Key Takeaway:
- Ebola is spreading beyond Ituri, with cases rising sharply in North Kivu and Haut-Uele.
- Congo has reported 6,843 cases and 3,310 deaths, while conflict, displacement and a health workers’ strike hinder containment.
- Vaccination efforts are expanding, with Ervebo used for front-line workers and clinical trials underway for a Bundibugyo virus vaccine.
Congo’s Ebola outbreak is spreading rapidly beyond its epicentre into neighbouring provinces, Africa CDC said Thursday, as insecurity, displacement and strained health services hinder efforts to contain the virus.
New cases surge in neighbouring provinces
The Congo Ebola outbreak, centred in eastern Congo’s Ituri province, has produced 6,843 reported cases and 3,310 deaths, according to government figures released Thursday. Ituri remains the hardest-hit province, with more than 5,400 cases.
But the pattern is shifting. New cases and deaths have declined in Ituri in recent weeks while infections have risen sharply in North Kivu and Haut-Uele, Africa CDC officials said during a weekly briefing.
North Kivu has recorded more than 1,000 cases since the outbreak was declared in May. New cases there more than doubled to 381 during the latest three-week period, compared with 165 in the previous period, said Yap Boum, Africa CDC’s head of emergency preparedness and response.
The virus has also reached two additional health zones in North Kivu, raising concerns about further transmission in an area where armed conflict has made public health operations more difficult.
Conflict and displacement complicate response
The Congo Ebola outbreak is spreading amid fighting, population movements and displacement. Government forces and Rwanda-backed M23 rebels are fighting in North Kivu, while the rebels control Goma, the provincial capital.
Displacement sites are especially vulnerable because many residents already live in crowded and precarious conditions. Africa CDC has warned that insecurity and movement across the region are making it harder for health teams to identify cases, trace contacts and limit transmission.
A health workers’ strike has added another obstacle to the response, according to Africa CDC. The combination of insecurity, displacement and limited access has complicated efforts to respond quickly as the outbreak expands into new areas.
The World Health Organisation has described the outbreak as “out of control” and warned it could surpass the 2014-16 Ebola outbreak in West Africa, which killed more than 11,000 people, primarily in Guinea, Liberia and Sierra Leone.
The Congo outbreak is caused by the Bundibugyo virus, a less common Ebola virus species. That distinction is important because vaccines used against the more common Zaire species do not have the same established role against Bundibugyo.
Congo expands vaccination and vaccine trials
Congo began vaccinating health workers and other front-line personnel last month with the Ervebo vaccine, which has been effective in previous Ebola outbreaks caused by the Zaire species.
At the same time, clinical trials are underway to evaluate a vaccine for the Bundibugyo virus. Placide Mbala Kingebeni, Africa CDC’s director for research, clinical trials and innovation, said the trials began in eastern Tshopo, Haut-Uele and Bas-Uele provinces.
Kingebeni said the initial vaccination campaign focused on newly affected provinces to help prevent additional spread. Vaccinations in Ituri, the outbreak’s epicentre, are scheduled to begin next week.
The widening geographic spread of the Congo Ebola outbreak places greater pressure on Congo’s health system as officials attempt to contain transmission while maintaining access to care in areas affected by conflict and displacement.
