Ebola Has Killed 1,707 People in Eastern Congo in 12 Weeks. Africa's Top Health Official Says Contact Tracing 'Is Not Working.'
The Bundibugyo strain, which has no approved vaccine or treatment, has produced 3,802 cases since May 15 — the fastest-growing Ebola outbreak ever recorded. Patient zero has still not been identified.
Ebola has killed 1,707 people in eastern Democratic Republic of Congo out of 3,802 confirmed cases, according to government figures released Tuesday, making this the fastest-growing outbreak of the disease ever recorded and one of the deadliest.
The outbreak was declared on May 15. It reached 1,000 deaths in a fraction of the time it took the 2014–2016 West Africa epidemic to do the same. That outbreak, still the largest on record, infected roughly 28,000 people and killed more than 11,000 — but took about eight months to pass 1,000 deaths. Congo's has done it in under three.
What makes this one different is the strain. It is Bundibugyo, a rare member of the Ebola family for which there is no approved vaccine and no approved treatment. The vaccines and monoclonal antibody drugs stockpiled after the West Africa epidemic were built against the Zaire strain and are not known to protect against Bundibugyo. Clinical trials of post-exposure prophylaxis drugs and candidate vaccines are now running in Ituri province, the United Kingdom and Canada, but they are being stood up in the middle of an emergency rather than ahead of one.
Nearly 90 percent of cases are in Ituri, a remote province in the northeast, though the virus has reached five other provinces including Kisangani, one of Congo's largest cities. Africa CDC Director-General Jean Kaseya said the core tool of outbreak control has broken down: "contact tracing is not working." Between 60 and 70 percent of new cases are arising from community spread rather than from lists of known contacts, meaning responders are finding infections they did not know were coming. Patient zero has never been identified, leaving the chain of transmission unanchored at its origin.
The obstacles are as much about the region as the pathogen. Ituri has been convulsed by armed conflict and illegal mining, both of which move large numbers of people across the province and out of reach of health teams. Health centers have been attacked. Health workers have gone unpaid, and more than 100 of them have been infected. The World Health Organization is now monitoring more than 17,000 potential contacts and processing over 2,000 samples a day, up from about 20 a day when the outbreak began — an enormous scale-up that still trails the spread.
Uganda, which borders Ituri and had its own scare earlier in the year, declared itself Ebola-free in mid-June. That is the one piece of good news in the region. Inside Congo, the trajectory has not turned: the case count roughly tripled between mid-July, when deaths stood near 600, and this week.
Originally reported by STAT News.