DRC Ebola outbreak becomes deadliest in country's history with 2,325 deaths

Surpassing the 2018-2020 outbreak

Government data released on August 16 confirmed that the Ebola outbreak in the Democratic Republic of Congo has killed 2,325 people, exceeding the 2,299 deaths recorded during the 2018-2020 outbreak and becoming the deadliest in the country's history. The DRC's National Public Health Institute reported 4,945 confirmed cases, including 101 new cases detected in the preceding 24 hours. This is the DRC's 17th Ebola outbreak, and it had already become the biggest in the country's history by number of cases in late July.

The outbreak was declared on May 15 and in May the WHO declared it a public health emergency of international concern, covering both the DRC and Uganda. On Friday the UN warned that the epidemic was killing one person every 30 minutes.

A virus with no approved vaccine

The current outbreak is caused by the Bundibugyo species of Ebola virus, for which there are no approved vaccines or treatments. The outbreak has gained momentum since it was declared, as weak health infrastructure, the region's remoteness, and ongoing conflict near the DRC's borders with South Sudan, Uganda, and Rwanda have hindered response efforts.

On Wednesday, WHO Director-General Tedros Adhanom Ghebreyesus said that at its current pace the outbreak is on track to eclipse the West African Ebola outbreak of 2014 to 2016, which killed more than 11,000 people across Guinea, Liberia, and Sierra Leone. According to the WHO, that earlier crisis resulted in 28,616 cases and 11,310 deaths.

Rising fatality and late detections

The proportion of people dying after a confirmed infection, the case fatality ratio, has risen from about 20 percent in early June to 46 percent, according to government data, meaning nearly one in every two confirmed cases is now deadly. Thomas Parisch, a public health specialist deployed to the DRC with medical charity Doctors Without Borders (MSF), described the trend as unusual.

Normally, as an outbreak progresses, the case fatality ratio should fall as contact tracing improves and patients are identified and treated earlier.

Instead, we're still seeing many cases detected very late, when treatment is less likely to succeed, with many identified only after they die in the community.

Geographic spread and international response

Six of the DRC's 26 provinces have been affected, mainly along the country's north-eastern border. More than 3,400 of the cases have been recorded in Ituri province, where the outbreak was first reported. Uganda has reported at least 20 cases, all in the capital, Kampala.

Tom Fletcher, the United Nations humanitarian chief, said in a statement on Friday that the outbreak is the fastest growing on record.

We need speed, scale, and solidarity before this virus gets even further ahead of us.

Ebola is winning in the Democratic Republic of the Congo. We cannot let the virus outrun our response.