Ebola outbreak expands to two more health zones in DR Congo

The Ebola outbreak in the Democratic Republic of the Congo has reached two additional health zones, with new cases reported in Bulu in South Ubangi governorate and Dungu in Haut-Uele province, according to the World Health Organization.

The expansion brings the outbreak to 63 affected health zones across seven provinces. Bulu is near the border with the Central African Republic, while Dungu is close to South Sudan, according to the information provided by WHO.

As of September 23, the DRC had recorded 7,890 confirmed Ebola cases and 3,799 deaths, WHO said. The outbreak is caused by the Bundibugyo strain, for which less is known and no approved vaccines are currently available.

Conflict complicates response

WHO Director-General Tedros Adhanom Ghebreyesus said insecurity and population movements were making it harder for response teams to reach communities and identify people who may have been exposed.

“It’s very difficult to see Ebola in isolation because even our response to Ebola is affected by the conflict, because there is displacement and there is an access problem to some areas,” Tedros said.

Health workers seeking contacts of people exposed to the virus have also been unable to meet their targets. Dr Jean Kaseya, director-general of the Africa Centres for Disease Control and Prevention, said the number of people being monitored was far below the estimated total.

Kaseya said more than 7,000 confirmed cases should correspond to about 420,000 contacts, but only 30,000 people were on the contact list.

“When the outbreak is at community level, we cannot talk about control,” he said.

Ituri remains the epicentre

Ituri province remains the centre of the outbreak, while North Kivu is the second most affected province. The source report said Ituri had recorded 6,032 confirmed cases since the epidemic began in May, including 868 in the previous 21 days.

North Kivu had reported 1,480 cases, with 567 recorded during the previous 21 days. WHO said the province accounted for about one-third of newly confirmed cases and deaths. Nearly 60 percent of people diagnosed there had died, compared with a national death rate of 48 percent cited in the report.

Medical staff in North Kivu said some patients were delaying visits to health facilities. Dr Michel Paluku Mukuloli, a doctor at a hospital in Butembo, said some patients feared they would be sent to treatment centres and would not survive.

“Patients think that if they arrive at the hospital, they will be immediately sent to the treatment centre to die,” Mukuloli said.

Responders have also reported that the Bundibugyo strain can begin with relatively mild symptoms resembling malaria or typhoid fever. That similarity may make early identification more difficult.

Trials being accelerated

Tedros said WHO was accelerating clinical trials of vaccines and treatments for the strain. The organisation has described the outbreak as difficult to manage because there are no approved vaccines for Bundibugyo Ebola.

North Kivu has experienced three previous Ebola outbreaks, including one between 2018 and 2020. Those outbreaks were caused by the Zaire strain rather than Bundibugyo.