The Ebola outbreak in Congo is rapidly spreading to new hot spots, leaving patients with minimal or no support, according to health officials and responders. Health workers acknowledge that the battle against the disease, which has already claimed over 4,000 lives, may be far from over.
Dr. Jean Kaseya, Director-General of Africa CDC, stated on Tuesday that more than 70% of new cases are originating from outside known contacts, and at least 60% of deaths are occurring outside of established treatment centers. “There are so many other people who are becoming sick, who are not tested, treated, or listed,” Kaseya told The Associated Press.
North Kivu province, a conflict-ridden and remote region, has emerged as the new epicenter, now accounting for approximately 40% of all newly confirmed cases in Congo, a significant increase from 24% at the end of August. However, Stephanie Hoffmann, a project coordinator with Doctors Without Borders (MSF), described the response on the ground as “chaotic.” Hoffmann told the AP, “There is a lack of coordination and organization, but there’s certainly a lack of actors present here.”
Declared in May, Congo's deadliest Ebola outbreak is caused by the Bundibugyo virus, for which no approved vaccine or treatment currently exists. The outbreak has unfolded under extremely challenging conditions, exacerbated by widespread population movements, rebel violence, deep-seated mistrust, and inadequate welfare for frontline workers.
Government data indicates that Congo has recorded more than 8,500 cases, making it the fastest-growing and deadliest Ebola outbreak in the country's history. On Tuesday, Kenya reported its first Ebola case involving a man who arrived from Congo and died while receiving treatment.
Dr. Kaseya identified contact tracing as the biggest challenge to date, with only 23% of expected contacts of Ebola patients successfully traced. The disease is proliferating in a region of Congo characterized by intense population movements driven by economic activities, conflict displacement, and mining, alongside profound public mistrust in the government and widespread misinformation about the virus.
“I’m unable to tell you when we can stop this outbreak unless we implement the village-centered approach,” the Africa CDC chief asserted, advocating for direct involvement of villages and local leaders in contact tracing efforts, safe burials of deceased patients, and isolation of cases.
The World Health Organization has reported that many Ebola treatment centers in North Kivu are grappling with shortages of health workers and supplies, contributing to increased patient fatalities. North Kivu’s case fatality rate stands at 58%, the highest among Congo’s seven affected provinces. The disease has spread to 17 of its 34 health zones, and in nine of those affected zones, more than half of patients with confirmed infections have died, according to Health Ministry data.
In a desperate search for care, patients in some areas of North Kivu have resorted to seeking treatment at regular health facilities, MSF noted. Hoffmann, who coordinates MSF’s Ebola treatment center in Butembo, North Kivu, highlighted the difficult choices faced by local healthcare workers: “Local healthcare workers are the ones feeling this the most because they have to make the decision between sending their community members home to potentially die by themselves or putting themselves at risk to help treat them in their health center.”
Nearly five months after the outbreak was declared, tracking the disease has become more difficult in parts of North Kivu, where residents still “have a hard time believing the disease exists,” according to Michel Ngimba of the National Institute of Biomedical Research in Butembo. Ngimba cited instances where families were reluctant to report a death or permit a sample to be taken from someone who died with Ebola symptoms. In other cases, families “want to arrange the funeral quickly,” he added, potentially creating new chains of transmission given that the bodies of individuals who die from Ebola are highly contagious.
