization
(WHO) warns is spreading faster than containment efforts can manage.[3] Because of frequent
movement between these Ebola-affected regions and India, particularly the state of Kerala,
authorities have to remain on high alert. To prevent the virus from entering the country, strict
precautionary protocols are necessary. Consequently, both the Central and State Governments of
India have proactively implemented comprehensive preparedness and monitoring measures.
Natural hosts
Although the definitive natural reservoir of EBOV remains unconfirmed, cumulative data from
African field studies, laboratory research, and epidemiological surveys strongly implicate fruit bats
as the principal animal reservoir. Notably, current evidence indicates that certain bat species serve
as asymptomatic carriers, harbouring the virus without manifesting clinical illness. Animal
outbreaks are often triggered by shifting fruit production and animal behaviour. A key source of
infection is partially eaten fruits contaminated by infected bats.[4]
Ebola viruses have also been detected in species such as duikers (a small wild antelope) and non-
human primates including apes and monkeys. However, because these primates are highly
sensitive to the virus and suffer a high mortality rate when infected, they are not considered natural
hosts. While it remains unclear exactly how non-human primates and duikers contract the virus
infection, most evidence points to direct contact with one or more natural hosts or their secretions.
Evidence indicates that both domestic dogs and pigs can be infected with EBOV. While dogs
appear to remain asymptomatic carriers, infected pigs can transmit the virus to at least some
primates. However, there is currently no evidence that domestic animals play an active role in
transmitting the disease to humans. [5]
Mode of transmission
Ebola spreads from person to person through direct contact with infected individuals or their body
fluids. These fluids include saliva, mucus, vomit, faeces, sweat, tears, breast milk, urine, and
semen. However, transmission occurs most frequently through blood, faeces, and vomit. The virus
enters the body through the eyes, nose, mouth, or any breaks in the skin, such as cuts, wounds, and
abrasions.[6] Ebola disease is frequently transmitted during patient care and traditional funeral
practices; health care workers are often infected while treating patients, and burial ceremonies
involving direct contact with the deceased further drive transmission.
Men who have recovered from EBOD should be aware that seminal fluid may remain infectious
for at least three months after the onset of symptoms. While there are currently no reports of the
live virus persisting in the vaginal secretions of recovering women, the risk of sexual transmission
cannot be entirely ruled out. Because of this, both men and women who have recovered from
EBOD should abstain from at least three months from the onset of symptoms. Likewise, it is
important for recovering patients to maintain strict personal hygiene including washing with soap
and water after sexual activity. [7]
Ebola is not transmitted through air, water, or generally by food. Additionally, there is no evidence
that mosquitoes or other insects can spread the virus. The transmission of EBOV in Africa is
frequently linked to the hunting, processing, and consumption of infected wildlife. This bushmeat
is often consumed raw or inadequately cooked, posing a severe health risk.[8]
Clinical features
Following an incubation period of 2 to 21days, the disease begins abruptly with early symptoms
like fever, fatigue, malaise, muscle pain, headache, and sore throat. This initial phase quickly
progresses to vomiting, diarrhoea, abdominal pain, and a rash, alongside signs of impaired kidney
and liver function. In advanced stages, some patients experience severe internal and external
bleeding, manifesting as blood in vomit and faeces, or haemorrhaging from the nose, gums, and
vagina, while central nervous system involvement can cause confusion, irritability, and
aggression.[9]
Ebola symptoms can easily be mistaken for other illnesses, such as malaria, cholera, typhoid fever,
meningitis, and various viral haemorrhagic fevers. Therefore, accurate diagnosis is crucial to
confirm the disease, which is achieved by testing blood samples for viral RNA, specific antibodies,
or the virus itself. [10]
Ebola outbreaks: A historical timeline
The EBOV was first identified in 1976 during two simultaneous outbreaks: one in Nzara, South
Sudan, and the other in Yambuku, a village near the Ebola River in the DRC. [11] Since then,
approximately 44 Ebola outbreaks have been reported globally, with most occurring in Central and
West Africa. Over the past 50 years, more than 35,013 Ebola cases and 15, 458 deaths were
reported worldwide, resulting in a case fatality rate of 44.1%. Most confirmed Ebola cases were
concentrated in the DRC, Gabon, the Republic of Congo, Sudan, and Uganda. During this period,
the DRC alone reported 4,790 cases and 3,229 deaths, resulting in a notably high case fatality rate
of 67.4%. Between 2014 and 2016, a severe Ebola epidemic ravaged West Africa (primarily
Guinea, Liberia, and Sierra Leone), with localized transmissions reaching Mali, Nigeria, Senegal,
and several Western countries, including Spain, Italy, the United Kingdom, and the United States.
