What is driving the spread of Ebola to new cities?

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Ebola is spreading to new cities because infectious bodies and burial risks are crossing provincial boundaries amid local mistrust and disrupted containment

More than 400 people have died as the Ebola outbreak spreads beyond its northeastern Ituri epicentre, reaching places such as Kisangani, nearly 600 kilometres away, and also moving into North Kivu and South Kivu. A key factor highlighted by health authorities is that the body of an Ebola victim was secretly transported by motorcycle to Kisangani from the Nia Nia health zone in Ituri, even as Ebola victims’ bodies remain highly infectious and can transmit the virus during burial rites. The outbreak response is further complicated by community resistance that has already led to an Ebola health centre being set on fire, allowing suspected cases to escape and protesters to retrieve bodies.
A secretly moved infectious body reached Kisangani
A first case in Kisangani was confirmed after a test on the body of a 24-year-old pregnant woman returned positive for Ebola, according to the National Institute of Public Health (INSP). Health authorities said the deceased’s body was secretly transported by motorcycle to Kisangani from the Nia Nia health zone in Ituri. Because a deceased Ebola victim’s body remains highly infectious and the virus has been transmitted during burial rites, this kind of movement and burial handling can help the virus reach new cities.
Burial rites and contact with bodily fluids are central to transmission
Ebola spreads through contact with bodily fluids, and the outbreak reporting specifically notes transmission during burial rites. This means that movement of cases or bodies into a new urban area can translate into exposure during funeral practices, not just through proximity at the original site. In the Kisangani case, the infectious body was transported from Ituri, tying the new-city case to events that can occur around death and burial.
Community mistrust disrupted isolation and sanitary burials
Health and aid workers face deep mistrust in Ituri, with some locals denying the disease exists and others accusing international organisations of profiting. In Nia Nia, an Ebola health centre managed by local health authorities was set on fire, and seven suspected cases who were in isolation fled and had not been found at the time of reporting. Protesters also retrieved two bodies before sanitary burial, after opposing burial practices and believing the illness was a “business,” creating a direct setting for infectious exposure.
Containment is also strained by shortages and escape incidents
Authorities described the risk of spreading as “major” after the centre was torched, with police intervening using warning shots and one police officer dying during the attack. Equipment and basic supplies in Ituri were reported as lacking, including protective kits and chlorine, which affects the ability to manage outbreaks in affected zones. In this context, escape from isolation and retrieval of bodies in places like Nia Nia can increase the chance that Ebola reaches additional locations, including cities such as Kisangani.

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What is driving the spread of Ebola to new cities?

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