Ebola Is Spreading Fast in Congo — Here's What's Going On

A deadly Ebola outbreak in the Democratic Republic of the Congo (DRC) has now reached a sixth province. A man who had travelled from one province to another died in the city of Buta, the capital of Bas-Uele province. Jean Kaseya, who leads Africa CDC — the African Union's public health agency — confirmed the death The Guardian.

Ebola is a serious viral disease that spreads through contact with bodily fluids and can cause severe bleeding and death. This outbreak is caused by a type of Ebola called the Bundibugyo virus. More than 2,100 people have died out of more than 4,500 confirmed cases, according to government figures cited by The Guardian. That number of deaths was reached almost three times faster than during the 2014–16 west Africa Ebola outbreak — the worst in history, which killed more than 11,000 people. The head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, said this outbreak could become worse than that one. He also confirmed that the outbreak has been declared a public health emergency of international concern, which is the highest global health alert the WHO can issue The Guardian.

The outbreak was officially declared on 15 May, but genetic testing shows it actually started months earlier, in February. The numbers have climbed quickly since then. By 11 June, there were 708 confirmed cases and 141 deaths across the DRC and Uganda. By 9 August, the DRC had reported 4,381 confirmed cases and 2,011 deaths, with 87 new cases in a single day. Uganda had reported 20 cases. On 12 August, the DRC reported a total of 4,566 confirmed cases and 2,128 deaths, according to the ECDC, Europe's disease control agency.

Six of the DRC's 26 provinces have now been affected. Cases had previously been found in Haut-Uele, Ituri, Nord-Kivu, Sud-Kivu, and Tshopo provinces. On 13 July, the outbreak spread to two more northeastern provinces, Haut-Uele and Tshopo, according to Reuters. More than 97 percent of all cases have been in just three provinces: Ituri, North Kivu, and South Kivu Africa Center for Strategic Studies.

The outbreak has also crossed national borders. As of 28 July, Uganda had reported 20 confirmed Ebola cases, including two deaths, according to the country's Ministry of Health.

Health authorities are struggling to keep track of the virus. Between 60% and 70% of new cases in the DRC are being found in people who were not already being watched — meaning health workers are not successfully finding everyone who may have been exposed before those people get sick and spread it further. Dr. Mohamed Yakub Janabi, the WHO's regional director for Africa, described the situation plainly: "We are chasing the virus; the virus is ahead of us" The Guardian.

A further problem is that there are no approved vaccines or treatments for the Bundibugyo type of Ebola causing this outbreak. Clinical trials of two possible treatments began last month in Ituri province. But health workers at a treatment centre in Nizi, Ituri, went on strike on Thursday after not being paid for three months, forcing the centre to close temporarily.

Bas-Uele province has seen Ebola before. An outbreak was detected there in 2017. The current outbreak is the 17th Ebola outbreak in the DRC, according to the US CDC.

The bigger picture here is deeply concerning. The outbreak is spreading to new areas, health workers cannot trace where the virus is moving, and the people fighting the outbreak on the ground are not getting paid. Unlike earlier Ebola outbreaks in the DRC, this one is caused by a virus type for which there are no approved vaccines or treatments. The strike at the Nizi treatment centre, happening just as clinical trials for two possible treatments are starting, raises serious questions about whether those trials can even continue when frontline workers go months without wages. The WHO's highest-level alert and Tedros's warning that this could surpass the 2014–16 epidemic show that global health institutions are alarmed. Whether that alarm leads to the funding, coordination, and urgency needed to get ahead of the virus is the question that will shape what happens next.