An Ebola outbreak also occurred in the DRC in 2014.[11] Annual Ebola outbreaks, cases and death
counts, and case fatality rates from 1976 to 2025 are detailed in Table 1.
Table 1: Chronology of Ebola virus disease outbreaks, showing the numbers of cases, deaths and case
fatality rates worldwide during 1976–2025.
Year
Countries involved
Species
Cases
Deaths
CFR %
1976
The DRC
Sudan
United Kingdom
Orthoebolavirus zairense
Orthoebolavirus sudanense
Orthoebolavirus zairense
318
284
01
280
151
0
88.1
53.2
0.0
1977
DRC
Orthoebolavirus zairense
01
01
100
1979
Sudan
Orthoebolavirus sudanense
34
22
64.7
1989
The Philippines*
United States*
Orthoebolavirus restonense
Orthoebolavirus restonense
031
041
0
0
NA
NA
1992
Italy*
Orthoebolavirus restonense
0
0
1994
Cote d’Ivoire
Gabon
Orthoebolavirus taiense
Orthoebolavirus zairense
01
51
0
31
0.0
60.8
1995
The DRC
Orthoebolavirus zairense
315
254
80.6
1996
Russia
The Philippines*
United States*
South Africa
Gabon
Orthoebolavirus zairense
Orthoebolavirus restonense
Orthoebolavirus restonense
Orthoebolavirus zairense
Orthoebolavirus zairense
01
0
0
02
91
01
0
0
01
66
100.0
0.0
0.0
50.0
72.5
2000
Uganda
Orthoebolavirus zairense
425
224
52.7
2001
The DRC
Gabon
Orthoebolavirus zairense
Orthoebolavirus zairense
59
65
44
53
74.6
81.5
Table 1: Contd…
Year
Countries involved
Species
Cases
Deaths
CFR %
2003
The DRC
Orthoebolavirus zairense
178
157
88.2
2004
Russia
Sudan
Orthoebolavirus zairense
Orthoebolavirus sudanense
01
17
01
07
100.0
41.2
2005
The DRC
Orthoebolavirus zairense
12
10
83.3
2007
Uganda
The DRC
Orthoebolavirus bundibugyoense
Orthoebolavirus zairense
131
264
42
187
32.1
70.8
2008
The DRC
The Philippiens*
Orthoebolavirus zairense
Orthoebolavirus restonense
32
061
15
0
46.9
NA
2011
Uganda
Orthoebolavirus sudanense
01
01
100.0
2012
Uganda
The DRC
Orthoebolavirus sudanense
Orthoebolavirus bundibugyoense
17
36
07
13
41.2
36.1
2014
The DRC
Guinea,
Liberia,
Sierra Leone
Italy
Mali
Nigeria
Senegal
Spain
United Kingdom
United States
Orthoebolavirus zairense
Orthoebolavirus zairense
Orthoebolavirus zairense
Orthoebolavirus zairense
Orthoebolavirus zairense
Orthoebolavirus zairense
Orthoebolavirus zairense
Orthoebolavirus zairense
Orthoebolavirus zairense
Orthoebolavirus zairense
Orthoebolavirus zairense
69
3,814
10,678
14,124
01
08
20
01
01
01
04
49
2,544
4,810
3956
0
06
08
0
0
0
01
71.0
66.7
45.0
28.0
0.0
75.0
40.0
0.0
0.0
0.0
25.0
2017
The DRC
Orthoebolavirus zairense
08
04
50.0
2018
The DRC
Orthoebolavirus zairense
3,524
2,320
65.8
2020
The DRC
Orthoebolavirus zairense
130
55
42.3
2021
The DRC
Guinea
Orthoebolavirus zairense
Orthoebolavirus zairense
23
23
15
12
65.2
52.2
2022
Uganda
The DRC
Orthoebolavirus sudanense
Orthoebolavirus zairense
164
06
55
06
33.5
100.0
2025
The DRC
Uganda
Orthoebolavirus zairense
Orthoebolavirus sudanense
64
14
45
04
70.3
28.6
*Infections without illness in people; 1Asymptomatic cases; NA=Not Applicable; CFR=Case fatality rates; DRC=Democratic
Republic of the Congo (The data presented in the table were compiled from various published sources listed in the references)
Intermittent Ebola outbreaks continued to emerge across the continent. From 2017 to 2022, the
DRC experienced recurring outbreaks of varying scales, and Guinea reported a resurgence in 2021.
