Ebola Spreads To Six Provinces As DRC Records Deadliest Outbreak In History

The ongoing Ebola outbreak in the Democratic Republic of Congo has become the deadliest in the country’s history, with more than 2,300 people reported to have died since the virus was declared on 15 May.

According to the latest situation report released on Sunday by the country’s health authorities, the DRC has recorded 4,945 confirmed cases, including 2,325 deaths, putting the case fatality rate at 47 per cent. The figure includes 101 new cases detected in the previous 24 hours. The latest death toll surpasses the 2,299 deaths recorded during the 2018-2020 Ebola outbreak in eastern DRC, which was previously the country’s worst on record.

The current outbreak is the 17th Ebola outbreak in the DRC since the virus was first identified in the country in 1976. It is caused by the Bundibugyo species of Ebola, a rare strain with only two previously known outbreaks. Unlike the Zaire species responsible for several major Ebola epidemics, including the 2014-2016 West Africa outbreak, there is currently no approved vaccine specifically available for the Bundibugyo strain.

The outbreak has spread to six of the country’s 26 provinces – Ituri, North Kivu, Haut-Uele, Tshopo, South Kivu and Bas-Uele – affecting 55 health zones. The World Health Organization has described the pace of transmission as “exceptional,” noting that the virus is spreading faster than any previous Ebola outbreak.

The United Nations humanitarian chief, Tom Fletcher, warned last week that the epidemic was killing approximately one person every 30 minutes at its peak. “We need speed, scale, and solidarity before this virus gets even further ahead of us,” Fletcher said in a statement.

The proportion of people dying from the outbreak after a confirmed infection, known as the case fatality ratio, has risen from about 20 per cent in early June to 46 per cent, according to government data. This means nearly one in every two confirmed cases is now fatal. Experts say the trend does not indicate the virus has become more lethal, but rather points to persistent shortcomings in surveillance, case detection and access to care.

“Normally, as an outbreak progresses, the case fatality ratio should fall as contact tracing improves and patients are identified and treated earlier,” said Thomas Parisch, a public health specialist recently deployed to the DRC with Médecins Sans Frontières. “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.”

The virus has largely remained within the DRC, although cases have been reported in neighbouring Uganda. Authorities there recorded 20 confirmed cases and two deaths before declaring an end to the outbreak in that country in July. A small number of cases have also been detected in Europe – two people were treated in Germany and one case was declared in France.

Efforts are under way to contain the outbreak. The WHO has said it aims to reverse the spread of the virus within three months, but warned that controlling transmission does not necessarily mean the outbreak will end immediately. “It’s already the second-biggest Ebola epidemic on record, and it’s moving faster than any previous Ebola outbreak,” WHO Director-General Tedros Adhanom Ghebreyesus told a press briefing in Geneva last Wednesday. “At its current pace, it’s on track to eclipse the West African Ebola outbreak of 2014 to 2016.”

The 2014-2016 West Africa epidemic, the largest Ebola outbreak ever recorded, infected more than 28,600 people and killed more than 11,310 across Guinea, Liberia and Sierra Leone. It took nearly five months from the declaration of that outbreak to reach 1,000 deaths, whereas the current outbreak hit 2,000 deaths in less than three months.

Scientists are working to develop vaccines against the Bundibugyo strain. The UK’s Medicines and Healthcare products Regulatory Agency has approved human trials of a vaccine developed by researchers at the University of Oxford. The Phase I study, designated BD-Ebov, is assessing the safety and immune response of the ChAdOx1 BDBV vaccine in 50 healthy adults aged 18 to 55. The vaccine uses similar technology to that employed in the Oxford-AstraZeneca COVID-19 vaccine. Three other groups are also developing different vaccines for the Bundibugyo strain, and the WHO is sponsoring a separate clinical trial in the DRC to see whether two existing antiviral therapies can improve survival rates.

Ebola is a rare but highly dangerous viral disease. Symptoms can include fever, headache and fatigue, followed by vomiting and diarrhoea in severe cases. The virus is primarily transmitted through direct contact with the blood or other bodily fluids of an infected person, living or dead.

Years of conflict, population movement and pressure on the country’s health system have made controlling outbreaks particularly difficult. Health authorities are increasing surveillance, treatment and infection-control measures as they work to slow the spread of the disease.