Scale of deadly Ebola outbreak in Congo remains murky

One month after Ebola cases were confirmed in eastern Congo, its true scale remains unknown, with major data gaps muddying the picture and persistent, sometimes violent, community resistance hampering the response, health workers and officials say.

The three affected provinces in the eastern Democratic Republic of Congo have so far recorded 782 confirmed cases and 181 deaths, meaning this is already the third deadliest Ebola outbreak on record.

The government’s figures likely understate the true toll, medical charity Doctors Without Borders said in a statement, echoing a view shared by aid groups and some Congolese officials.

“No one knows the true scale or exactly where the disease is spreading in DRC,” said Kate White, emergency medical coordinator for the group, which operates treatment centers across the Ebola-hit east.

Data sources difficult to harmonize

Testing remains “one of the most significant weaknesses in the response,” the Doctors Without Borders statement said.

Many communities, particularly those affected by active armed conflict, still lack access to test kits, while treatment centers face significant delays receiving laboratory results, it said.

A senior Congolese public health official, speaking on condition of anonymity as he was not authorized to brief the media, told Reuters the problems run deeper than testing alone.

Data flowing from three separate sources – laboratories, hospitals and treatment centers, and epidemiological surveillance teams – is extremely difficult to harmonize, creating distortions in both directions, said the official.

Cases may be overcounted when patients cross health zones and are tested more than once. Meanwhile, people continue to die in communities without ever coming to the attention of health authorities, said the official, adding that he believed the virus began circulating in February.

The gap between official figures and the reality on the ground is visible at the local level.