In 2018, an Ebola outbreak in the DRC caused more than 3,524 cases and 2,320 deaths, continuing
into the following years with slightly lower severity. Driven by the escalating scale of the epidemic,
the WHO declared the crisis a Public Health Emergency of International Concern on July 17,
2019.[12] More recently, Uganda faced two distinct outbreaks caused by the Sudan virus strain: the
first running from September 2022 to January 2023, and the second from January to April 2025.
On September 4, 2025, the DRC Ministry of Public Health, Hygiene and Prevention officially
declared an Ebola outbreak in the remote Bulape health zone of Kasai province, making the
country’s 16th outbreak since the virus was first recorded there in 1976. Of the 44 Ebola outbreaks
reported between 1976 to 2025, the vast majority (81.8%) were caused by the Zaire ebolavirus.
The remaining outbreaks were attributed to Sudan ebolavirus (11.4%), Bundibugyo ebolavirus
(4.5%), and Tai Forest ebolavirus (2.3%). Case fatality rates vary drastically between Ebola virus
species; across all outbreaks, the average rate is approximately 50%, with a range spanning from
25% to 90%. Key Ebola virus species and their human fatality rates are detailed in Table 2.
Ebola Outbreak, 2026
Recently, an outbreak of illness with an unknown etiology emerged in the DRC in April 2026. The
first cases were reported in the Mongbwalu Health Zone, which continues to account for a large
portion of the case count. Response and commitment efforts face severe challenges due to violent
conflicts involving militant factions driven by local mining activities, both within the DRC and
across the border into Uganda. Consequently, there are uncertainties regarding the true number of
infections and the current geographic spread of the outbreak. Furthermore, the epidemiological
links among known and suspected cases remain poorly understood. The earliest identified suspected case
Table 2: Characteristics and fatality rates of major Ebola virus species
EBOV Species
Case Fatality Rate
Characteristics
Zaire ebolavirus
(O. zairense)
50% to 90%
(Average 83%)
Most deadly and
widespread species,
Responsible for largest
Ebola virus disease
outbreaks.
Sudan ebolavirus
(O. sudanense)
40% to 60%
(Average 50%)
Second most common
species. Responsible
for initial outbreaks in
1976.
Bundibugyo ebolavirus
(O. bundibugyoense)
30% to 55%
First identified in
Uganda in 2007.
Slightly lower fatality
rate than
Zaire species.
Tai Forest ebolavirus
(O. taiense)
0% to 20%
Causes mild to
moderate illness in
humans. It is highly
pathogenic to
Chimpanzees, from
whom the sole human
case was reported in
1994.
(The data presented in the table were compiled from various published sources listed in the References section)
involved a 59-year-old man who developed symptoms on April 24 and died at a hospital in Ituri
Province, DRC on April 27. By May 4, when health authorities were first alerted to the outbreak
via social media, 50 deaths had already been recorded. [13]
On May 5, 2026, the WHO received an alert regarding a highly lethal, unknown illness in the
Mongbwalu Health Zone of Itri Province, DRC, where four workers died within four days.
