DR Congo Ebola outbreak spreading faster than reported: UN

The Ebola outbreak in the Democratic Republic of Congo is spreading faster than previously understood, with the United Nations warning that the epidemic could be at least two to four times larger than official figures and is recording some of the highest daily infection numbers since it began two months ago.

With nearly 2,000 confirmed cases and more than 700 deaths across five provinces as of July 11, health officials said the outbreak has become the third-largest Ebola epidemic ever recorded and the fastest-growing in recent history.

“We’ve seen the fastest growth in a single month since the outbreak started and of all the Ebola outbreaks that we have managed,” Chikwe Ihekweazu, executive director of the WHO Health Emergencies Programme, told reporters in Geneva after returning from Bunia in eastern DR Congo, the epicenter of the outbreak, according to a UN statement on Tuesday.

“Over the last few days, we’ve seen some of the highest numbers of new infections in a single day,” he said, noting that more than 80 cases were confirmed within a 24-hour period in recent days, among the highest daily increases recorded since the outbreak began.

Many of the newly reported deaths are occurring in communities, with patients dying before reaching health facilities, a development described by WHO as one of the most alarming aspects of the outbreak.

The current outbreak, caused by the Bundibugyo strain of Ebola virus, has now spread beyond its original epicenter in Ituri Province into Haut-Uele and Tshopo provinces, raising concerns about further geographic expansion.

Although about 95 percent of cases are still concentrated in Ituri, WHO officials warned that hidden transmission chains are driving the epidemic. The most alarming finding, Ihekweazu said, is that many of the newly reported deaths are of people who died in their communities without ever reaching health facilities or receiving care.

WHO modeling indicates the true scale of the outbreak could be significantly larger than official figures suggest. “We think, with some of our support and modeling, the scale of the outbreak is at least two to four times the number of cases we are finding,” Ihekweazu said.

“You have to imagine that this is a fire. There’s something driving the fire in its heart, and it’s also expanding at the same time.”

Despite improvements in diagnostics and surveillance, approximately 80 percent of newly confirmed cases are emerging outside known contact lists, suggesting that large chains of transmission remain undetected.

Healthcare workers have also been severely affected, with Africa Centres for Disease Control and Prevention, or Africa CDC, reporting at least 112 infections and 35 deaths among frontline personnel.

For aid agencies working on the ground, the rapidly changing dynamics of the outbreak are complicating containment efforts.

Frederick Lai Manantsoa, emergency coordinator for Doctors Without Borders in DR Congo, said insecurity, large population movements and displacement are making surveillance and contact tracing increasingly difficult.

“The success of the response depends on how quickly we can identify suspected cases, isolate them and cut the chain of transmission,” he said. “There are several dynamics of the outbreak which make surveillance and contact tracing extremely complex.”

Important progress

Despite the worsening situation, health officials say important progress has been made.

The response entered a new phase with the launch of new clinical trials aimed at identifying effective treatments and preventive therapies for the Bundibugyo strain, for which there are currently no approved vaccines or targeted treatments.

The EBO-PEP platform trial, launched this week in Ituri Province, is expected to recruit nearly 1,000 high-risk contacts in DR Congo and Uganda to evaluate whether antiviral drugs can prevent Ebola infection after exposure.

Africa CDC has pledged $1 million to support the study, while DR Congo and South Africa have committed an additional $5 million.

Tedros Adhanom Ghebreyesus, director-general of WHO, said the study could become a “game-changing approach” for preventing Ebola among exposed individuals and help bring future outbreaks under control.

sharon@chinadailyafrica.com