Eighth province hit

Congo's Health Ministry said on Sunday, 18 October, that two cases, including one death, had been recorded in Nord-Ubangi province, which borders the Central African Republic. Both patients were men in their 20s living in the Wapinda health zone, which borders Bas-Uele province, where cases had already been reported. Nord-Ubangi lies between Sud-Ubangi and Bas-Uele, the two provinces the disease had reached previously along that border. Two cases in the province had been reported on Thursday, 15 October, citing two health officials, before any official government statement. The national public health institute confirmed the infections and named the eighth affected province, joining North Kivu, Ituri, Haut-Uele, Tshopo, South Kivu, Bas-Uele and South Ubangi.

Outbreak totals and hotspots

The latest situation report, covering the 24 hours to 16 October, puts the cumulative total at 9,415 cases and 4,536 deaths since the outbreak was declared in mid-May. That day added 67 new confirmed cases and 26 deaths, with Ituri reporting 44 of the new cases. Earlier reports had cited at least 9,400 cases and more than 4,500 deaths. Ituri remains the epicentre, accounting for almost three quarters of confirmed cases, and government data shows 66 health zones affected since the start of the outbreak. The strain is Bundibugyo, for which there is no approved vaccine or treatment.

Mohamed Yakub Janabi, WHO regional director for Africa, spoke to The Associated Press in Beni in eastern Congo on Friday, 16 October.

“We see pockets of Ebola generally going down, but unfortunately geographically it's spreading out.”

He said convincing sick people to seek medical care has been one of the biggest challenges, and that some deaths occur in communities outside health centres.

Kenya's eighth case

Kenya's Director-General for Health, Patrick Amoth, told Citizen TV that 38 people were tested on Sunday and one returned positive. The new patient, a 49-year-old man who worked as a patient attendant cleaning utensils and linen, was likely exposed to Kenya's first case. That patient, a man who had travelled from the DRC to Nairobi, died at a Nairobi hospital on 5 October. The ministry had reported four new cases on Saturday, 17 October, three of them health workers who treated the first patient and one person related to the deceased man. Amoth said the six other patients were stable after supportive treatment.

“He is a 49-year-old man who is not a healthcare worker.”

Regional spread and measures

Uganda recorded 20 confirmed cases, 15 of them imported from the DRC, and two deaths before it was declared Ebola-free in August. North Kivu province, where the WHO said substantial transmission continues, is introducing a one-week ban from Monday, 19 October, on people entering from Ituri. Other measures include limits on passenger numbers in cars and on motorbikes, and suspension of large public gatherings, according to the state news agency ACP. The Central African Republic has no confirmed cases, though armed violence there has forced thousands to flee into Congolese border communities.

Confirmed cases20

Imported from DRC15

Deaths2

Confirmed cases

20

Imported from DRC

15

Deaths

2

Data from the article text

Why it keeps spreading

Access in the border region is difficult because of poor roads and limited communication networks. The spread is fuelled by mass population movements, rebel violence, mistrust and poor working conditions for front-line workers. Bundibugyo is less common than Zaire ebolavirus and had caused just two earlier outbreaks: in Uganda in 2007-2008, with 149 people infected and 37 killed, and in Isiro, Congo, in 2012, with 57 cases and 29 deaths.