Following an in-depth investigation by rapid response teams in the Mongbwalu and Rwampara
Health Zones on May 13, the outbreak was confirmed as Bundibugyo virus disease (BVD), caused
by Bundibugyo virus (Orthoebolavirus bundibugyoense). DRC’s Ministry of Public Health,
Hygiene and Social Welfare officially declared the country’s 17th Ebola outbreak on 15 May 2026,
with cases initially concentrated in the Rwampara, Mongbwalu, and Bunia health zones.[14]
As of May 16, 2026, health officials in the DRC’s Ituri Province have reported eight laboratory-
confirmed cases, 246 suspected cases, and eighty suspected deaths. The outbreak spans at least
three health zones including Bunia, Rwampara, and Mongbwalu.[15] The WHO has declared the
BVD outbreak in the DRC and Uganda a public health emergency of international concern as of
May 17, 2026. By late May 2026, the cumulative number of cases had escalated substantially. The
DRC reported a total of 125 confirmed cases including 17 deaths and 906 suspected cases and 223
Table 3: Details of Bundibugyo virus disease outbreak reported in the Democratic Republic of the
Congo, as of June 8, 2026
Province/Zone
Confirmed cases
Confirmed deaths
CFR %
ITURI:
Bunia
163
15
9.2
Rwampara
122
20
16.4
Mongbwalu
114
40
35.1
Nyankunde
32
01
3.1
Bambu
05
02
40.0
Aru
03
01
33.3
Kilo
04
01
25.0
Nizi
05
0
0.0
Mangala
01
0
0.0
Damas
03
0
00
Aungba
02
01
50.0
Gety
01
0
0.0
Komanda
03
0
0.0
Lita
04
0
0.0
Logo
02
0
0.0
Mambasa
02
01
50.0
Rimba
03
0
0.0
Autres ZS
94
10
10.6
Sub Total
563
92
16.3
NORD-IVU:
Katwa
12
08
66.7
Beni
09
07
77.8
Butembo
06
04
66.7
Oicha
02
02
100.0
Kalunguta
01
01
100.0
Kyondo
01
0
0.0
Goma
01
0
0.0
Sub Total
32
22
66.8
SUD-KIVU:
Miti- Murhesa
03
01
33.3
Sub Total
03
01
33.3
TOTAL
598
115
19.2
CFR=Case fatality rate
suspected deaths as of May 27, 2026. Meanwhile, the total number of confirmed cases in both
countries reached 134 (including nine in Uganda), with 18 confirmed deaths, one of which was in
Uganda.[16]
According to a June 9, 2026 report from the DRC Ministry of Health, confirmed cases have risen
to 598 with 115 related deaths, reflecting 48 new cases and 14 new deaths since the previous update
(Table 3). Additionally, 297 individuals remained hospitalized in isolation as of June 8, 2026.[17]
Investigators traced all infections back to travellers entering the country from the Ituri and North
Kivu provinces of the DRC.[17,18]
As of June 23, 2026, the Ebola outbreak in the DRC has spread to three new health zones, bringing
the total to 1,118 confirmed cases and 291 deaths. Uganda reported 20 confirmed cases and two
deaths up to June 25, 2026 since the beginning of 2026 outbreak. Rather than being localized to a
specific province, these cases were concentrated in the Central Region’s Kampala and Wakiso
districts.[16,19] On June 24, 2026, France confirmed its first case of Ebola, marking the first
documented spread of the current outbreak beyond Africa.[16] Due to heavy cross-border
movement, the Africa Centres for Disease Control and Prevention (Africa CDC) warns that ten
neighbouring and interconnected nations are now at increased risk. These high-risk countries
include Angola, Burundi, the Central African Republic, the Republic of Congo, Ethiopia, Kenya,
Rwanda, South Sudan, Tanzania, and Zambia.[20]
The DRC and Uganda have emerged as the primary locus for Ebola transmission, including the
2026 outbreak (Figure 1). This pattern is exacerbated by the convergence of significant viral
reservoirs in wildlife, cross-border population movement, ongoing regional instability, and limited
health infrastructure.[21]
India’s preparedness for Ebola virus disease in view of rising cases in parts of Africa
India has never recorded an indigenous case of Ebola, and the current outbreak in Africa poses a
minimal risk to the country. However, following recent emergency declarations by the WHO and
Africa CDC, the Government of India has proactively intensified nationwide surveillance and
Figure 1: Confirmed cases of Ebola 2026 reported from the DRC and Uganda
preparedness measures as a precautionary step to safeguard public health. These measures were
developed in close coordination with key stakeholders, including National Centre for Disease
Control (NCDC), Directorate General of Health Services (DGHS), Indian Council of Medical
Research (ICMR), Civil Aviation, Immigration authorities, and other relevant Ministries and
Departments.[22]
In response to the sudden Ebola outbreaks in the DRC and Uganda, the Government of India has
implemented the following urgent and stringent measures.
