Health authorities in Africa said on Friday that 246 suspected Ebola cases and 65 deaths had been recorded in Ituri province in northeastern Democratic Republic of Congo, while Uganda reported one Ebola death in Kampala after a Congolese man traveled across the border.

The Africa Centres for Disease Control and Prevention said preliminary laboratory results from Congo had detected the Ebola virus in 13 of 20 samples tested, and that four deaths had already been reported among laboratory-confirmed cases. Uganda's Ministry of Health said the man who died in Kampala was tested after Kinshasa announced the outbreak, and that the country has not yet confirmed a locally transmitted case.

The numbers point to a fast-moving emergency in a region that has seen Ebola before and where cross-border movement can quickly carry infections far from the original cluster. Ituri is more than 1,000km from Kinshasa, and suspected cases have also been reported in Bunia, pending confirmation.

The outbreak comes about five months after Congo's last Ebola outbreak was declared over. That outbreak left 43 people dead, and the country has had more than a dozen Ebola outbreaks since the disease was first identified in 1976 and thought to have crossed over from bats. The deadliest outbreak in Congo, from 2018 to 2020, killed nearly 2,300 people.

There is also a second crisis in the same province. Last week, an attack by armed rebels in Ituri killed at least 69 people, underlining how hard it is for the Congolese government to secure the eastern part of the country, where armed groups compete for control of valuable mineral deposits and road access is poor.

Jay Bhattacharya said the CDC had extensive experience and expertise in responding to Ebola outbreaks and was working closely with Congo's health ministry through its country office to support response efforts. He also said the agency had heard from Uganda's government confirming an outbreak there and was coordinating with its country office and local colleagues to track and help with the response. Africa CDC said it was convening an urgent high-level meeting with health authorities from Congo, Uganda and South Sudan, along with key partners, to strengthen cross-border surveillance, preparedness and response.

The immediate question is whether the deaths in Congo and Uganda are linked by a wider chain of transmission or whether health workers can still contain the spread before it hardens into another regional outbreak. With cases already appearing on both sides of the border, the answer will depend on speed, testing and cooperation now, not later.