Government data released on Tuesday indicated that the Ebola outbreak in Congo has reached over 10,000 confirmed cases, while health authorities work intensively to control the spread of the disease in several African countries.
This outbreak is considered the fastest growing in history, and according to information from the Congolese Ministry of Health, nearly half of the 10,060 diagnosed individuals have died, making it the deadliest of the disease in the country.
The outbreak, which was reported in May, is caused by the Bundibugyo virus, a pathogen for which there are no approved vaccines or treatments. Response teams face numerous obstacles, including armed conflicts, poor road infrastructure, and public hostility driven by misinformation and distrust.
These obstacles hinder people's adherence to reporting symptoms and seeking medical assistance in communities that historically deal with violence and successive epidemics.
Comparison with previous outbreaks
Compared to the Ebola outbreak in West Africa between 2014 and 2016—the largest and deadliest in history, with over 28,000 cases and more than 11,000 deaths—the current outbreak has recorded at least three times more cases and deaths since its declaration in the same period.
The disease has spread throughout Africa, surpassing any previous outbreak, and has reached three regions. Cases have been registered in five nations, including Uganda, as well as France, which currently has no active cases.
A persistent problem in the disease's spread in Africa is the apparent failure in surveillance, given that most initial cases were only confirmed long after the onset of symptoms or after individuals traveled.
Distribution and Challenges in Congo
In Congo, the disease has expanded to 66 health zones across eight provinces, a significant increase from the three zones existing when the outbreak was declared in May. Professionals involved in the response informed the Associated Press that treatment centers in certain areas are overwhelmed, and that part of the population remains distrustful, reacting with violence.
Furthermore, health professionals have regularly gone on strike due to delays or absence of salary payments. Sephora Bgosi, a member of the team responsible for burying Ebola victims in the Ituri province, the epicenter of the outbreak, warned: 'Some people still don't seem to understand the seriousness of the situation, even though they are directly exposed to the risk.' She emphasized that 'Ebola is extremely dangerous and can be fatal.'
It is estimated that about 80% of the registered cases are still identified outside the monitored contact circle, suggesting the existence of transmission routes unknown to health authorities. The African Centre for Disease Control and Prevention (Africa CDC) points out that for the outbreak to be considered widely controlled, at least 95% of cases should be among known contacts.
At least half of the registered deaths occurred among individuals who were not admitted to treatment centers, indicating that in many localities, residents are still not reporting their symptoms.
In various areas, health professionals face everything from basic shortages, such as a lack of appropriate vehicles, to more complex issues, such as persuading families to hand over sick or deceased relatives for safe burial.
Last week, in the Nia Nia health zone in Ituri province, some Ebola response workers, including surveillance and community mobilization agents, went on strike over unpaid bonuses since the end of August, a recurring problem in several affected regions.
More than five months after the start of the outbreak, health professionals continue to be attacked by residents. A nurse was murdered and another professional was seriously injured while responding to an Ebola alert in Bafwasende, Tshopo province, last Saturday.
Impact on Healthcare Services in Congo
The outbreak has compromised essential health services, which were already operating with resource scarcity and overload, and diverted focus from other epidemics faced by the country, such as cholera.
There is an increase in maternal deaths, as pregnant women avoid hospitals for fear of infection and isolation, resulting in double the maternal mortality in some provinces shortly after the outbreak was declared.
The epidemic has also affected routine services, such as childhood vaccination, interrupted classes in regions where millions of children were already out of school, caused stigma and trauma in affected families, and worsened the living conditions of many people already in vulnerable situations.