1. Authorities have launched enhanced screening and surveillance measures at international
airports and other entry points. They have also issued Standard Operating Procedures (SOPs) to
all States and Union Territories (UTs) to guide laboratory testing, quarantine, clinical management,
and infection prevention.
2. On May 21, 2026, the Union Health Ministry issued SOPs on public health preparedness and
response to Ebola, which details protocols for international passengers.
3. On May 22, 2026, the Ministry released additional guidelines focussing on hospital infection
control, isolation facility preparedness, and the safe and dignified handling of human remains.
4. On May 24, 2026, India issued a travel advisory advising the citizens against non-essential travel
to the DRC, South Sudan, and Uganda.
5. Integrated Disease Surveillance Programme (IDSP) units and Airport Health Organizations
(APHOs) must closely monitor international travellers for unexplained febrile illnesses and
promptly report and manage any suspected cases.
Furthermore, India has been actively supporting the Africa CDC by providing urgent medical
supplies, such as protective gear and essential medicines.
Precautionary measures implemented by the Government of Kerala to prevent the import of
Ebola
Kerala has stepped up Ebola precautions following the WHO’s declaration of a global health
emergency over the virus’s spread in parts of Africa. The State Health Department is strengthening
surveillance and issuing detailed prevention guidelines to stop any potential import of the disease.
In addition, health authorities have intensified the screening of international arrivals from Ebola-
affected regions, requiring symptomatic travellers to report immediately to health officials at
international airports in Kerala. Noticeably, according to a news report published in The Hindu on
June 26, 2026, Ebola surveillance and precautionary measures are further strengthened at the
Cochin International Airport Ltd (CIAL) following an emergency preparedness meeting between
the airport management and the Airport Health Organisation. CIAL has implemented enhanced
screening measures under a newly activated special surveillance protocol. Passengers will be
subjected to thermal screening, visual inspection, and a review of their travel history over the
preceding 21 days. Additionally, international travellers must submit self-declaration forms to
immigration authorities. As part of this comprehensive preparedness strategy, round-the-clock
surveillance systems and dedicated on-site isolation facilities have also been established. The
WHO advises against broad international travel bans. In this context, while complying with
mandatory Ebola-related protocols, international travellers have a responsibility to cooperate with
public health authorities by adhering to self-monitoring guidelines, as recommended.
As per the quarantine and isolation protocols released by the Kerala State Health Department,
travellers arriving from affected countries must undergo a 21-day quarantine or monitoring period.
During this time, asymptomatic passengers with no history of contact are placed under home
quarantine, while anyone showing symptoms or having a known contact history is immediately
moved to hospital isolation wards. According to the daily bulletin from the Kerala Department of
Health and Family Welfare dated June 14, 2026, a total of 175 passengers arrived at Kerala Points
of Entry (PoE), of whom 68 were cross-notified to other states, for follow-up surveillance. A total
of 105 passengers were placed under home quarantine, with the highest numbers in Ernakulam
(21), followed closely by Kannur with 20, Thrissur (10) and Malappuram (9) and 16 passengers
were released from quarantine as of June 14, 2026.[23] The state has fully equipped dedicated
isolation wards and intensive care facilities across all major Government Medical Colleges,
including those in Thiruvananthapuram, Ernakulam, Manjeri (Malappuram district), and Kannur.
Additionally, quarantine facilities for asymptomatic contacts have been set up in every district
(Table 4).[23] Passenger data from affected countries as of June 14, 2026, is detailed in Table 5,
reflecting the heightened surveillance measures implemented across all airports since May 22,
2026.[23]
Disease management
Early Ebola symptoms, such as fever, aches, and fatigue that closely mimic malaria, and typhoid.
Because of these overlapping symptoms, prompt and accurate laboratory testing is crucial to
distinguish Ebola from other infections. Diagnosis relies primarily on molecular and serological
blood tests, including reverse transcription polymerase chain reaction (RT-PCR), antigen-capture
enzyme-linked immunosorbent assay (ELISA), antigen detection, and serum neutralization tests.
