Ebola outbreak in Congo kills 1,521, becomes second-deadliest ever as cases double every 20 days

Scale of the outbreak

The Ebola outbreak in eastern Democratic Republic of Congo has killed 1,521 people and infected 3,442 since the first confirmed case in late April, according to government figures released on Thursday. The Bundibugyo strain, for which no approved vaccine exists, has a case fatality rate of 44 percent. Cases are doubling every 20 days, making this the fastest-growing Ebola outbreak ever recorded. The Africa Centres for Disease Control and Prevention said the sharp rise partly reflects a backlog of unconfirmed cases. Dr. Jean Kaseya, its director general, told reporters that authorities are not in control.

I'm not in a position to tell you we are in total control of this outbreak today.

Carl Skau, deputy head of the World Food Programme, called it the fastest-growing Ebola outbreak of all time. The outbreak is already the second-deadliest on record, surpassing the 2018-2020 Congo epidemic that took more than 10 months to reach a similar toll. By comparison, the 2014-2016 West Africa outbreak, which killed over 11,000 people, needed eight months to record 1,000 deaths; the current outbreak reached that mark in two months.

This is the fastest-growing Ebola outbreak of all time.

Response overwhelmed

Health authorities are struggling to keep pace. Contact tracing covers only 78 percent of known contacts, well below the 95 percent threshold needed to break transmission chains. In the past two weeks, 63 percent of confirmed deaths occurred outside treatment centres, often because families handled highly infectious bodies. The World Health Organization declared a public health emergency in mid-May, but the virus is believed to have been circulating since February. A strike by healthcare workers in Ituri over unpaid wages and unsafe conditions, and a July 15 attack on a hospital and treatment centre in Nyakunde that forced international partners to relocate, have further hampered the response. Julien Harneis, the UN Ebola coordinator, said the gap between the epidemic and the response is widening.

The number of cases is rising exponentially, doubling every 20 days. This is far faster than the expansion of our aid measures. We must massively strengthen our response, in terms of supplies, especially protective equipment, and personnel, whether medical specialists or logisticians.

Regional dimensions

Ituri province, a conflict-ridden region on the border with Uganda and South Sudan, accounts for nearly 90 percent of cases. Five other provinces have confirmed infections, including Kisangani, one of the country's largest cities. Uganda declared its own related Bundibugyo outbreak over on Tuesday after four weeks with no new cases, recording 20 infections and three deaths. Health Minister Chris Baryomunsi urged continued vigilance and pledged support to Congo.

I have urged Ugandans to remain vigilant. We will continue to support our brothers and sisters in the Democratic Republic of Congo in containing the Ebola epidemic there.

Funding and aid cuts

The UN has received less than half of the $2.1 billion requested for the response. Skau said the WFP had been forced to cut support from three million people in the region to one million, and 1,000 health centres had closed due to lack of funds. Harneis called on member states to keep borders open so personnel and supplies can move freely.

Outlook

The World Health Organization estimates the true number of infections could be two to four times higher than confirmed cases. Epidemiologist Maximilian Gertler, who has worked on multiple Ebola outbreaks with Médecins Sans Frontières, warned that without a massive scale-up, the outbreak could extend well into next year and spread to neighbouring countries.

If that does not happen to a sufficient extent, we must currently assume that the outbreak will continue for a very long time, certainly into next year, and could also reach other countries in the region.