Congo Ebola Outbreak Hits an 8th Province as Cases Pass 9,000

What happened

The Ebola outbreak in the Democratic Republic of Congo has spread to an eighth province. Two cases were confirmed in North Ubangi, a province on Congo’s northern border with the Central African Republic, two health officials told Reuters on Oct. 15. Congolese authorities had not yet announced the cases publicly.

Testing began after a string of suspected deaths in a mining area of the Wapinda health zone, close to the border with Bas-Uele province. Samples were sent to a provincial lab and to Kinshasa, the capital, for analysis.

The move north matters because it carries the Congo Ebola outbreak to the edge of a new neighboring country. The epicenter is still Ituri province in the far east, which accounts for roughly 88% of cases.

The numbers

Sources: AP via Al Jazeera and Africanews.

Besides Ituri and North Ubangi, cases have been confirmed in North Kivu, South Kivu, Tshopo, Haut-Uele, Bas-Uele and South Ubangi, according to Reuters. North Kivu has seen a recent rise.

How big is this outbreak?

It is the largest and deadliest Ebola outbreak in Congo’s history, and the second deadliest anywhere. Only the 2014–2016 epidemic in Guinea, Liberia and Sierra Leone was worse. WHO figures cited by AP put that epidemic at 28,600 confirmed infections, with deaths topping 11,000.

Put side by side, Congo’s death toll is already about 40% of West Africa’s. The speed is the alarming part. In mid-August, the WHO said there had been more than 2,000 deaths and called this the fastest-moving Ebola outbreak on record, Al Jazeera reported. The toll has more than doubled in the two months since.

The death rate is also higher. Roughly 48% of confirmed patients in Congo have died, compared with about 39% in West Africa, based on the totals above.

A quick timeline

• February: Genetic sequencing later showed the virus was already spreading quietly.
• May 15: Congo declares its 17th Ebola outbreak, in Ituri.
• August: Uganda is declared Ebola-free after 20 cases and two deaths. The WHO warns Congo’s outbreak could become the deadliest ever.
• Early October: Kenya records its first case.
• Oct. 13: Confirmed cases pass 9,000.
• Oct. 15: Cases are confirmed in North Ubangi, the eighth province.

Why this strain is different

Ebola is a family of viruses, not one virus. The vaccine and antibody treatments developed after West Africa’s epidemic target the Zaire species. This outbreak is caused by Bundibugyo, a rarer species that had caused only two earlier outbreaks, in Uganda in 2007–2008 and in Congo in 2012.

No vaccine or treatment is approved for Bundibugyo. That leaves responders relying on older tools: finding cases fast, tracing their contacts, isolating the sick and making burials safe. Ebola spreads through contact with the bodily fluids of an infected person, which is why caregivers and funeral attendees face the highest risk.

Why it’s so hard to stop

Officials and aid groups point to several problems at once:

• Conflict. Fighting between the M23 rebel group and government forces makes it hard to move supplies into remote areas, AP reports.
• Mistrust. Many residents believe the outbreak is an excuse for officials to steal money. In September, a local politician in eastern Congo was beaten to death after defending the government’s Ebola response on the radio, according to his party.
• Weak health systems. The WHO has cited poor infrastructure, under-resourced clinics, misinformation and health worker strikes over unpaid wages.

The spread beyond Congo

Kenya became the fourth country with a case tied to Congo’s epidemic. Its first patient, a Kenyan citizen who had been living in Congo, traveled by road into Uganda and then flew to Nairobi, where he died. Officials have not explained how he got into Uganda, which closed its border with Congo in May.

On Oct. 14, Kenya’s health ministry confirmed a second case: a 39-year-old man who is a close relative of the first patient. He was already in quarantine when he developed a fever, fatigue and joint pain, and he is being treated at a designated center.

What happens next

• Vaccine trials. The WHO expects the first vaccine trial in Congo by the end of October. Dr. Chikwe Ihekweazu, head of the WHO’s emergencies program, said on Oct. 13 that it should begin in the coming weeks.
• Which vaccines. A single trial is planned to test several candidates, AFP reported. Merck’s Ervebo, licensed for the Zaire strain, is expected to go first because early data, mostly from animals, suggests some cross-protection. Moderna and the University of Oxford also have Bundibugyo vaccines in safety trials in the U.K. and Canada.
• North Ubangi. Watch for Congo’s government to confirm the new cases and for any reports from the Central African Republic side of the border.
• Duration. In August, the WHO’s projections said a moderate scenario would peak within six months, while a severe one could last nine to 12 months.

Quick answers

Is there an Ebola vaccine for this outbreak?

Not an approved one. Existing Ebola vaccines target a different species, and Ervebo is being used against Bundibugyo only inside clinical research while trials get underway.

How does Ebola spread?

Through direct contact with the blood or other bodily fluids of someone who is sick or has died from it. It is not spread through the air like measles or the flu.

Which countries have Ebola cases now?

Congo has the vast majority. Uganda had cases earlier this year but was declared Ebola-free in August, and Kenya has confirmed two cases.

This article is general information, not medical advice. Talk to a health care provider about your situation.