Jens Asbjørn Bøgen
Decades of outbreaks have taught Congo how to fight Ebola, but this one is slipping past the usual playbook.
In the eastern Democratic Republic of the Congo, more than five months after health authorities first declared the outbreak, the virus is moving faster than contact tracers can map it. Officials now say most new infections cannot be linked to any known chain of transmission.
The confirmed case count passed 10,060 by October 27, with 4,887 deaths, according to the latest tally carried by Newscord, giving the outbreak a case fatality rate of about 48.6%. By volume it is now the second-largest Ebola epidemic ever recorded, trailing only the 2014-2016 West African crisis.
The Africa Centres for Disease Control and Prevention set the bar for a controlled outbreak at 95% of new cases turning up among people already being monitored as contacts of the infected. Across the DRC right now that figure sits at roughly 12%, Africa CDC epidemiologist Wessam Mankoula told reporters, as cited by Newscord. The remaining infections are appearing outside the health system’s view.
A strain with no licensed defense
The outbreak was declared on May 15 and is caused by Bundibugyo virus, a rarely seen member of the Orthoebolavirus family, the World Health Organization confirmed. Unlike the Zaire strain behind past Congolese outbreaks, Bundibugyo has no licensed vaccine and no approved treatment.
By October 20 the WHO counted 9,704 confirmed cases across 66 health zones in eight DRC provinces, with a case fatality ratio of 48.3%. Kenya had reported nine cases and one death, and Nigeria one confirmed case. A separate flare-up in Uganda, with 20 cases and two deaths, was declared over at the end of August.
Dr. Mohamed Janabi, the WHO regional director for Africa, told UN News that the virus “does not wait. It follows movement, exploits gaps and tests the strength of our health systems.” Roughly 60% of DRC deaths have occurred outside health facilities, UN News reported, complicating any effort to break transmission.
First shots in Bunia
A first clinical defense was finally put into arms over the weekend. The Tumaini trial, named after the Swahili word for hope, dosed its first participant on October 24 in Bunia, the capital of Ituri province and the outbreak’s epicenter.
The Phase 2/3 study is testing three candidates: Merck’s Ervebo, which is licensed only against the Zaire strain, alongside experimental shots developed by Moderna and by Oxford with the Serum Institute of India, Gazette NGR reported. The trial uses a ring vaccination strategy, offering the shots to contacts of confirmed cases and to the contacts of those contacts.
The scale of what the response is up against is captured by one grim detail from the field. In the rural commune of Mangina, in Beni territory, roughly 15 people are dying every day, UN News reported on October 22.
