The Africa Centers for Disease Control (Africa CDC) said on Thursday that the Ebola outbreak in the Democratic Republic of the Congo (DRC) and Uganda has now killed over 200 people, and the number of confirmed cases surged by 38 percent in just the past week.
Africa CDC reported 894 confirmed cases in total, with most of them sourced to the eastern DRC. This makes the current outbreak of the Bundibugyo strain of Ebola much worse than Uganda’s first known Ebola outbreak in 2000, but not yet as bad as the devastating DRC outbreaks in 2014 and 2018.
Doctors fear the current outbreak will prove to be much larger than the confirmed case totals, because epidemiologists are not certain exactly when it began, and they are struggling to perform contract tracing on the large number of people who came into contact with known Ebola victims.
Africa CDC epidemiologist Wessam Mankoula said there should be 17,000 to 35,000 contacts for the 894 confirmed cases – but so far only about 4,000 contacts have been traced, or about 15 percent of the total.
“We are still far from controlling the situation of this outbreak,” he warned.
Mankoula cited inadequate funding and staffing as reasons for the poor contract tracing, complaining that only ten percent of the international funds pledged to combat the outbreak have been released so far. Africa CDC estimates it would need at least 540 staffers to handle the outbreak, but it only has 84.
Africa CDC’s Director-General Jean Kaseya said earlier this week that given the population density and social habits of the outbreak region, each confirmed Ebola case would have about 40 contacts that should be traced.
Kaseya also worried about contacts with the Ebola victims who have died, noting the importance of quickly and cleanly interring their bodies to minimize contact with healthy people. Some of the extra staffers Mankoula wanted to hire would be assigned to deal with the contagious dead bodies.
International Federation of Red Cross (IFRC) operations manager Bruno Michon warned on Tuesday that the “peak” of the current outbreak has not yet been reached.
“We are afraid that this could last one year, to end this disease,” he said.
Michon said one of the biggest problems facing health workers is mistrust and hostility from people living in the eastern Congo. He said IFRC teams have been subjected to “verbal abuse, threats, and attacks” while reaching out to remote communities and overseeing safe burials for Ebola victims.
Doctors Without Borders (MSF) emergency medical coordinator Kate White noted that most of the new patients pouring into the eastern Congo’s “overwhelmed” treatment centers are people who were not previously tracked as Ebola contacts. This means each new patient brings dozens more contacts that need to be traced.
Another major obstacle is the large number of internally displaced persons (IDP) living in the outbreak region. Over two million people who have been forcibly displaced from their homes by relentless jihadist and insurgent violence are at risk of contracting Ebola, according to UNHCR, the U.N. refugee agency. Some 320,000 of those people are packed into unsanitary refugee camps, while the rest could spread Ebola to other parts of the DRC and neighboring countries with their movements.
UNHCR relayed an alarming incident from June 7, where “movements of armed groups triggered panic” and caused 2,250 people from Mbau, a town near Beni – a city at the center of the Ebola outbreak – to flee to the town of Oicha in North Kivu province, This type of panicked movement has a significant risk of spreading Ebola, and it is very difficult to trace the people involved, or the people they come into contact with.
“For refugees and internally displaced people already facing trauma and insecurity and a lack of adequate humanitarian assistance, the outbreak is fueling fear and misinformation, eroding trust in response teams and delaying access to life‑saving care,” UNHCR added.