Society 6 min read By Bethany Hadley
Ebola outbreak in Congo passes 10,000 confirmed cases
Congo has recorded more than 10,000 confirmed Ebola cases, with nearly half of those infected dead, making it the fastest-growing and deadliest outbreak of the disease in the country's history.
The Ebola outbreak in the Democratic Republic of Congo has reached 10,000 confirmed cases, according to government data released on Tuesday, as health authorities struggle to slow the disease's spread across several African countries. Of the 10,060 people confirmed to have the virus, nearly half have died, according to figures from Congo's Ministry of Health. The outbreak is now the fastest-growing Ebola outbreak on record and the deadliest the country has ever experienced.
The outbreak was declared in May and is caused by the rare Bundibugyo virus, for which there is currently no approved vaccine or treatment. Response teams are working in difficult conditions, contending with armed conflict, poor roads and violence from residents fuelled by mistrust and misinformation. These obstacles make it harder to persuade people to report symptoms and accept care in communities that have already endured years of violence and repeated epidemics.
Compared with the West Africa Ebola outbreak of 2014 to 2016, the largest and deadliest on record with more than 28,000 cases and over 11,000 deaths, the current outbreak has recorded at least three times as many cases and deaths in the period since it was declared. It has also spread farther across Africa than any previous Ebola outbreak, with cases recorded in three regions of Congo as well as in Kenya and Nigeria. In total, the virus has been recorded in five countries, including Uganda and France, although neither of those two currently has active cases.
A recurring problem has been the apparent weakness of surveillance efforts. Most of the first cases were confirmed long after people had begun showing symptoms or after they had travelled. African health ministers are due to hold a virtual summit on Wednesday to strengthen the continent's collective response. Dr Jean Kaseya, head of Africa CDC, has said: « Ebola is crossing borders. Our response must move faster, with stronger coordination, greater solidarity and decisive political leadership. »
There have been rare moments of encouragement. At least 2,600 patients have recovered from the disease in Congo. A viral video this week showed health workers in full protective gear dancing as the last two patients were discharged from a treatment centre in Mongbwalu, in Ituri province. World Health Organization Director-General Tedros Adhanom Ghebreyesus said of the video: « The outbreak is far from over, but every life saved is worth celebrating. »
The disease has now spread to 66 health zones across eight provinces in Congo, up from three zones when it was first declared in May. Responders have told the Associated Press that treatment centres in some of these zones are becoming overwhelmed, that many people remain sceptical and in some cases violent towards health workers, and that staff regularly go on strike to protest delayed or unpaid wages.
Sephora Bgosi, who works with the Ebola burial team in Ituri province, the epicentre of the outbreak, said: « Some people still don't seem to understand the seriousness of the situation even though they are directly exposed to the risk. » She added: « Ebola disease is extremely dangerous and can be deadly. »
Surveillance data point to a serious gap in knowledge. About 80 per cent of recorded cases are still coming from outside monitored contacts, which indicates ongoing chains of transmission that health authorities are not aware of. The Africa CDC has said that at least 95 per cent of recorded cases should come from known contacts before officials can say the outbreak is largely under control. At least half of the recorded deaths are among people who were never admitted to treatment centres, a sign that many people in affected areas are not reporting symptoms at all.
In many zones, health workers face challenges ranging from basic needs such as adequate vehicles to more complex ones, including persuading families to release relatives who are sick or have died from the disease so that they can be buried safely. Last week in the Nia Nia health zone in Ituri, some Ebola responders, including surveillance and community engagement officers, went on strike over bonuses unpaid since late August, a trend seen across many affected localities. More than five months after the outbreak was declared, health workers are still being attacked by angry villagers. On Saturday, a nurse was killed and another health worker was severely injured while responding to an Ebola alert in Bafwasende, in Tshopo province.
The outbreak has also disrupted essential health services that were already underfunded and overstretched, and has drawn attention away from other diseases the country is fighting, such as cholera. Pregnant women are avoiding hospitals out of fear of infection and isolation, and maternal mortality has doubled in some provinces soon after the outbreak was declared. Routine services such as childhood vaccinations have been disrupted, schooling has been interrupted for children in a country where millions are already out of school, and affected families face trauma and stigma, adding to hardship for communities already struggling.
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