Outbreak Reaches New Province, Cases Top 5,000

Congo's Ebola outbreak has now spread to a sixth province, with the Africa CDC Director-General Jean Kaseya reporting Thursday that a man died in Bas-Uele province after traveling from Isiro in Haut-Uele to Buta, the provincial capital. The outbreak, caused by the rare Bundibugyo virus, has surpassed 5,000 confirmed cases, according to Congo's Ministry of Health, which recorded 5,021 cases and 2,378 deaths as of Sunday.

The World Health Organization has warned that the outbreak could eventually surpass the 2014-2016 West Africa epidemic that killed more than 11,000 people. The current outbreak is already the worst ever caused by the Bundibugyo virus and the deadliest Ebola outbreak in Congo's history, according to the WHO and Congo's Ministry of Health.

The Rare Virus and Its Challenges

The Bundibugyo virus is a rare type of Ebola with no approved vaccine or treatment. Unlike the more common Zaire virus, which caused many of Congo's previous outbreaks, Bundibugyo has only been identified twice before: in western Uganda in 2007, where it killed 37 people, and in Congo in 2012. Clinical trials of two possible treatments for this strain began last month in Ituri province, according to the Africa CDC.

The current outbreak's case fatality rate is 47.4% overall, but in North Kivu province it reaches 70%. Nearly half of confirmed patients have died. The virus spreads through direct contact with blood or other bodily fluids of infected people, and through contaminated objects; it is not generally airborne. Symptoms appear two to 21 days after infection, often starting with fever, fatigue, and headache.

Rapid Spread and Response Challenges

The outbreak has grown quickly. The death toll of over 2,100 was reached almost three times faster than in the 2014-16 West Africa outbreak, the worst on record. Health authorities say 60% to 70% of new cases are among people who were not already being monitored, describing the spread as "alarming." WHO regional director for Africa, Dr. Mohamed Yakub Janabi, said, "We are chasing the virus; the virus is ahead of us."

The outbreak is unfolding amid strikes by unpaid health workers, threats from rebel groups, community anger, and misinformation claiming Ebola isn't real. Health workers at the Nizi Treatment Center in Ituri province went on strike Thursday, temporarily closing the center after saying they had not been paid for three months. Six of Congo's 26 provinces are now affected.

The outbreak was declared on May 15, but WHO sequencing indicates it began months earlier, in February. It has crossed into neighboring Uganda, which has stopped transmission, and a confirmed case in France in June involved a doctor who recovered.