Table 4: District-wise Quarantine facilities for asymptomatic contacts in Kerala
District
Quarantine Centre
Thiruvananthapuram
CHC Iranimuttom
Kollam
CHC Nedumpana
Alappuzha
GH Alappuzha
FHC Kadavoor
Pathanamthitta
GH Adoor
CHC Enadimangalam
Kottayam
GH Pala
Idukki
CHC Vandamedu
Ernakulam
DH Aluva
THQH Kothamangalam
Thrissur
GH Thrissur
DH Wadakanchery
Palakkad
DH Palakkad
THQH Chittur
Malappuram
GMCH Manjeri
THQH Tirarangadi
Kozhikode
GH Kozhikode
Wayanad
GTH Nallornadu
THQH Sultan Batheri
Kannur
TH Pazhayangadi
Kasaragod
CHC Periya
THQH Vellarikkundu Poodamkallu
CHC=Community Health Centre; FHC=Family Health Centre; GH=General Hospital;
THQH= Taluk Headquarters Hospital; DH=District Hospital; GMCH=Government Medical College Hospital
Table 5: Ebola surveillance at points of entry in Kerala (as on June 14, 2026)
Points of
Entry
Number of passengers from affected countries since May 22, 2026
Asymptomatic
with no contact
Asymptomatic
with contact
history
Symptomatic
Quarantine
in Kerala
Cross
notified to
other states
Cochin Airport
24
0
0
24
0
TRV Airport
59
0
0
05
54
Calicut Airport
23
0
0
23
0
Kannur Airport
01
0
0
01
0
Points of entry*
68
0
0
68
0
Total
175
0
0
121
54
*Points of entry in other states (Destination Kerala); TRV=Thiruvananthapuram
Treatment focuses on intensive supportive care and intravenous (IV) fluid therapy, alongside Food
and Drug Administration (FDA)-approved monoclonal antibodies specifically targeted against the
Zaire ebolavirus strain.[8] In the absence of an approved vaccine or targeted treatment for the
Bundibugyo ebolavirus outbreak in Africa, mitigating human infection and mortality relies heavily
on public awareness and preventive measures. Educating communities on risk factors and
protective behaviours remains a primary line of defence.
Conclusion
After the recent emergency declarations by the WHO and Africa CDC, the Government of India
has proactively intensified nationwide surveillance and preparedness measures to safeguard public
health against any importation of Ebola into the country. In Kerala, the State Health Department
is strengthening surveillance and issuing detailed prevention guidelines to healthcare institutions
to forestall any potential import of the disease. Community engagement is the backbone of Ebola
outbreak control. While clinical care, surveillance and laboratory services are vital, educating the
public on risk factors and protective steps is one of the most effective ways to reduce human
infection and transmission of the disease. Early supportive care through rehydration and
symptomatic treatment directly improves patient survival. However, comprehensive studies are
still required to map the disease’s geographical distribution, to clarify its transmission modes, and
also to develop effective vaccines and therapeutics.
Acknowledgement
The author is grateful to Shri. Prakash Chandran, Director, Centre for Development Research and Action
(CDRA), Thiruvananthapuram, and Ms. S.B. Anusree, Research Assistant, NCDC, Thiruvananthapuram
for their technical support.
Financial support and sponsorship
Nil.
Conflict of interest
There are no conflicts of interest.
References
1. World Health Organization. Ebola disease. Key facts. 24 April 2025. Available from: https://www.who.int . [Last accessed on
2026 Jun 03].
2. Badetia VK. The Indian Diaspora is Critical to India’s Connections with Africa. International Journal of Advanced Research
in Management and Social Sciences 2016; 5(4):353-62.
3. Oman Observer. Ebola Spreading ‘fast’ in DR Congo warn WHO. June 19, 2026. Available from:
https://www.omanobserver.om. [Last accessed on 2026 Jun 20].
4. Gonzalez JP, Pourrut X, Leroy E. Ebolavirus and other Filoviruses. Curr Top Microbiol Immunol 2007; 315:363-87.
5. Weingartl HM, Nfron C, Kobinger G. Review of Ebola virus infections in domestic animals. Dev Biol (Basel) 2013;135:211-8.
6. Centers for Disease Control and Prevention. How Ebola Disease Spreads. June 2, 2026. Available from: https://www.cdc.gov.
