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Timeline of the outbreak

According to Tedros Adhanom Ghebreyesus, the head of the World Health Organization, the outbreak may have started as early as January. Based on models of the spread of Bundibugyo virus, it is estimated that the virus crossed over into humans in January or February, the most plausible time of a spillover event being in mid-to-late February. An investigation indicates that outbreak may have started with the funeral of a pastor in Mongbwalu on 4 February, meaning that the pastor may have been patient zero. During the funeral, the coffin was broken and the corpse was handled by family members; despite the pastor never being diagnosed with Ebola, nearly 50 others were reported to have died with Ebola-like symptoms following the funeral, including several of his brothers.

Initially, the earliest known suspected case (index case) in Ituri was a man who began experiencing haemorrhagic symptoms on 24 April 2026. Early intra-household transmission occurred when a sibling developed symptoms on 26 April and died the following day. The index case subsequently died on 28 April. On 23 May, the Red Cross announced that three workers who died between 5 and 16 May are believed to have contracted Ebola on 27 March during dead body management activities in Mongbwalu before the outbreak had been identified.

A potential outbreak signal was reported on 30 April, though initial testing in Bunia was negative for Zaire Ebola and samples were sent to the INRB laboratory in Kinshasa. On 5 May, the WHO was alerted to the potential Ebola outbreak in Ituri and dispatched a response team. On 14 May, the INRB confirmed eight cases of a non-Zaire filovirus aetiology. Genomic sequencing on 15 May classified it as of the Bundibugyo ebolavirus species. That same day, Uganda declared an outbreak due to an imported case.

On 15 May, the Congolese Ministry of Public Health, Hygiene, and Social Welfare publicly confirmed the outbreak of Ebola virus disease in the Ituri Province, including 246 suspected cases. By 16 May, the three health zones of Bunia, Mongwalu and Rwampara in Ituri had confirmed or suspected cases. Cases were confirmed in the Ugandan capital Kampala. The next day, the World Health Organization reported eight laboratory-confirmed cases of Bundibugyo virus in Ituri, one confirmed case in Kinshasa, and two confirmed cases in Kampala. Furthermore, given the unusual clusters of suspected cases appearing across multiple parts of the eastern DRC, the WHO was unable to ascertain the geographic spread of the epidemic or the true number of infections. Alongside the cases in Uganda confirming an international risk, this led the WHO to declare the epidemic a public health emergency of international concern.

Cases were later reported in Goma, North Kivu Province on 17 May, a territory controlled by the March 23 Movement, Butembo in North Kivu and the Nyakunde health zone in Ituri on 18 May, a fatality in Congo River Alliance controlled Bukavu, South Kivu province on 21 May, Beni, North Kivu on 29 May, Haut-Uélé province on 29 June, Kisangani, Tshopo province on 30 June (death 27 June in Bunia), and Buta, Bas-Uélé province on 13 August.

Confirmed cases in the DRC exceeded 1000 cases on 20 June, 2000 cases on 13 July, 3000 cases on 24 July, and 4000 cases on 7 August. The death toll reached 500 on 4 July, 1000 on 22 July, and 2000 on 9 August.

On 18 May, WHO reported that the DRC had 516 suspected cases and 131 deaths, in addition to 33 confirmed cases and four confirmed deaths in four health zones in Ituri Province and three health zones in North Kivu Province. Uganda had two confirmed cases and one confirmed death in Kampala.

On 22 May, the WHO upgraded the Ebola risk level in the DRC to "very high", while the regional risk remained "high" and the global risk remained low.

The DRC Ministry of Health updated its total suspect case count on 29 May to remove suspected cases ruled out after investigation and suspected deaths pending the results of ongoing investigation. The WHO followed suit on 2 June, announcing that only 116 cases out of 906 were still suspected following additional testing.

On 24 June, France confirmed its first case after a doctor who had been in the DRC on a humanitarian mission returned to the country.

On 11 July, the United States confirmed that a citizen of theirs working for a humanitarian organisation to combat the outbreak in DR Congo tested positive for the disease.

On 15 July, the humanitarian organisation Médecins Sans Frontières described the epidemic as follows: "In two months, this outbreak has become the third largest, and fastest growing, Ebola disease outbreak on record", adding that communities outside of major urban areas remain without adequate support.

On 2 August, the WHO noted that this is the second largest outbreak of Ebola disease in history, exceeded only by the Western Africa Ebola epidemic of 2013–2016.