The 2018 Kivu Ebola outbreak began on 1 August 2018, when it was confirmed that four cases had tested positive for Ebola virus disease (EVD) in the eastern region of Kivu in the Democratic Republic of the Congo (DRC). The Kivu outbreak included Ituri Province, after the first case was confirmed on 13 August. This outbreak started just days after the end of the outbreak in Équateur province.
The affected province and general area are currently undergoing a military conflict, which is hindering treatment and prevention efforts. The World Health Organization's (WHO) Deputy Director-General for Emergency Preparedness and Response has described the combination of military conflict and civilian distress as a potential "perfect storm" that could lead to a rapid worsening of the outbreak. The WHO reports that since January there have been 42 attacks on health facilities and 85 health workers have been wounded or killed. In some areas aid organizations have had to stop their work due to violence. Health workers also have to deal with fake news and other misinformation spread by opposing politicians. Due to the deteriorating situation in North Kivu and surrounding areas the WHO raised the risk assessment at the national and regional level from "high" to "very high" on 27 September 2018; as of April 2019, the outbreak is not yet considered to be a Public Health Emergency of International Concern.
On 3 October, the United Nations Security Council stressed that all armed hostility should come to a stop in the DRC, to better fight the ongoing EVD outbreak. For the week ending 14 October, 33 cases were identified, of which 24 died. On 9 November, at 319 probable and confirmed cases the 2018 North Kivu and Ituri province Ebola virus outbreak became the biggest in the DRC's history, and by 30 November, the outbreak had become the second largest outbreak in recorded history, behind only the 2013–2016 West Africa epidemic. On 13 February 2019, the total cases (confirmed, probable and suspected) equalled 1,000 individuals in the DRC; it is a cases count ( ≥ 1,000) for a single country not seen since the 2013 West Africa Epidemic, in Liberia, Guinea and Sierra Leone. On 3 May 2019, nine months into the outbreak, the DRC outbreak surpassed 1,000 deaths due to the EVD epidemic that has yet to be brought under control. For comparison, during the West African Ebola virus outbreak which lasted two years, Guinea (one of the three hardest hit countries) had a total of approximately 2,500 deaths due to EVD.
Location of North Kivu and Ituri province in the Democratic Republic of the Congo