The Democratic Republic of the Congo (DRC) is facing a significant Ebola outbreak, with health officials expressing concerns that the virus may be undergoing mutations as the number of confirmed cases exceeds 4,000.
The African public health authority has indicated that the time for gradual measures has passed and announced an initiative to enhance the response efforts, including a strategy to conduct “door-to-door” outreach in search of affected individuals.
This outbreak, attributed to the Bundibugyo strain, was initially reported on May 15, although it is suspected that the virus may have been circulating since January. As of August 4, the DRC’s national public health institute reported 3,973 cases and 1,801 fatalities. During a press conference on Thursday, Dr. Jean Kaseya, the director general of the Africa Centres for Disease Control and Prevention (Africa CDC), confirmed that the number of cases has now surpassed 4,000.
This incident marks the second-largest Ebola outbreak in history. Comparatively, there are eight times the number of cases and six times the fatalities compared to the early weeks of the West Africa Ebola outbreak from 2014 to 2018, which ultimately affected over 28,000 individuals and resulted in at least 11,000 deaths.
Dr. Kaseya mentioned discussions with Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, regarding studies to determine if there are any complications, including potential mutations of the virus. He noted that the severity of this Bundibugyo outbreak is unprecedented.
The majority of Ebola-related deaths are occurring within the community rather than in medical facilities. In a treatment center operated by Médecins Sans Frontières (MSF) in Bunia, the capital of Ituri province, it was found that 90% of patients admitted did not appear on the official contact lists. This highlights significant untracked transmission levels.
Dr. Kaseya pointed out that contact tracing efforts in the DRC are inadequate, with only about 10 contacts identified for each Ebola case, while the expected number is closer to 40.
Ebola, a viral hemorrhagic fever, can result in severe symptoms such as vomiting, diarrhea, organ failure, and internal bleeding. The outbreak is primarily located in the conflict-affected Ituri province but has also spread to Nord-Kivu, Sud-Kivu, Haut-Uele, and Tshopo. Uganda reported 20 cases before successfully controlling its own outbreak.
Dr. Wessam Mankoula, who is acting as the head of emergency preparedness and response at Africa CDC, stated that response teams are shifting focus from contact tracing to actively searching for cases. Community health workers will be visiting households to inquire about anyone exhibiting Ebola symptoms. He remarked, “The time for incremental action is over; we are entering a phase of scaling up our efforts.”
Dr. Kaseya emphasized a “village-centered response” that will engage local communities, utilize more digital resources, and provide increased support in camps for individuals displaced by conflict in the affected regions.
Additionally, officials announced plans to administer the antiviral medication remdesivir on a compassionate use basis for treatment, and they will evaluate whether the Ervebo vaccine, approved for a different strain of Ebola, should be deployed in the impacted provinces. Preliminary data suggests that individuals vaccinated with Ervebo experienced less severe disease and had “zero deaths.”
Dr. Placide Mbala Kingebeni, Africa CDC’s director of research, clinical trials, and innovation, remarked, “Given the expansion of this outbreak, relying solely on public health measures will not suffice to swiftly control or eradicate this situation.”
The DRC authorities are also investigating a suspected Ebola-related death on a vessel traveling to Kinshasa from northeastern regions, with plans to quarantine and test other passengers on board.
UNICEF has raised alarms about the outbreak’s disruption of essential healthcare services, as fear of infection and service interruptions deter families from seeking care. In Mongbwalu, the mining town at the outbreak’s epicenter, the percentage of children receiving their first measles vaccine has plummeted by 69%.
