A record outbreak in eastern Congo
The Ebola outbreak in the Democratic Republic of Congo has surpassed 5,000 confirmed cases, according to government data released Wednesday, making it the deadliest Ebola outbreak in the country's history. Congo's Ministry of Health recorded 5,021 cases and 2,378 deaths as of Sunday.
Responders are warning that the virus is spreading at an unprecedented speed, outpacing efforts to slow it in the remote eastern part of the country. Starting from the first officially confirmed case in mid-May, the current outbreak has spread about three times faster than the deadliest on record, according to multiple reports.
The outbreak is caused by the Bundibugyo virus, a rare type of Ebola that has no approved vaccine or treatment. It is already the worst ever caused by this virus and the deadliest Ebola outbreak in Congo's history. The World Health Organization has warned it could eventually surpass the devastating 2014-2016 outbreak in West Africa, which killed more than 11,000 people.
Far from under control
At a meeting convened by the agency on Tuesday, WHO Director-General Tedros Adhanom Ghebreyesus said the outbreak "has spread rapidly and the risk of further national and international spread remains high." He added: "We must be frank: the epidemic is far from being under control."
The WHO has said the outbreak remains a global health emergency with a high risk of spreading to more countries in the region. The agency has advised against broad travel or trade restrictions, saying they could disrupt supply chains and make it harder to move resources needed to fight the outbreak.
A response under strain
The response in the six eastern provinces has been complicated by ongoing armed conflict, mass displacement, and weakened healthcare services. Acute shortages and delays in funding reaching the ground have left overworked health staff unpaid for months, triggering strikes and walkouts on the frontline.
Thérèse Anyiya, a nurse working in Ituri's capital Bunia, said she is exhausted by the work demands and poor working conditions. "If the managers don't take things seriously, we too will end up withdrawing. The way this epidemic is being managed is exhausting," she told the Associated Press.
Deep mistrust within communities has led to attacks on health workers, notably at the epicenter in Ituri province. Residents on Monday attacked a health team in the territory of Aru after a suspected case was reported there. A mob set fire to an ambulance and damaged two other vehicles, according to Michael Wani, president of the Union of Cultural Associations for the Development of Ituri.
Most new cases are being reported outside of the people being monitored, showing the virus has spread quickly and left surveillance teams racing to catch up. Contact tracing has been difficult, with 60% to 70% of new cases detected among people who weren't already being monitored, according to the WHO.
Other challenges include threats from rebel groups, anger from long-traumatized communities, territories difficult to reach due to bad roads, and misinformation asserting that Ebola isn't real.
A rare virus
The Bundibugyo virus was first identified in Uganda in 2007 during an outbreak that killed 37 people; the only other known outbreak occurred in Congo in 2012. The current outbreak has crossed into Uganda, which has since stopped transmission, according to the WHO; a confirmed case was reported in France in June in a doctor who recovered.
The first detected patient in the current outbreak developed symptoms in late April and died in Bunia; health officials were alerted in early May to a cluster around Mongbwalu, and the outbreak was declared on May 15. Experts believe the virus may have been spreading from Mongbwalu as early as February, months before the declaration.
The case fatality rate is 47.4% overall but 70% in North Kivu province. The current outbreak has surpassed Congo's 2018-2020 outbreak, which infected nearly 3,500 people and killed more than 2,200.
Ebola spreads through direct contact with blood or bodily fluids of infected people or objects contaminated with those fluids, and is not generally airborne. Symptoms appear 2-21 days after infection and include fever, fatigue, headache, muscle pain, sore throat, vomiting, and diarrhea; some patients develop internal or external bleeding.
Vaccine doses arrive
Congo has received more than 16,000 doses of the Ervebo vaccine, the country's health minister said. The 16,250 doses arrived at N'djili International Airport in the capital, Kinshasa, late Friday, as part of 70,000 doses expected from the WHO and partners. The Ervebo vaccine is licensed for Ebola and may provide some protection against the Bundibugyo virus, according to the WHO.
The latest outbreak has recorded 2,557 deaths out of 5,375 confirmed cases across six affected provinces, according to Africa CDC data. Data from the Africa Centre for Disease Control shows that transmission has not yet peaked and could reach three times its known rate.
Over the weekend, the WHO warned that the outbreak reached a weekly record of 579 cases and 304 deaths in the previous week. UN humanitarian chief Tom Fletcher announced the allocation of an additional $30.5 million and deployment of 20 more staff, saying "This is a wake-up call."