The Ebola outbreak in the Democratic Republic of the Congo reached an eighth province this week, as Nord Ubangi, which borders the Central African Republic, confirmed infections amid armed violence that continues to uproot thousands of people. The outbreak, declared in mid-May and caused by Bundibugyo virus, has led to more than 4,600 deaths and a total of 9,552 confirmed infections, and around six in ten deaths have occurred outside health centres, a sign that community transmission is still outrunning the response.
The outbreak is now regional. Nigeria is the fifth country this year, after the DRC, France, Uganda and Kenya, to confirm Bundibugyo virus disease. Abuja’s first case arrived from Uganda, developed symptoms on October 7 and was hospitalised 48 hours later, and investigators still do not know where she was exposed. More than 40 close contacts have been identified and genetic sequencing is under way to confirm the strain matches the one circulating in the DRC. Kenya has reported nine cases including one death, of a Kenyan national who had worked in the DRC and flown back to Nairobi via Entebbe, and its health ministry says all 135 traced contacts of that patient have been accounted for. Uganda previously recorded two deaths and 20 confirmed cases before declaring the threat over at the end of August.
Inside the DRC, the hardest-hit areas remain the least accessible. WHO reported 15 deaths per day last week in the rural commune of Mangina in Beni territory, North Kivu, where an emergency team negotiated access two weeks ago after initial community resistance. Vaccination research is continuing with the Ervebo vaccine, which was designed for the Zaire species, and WHO says it has no preliminary data yet on whether it cross-protects against Bundibugyo.
Ebola does not wait, WHO’s Africa regional director Mohamed Janabi said, adding that the virus is no longer confined to one place and is a regional concern. The response test for the coming weeks is whether contact tracing in Kenya and Nigeria holds the imported cases to single chains, and whether access in North Kivu improves enough to cut the share of deaths occurring outside health centres.