[7] The outbreak began on 8 May 2018, when it was reported that 17 people were suspected of having died from EVD near the town of Bikoro in the Province of Équateur.

[1][11] On 17 May, the virus was confirmed to have spread to the inland port city of Mbandaka, causing the WHO to raise its assessment of the national risk level to "very high",[12][13] but not yet to constitute an international public health emergency.

[15][16][3] Subsequent to the end of this outbreak, the Kivu Ebola epidemic commenced in the eastern region of the country on 1 August 2018;[17] it was declared over on 25 June 2020 with 2,280 deaths recorded.

[23] Équateur province's Provincial Health Division reported 21 cases with symptoms consistent with Ebola virus disease, of whom 17 had died, on 3 May 2018.

[25] The outbreak was declared on 8 May after samples from two of five patients in Bikoro tested positive for the Zaire strain of the Ebola virus.

The WHO reported on 17 May 2018 that the first case of this outbreak in an urban area[22] had been confirmed in the Wangata district of Mbandaka city, the capital of Équateur province, about 100 miles north of Bikoro.

[24][22] The following day, the WHO raised the health risk in DRC to "very high" due to the presence of the virus in an urban area.

[13] The DRC government was particularly concerned about the virus spreading by boat transport along the Congo between Mbandaka and the capital, Kinshasa.

[46] On 29 May, the WHO indicated that nine neighbouring countries had been alerted for being at high risk of spread of EVD,[47] On 4 June, it was reported that Angola had closed its border with the DRC due to the outbreak.

[24][25] Bikoro lies in dense rain forest,[22] and the area's remoteness and inadequate infrastructure hindered treatment of EVD patients, as well as surveillance and vaccination efforts.

[42] Adherence was another challenge: on 20–21 May, three individuals with EVD in an isolation ward of a treatment center in Mbandaka fled; two later died after attending a prayer meeting, at which they may have exposed 50 other attendees to the virus.

[22] After the virus spread to the city of Mbandaka, DRC health minister Oly Ilunga Kalenga announced that healthcare would be provided free for those affected.

[65][66] US President Donald Trump has advocated rescinding Ebola funding and most financing for State Department emergency responses.

[24] The DRC Ministry of Public Health identified 115 areas where movement of people increased the risk of virus transmission, including 83 river ports, nine airports and seven bus stations, as well as 16 markets.

[69] A laboratory commenced operations in Bikoro on 16 May, enabling local testing of patient samples for Ebola virus.

[23] Burials were organized by MSF and the Red Cross of the Democratic Republic of the Congo to minimize the risk of transmission.

This live-attenuated vaccine expresses the surface glycoprotein of the Kikwit 1995 strain of Zaire ebolavirus in a recombinant vesicular stomatitis virus vector.

[7] Health officials considered trialing experimental treatments, including the antiviral agents favipiravir and GS-5734, and the antibody ZMapp.

The panel agreed that "the benefits of ZMapp outweigh its risks" while noting that it presented logistical challenges, particularly that of requiring a cold chain for distribution and storage.

[2] In 2014, the WHO considered that the DRC was lagging behind the rest of Africa in health expenditures, at the relative rate of Intl$32 per head.