[Last accessed on 2026 Jun 07].
7. World Health Organization. Sexual and reproductive health. Sexual transmission of Ebola Virus: evidence and knowledge
gaps. 4 April 2015. Available from: https://www.who.int.in. [Last accessed on 2026 Jun 08].
8. CD Alert. Ebola Virus Disease. National Center for Disease Control, Directorate General of Health Services, Ministry of
Health and Family Welfare, Government of India. May 2026. Available from: https://ncdc.mohfw.gov.in. [Last accessed on
2026 Jun 06].
9. Centers for Disease Control and Prevention. Signs and Symptoms of Ebola Disease. April 23, 2024. CDC. ESPANOL.
Available from: https://www.cdc.gov. [Last accessed on 2026 Jun 04].
10. Broadhurst MJ, Brooks TJ, Pollock NR. Diagnosis of Ebola Virus Disease: Past, Present, and Future. Clinical Microbiology
Reviews 2016; 29(4):773-93. Accessed on 7 June 2026.
11. Centers for Disease Control and Prevention. History of Ebola outbreaks. 29 May, 2026. Available from: https://www.cdc.gov.
[Last accessed on 2026 Jun 04].
12. Denise G. Ebola Outbreak in Congo is Declared a Global Health Emergency. The New York Times July 17 2019. Available
from: https://www.nytimes.com. [Last accessed on 2026 Jun 10].
13. Asadu C. WHO declares Ebola outbreak in Congo and Uganda a Global Health Emergency. Public Broadcasting Service
(PBS) News, Associated Press, May 17, 2026. Available from: https://apnews.com. [Last accessed on 2026 Jun 10].
14. World Health Organization. Disease Outbreak News. Ebola disease caused by Bundibugyo virus, Democratic Republic of the
Congo & Uganda. 16 May 2026. Available from: https://www.who.int. [Last accessed on 2026 Jun 10].
15. World Health Organization. Disease Outbreak News. Ebola disease ca World Health Organization. Epidemic of Ebola Disease
caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda determined a public health emergency of
international concern. 17 May 2026. Available from: https://www.who.int. [Last accessed on 2026 Jun 10].
16. World Health Organization. Disease Outbreak News. Ebola disease caused by Bundibugyo virus, Democratic Republic of the
Congo & Uganda. 29 May 2026. Available from: https://who.int. [Last accessed on 2026 Jun 26].
17. European Center for Disease Prevention and Control (ECDC). Ebola Disease outbreak in the Democratic Republic of the
Congo and Uganda. Updated 10 June 2026. Available from: https://www.ecdc.europa.eu. [Last accessed on 2026 Jun 11].
18. World Health Organization. Disease Outbreak News. Ebola disease caused by Bundibugyo virus, Democratic Republic of the
Congo &Uganda. 08 June 2026. Available from: https://www.who.int. [Last accessed on 2026 Jun 11].
19. Centers for Disease Control and Prevention. Ebola Outbreak: Current Situation. June 26, 2026. CDC. ESPANOL. Available
from: https://www.cdc.gov. [Last accessed on 2026 Jun 26].
20. Yeni Safak. Africa CDC warns 10 countries at risk of Ebola outbreak. 24.05.2026. Available from:
https://www.yenisafak.com/en. [Last accessed on 2026 Jun 12].
21. Catholic Relief Services | CRS. Ebola Outbreak in the DRC and Uganda: What’s Happening and How to Help. May 27, 2026.
Available from: https://www.crs.org. [Last accessed on 2026 Jun 14].
22. Ministry of Health and Family Welfare, Government of India. Union Health Minister Shri. JP Nadda Reviews Preparedness
Measures for Ebola Disease in View of Rising Cases in Parts of Africa. 25 May 2026. PIB Delhi. Available from:
https://www.pib.gov.in. [Last accessed on 2026 Jun 09].
23. Health & Family Department, Government of Kerala, Outbreak Control and Prevention Sate Cell. Daily Ebola bulletin dated
14.06.2026. Available from: https://health.kerala.gov.in. [Last accessed on 2026 Jun 17].
_____________________________________________________________________________________
© 2026 Journal of Experimental Biology and Zoological Studies
Published by UNIZOA