Reuters reported on Wednesday that two babies have died of Ebola at a church-run orphanage in the eastern Congolese province of Ituri, the epicenter of the Ebola Bundibugyo outbreak.
Three of the people caring for the children have now tested positive for the deadly disease, including a nun.
The two babies who succumbed to the illness were named Buswaza and Cherie. Buswaza was only a few weeks old when she was brought to the orphanage in the city of Bunia after her mother died from unspecified causes. The baby was soon found to be running a fever, and died of Ebola within a matter of days.
The second young victim, Cherie, was an orphaned triplet who was taken to a local hospital along with five other children who displayed symptoms of Ebola. The other five tested negative and were discharged, but Cherie died in the care of the Evangelical Medical Center (CME) on Wednesday.
The orphanage in Bunia reportedly houses 69 other children, many of them orphaned by the violent conflict that has raged in the eastern Congo for years. The facility is receiving regular visits from medical professionals to check up on the children and staffers.
It is possible that Buswaza and Cherie contracted Ebola from their mothers or other vectors outside the orphanage, so there may not have been any internal transmission yet, but the staff remains apprehensive.
“We are nuns but we are also humans and it has been very emotional,” one of the sisters said.
UNICEF, the United Nations children’s agency, cautioned that the Ituri region of the Democratic Republic of the Congo (DRC) was already impoverished and prone to malnutrition before the Ebola outbreak began. Children stand an elevated risk of being exposed to bodily fluids that could infect them, and it is very difficult for malnourished children to survive Ebola.
UNICEF also noted that Ebola can cause children to be abruptly separated from their caregivers or leave them orphaned. Some communities stigmatize Ebola victims and their families.
Congolese health officials say contact tracing and diagnostics have improved dramatically from the early days of the outbreak — but they were so meager at first that health officials are still uncertain of exactly when, or where, the outbreak began.
The latest theory concerns the death of Pastor Paluki Makundi Denis, who died on February 3 at the age of 44. His body was packed into a wooden coffin and driven by truck to Mongbwalu, the mining town frequently cited as ground zero for the epidemic. The pastor’s coffin was on the bottom of a stack of coffins, and it cracked from the stress of the weight above it, combined with the bumpy road conditions.
Residents of Mongbwalu were appalled by the cracked coffin, since Makundi had been a respected figure in their community, so they decided to move the pastor’s body to a new one — a potentially disastrous decision, since it brought numerous people into direct physical contact with a potential Ebola victim. The cracked coffin was burned, which created its own set of problems, as the locals began to murmur of curses and witchcraft.
A wake was then held for Makundi at his family compound, and at least 80 people turned out for his funeral. Congolese wakes often involve mourners touching and kissing the deceased.
Makundi had been diagnosed with a serious abdominal infection in Bunia, but he was not tested for Ebola — and even if he had been, few hospitals in that part of the DRC had the correct test kids for the rare Bundibugyo strain at that point.
Pastor Makundi’s funeral was on February 4, and might have been the first “super-spreader” event of the outbreak, which has now infected at least 635 people and claimed 127 victims. The rash of sickness and death following his funeral lines up fairly well with estimates from epidemiologists that Ebola Bundibugyo began spreading four to six months before the outbreak was officially declared on May 15.