The current Ebola outbreak in the Democratic Republic of Congo (DRC) has spread to the sixth province. According to the latest report published on Friday by DRC health authorities, the number of confirmed cases has reached 4727, and deaths stand at 2214.
The report indicates that the outbreak has affected 55 health zones across the provinces of Bas-Uele, Haut-Uele, Ituri, North Kivu, South Kivu, and Tshopo, with Ituri remaining the epicenter of the disease.
The health zone of Buta in Bas-Uele was recently affected. Jean Kasai, Director General of the Africa Centre for Disease Control and Prevention (Africa CDC), reported on Thursday that one person traveled from Isiro to neighboring Haut-Uele in Butu and subsequently died there.
Since the start of the epidemic, 976 people have recovered. Health authorities warn that sustained community transmission and gaps in contact tracing could prolong what is already the second-largest Ebola epidemic in history.
Community Transmission Continues
Kasai noted that over 63% of Ebola deaths are currently occurring in communities rather than in treatment centers or hospitals. He added that deaths in communities complicate response efforts because health authorities may not know who had contact with infected individuals before or after their death, which hinders contact tracing and safe and dignified burials.
The latest government report set the contact tracing rate at 82.6%. However, Africa CDC emphasized that the proportion of registered contacts receiving attention does not reflect the effectiveness of contact tracing if many contacts were not identified initially. Kasai stated that strengthening community-level surveillance and contact identification is necessary.
World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus stated on Wednesday that the high proportion of deaths continuing to occur in communities, and that many new cases are being found among people not included in existing contact lists, indicates that some transmission chains have yet to be identified.
Tedros said at a press briefing in Geneva: 'This is developing faster than any previous Ebola outbreak. At the current pace, it is on track to surpass the 2014–2016 West African Ebola outbreak.'
The 2014–2016 West African Ebola epidemic, which was the largest in history, infected more than 28,600 people.
True Scale Remains Unclear
The DRC officially declared the outbreak on May 15, but Kasai reported that Africa CDC investigations suggest transmission may have begun around February. He added: 'We have no idea what happened from February to May,' clarifying that data collected since the announcement should not necessarily be viewed as a complete picture of the epidemic.
Africa CDC is currently pushing for a more village-oriented approach that will also focus on reconstructing the early stages of the outbreak. Kasai said that communities will be asked to help identify people who died or showed symptoms similar to Ebola between January and May. Even if laboratory confirmation is no longer possible, this information can help authorities assess the scale of transmission before the official detection of the outbreak.
Chike Ikechewazu, Executive Director of the WHO Emergency Programme, also stated that preliminary investigations suggest the virus may have been circulating for two to three months before the official detection of the outbreak. Nevertheless, the exact start of transmission remains under investigation.
Outbreak Could Last a Year
Abdirahman Mahmud, WHO Director for Health Emergencies Operations, reported on Wednesday that response planning is currently based on a moderate scenario, according to which the outbreak could last about six months. He added: 'There is a worst-case scenario where this outbreak could last from nine to twelve months,' noting that efforts are underway to shorten the duration of the epidemic.
Africa CDC issued an even stronger conditional warning. Kasai warned: 'If we do not stop this outbreak, it could last more than a year and ultimately become the largest Ebola epidemic in history.'
Kasai explained that changing the trajectory will require a combination of measures, including devolving greater responsibility for surveillance and response to villages, ensuring access to essential health services, strengthening the targeting of suspected cases, deploying additional medical resources, and improving coordination of response resources.
